Am. J. Respir. Crit. Care Med., Volume 158, Number 3, September 1998, 991-994

Elevated Levels of Expired Breath Hydrogen Peroxide in Bronchiectasis

STELIOS LOUKIDES, ILDIKO HORVATH, THERESA WODEHOUSE, PETER J. COLE, and PETER J. BARNES

Department of Thoracic Medicine, National Heart and Lung Institute, Imperial College of Medicine, London, United Kingdom

Airway inflammation is important in the development and progression of many lung diseases, including bronchiectasis. Activation of inflammatory cells such as neutrophils, eosinophils, and macrophages induces a respiratory burst resulting in the production of reactive oxygen species such as hydrogen peroxide (H₂O₂). We have measured exhaled H₂O₂ in patients with documented bronchiectasis and investigated whether the concentration of H₂O₂ is related to the disease severity, as defined by lung function. We also investigated whether the concentrations of expired H₂O₂ were different in bronchiectatic patients who received inhaled corticosteroids compared with steroid-naïve patients. In 37 patients with bronchiectasis (mean age, 45 ± 2.5 yr; FEV₁, 59 ± 3% pred), mean H₂O₂ concentration in exhaled breath condensate was significantly elevated as compared with the values in 25 age-matched (mean age, 42 ± 2 yr) normal subjects (0.87 ± 0.01 versus 0.26 ± 0.04 µM, p < 0.001). There was a significant negative correlation between H₂O₂ and FEV₁ (r = 0.76, p < 0.0001). Patients treated with inhaled corticosteroids had values of H₂O₂ similar to those of steroid-naïve patients (0.8 ± 0.1 versus 0.9 ± 0.1, p > 0.05). We conclude that H₂O₂ is elevated in exhaled air condensate of patients with bronchiectasis and is correlated with disease severity. Measurement of H₂O₂ may be used as a simple noninvasive method to monitor airway inflammation and oxidative stress.

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