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Leukotrienes (LTs) are involved in the pathogenesis of lung fibrosis and were increased in exhaled breath condensate (EBC) of the patients with pneumoconiosis. However the possible influence of extra-pulmonary disorders on the EBC markers is not known. Therefore in parallel with EBC, LTs' levels in the plasma and urine were measured in patients with pneumoconiosis (45 × asbestos exposure, 37 × silica exposure) and in 27 controls. Individual LTs B4, C4, D4 and E4 were measured by liquid chromatography - electrospray ionization - tandem mass spectrometry (LC-ESI-MS/MS). In EBC, LT D4 and LT E4 were increased in both groups of patients (p<0.001 and p<0.05), comparing with the controls. Both LT B4 and cysteinyl LTs were elevated in asbestos-exposed subjects (p<0.05). Asbestosis with more severe radiological signs (s1/s2-t3/u2) and lung functions impairment has shown higher cysteinyl LTs and LT C4 in the EBC (p<0.05) than mild asbestosis (s1/s0-s1/s1). In addition, in the subjects with asbestosis, cysteinyl LTs in EBC correlated with TLC (-0.313, p<0.05) and TLCO/Hb (-0.307, p<0.05), and LT C4 with TLC (-0.358, p<0.05). In pneumoconioses, EBC appears the most useful from the 3 fluids studied.

Asbestosis and pleural plaques exhibit unpredictable but progressive development, and there are no markers routinely available to measure their prognosis. Asbestos exposure induces the generation of reactive oxygen species, and 8-isoprostane is involved in experimental asbestos-related lung toxicity. This oxidative stress marker was measured in exhaled breath condensate (EBC) in 92 former asbestos workers with mean age 68.8+/-1.7 yr and mean duration of asbestos exposure 24.1+/-2.0 yr. The control group had 46 subjects with mean age 65.2+/-3.3 yr. The mean level of 8-isoprostane, analyzed by liquid chromatography-electrospray ionization-mass spectrometry, was higher in asbestos-exposed subjects (69.5+/-6.6 pg/ml, p=0.0001) compared with the control group, where the concentration was 47.0+/-7.8 pg/ml. The results presented support the hypothesis that oxidative stress due to asbestos is the main cause of increased 8-isoprostane in EBC. Measurement of 8-isoprostane in EBC is a promising non-invasive means for assessing the activity of asbestos-induced diseases.

Silicosis has progressive, but unpredictable development. There are no markers routinely available to measure the activity and prognosis of silicosis. 8-isoprostane, a marker of oxidative stress and leukotrienes B4, C4, D4, and E4 were measured in exhaled breath condensate in patients with silicosis. Sixty subjects were examined, with mean age 66.7+/-2.0 yr and mean exposure to silica 23.6+/-2.5 yr. The control group had 25 subjects, with mean age 64.7+/-4.8 yr. Exhaled breath was collected using the EcoScreen (Jaeger, Germany); 8-isoprostane and leukotrienes were analyzed by high-performance liquid chromatography/mass spectrometry. Several lung functions parameters were impaired in silicotics in comparisons with the controls; ESR, alpha1-antitrypsin and proteinuria were higher in the silicotics. Antineutrophilic cytoplasmic antibodies were more frequent in the silicotics (39%) than in the controls (4%), (p=0.0017). The mean level of 8-isoprostane in the patients with silicosis was 73.6+/-9.9 vs. 43+/-10 pg/ml (p=0.0001) in the controls. Silica exposure category (high, medium, none) was positively associated with the level of 8-isoprostane. In the patients with complicated silicosis, a high level of 8-isoprostane was found more frequently (p=0.0194). Leukotriene D4 was also increased in the silicotics (21.1+/-2.7 pg/ml) vs. the controls (14.7+/-2.7 pg/ml), (p=0.001). No significant effect of smoking or alcohol consumption on the markers examined was seen. This is the first study using exhaled breath condensate analysis in patients with silicosis.