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Comparison of Nasal and Oral Inhalation during Exhaled Breath Condensate Collection

Departments of Pathophysiology, Clinical Chemistry, and Anesthesiology and Intensive Therapy, National Korányi Institute for Pulmonology, Semmelweis University of Medicine; and Oto-Rhino-Laryngology Department, Peterffy S. Hospital, Budapest, Hungary

Correspondence and requests for reprints should be addressed to Ildikó Horváth, M.D., D.Sc., National Korányi Institute for Pulmonology, Department of Pathophysiology, Budapest, Pihen út 1., P.O. Box 1 H-1529, Hungary. E-mail: hildiko{at}koranyi.hu

Analysis of exhaled breath condensate is a method for noninvasive assessment of the lung. Condensate can be collected with a nose clip (subjects inhale and exhale via the mouth) or without it (subjects inhale via the nose and exhale via the mouth), but the mode of inhalation may influence condensate volume and mediator levels. We compared condensate volume and adenosine, ammonia, and thromboxane B₂ levels in young healthy volunteers (n = 25) in samples collected for 10 minutes from subjects with or without a nose clip. Patients with allergic rhinitis (n = 8) were also studied to assess the effect of upper airway inflammation on mediator levels. Adenosine, ammonia, and thromboxane B₂ levels were determined by HPLC, spectrophotometry, and radioimmunoassay, respectively. Volume of condensate was significantly higher without nose clip than that with nose clip (mean ± SD, 2321 ± 736 µl and 1746 ± 400 µl, respectively; p = 0.0001). We found no significant difference in any mediator levels between these two collection modes in healthy volunteers, but adenosine showed a tendency to differ between oral and nasal inhalation in patients with allergic rhinitis. Our data indicate that whereas a greater volume of condensate can be obtained when subjects inhale through their noses, the mode of inhalation does not influence mediator levels in young healthy volunteers, but may affect these levels in patients with allergic rhinitis.

Key Words: airway inflammation • noninvasive monitoring • adenosine • ammonia • thromboxane

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