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1Los Angeles Biomedical Research Institute at Harbor-University of California-Los Angeles Medical Center, Torrance, California; 2Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; and 3Pfizer Global Research and Development, Groton, Connecticut
Submitted 29 March 2005 ; accepted in final form 20 May 2005
The exhaled breath condensate (EBC) method represents a new, noninvasive way to detect inflammatory and metabolic markers in the fluid that covers the airways [epithelial lining fluid (ELF)]. However, respiratory droplets represent only a very small and variable fraction of the EBC, most (
99.99%) of which is water vapor. Our objective was to show that ELF concentrations could be calculated from EBC values by using any of three dilutional indicators (urea, total cations, and conductivity) in nine normal and nine chronic obstructive lung disease (COPD) subjects. EBC concentrations of Na+, K+, Ca2+, Mg2+, total cations, urea, and conductivity varied over a 10-fold range among individuals, but concentrations of these constituents (except Ca2+) remained well correlated (r2 = 0.440.83, P < 0.001). Dilution (D) of respiratory droplets in water vapor was calculated by dividing plasma concentrations of the dilutional indicators by EBC concentrations. Estimates of D were not significantly different among these indicators, and urea D averaged 10,800 ± 2,100 (SE) in normal and 12,600 ± 3,300 in COPD subjects. Although calculated Na+ concentrations in the ELF were less than one-half those in plasma, and concentrations of K+, Ca2+, and Mg2+ exceeded those in plasma, total cation concentrations in ELF were not significantly different from those in plasma, indicating that ELF is isotonic in both normal and COPD subjects. EBC amylase concentrations (measured with an ultrasensitive procedure) indicated that saliva represented <10% of the respiratory (ELF) droplets in all but three samples. Dilutional and salivary markers are essential for interpretation of EBC studies.
exhaled breath condensate; osmolality of airway fluid; cations; urea; osmolality
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