This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kostikas, K. Articles by Loukides, S. Search for Related Content PubMed PubMed Citation Articles by Kostikas, K. Articles by Loukides, S.

pH in Expired Breath Condensate of Patients with Inflammatory Airway Diseases

Department of Pneumonology and Clinical Research Unit, Athens Army General Hospital, Athens, Greece

Correspondence and requests for reprints should be addressed to Stelios Loukides, Smolika 2 16673, Athens, Greece. E-mail: ssat{at}hol.gr

Endogenous airway acidification, as assessed by pH in expired breath condensate, has been implicated in asthma pathophysiology. We measured pH in breath condensate of patients with inflammatory airway diseases in stable condition and examined its relationship with the inflammatory process (as assessed by differential cell counts in induced sputum), oxidative stress (as assessed by H₂O₂ and 8-isoprostane), and nitric oxide metabolism (as assessed by total nitrate/nitrite). We studied 40 patients with bronchial asthma (20 with moderate disease, forced expiratory volume in 1 second 60 [10]% SD predicted), 20 patients with bronchiectasis, 20 patients with chronic obstructive pulmonary disease (COPD), and 10 normal subjects. Mean (95% confidence intervals) pH values were significantly lower in patients with COPD and bronchiectasis compared with patients with asthma and control subjects (7.16, 7.09–7.23 and 7.11, 7.04–7.19 versus 7.43, 7.35–7.52 and 7.57, 7.51–7.64, respectively, p < 0.0001). Patients with moderate asthma had significantly lower values compared with mild and control subjects. In patients with COPD and bronchiectasis, the values of pH were significantly correlated with both sputum neutrophilia and oxidative stress. Respectively, in patients with moderate asthma, a significant correlation was observed between pH and sputum eosinophilia, total nitrate/nitrite, and oxidative stress. The pH of the expired breath condensate might be a simple, noninvasive, inexpensive, and easily repeatable procedure for the evaluation of the inflammatory process in airway diseases.

Key Words: pH • expired breath condensate • COPD • asthma • bronchiectasis

This article has been cited by other articles:

				L. C. Kottyan, A. R. Collier, K. H. Cao, K. A. Niese, M. Hedgebeth, C. G. Radu, O. N. Witte, G. K. Khurana Hershey, M. E. Rothenberg, and N. Zimmermann Eosinophil viability is increased by acidic pH in a cAMP- and GPR65-dependent manner Blood, September 24, 2009; 114(13): 2774 - 2782. [Abstract] [Full Text] [PDF]

				L. Prieto, S. Esnal, V. Lopez, D. Barato, R. Rojas, and J. Marin Maximal Response Plateau to Adenosine 5'-Monophosphate in Asthma: Relationship With the Response to Methacholine, Exhaled Nitric Oxide, and Exhaled Breath Condensate pH Chest, June 1, 2009; 135(6): 1521 - 1526. [Abstract] [Full Text] [PDF]

				M.-J. Cruz, S. Sanchez-Vidaurre, P.-V. Romero, F. Morell, and X. Munoz Impact Of Age on pH, 8-Isoprostane, and Nitrogen Oxides in Exhaled Breath Condensate Chest, February 1, 2009; 135(2): 462 - 467. [Abstract] [Full Text] [PDF]

				R. Do, K. H. Bartlett, H. Dimich-Ward, W. Chu, and S. M. Kennedy Biomarkers of Airway Acidity and Oxidative Stress in Exhaled Breath Condensate from Grain Workers Am. J. Respir. Crit. Care Med., November 15, 2008; 178(10): 1048 - 1054. [Abstract] [Full Text] [PDF]

				T. Matsuno, Y. Ito, T. Ohashi, M. Morise, N. Takeda, K. Shimokata, K. Imaizumi, H. Kume, and Y. Hasegawa Dual Pathway Activated by tert-Butyl Hydroperoxide in Human Airway Anion Secretion J. Pharmacol. Exp. Ther., November 1, 2008; 327(2): 453 - 464. [Abstract] [Full Text] [PDF]

				K Terada, S Muro, S Sato, T Ohara, A Haruna, S Marumo, D Kinose, E Ogawa, Y Hoshino, A Niimi, et al. Impact of gastro-oesophageal reflux disease symptoms on COPD exacerbation Thorax, November 1, 2008; 63(11): 951 - 955. [Abstract] [Full Text] [PDF]

				L. J. Janssen Isoprostanes and Lung Vascular Pathology Am. J. Respir. Cell Mol. Biol., October 1, 2008; 39(4): 383 - 389. [Abstract] [Full Text] [PDF]

				Z. L. Borrill, K. Roy, and D. Singh Exhaled breath condensate biomarkers in COPD Eur. Respir. J., August 1, 2008; 32(2): 472 - 486. [Abstract] [Full Text] [PDF]

				D. Ni and L.-Y. Lee Effect of increasing temperature on TRPV1-mediated responses in isolated rat pulmonary sensory neurons Am J Physiol Lung Cell Mol Physiol, March 1, 2008; 294(3): L563 - L571. [Abstract] [Full Text] [PDF]

				M. Cazzola, W. MacNee, F. J. Martinez, K. F. Rabe, L. G. Franciosi, P. J. Barnes, V. Brusasco, P. S. Burge, P. M. A. Calverley, B. R. Celli, et al. Outcomes for COPD pharmacological trials: from lung function to biomarkers Eur. Respir. J., February 1, 2008; 31(2): 416 - 469. [Abstract] [Full Text] [PDF]

				V. Seto, C. Hirota, S. Hirota, and L. J. Janssen E-Ring Isoprostanes Stimulate a Cl Conductance in Airway Epithelium via Prostaglandin E2-Selective Prostanoid Receptors Am. J. Respir. Cell Mol. Biol., January 1, 2008; 38(1): 88 - 94. [Abstract] [Full Text] [PDF]

				C. Paredes, T. Tazzeo, and L. J. Janssen E-Ring Isoprostane Augments Cholinergic Neurotransmission in Bovine Trachealis via FP Prostanoid Receptors Am. J. Respir. Cell Mol. Biol., December 1, 2007; 37(6): 739 - 747. [Abstract] [Full Text] [PDF]

				P. Montuschi Review: Analysis of exhaled breath condensate in respiratory medicine: methodological aspects and potential clinical applications Therapeutic Advances in Respiratory Disease, October 1, 2007; 1(1): 5 - 23. [Abstract] [PDF]

				A. Schmid, Z. Sutto, M.-C. Nlend, G. Horvath, N. Schmid, J. Buck, L. R. Levin, G. E. Conner, N. Fregien, and M. Salathe Soluble Adenylyl Cyclase Is Localized to Cilia and Contributes to Ciliary Beat Frequency Regulation via Production of cAMP J. Gen. Physiol., July 1, 2007; 130(1): 99 - 109. [Abstract] [Full Text] [PDF]

				M. Kodric, A. N. Shah, L. M. Fabbri, and M. Confalonieri An Investigation of Airway Acidification in Asthma Using Induced Sputum: A Study of Feasibility and Correlation Am. J. Respir. Crit. Care Med., May 1, 2007; 175(9): 905 - 910. [Abstract] [Full Text] [PDF]

				D. D. Noble, J. B. McCafferty, A. P. Greening, and J. A. Innes Respiratory heat and moisture loss is associated with eosinophilic inflammation in asthma Eur. Respir. J., April 1, 2007; 29(4): 676 - 681. [Abstract] [Full Text] [PDF]

				T. Kullmann, I. Barta, Z. Lazar, B. Szili, E. Barat, M. Valyon, M. Kollai, and I. Horvath Exhaled breath condensate pH standardised for CO2 partial pressure Eur. Respir. J., March 1, 2007; 29(3): 496 - 501. [Abstract] [Full Text] [PDF]

				H.-W. Shin, D. A. Shelley, E. M. Henderson, A. Fitzpatrick, B. Gaston, and S. C. George Airway nitric oxide release is reduced after PBS inhalation in asthma J Appl Physiol, March 1, 2007; 102(3): 1028 - 1033. [Abstract] [Full Text] [PDF]

				C. Liu, T. Tazzeo, and L. J. Janssen Isoprostane-induced airway hyperresponsiveness is dependent on internal Ca2+ handling and Rho/ROCK signaling Am J Physiol Lung Cell Mol Physiol, December 1, 2006; 291(6): L1177 - L1184. [Abstract] [Full Text] [PDF]

				N. C. Nicolaou, L. A. Lowe, C. S. Murray, A. Woodcock, A. Simpson, and A. Custovic Exhaled Breath Condensate pH and Childhood Asthma: Unselected Birth Cohort Study Am. J. Respir. Crit. Care Med., August 1, 2006; 174(3): 254 - 259. [Abstract] [Full Text] [PDF]

				P. J. Barnes, B. Chowdhury, S. A. Kharitonov, H. Magnussen, C. P. Page, D. Postma, and M. Saetta Pulmonary Biomarkers in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., July 1, 2006; 174(1): 6 - 14. [Abstract] [Full Text] [PDF]

				J. Hunt Exhaled Breath Condensate pH: Reflecting Acidification of the Airway at All Levels Am. J. Respir. Crit. Care Med., February 15, 2006; 173(4): 366 - 367. [Full Text] [PDF]

				R. M. Effros, R. Casaburi, J. Su, M. Dunning, J. Torday, J. Biller, and R. Shaker The Effects of Volatile Salivary Acids and Bases on Exhaled Breath Condensate pH Am. J. Respir. Crit. Care Med., February 15, 2006; 173(4): 386 - 392. [Abstract] [Full Text] [PDF]

				A. O. Paget-Brown, L. Ngamtrakulpanit, A. Smith, D. Bunyan, S. Hom, A. Nguyen, and J. F. Hunt Normative Data for pH of Exhaled Breath Condensate. Chest, February 1, 2006; 129(2): 426 - 430. [Abstract] [Full Text] [PDF]

				ATS Workshop Proceedings: Exhaled Nitric Oxide and Nitric Oxide Oxidative Metabolism in Exhaled Breath Condensate. Proceedings of the ATS, January 1, 2006; 3(2): 131 - 145. [Full Text] [PDF]

				G. E. Carpagnano, M P. Foschino Barbaro, M. Cagnazzo, G Di Gioia, T Giliberti, C Di Matteo, and O Resta Use of Exhaled Breath Condensate in the Study of Airway Inflammation After Hypertonic Saline Solution Challenge Chest, November 1, 2005; 128(5): 3159 - 3166. [Abstract] [Full Text] [PDF]

				I. Horvath, J. Hunt, P. J. Barnes, and On behalf of the ATS/ERS Task Force on Exhaled Bre Exhaled breath condensate: methodological recommendations and unresolved questions Eur. Respir. J., September 1, 2005; 26(3): 523 - 548. [Abstract] [Full Text] [PDF]

				G. MacGregor, S. Ellis, J. Andrews, M. Imrie, A. Innes, A. P. Greening, and S. Cunningham Breath condensate ammonium is lower in children with chronic asthma Eur. Respir. J., August 1, 2005; 26(2): 271 - 276. [Abstract] [Full Text] [PDF]

				K. Kostikas, M. Gaga, G. Papatheodorou, T. Karamanis, D. Orphanidou, and S. Loukides Leukotriene B4 in Exhaled Breath Condensate and Sputum Supernatant in Patients With COPD and Asthma Chest, May 1, 2005; 127(5): 1553 - 1559. [Abstract] [Full Text] [PDF]

				A Morice, C F Everett, S A Mulrennan, K F Chung, and A Niimi Exhaled breath condensate in chronic cough * Authors' reply Thorax, March 1, 2005; 60(3): 259 - 259. [Full Text] [PDF]

				A Morice EBC pH and chronic cough Thorax, March 1, 2005; 60(3): 257 - 257. [Full Text] [PDF]

				Z. Borrill, C. Starkey, J. Vestbo, and D. Singh Reproducibility of exhaled breath condensate pH in chronic obstructive pulmonary disease Eur. Respir. J., February 1, 2005; 25(2): 269 - 274. [Abstract] [Full Text] [PDF]

				J C Ojoo, S A Mulrennan, J A Kastelik, A H Morice, and A E Redington Exhaled breath condensate pH and exhaled nitric oxide in allergic asthma and in cystic fibrosis Thorax, January 1, 2005; 60(1): 22 - 26. [Abstract] [Full Text] [PDF]

				K Wells, J Vaughan, T N Pajewski, S Hom, L Ngamtrakulpanit, A Smith, A Nguyen, R Turner, and J Hunt Exhaled breath condensate pH assays are not influenced by oral ammonia Thorax, January 1, 2005; 60(1): 27 - 31. [Abstract] [Full Text] [PDF]

				M. Corradi, P. Pignatti, P. Manini, R. Andreoli, M. Goldoni, M. Poppa, G. Moscato, B. Balbi, and A. Mutti Comparison between exhaled and sputum oxidative stress biomarkers in chronic airway inflammation Eur. Respir. J., December 1, 2004; 24(6): 1011 - 1017. [Abstract] [Full Text] [PDF]

				R. M. Effros, M. B. Dunning III, J. Biller, and R. Shaker The promise and perils of exhaled breath condensates Am J Physiol Lung Cell Mol Physiol, December 1, 2004; 287(6): L1073 - L1080. [Abstract] [Full Text] [PDF]

				S. A. Kharitonov and P. J. Barnes Effects of Corticosteroids on Noninvasive Biomarkers of Inflammation in Asthma and Chronic Obstructive Pulmonary Disease Proceedings of the ATS, November 1, 2004; 1(3): 191 - 199. [Abstract] [Full Text] [PDF]

				C. Schwarzer, T. E. Machen, B. Illek, and H. Fischer NADPH Oxidase-dependent Acid Production in Airway Epithelial Cells J. Biol. Chem., August 27, 2004; 279(35): 36454 - 36461. [Abstract] [Full Text] [PDF]

				F. L. M. Ricciardolo, P. J. Sterk, B. Gaston, and G. Folkerts Nitric Oxide in Health and Disease of the Respiratory System Physiol Rev, July 1, 2004; 84(3): 731 - 765. [Abstract] [Full Text] [PDF]

				A Niimi, L T Nguyen, O Usmani, B Mann, and K F Chung Reduced pH and chloride levels in exhaled breath condensate of patients with chronic cough Thorax, July 1, 2004; 59(7): 608 - 612. [Abstract] [Full Text] [PDF]

				J. Hunt From the Authors Eur. Respir. J., June 1, 2004; 23(6): 962 - 962. [Full Text] [PDF]

				G. E. Carpagnano, P. J. Barnes, J. Francis, N. Wilson, A. Bush, and S. A. Kharitonov Breath Condensate pH in Children With Cystic Fibrosis and Asthma: A New Noninvasive Marker of Airway Inflammation? Chest, June 1, 2004; 125(6): 2005 - 2010. [Abstract] [Full Text] [PDF]

				Y. Ito, M. Son, S. Sato, T. Ohashi, M. Kondo, K. Shimokata, and H. Kume Effects of Fluoranthene, a Polycyclic Aromatic Hydrocarbon, on cAMP-Dependent Anion Secretion in Human Airway Epithelia J. Pharmacol. Exp. Ther., February 1, 2004; 308(2): 651 - 657. [Abstract] [Full Text] [PDF]

				H.-W. Shin, C. M. Rose-Gottron, D. M. Cooper, R. L. Newcomb, and S. C. George Airway diffusing capacity of nitric oxide and steroid therapy in asthma J Appl Physiol, January 1, 2004; 96(1): 65 - 75. [Abstract] [Full Text] [PDF]

				E. D. Moloney, S. E. Mumby, R. Gajdocsi, J. H. Cranshaw, S. A. Kharitonov, G. J. Quinlan, and M. J. Griffiths Exhaled Breath Condensate Detects Markers of Pulmonary Inflammation after Cardiothoracic Surgery Am. J. Respir. Crit. Care Med., January 1, 2004; 169(1): 64 - 69. [Abstract] [Full Text] [PDF]

				J. Vaughan, L. Ngamtrakulpanit, T.N. Pajewski, R. Turner, T-A. Nguyen, A. Smith, P. Urban, S. Hom, B. Gaston, and J. Hunt Exhaled breath condensate pH is a robust and reproducible assay of airway acidity Eur. Respir. J., December 1, 2003; 22(6): 889 - 894. [Abstract] [Full Text] [PDF]

				C. Wijkstrom-Frei, S. El-Chemaly, R. Ali-Rachedi, C. Gerson, M. A. Cobas, R. Forteza, M. Salathe, and G. E. Conner Lactoperoxidase and Human Airway Host Defense Am. J. Respir. Cell Mol. Biol., August 1, 2003; 29(2): 206 - 212. [Abstract] [Full Text] [PDF]

				E Baraldi, S Carraro, R Alinovi, A Pesci, L Ghiro, A Bodini, G Piacentini, F Zacchello, and S Zanconato Cysteinyl leukotrienes and 8-isoprostane in exhaled breath condensate of children with asthma exacerbations Thorax, June 1, 2003; 58(6): 505 - 509. [Abstract] [Full Text] [PDF]

				S. K. Inglis, S. M. Wilson, and R. E. Olver Secretion of acid and base equivalents by intact distal airways Am J Physiol Lung Cell Mol Physiol, May 1, 2003; 284(5): L855 - L862. [Abstract] [Full Text] [PDF]

				J. Widdicombe, J. F. Hunt, B. Gaston, K. Kostikas, and S. Loukides "Acidopnea" and the dictionary Am. J. Respir. Crit. Care Med., March 1, 2003; 167(5): 800 - 801. [Full Text]

				B. Gaston Breath Condensate Analysis: Perhaps Worth Studying, After All Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 292 - 293. [Full Text] [PDF]

				M. J. Tobin Asthma, Airway Biology, and Nasal Disorders in AJRCCM 2002 Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 319 - 332. [Full Text] [PDF]

				R. M. Effros, B. M. Gaston, and J. F. Hunt Do low exhaled condensate nh4+ concentrations in asthma reflect reduced pulmonary production? Am. J. Respir. Crit. Care Med., January 1, 2003; 167(1): 91 - 92. [Full Text]

				B. Gaston and J. F. Hunt How Acidopneic Is My Patient? A New Question in the Pulmonary Laboratory Am. J. Respir. Crit. Care Med., May 15, 2002; 165(10): 1349 - 1350. [Full Text] [PDF]