Diagnostic utility of exhaled breath condensate analysis in conjunction with specific inhalation challenge in individuals with suspected work-related asthma

Sara Snchez-Vidaurre, Maria Jesus Cruz, Susana Gmez-Olls, Ferran Morell, Xavier Muoz

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    8 Citations (Scopus)

    Abstract

    Background: Establishing the role of exhaled breath condensate (EBC) analysis in work-related asthma (WRA), and more specifically, in conjunction with specific inhalation challenge (SIC), is difficult. Objective: To measure EBC pH, and nitrite/nitrate concentrations before and after SIC in individuals with suspected WRA exposed to either high-molecular-weight (HMW) or low-molecular-weight (LMW) agents and evaluate whether these changes are useful to distinguish between occupational asthma (OA) and work-exacerbated asthma (WEA). Methods: One hundred twenty-five consecutive workers undergoing SIC were enrolled. Exhaled breath condensate was collected at the end of the baseline day and 24 hours after exposure to the offending agent. In all EBC samples, pH was measured, and nitrite and nitrate concentrations were determined. Results: Specific inhalation challenge was positive in 66 individuals, who were then diagnosed with OA. Work-exacerbated asthma was diagnosed in 14, and in 45 patients establishing a direct relationship between the symptoms and work exposure was not possible. In patients with WEA, EBC pH values after SIC were significantly lower than those before SIC (P =.0047). Using the receiver operating characteristic (ROC) curve, we found that an EBC pH decrease of greater than 0.4 units after SIC achieved the most satisfactory sensitivity 79% (confidence interval [CI]: 4994) and specificity of 100% (CI: 68100), considering only patients with asthma and without OA. A decrease in EBC pH of 0.4 or more common in those exposed to HMW agents (8/19, 42%) than in those exposed to LMW agents (7/47, 15%). Conclusions: Exhaled breath condensate pH in conjunction with SIC may be useful for diagnosing WEA. © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
    Original languageEnglish
    Pages (from-to)151-156
    JournalAnnals of Allergy, Asthma and Immunology
    Volume108
    Issue number3
    DOIs
    Publication statusPublished - 1 Mar 2012

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