Correlation of exhaled breath temperature with bronchial blood flow in asthma

Paolo Paredi, Sergei A Kharitonov, Peter J Barnes, Paolo Paredi, Sergei A Kharitonov, Peter J Barnes

Abstract

In asthma elevated rates of exhaled breath temperature changes (Deltae degrees T) and bronchial blood flow (Qaw) may be due to increased vascularity of the airway mucosa as a result of inflammation.We investigated the relationship of Deltae degrees T with Qaw and airway inflammation as assessed by exhaled nitric oxide (NO). We also studied the anti-inflammatory and vasoactive effects of inhaled corticosteroid and beta2-agonist.Deltae degrees T was confirmed to be elevated (7.27 +/- 0.6 Delta degrees C/s) in 19 asthmatic subjects (mean age +/- SEM, 40 +/- 6 yr; 6 male, FEV1 74 +/- 6 % predicted) compared to 16 normal volunteers (4.23 +/- 0.41 Delta degrees C/s, p < 0.01) (30 +/- 2 yr) and was significantly increased after salbutamol inhalation in normal subjects (7.8 +/- 0.6 Delta degrees C/ s, p < 0.05) but not in asthmatic patients. Qaw, measured using an acetylene dilution method was also elevated in patients with asthma compared to normal subjects (49.47 +/- 2.06 and 31.56 +/- 1.6 mul/ml/min p < 0.01) and correlated with exhaled NO (r = 0.57, p < 0.05) and Deltae degrees T (r = 0.525, p < 0.05). In asthma patients, Qaw was reduced 30 minutes after the inhalation of budesonide 400 mug (21.0 +/- 2.3 mul/ml/min, p < 0.05) but was not affected by salbutamol.Deltae degrees T correlates with Qaw and exhaled NO in asthmatic patients and therefore may reflect airway inflammation, as confirmed by the rapid response to steroids.

Figures

Figure 1
Figure 1
Method for the measurement of bronchial blood flow (Qaw). Subjects inhale 60% of their vital capacity from a reservoir containing acetylene 0.3% and then exhale into a mass spectrometer (Panel A). Panel B shows a tracing of acetylene, the area under the curve, corresponding to the conducting airways, is proportional to airway blood flow.
Figure 2
Figure 2
Levels of bronchial blood flow (Qaw) (Panel A) and exhaled breath temperature gradients (Δe°T) (Panel B) in normal subjects (□) and patients with asthma (•).
Figure 3
Figure 3
Correlation of bronchial blood flow (Qaw) with exhaled nitric oxide (NO) (Panel A) and exhaled breath temperature gradients (Δe°T) (Panel B) in patients with asthma.
Figure 4
Figure 4
Acute effect of budesonide inhalation (400 μg) (Panel A) and salbutamol (200 μg) (Panel B) on bronchial blood flow (Qaw).
Figure 5
Figure 5
Acute effect of budesonide inhalation (400 μg) (Panel A) and salbutamol (200 μg) (Panel B) on exhaled breath temperature gradients (Δe°T).

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