Abstract
Non-invasive methods to assess inflammation of lower airways are induced sputum (IS), exhaled nitric oxide (eNO), and exhaled breath condensate (EBC). Here we focused on the assessment of airway inflammation with a panel of non-invasive methods in health care workers (HCWs) with suspected latex allergy with and without current allergic respiratory symptoms about 10 years after the latex ban in German health care facilities. Seventy-seven non-smoking subjects were examined by skin prick test and specific IgE measurements, eNO, IS, and EBC. Sensitivity, specificity, and positive and negative predicted values for relevant biomarkers were calculated using current asthma symptoms as the gold standard. Twenty-nine subjects (38%) reported ongoing asthmatic symptoms (AS). In these subjects the EBC concentrations of nitrogen oxides (NOx; p=0.027) and leukotriene B4 (p=0.025) were significantly higher than in subjects without AS. In addition, in the subjects with AS the numbers of eosinophils (p=0.015) and the concentrations of IL-5 (p= 0.021) in IS samples were significantly higher than in the subjects without AS. A good correlation between several inflammatory markers in IS was detected. The maximum Youden Index was reached for IS total eosinophils ≥3.5·104 with a test efficiency of 0.72. In conclusion, non-invasive inflammatory monitoring with EBC and IS may assist the diagnosis of allergic asthma. Self-reported current asthmatic symptoms were reflected by eosinophilic inflammation and the best parameter to support the asthma diagnosis is a total number of eosinophils ≥3.5·104 in IS.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Barck, C., Lundahl, J., Halldén, G., & Bylin, G. (2005). Total eosinophil cationic protein levels in induced sputum as a marker of changes in eosinophilic inflammation in a patient with allergic asthma. Annals of Allergy, Asthma & Immunology, 95, 86–92.
Bradford M. M. (1976). A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Analytical Biochemistry, 72, 248–254.
Caballero Balanzá, S., Marorell Aragonés, A., Cerdá Mir, J. C., Belda Ramírez, J., Navarro Ivánez, R., Navarro Sorinano, A., Félix Toledo, R., & Escribano Montaner, A. (2010). Leukotriene B4 and 8-isoprostane in exhaled breath condensate of children with episodic and persistent asthma. Journal of Investigational Allergology and Clinical Immunology, 20, 237–243.
Cepelak, I., & Dodig, S. (2007). Exhaled breath condensate: A new method for lung disease diagnosis. Clinical Chemistry and Laboratory Medicine, 45, 945–952.
Fahy, J. V., Liu, J., Wong, H., & Boushey, H. A. (1993). Cellular and biochemical analysis of induced sputum from asthmatic and from healthy subjects. American Review of Respiratory Disease, 147, 1126–1131.
Feinstein, A. R. (1975). Clinical biostatistics XXXI. On the sensitivity, specificity and discrimination of diagnostic tests. Clinical Pharmacology and Therapeutics, 17, 104–116.
Gibson, P. G., Woolley, K. L., Carty, K., Murree-Allen, K., & Saltos, N. (1998). Induced sputum eosinophil cationic protein (ECP) measurement in asthma and chronic obstructive airway disease (COAD). Clinical and Experimental Allergy, 28, 1081–1088.
Henriksen, A. H., Lingaas-Holmen, T., Sue-Chu, M., & Bjemer, L. (2000). Combined use of exhaled nitric oxide and airway hyperresponsiveness in characterizing asthma in a large population survey. European Respiratory Journal, 15, 849–855.
Hoffmeyer, F., Harth, V., Merget, R., Goldscheid, N., Heinze, E., Degens, P., Pesch, B., Bünger, J., Brüning, T., & Raulf-Heimsoth, M. (2007). Exhaled breath condensate analysis: evaluation of a methodological setting for epidemiological field studies. Journal of Physiology and Pharmacology, 58(Suppl. 5), 289–298.
Hoffmeyer, F., Raulf-Heimsoth, M., & Brüning, T. (2009). Exhaled breath condensate and airway inflammation. Current Opinion in Allergy and Clinical Immunology, 9, 16–22.
Holz, O., Jorres, R. A., Koschyk, S., Speckin, P., Welker, L., & Magnussen, H. (1998). Changes in sputum composition during sputum induction in healthy and asthmatic subjects. Clinical and Experimental Allergy, 28, 284–292.
Kulkarni, N. S., Hollins, F., Sutcliffe, A., Saunders, R., Shah, S., Siddiqui, S., Gupta, S., Haldar, P., Green, R., Pavord, I., Wardlaw, A., & Brightling, C. E. (2010). Eosinophil protein in airway macrophages: A novel biomarker of eosinophilic inflammation in patients with asthma. Journal of Allergy and Clinical Immunology, 126, 61–69.
Merget, R., van Kampen, V., Sucker, K., Heinze, E., Taeger, D., Goldscheid, N., Haufs, M. G., Raulf-Heimsoth, M., Kromark, K., Nienhaus, A., & Brüning, T. (2010). The German experience 10 years after the latex allergy epidemic: Need for further preventive measures in healthcare employees with latex allergy. International Archives of Occupational and Environmental Health, 83, 895–903.
Motojima, S., Akutsu, I., Fukuda, T., Makino, S., & Takatsu, K. (1993). Clinical significance of measuring levels of sputum and serum ECP and serum IL-5 in bronchial asthma. Allergy, 48, 98–106.
Quirce, S., Lemière, C., de Blay, F., Del Pozo, V., Gerth Van Wijk, R., Maestrelli, P., Pauli, G., Pignatti, P., Raulf-Heimsoth, M., Sastre, J., Storaas, T., & Moscato, G. (2010). Noninvasive methods for assessment of airway inflammation in occupational settings. Allergy, 65, 445–458.
Raulf-Heimsoth, M., Pesch, B., Kendzia, B., Spickenheuer, A., Bramer, R., Marczynski, B., Merget, R., & Brüning, T. (2011). Irritative effects of vapours and aerosols of bitumen on the airways assessed by non-invasive methods. Archives of Toxicology, 85, S41–S52.
Vagaggini, B., Taccola, M., Cianchetti, S., Carnevali, S., Bartoli, M. L., Bacci, E., Dente, F. L., Di Franco, A., Giannini, D., & Paggiaro, P. L. (2002). Ozone exposure increases eosinophilic airway response induced by previous allergen challenge. American Journal of Respiratory and Critical Care Medicine, 166, 1073–1077.
van Kampen, V., Merget, R., Sander, I., Brüning, T., Broding, H. C., Keller, C., Müsken, H., Overlack, A., Schultze-Werninghaus, G., Walusiak, J., & Raulf-Heimsoth, M. (2009). Comparison of wheat and rye flour solutions for skin prick testing: A multi-centre study (Stad. 1). Clinical and Experimental Allergy, 39, 1896–1902.
Acknowledgements
This study was part of the IPA-project LABeL funded by DGUV (German Social Accident Insurance).
Conflicts of Interest: The authors declare no conflicts of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media Dordrecht
About this paper
Cite this paper
Raulf-Heimsoth, M. et al. (2013). Comparison of Different Non-invasive Methods for Detection of Allergic Asthma. In: Pokorski, M. (eds) Respiratory Regulation - Clinical Advances. Advances in Experimental Medicine and Biology, vol 755. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4546-9_7
Download citation
DOI: https://doi.org/10.1007/978-94-007-4546-9_7
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-4545-2
Online ISBN: 978-94-007-4546-9
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)