Nitin Mohan1,2, Rabeya Akter3, Katherine Bryant4, Cristan Herbert4, Sharron Chow4, Paul S Thomas5,6,4. 1. Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia. n.mohan@unswalumni.com. 2. Department of Respiratory Medicine, Prince of Wales Hospital, Sydney, NSW, Australia. n.mohan@unswalumni.com. 3. Elemental Analysis Laboratory, SSEAU, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia. 4. Inflammation and Infection Research, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia. 5. Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia. 6. Department of Respiratory Medicine, Prince of Wales Hospital, Sydney, NSW, Australia.
Abstract
OBJECTIVE: Granuloma formation in sarcoidosis is dependent upon the interaction between alveolar macrophages (AMs) and a CD4+-driven TH1 response. This study aimed to measure TNF-α and calcium ion concentrations as markers of AM activity, in addition to total protein as a non-specific inflammatory marker in the exhaled breath condensate (EBC) of patients with sarcoidosis as well as control subjects. METHODS: EBC was collected from 17 sarcoidosis patients and 23 healthy volunteers. Protein was measured by the bicinchoninic acid assay, TNF-α concentration was measured by ELISA and Ca(2+) concentration was measured by inductively coupled plasma-mass spectrometry. Conductivity of EBC was assessed using a conductivity probe. RESULTS: Total protein concentration was significantly elevated in EBC from patients with sarcoidosis compared to control subjects (19.51 ± 4.52 vs. 10.60 ± 1.31 µg/ml, p = 0.020), as was TNF-α (3.37 ± 0.38 vs. 2.59 ± 0.40 pg/ml, p = 0.037) and conductivity (66.68 ± 16.73 vs. 36.85 ± 3.070 µS/cm, p = 0.044). EBC Ca(2+) concentration was significantly higher in healthy controls compared to patients with sarcoidosis (116.50 ± 12.19 vs. 73.88 ± 13.35 µmol/l, p = 0.018), although this was in the context of normal serum Ca(2+) in the sarcoidosis cohort. CONCLUSIONS: Total protein and TNF-α concentrations were elevated in EBC from patients with sarcoidosis and could indicate disease activity. The reduction in EBC Ca(2+) concentrations could represent granulomatous activity in the lung.
OBJECTIVE:Granuloma formation in sarcoidosis is dependent upon the interaction between alveolar macrophages (AMs) and a CD4+-driven TH1 response. This study aimed to measure TNF-α and calcium ion concentrations as markers of AM activity, in addition to total protein as a non-specific inflammatory marker in the exhaled breath condensate (EBC) of patients with sarcoidosis as well as control subjects. METHODS:EBC was collected from 17 sarcoidosispatients and 23 healthy volunteers. Protein was measured by the bicinchoninic acid assay, TNF-α concentration was measured by ELISA and Ca(2+) concentration was measured by inductively coupled plasma-mass spectrometry. Conductivity of EBC was assessed using a conductivity probe. RESULTS: Total protein concentration was significantly elevated in EBC from patients with sarcoidosis compared to control subjects (19.51 ± 4.52 vs. 10.60 ± 1.31 µg/ml, p = 0.020), as was TNF-α (3.37 ± 0.38 vs. 2.59 ± 0.40 pg/ml, p = 0.037) and conductivity (66.68 ± 16.73 vs. 36.85 ± 3.070 µS/cm, p = 0.044). EBCCa(2+) concentration was significantly higher in healthy controls compared to patients with sarcoidosis (116.50 ± 12.19 vs. 73.88 ± 13.35 µmol/l, p = 0.018), although this was in the context of normal serum Ca(2+) in the sarcoidosis cohort. CONCLUSIONS: Total protein and TNF-α concentrations were elevated in EBC from patients with sarcoidosis and could indicate disease activity. The reduction in EBCCa(2+) concentrations could represent granulomatous activity in the lung.
Authors: Richard M Effros; Julie Biller; Bradley Foss; Kelly Hoagland; Marshall B Dunning; Daniel Castillo; Mark Bosbous; Feng Sun; Reza Shaker Journal: Am J Respir Crit Care Med Date: 2003-09-25 Impact factor: 21.405
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