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Allergy Asthma Immunology
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vol 3. no 3. winter 2006  

 Bronchial asthma
Non-invasive pulmonary assessment
Adam Antczak, Violetta Piotrowska

Several attempts have been made to detect and monitor inflammatory changes and mediators in the airways using non-invasive methods. There is also a need for objective and early criteria to evaluate airway inflammation. Recent efforts have been made to detect markers in induced sputum and exhaled markers of airway inflammation.
Unfortunately, collection of induced sputum by inhalation of hypertonic saline may irritate the airways and subsequently is similar to bronchial challenge tests. Repetitive measurements are also not recommended due to cell count changes and proinflammatory action of sputum induction over short period of time.
Exhaled nitric oxide (NO) is the most extensively studied exhaled marker and abnormalities in NO levels have been documented in several lung diseases.
Recently exhaled breath condensate (EBC) has been more and more extensively used and a novel and non-invasive method to study airway inflammation. The volatile and non-volatile substances in human breath can potentially be used in assessment of airway inflammation based on the assumption that aerosol particles and vapor in exhaled air reflect the composition of the lower airway fluids. The composition of the condensate is very complex. There are several hints indicating that there are two phase (vapor and aerosol) constituting breath condensate. Leukotrienes and prostaglandins are good examples of molecules that normally are only hardly volatile and can evaporate easily with in the vapor phase of the breath condensate.
Exhaled air and breath condensate have the advantage of being non-invasive and also directly samples mediators from the respiratory tract, thus giving a more direct approach to the insight of inflammatory mediators in airway diseases.

keywords: kondensat powietrza wydechowego, tlenek azotu, indukowana plwocina, exhaled nitric oxide, exhaled breath condensate, induced sputum

pages: from 39 to 43

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