Measurement of tumor necrosis factor-α, leukotriene B4, and interleukin 8 in the exhaled breath condensate in patients with acute exacerbations of chronic obstructive pulmonary disease

Figures & data

Table 1 Clinical characteristics of the subjects

	COPD patients with acute exacerbations (n = 26)	Stable COPD subjects (n = 11)	Normal controls (n = 14)
Age (yrs)	73.1 ± 7.6	74.4 ± 4.9	75.2 ± 4.1
Sex (M/F)	22/6	8/3	9/5
Smoking history (pack years)	40.1 ± 20.9	41.3 ± 10.5	0
Body mass index (kg/m2)	22.1 ± 4.1	22.8 ± 5.1	22.5 ± 2.2
FEV1 (L)*	0.91 ± 0.36	0.94 ± 0.38	2.00 ± 0.41
FVC (L)*	1.74 ± 0.62	1.69 ± 0.70	2.57 ± 0.47
FEV1/FVC (%)*	53.9 ± 11.5	57.6 ± 11.7	77.8 ± 2.7#
FEV1 (% predicted)*	44.8 ± 14.3	49.4 ± 19.6	104.1 ± 17.0#
FVC (% predicted)*	62.0 ± 18.7	62.5 ± 21.4	96.9 ± 12.3#
Current ICS use	12 (46.1)	5 (45.5)	0 (0)
Current theophylline use	7 (26.9)	4 (36.4)	0 (0)

Notes: Data were presented as mean ± SD or number (%);

* for the COPD patients with acute exacerbation, the lung function (post-bronchodilator) at Day 60 after admission to hospital was presented;

# FEV₁% predicted, FVC % predicted and FEV₁/FVC ratio were higher in the normal controls when compared to COPD patients with acute exacerbations and stable COPD patients, p < 0.001.

Abbreviations: COPD, chronic obstructive pulmonary disease; FEV₁, forced expiratory volume in one second; FVC, forced vital capacity; ICS, inhaled corticosteroid; SD, standard deviation.

Table 2 Detection rates of TNF-α, LTB4 and IL-8 in exhaled breath condensate

	TNF-α (pg/ml)	LTB4(pg/ml)	IL-8(pg/ml)
	n (%)	n (%)	n (%)
AECOPD Day 5	26 (100)	23 (89)	1 (4)
AECOPD Day 14	26 (100)	26 (100)	4 (15)
AECOPD Day 30	26 (100)	25 (96)	3 (12)
AECOPD Day 60	26 (100)	25 (96)	2 (8)
Stable COPD	11 (100)	9 (82)	0 (0)
Normal controls	14 (100)	14 (100)	2 (14)

Abbreviations: AECOPD, acute exacerbations of chronic obstructive pulmonary disease; IL-8, interleukin-8; LTB4, leukotriene B4; TNF-α, tumor necrosis factor-α.

Table 3 Levels of the biomarkers

	TNF-α (pg/ml)	LTB4 (pg/ml)
AECOPD Day 5	5.08 (3.80–6.32)	6.30 (5.17–8.07)
AECOPD Day 14	5.84 (4.91–9.14)*	6.47 (5.05–8.00)
AECOPD Day 30	6.14 (3.82–7.67)*	6.26 (4.70–7.99)
AECOPD Day 60	5.60 (4.53–8.80)*	5.77 (4.82–7.37)
Stable COPD	5.39 (3.80–6.89)	5.90 (5.21–7.10)
Normal controls	4.84 (3.86–5.81)**	5.80 (5.29–7.54)

Notes: Data were presented in median (IQR);

* p < 0.05 when compared with the level of biomarker at Day 5;

** p = 0.036 when comparing levels of biomarker between control subjects and Day 14 post-hospitalization for patients with AECOPD.

Abbreviations: AECOPD, acute exacerbations of chronic obstructive pulmonary disease; LTB4, leukotriene B4; TNF-α, tumor necrosis factor-α.

Figure 1 Levels of TNF-α in the subjects with AECOPD, stable COPD and normal controls

Abbreviations: AECOPD, acute exacerbations of chronic obstructive pulmonary disease; COPD, chronic obstructive pulmonary disease; TNF-α, tumor necrosis factor-α.

Table 4 Serial spirometry results of the subjects with acute exacerbation of COPD (n = 26)

	Day 5	Day 14	Day 30	Day 60
FEV1% predicted	41.5 ± 12.9	46.1 ± 14.2	43.6 ± 14.2	44.5 ± 14.6
FVC% predicted	54.8 ± 17.8	61.5 ± 20.5	61.7 ± 18.2	62.1 ± 19.0
FEV1/FVC (%)	57.0 ± 12.3	56.1 ± 12.0	52.8 ± 11.8	53.4 ± 11.6
FEV1 (L)	0.83 ± 0.29	0.91 ± 0.28	0.89 ± 0.37	0.91 ± 0.62
FVC (L)	1.54 ± 0.56	1.66 ± 0.56	1.72 ± 0.59	1.74 ± 0.62

Note: Data were presented as mean ± SD.

Abbreviations: FEV₁, forced expiratory volume in one second; FVC, forced vital capacity.

Figure 2 Bland and Altman’s plot of the repeatability measurements of TNF-α and LTB4.

Abbreviations: LTB4, leukotriene B4; TNF-α, tumor necrosis factor-α.