Leukotrienes and 8-isoprostane in exhaled breath condensate of children with stable and unstable asthma

Background: Cysteinyl-leukotrienes (cys-LTs) and 8-isoprostane are biomarkers of airway inflammation and oxidative stress. Objective: The aim of this study was to evaluate cys-LT and 8-isoprostane levels in exhaled breath condensate (EBC) of children with different degrees of asthma severity. Methods: EBC was collected from 14 steroid-naive children with mild persistent asthma, 13 children with stable mild-to-moderate persistent asthma treated with inhaled corticosteroids (ICS), 9 ICS-treated children with unstable asthma, and 19 healthy children. Results: In the three groups of asthmatic children, EBC concentrations of cys-LTs and 8-isoprostane were significantly higher than in control children (steroid-naive asthmatic children: cys-LTs median, 10.8 pg/mL, P < .001, 8-isoprostane, 16.2 pg/mL, P < .001; ICS-treated stable asthmatic children: cys-LTs , 12.7 pg/mL, P < .001, 8-isoprostane, 18.1 pg/mL, P < .001; children with unstable asthma: cys-LTs, 106.0 pg/mL, P < .01, 8-isoprostane, 29.7 pg/mL, P < .01; control children: cys-LTs,, 4.3 pg/mL, 8-isoprostane, 3.5 pg/mL). Cys-LT levels were higher in children with unstable asthma than in the other two asthmatic groups (P < .05). FENO levels were significantly higher in steroid-naive and in children with unstable asthma compared with ICS-treated children with stable asthma (P < .01). Conclusions: Our study shows that EBC cys-LTs and 8-iso-prostane concentrations are higher in asthmatic children than in healthy control children, with scattered values in patients with unstable asthma. These findings suggest that EBC eicosanoid measurement may have useful clinical implications for investigating phenotype differences among asthmatic patients.