Source: Annual Congress 2006 - Pneumonia and other invasive pulmonary infections in children

Abstract

Rationale: The alveolar infiltrate in pneumonia is characterized by a high number of activated neutrophils, for which leukotriene B4 (LTB4) is a strong activating and chemotactic agent. Exhaled breath condensate (EBC) is a safe and non-invasive technique that allows the study of lower airways. The present study was conducted to measure EBC LTB4 as a potential non-invasive marker of the inflammatory response which occurs in community acquired pneumonia (CAP).
Methods: 11 children with CAP were recruited. They underwent physical examination, chest X-ray and a blood sample was drawn to measure leukocyte count and C-reactive protein. Moreover, children performed spirometry and EBC collection using a refrigerating system supplied with disposable device (Turbo DECCS, Parma, Italy). EBC collection and spirometry were repeated after one week of antibiotic therapy and one month later. LTB4 levels were assessed using an EIA system (Amersham Biosciences).
Results: LTB4 EBC concentrations were increased in the acute phase of CAP (mean + SEM: 14.8 + 2.0 pg/ml) and decreased significantly after one week of antibiotic therapy (6.0 + 1.4 pg/ml, p<0.001). No further reduction was demonstrated one month later (5.4 + 1.7 pg/ml, p=ns). Spirometry demonstrated a restrictive pattern in the acute phase (mean FEV1 67% pred, mean FVC 65% pred) and improved significantly one week later (mean FEV1 81% pred, mean FVC 81% pred, p<0.01).
Conclusion: LTB4 concentrations are increased in EBC of children with CAP and decrease after a course of antibiotic therapy. Our findings suggest that LTB4 is involved in the inflammatory response which characterizes CAP. EBC may represent a new approach to study the pathophysiology of deep lung infections.

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Citations should be made in the following way:
S. Carraro, B. Andreola, L. Da Dalt, S. Callegaro, R. Alinovi, C. Corradi, E. Baraldi (Padova, Parma, Italy). Exhaled leukotriene B4 and community acquired pneumonia in children. Eur Respir J 2006; 28: Suppl. 50, 1795

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