Tuberc Respir Dis > Epub ahead of print
DOI:    [Epub ahead of print]
Published online October 12, 2023.
Roles of Inflammatory Biomarkers in Exhaled Breath Condensates in Respiratory Clinical Fields
Yong Jun Choi, M.D.1  , Min Jae Lee, M.D.1  , Min Kwang Byun, M.D., Ph.D.1, Sangho Park, B.S.1, Jimyung Park, M.D., Ph.D.2, Dongil Park, M.D., Ph.D.3, Sang-Hoon Kim, M.D., Ph.D.4, Youngsam Kim, M.D., Ph.D.5, Seong Yong Lim, M.D., Ph.D.6, Kwang Ha Yoo, M.D., Ph.D.7, Ki Suck Jung, M.D., Ph.D.8, Hye Jung Park, M.D., Ph.D.1
1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
3Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
4Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea
5Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
7Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Republic of Korea
Correspondence:  Hye Jung Park, Tel: 82-2-2019-3302, 
Received: 4 March 2023   • Revised: 12 August 2023   • Accepted: 3 October 2023
*Yong Jun Choi and Min Jae Lee contributed equally to this study as co-first authors.
Exhaled condensates contain inflammatory biomarkers; however, their roles in the clinical field have been under-investigated.
We prospectively enrolled subjects admitted to pulmonology clinics. We collected exhaled breath condensates (EBC) and analysed the levels of six and 12 biomarkers using conventional and multiplex enzyme-linked immunosorbent assay, respectively.
Among the 123 subjects, healthy controls constituted the largest group (81 participants; 65.9%), followed by the preserved ratio impaired spirometry group (21 patients; 17.1%) and the chronic obstructive pulmonary disease (COPD) group (21 patients; 17.1%). In COPD patients, platelet derived growth factor-AA exhibited strong positive correlations with COPD assessment test (ρ=0.5926, p=0.0423) and COPD-specific version of St. George’s Respiratory Questionnaire (SGRQ-C) score (total, ρ=0.6725, p=0.0166; activity, ρ=0.7176, p=0.0086; and impacts, ρ=0.6151, p=0.0333). Granzyme B showed strong positive correlations with SGRQ-C score (symptoms, ρ=0.6078, p=0.0360; and impacts, ρ=0.6007, p=0.0389). Interleukin 6 exhibited a strong positive correlation with SGRQ-C score (activity, ρ=0.4671, p=0.0378). The absolute serum eosinophil and basophil counts showed positive correlations with pro-collagen I alpha 1 (ρ=0.6735, p=0.0164 and ρ=0.6295, p=0.0283, respectively). In healthy subjects, forced expiratory volume in 1 second (FEV1)/forced vital capacity demonstrated significant correlation with CC chemokine ligand 3 (CCL3)/macrophage inflammatory protein 1 alpha (ρ=0.3897 and p=0.0068). FEV1 exhibited significant correlation with CCL11/eotaxin (ρ=0.4445 and p=0.0017).
Inflammatory biomarkers in EBC might be useful to predict quality of life concerning respiratory symptoms and serologic markers. Further studies are needed.
Key Words: Exhaled Condensates, Chronic Obstructive Pulmonary Disease, Lung Function Test, Eosinophils

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