Asthma and lower airway disease
Exhaled breath malondialdehyde as a marker of effect of exposure to air pollution in children with asthma

https://doi.org/10.1016/j.jaci.2007.12.004Get rights and content

Background

Assessment of the adverse effects of oxidative stress related to air pollution is limited by the lack of biological markers of dose to the lungs.

Objective

We evaluated the use of exhaled breath condensate (EBC) malondialdehyde as a biomarker of exposure to traffic-related pollution in children with asthma as part of a panel study in Mexico City.

Methods

Standard spirometry and collection of EBC and nasal lavage were performed. Environmental monitoring sites were located within 5 km of the children's homes and schools. Data were analyzed by using generalized estimating equations.

Results

A total of 480 samples of malondialdehyde were obtained from 107 patients with asthma, with a median level of 18.7 (interquartile range [IQR], 12.4-28.7) nmol. Ambient particulates less than 2.5 μg/m3 and ozone levels on the day of sampling were significantly associated with higher malondialdehyde levels. A 14.2-μg/m3 (IQR) increase in 8-hour moving average particulates less than 2.5 μg/m3 in size was associated with a 1.12-nmol increase in malondialdehyde and a 15.9-ppb (IQR) increase in 8-hour moving average ozone with a 1.16-nmol increase in malondialdehyde. Malondialdehyde levels were inversely associated with forced vital capacity and FEV1 and positively associated with IL-8 levels in nasal lavage.

Conclusion

Exhaled breath condensate malondialdehyde was related to both air pollution exposure and changes in lung function and inflammatory markers.

Section snippets

Methods

See this article's Methods in the Online Repository at www.jacionline.org for expanded methodology.

Our study population included 107 children with asthma living in Iztapalapa and Nezahualcoyotl, 2 areas of Mexico City with high population and traffic densities, recruited from the allergy clinic of the Hospital Infantil Federico Gómez. The study was conducted as a panel study from January 28 to October 10, 2004. Children were followed for 8 weeks average (minimum, 2, to maximum, 16 weeks) during

Study population

Table I presents the characteristics of the study population. The mean age of participants was 9.5 years. Fifty-six (52.3%) of the children were classified as having mild intermittent, 27.1% mild persistent, and 19.6% moderate persistent asthma. Eighty-nine (89.9%) of the children had positive skin prick test results, with the most common sensitivities to house dust mite (Dermatophagoides pteronyssinus; 62.6%), cat (Fel d 1; 23.2%), and cockroach (Blatella americana; 12.1%). Malondialdehyde was

Discussion

The results of the current study show that malondialdehyde levels in EBC are increased in relation to increased exposure to traffic-related pollutants. In addition, these increased levels of malondialdehyde are associated with lower lung function and increased levels of the inflammatory cytokine IL-8 in nasal lavage. These data suggest that malondialdehyde level in EBC is a suitable biomarker of effect of traffic-related pollutants and could be used as a noninvasive marker in epidemiologic

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    Supported by the Mexican Sciences and Technology Council, grant no. 38911-M; the National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga; the Global Allergy and Asthma European Network (GA2LEN) project (European Union contract FOODCT-2004-506378); and the Ministry of Education and Science, Spain, SAB2004-0192.

    Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

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