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1 Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Medicine, Medical College of Wisconsin, Milwaukee, CA, USA
2 Pfizer Global REsearch and Development, Groton, Connecticut, USA
3 Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
4 Department of Medicine, Medical College of Wisconsin, Milwaukee, CA, USA
* To whom correspondence should be addressed. E-mail: reffros{at}labiomed.org.
The exhaled breath condensate (EBC) method represents a new, non-invasive 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 3 dilutional indicators (urea, total cations and conductivity) in 9 normal and 9 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 Ca++) remained well correlated (r2 = 0.44 to 0.83, 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 Durea averaged 10,800 ± 2,100 (sem) in normal and 12,600 ± 3,300 in COPD subjects. Although calculated Na+ concentrations in the ELF were less than 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 less than 10% of the respiratory (ELF) droplets in all but 3 samples. Dilutional and salivary markers are essential for interpretation of EBC studies.
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