Twenty-Four Hour Ambulatory Simultaneous Impedance and pH Monitoring: A Multicenter Report of Normal Values From 60 Healthy Volunteers

Investigation of inflammatory markers in the exhaled breath condensate (EBC) is a non-invasive method for evaluation and monitoring of bronchopulmonary inflammation. Endogenous oxidative processes in the airways can be evaluated by pH measurement in the EBC. We examined 153 healthy volunteers (of them, 51 smokers) and 615 patients with lung pathology (of them, 131 asthma (BA) patients, 205 COPD patients, 43 patients with bronchiectasis, 72 patients with idiopathic lung fibrosis (ILF), 142 pneumonia patients, and 42 cystic fibrosis patients). EBC was collected with ECoScreen equipment (Erich Jaeger, Germany) using a standardized method. The EBC pH was measured using the f32 PH-meter (Beckman, USA) with a glass microelectrode. The average ECB pH was 6.16 ± 0.52 in BA, 6.35 ± 0.56 in COPD, 6.13 ± 0.46 in bronchiectasis, 5.98 ± 0.30 in ILF, 5.96 ± 0.37 in pneumonia, and 6.35 ± 0.23 in cystic fibrosis. It was significantly lower than in the healthy volunteers (6.97 ± 0.31, р < 0.0001). In patients with exacerbation of BA and COPD ECB pH was considerably lower compared with those in stable condition. A reliable growth of pH was noted in pneumonia patients after treatment of the disease. There was a correlation between ECB pH and severity of fibrotic and inflammatory disorders of lung tissue according to HRCT (r = –0.62, p = 0.01), lung diffusing capacity (r = 0.51, p = 0.01), Tiffeneau index (r = 0.68, p = 0.004) in ILF. Therefore, the ECB pH is a distinct marker of the airway inflammatory severity in lung pathology. The ECB pH monitoring can assess the inflammatory activity and efficacy of anti-inflammatory therapy in lung diseases.

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Biomarkers of system inflammation in local and diffuse peritonitis

Biomeditsinskaya Khimiya ◽

10.18097/pbmc20206605411 ◽

2020 ◽

Vol 66 (5) ◽

pp. 411-418

Author(s):

E.V. Mikhalchik ◽

I.V. Borodina ◽

I.V. Vlasova ◽

T.V. Vakhrusheva ◽

N.P. Gorbunov ◽

...

Keyword(s):

Inflammatory Response ◽

Healthy Volunteers ◽

Normal Values ◽

Diffuse Peritonitis ◽

Surgical Operation ◽

Neutrophil Activity ◽

Plasma Antioxidant Capacity ◽

Group 3 ◽

Group 2 ◽

Group 1

In cases of any acute surgical abdominal disease the progression of purulent inflammation can lead to local or diffuse peritonitis. The indicators of the degree and specificity of the inflammatory response in blood such as cytokine concentration, neutrophil activity, plasma antioxidant capacity (thiols concentration) could be considered as potential predictors of complications. The luminol-dependent chemiluminescence (CL) response of blood activated by the phorbol ester (PMA), and the concentration of cytokines IL-6, IL-8, IL-10, myeloperoxidase (MPO) and thiols in plasma were measured in patients with uncomplicated condition (group 1, n=8), local peritonitis (group 2, n=9) or diffuse peritonitis (group 3, n=9) at admission to surgery (before surgical operation, b/o), immediately after surgical operation (a/o) and a day after surgery (1 day) as well as in healthy volunteers (norm, n=12). In all time-points the cytokines and MPO concentrations measured by ELISA, in group 3 were higher than in healthy volunteers and in patients in groups 1 and 2. Blood CL demonstrated a more than 5-fold increase above the normal values in all patients, and was also higher in group 2 as compared to group 1 (b/o and a/o). Patients in group 3 had shown both maximum and minimum of CL values, which could be a consequence of neutrophil priming or exhaustion (“immune paralysis”), respectively. The same patients' plasma exhibited low thiol concentration (≤30% vs normal values). In patients with fatal outcomes (group 3, n=2) within a day after surgery, either a decrease of the CL to zero values concurrently with elevated IL-8 and IL-6 concentrations and low thiol levels was observed, or CL exceeded normal values more than 20 times with concurrent complete exhaustion of the plasma thiol pool. No clear dependency between the plasma parameters and neutrophil activity was found. Hence a parameter set for prognosis and/or early diagnosis of infectious complications in acute abdominal pathology should include different biomarkers of the inflammatory response: cytokine profile (IL-6, IL-8, IL-10), MPO and neutrophil activity, antioxidant plasma capacity (e.g., total thiols concentration).

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