Increased Blood Carboxyhaemoglobin Concentrations in Inflammatory Pulmonary Diseases

Overview

Journal Thorax

Date 2002 Aug 30

PMID 12200522

Citations 22

Authors

H Yasuda

M Yamaya

M Yanai

T Ohrui

H Sasaki

Affiliations

Soon will be listed here.

Abstract

Background: Exhaled carbon monoxide has been reported to increase in inflammatory pulmonary diseases and to be correlated with blood carboxyhaemoglobin (Hb-CO) concentration. A study was undertaken to determine whether arterial blood Hb-CO increases in patients with inflammatory pulmonary diseases.

Methods: The Hb-CO concentration in arterial blood was measured with a spectrophotometer in 34 normal control subjects, 24 patients with bronchial asthma, 52 patients with pneumonia, and 21 patients with idiopathic pulmonary fibrosis (IPF).

Results: The mean (SE) Hb-CO concentrations in patients with bronchial asthma during exacerbations (n=24, 1.05 (0.05)%), with pneumonia at the onset of illness (n=52, 1.08 (0.06)%), and with IPF (n=21, 1.03 (0.09)%) were significantly higher than those in control subjects (n=34, 0.60 (0.07)%) (mean difference 0.45% (95% confidence interval (CI) 0.23 to 0.67), p<0.01 in patients with bronchial asthma, mean difference 0.48% (95% CI 0.35 to 0.60), p<0.0001 in patients with pneumonia, and mean difference 0.43% (95% CI 0.26 to 0.61) p<0.001 in patients with IPF). In 20 patients with bronchial asthma the Hb-CO concentration decreased after 3 weeks of treatment with oral glucocorticoids (p<0.001). In 20 patients with pneumonia the Hb-CO concentration had decreased after 3 weeks when patients showed evidence of clinical improvement (p<0.001). The values of C-reactive protein (CRP), an acute phase protein, correlated with Hb-CO concentrations in patients with pneumonia (r=0.74, p<0.0001) and in those with IPF (r=0.46, p<0.01). In patients with bronchial asthma changes in Hb-CO concentrations were significantly correlated with those in forced expiratory volume in 1 second (FEV(1)) after 3 weeks (r=0.67, p<0.01). Exhaled carbon monoxide (CO) concentrations were correlated with Hb-CO concentrations (n=33, r=0.80, p<0.0001).

Conclusions: Hb-CO concentrations are increased in inflammatory pulmonary diseases including bronchial asthma, pneumonia, and IPF. Measurement of arterial Hb-CO may be a useful means of monitoring pulmonary inflammation.

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References

Uasuf C, Jatakanon A, James A, Kharitonov S, Wilson N, Barnes P . Exhaled carbon monoxide in childhood asthma. J Pediatr. 1999; 135(5):569-74. DOI: 10.1016/s0022-3476(99)70054-5. View

Monma M, Yamaya M, Sekizawa K, Ikeda K, Suzuki N, Kikuchi T . Increased carbon monoxide in exhaled air of patients with seasonal allergic rhinitis. Clin Exp Allergy. 1999; 29(11):1537-41. DOI: 10.1046/j.1365-2222.1999.00684.x. View

Antuni J, Kharitonov S, Hughes D, Hodson M, Barnes P . Increase in exhaled carbon monoxide during exacerbations of cystic fibrosis. Thorax. 2000; 55(2):138-42. PMC: 1745687. DOI: 10.1136/thorax.55.2.138. View

Togores B, Bosch M, Agusti A . The measurement of exhaled carbon monoxide is influenced by airflow obstruction. Eur Respir J. 2000; 15(1):177-80. DOI: 10.1183/09031936.00.15117700. View

Vreman H, Wong R, Stevenson D . Exhaled carbon monoxide in asthma. J Pediatr. 2000; 137(6):889-91. DOI: 10.1067/mpd.2000.107625. View

Crystal R, Fulmer J, Roberts W, Moss M, Line B, Reynolds H . Idiopathic pulmonary fibrosis. Clinical, histologic, radiographic, physiologic, scintigraphic, cytologic, and biochemical aspects. Ann Intern Med. 1976; 85(6):769-88. DOI: 10.7326/0003-4819-85-6-769. View

Jarvis M, Russell M, Saloojee Y . Expired air carbon monoxide: a simple breath test of tobacco smoke intake. Br Med J. 1980; 281(6238):484-5. PMC: 1713376. DOI: 10.1136/bmj.281.6238.484. View

Crystal R, Bitterman P, Rennard S, HANCE A, Keogh B . Interstitial lung diseases of unknown cause. Disorders characterized by chronic inflammation of the lower respiratory tract (first of two parts). N Engl J Med. 1984; 310(3):154-66. DOI: 10.1056/NEJM198401193100304. View

Hariharan M, VanNoord T, Greden J . A high-performance liquid-chromatographic method for routine simultaneous determination of nicotine and cotinine in plasma. Clin Chem. 1988; 34(4):724-9. View

10.

Kohno N, Kyoizumi S, Awaya Y, Fukuhara H, Yamakido M, Akiyama M . New serum indicator of interstitial pneumonitis activity. Sialylated carbohydrate antigen KL-6. Chest. 1989; 96(1):68-73. DOI: 10.1378/chest.96.1.68. View

11.

Henderson F, Reid H, Morris R, Wang O, Hu P, HELMS R . Home air nicotine levels and urinary cotinine excretion in preschool children. Am Rev Respir Dis. 1989; 140(1):197-201. DOI: 10.1164/ajrccm/140.1.197. View

12.

Keyse S, Applegate L, Tromvoukis Y, Tyrrell R . Oxidant stress leads to transcriptional activation of the human heme oxygenase gene in cultured skin fibroblasts. Mol Cell Biol. 1990; 10(9):4967-9. PMC: 361123. DOI: 10.1128/mcb.10.9.4967-4969.1990. View

13.

Cantoni L, Rossi C, RIZZARDINI M, Gadina M, Ghezzi P . Interleukin-1 and tumour necrosis factor induce hepatic haem oxygenase. Feedback regulation by glucocorticoids. Biochem J. 1991; 279 ( Pt 3):891-4. PMC: 1151529. DOI: 10.1042/bj2790891. View

14.

McCormack D, Paterson N . Loss of hypoxic pulmonary vasoconstriction in chronic pneumonia is not mediated by nitric oxide. Am J Physiol. 1993; 265(5 Pt 2):H1523-8. DOI: 10.1152/ajpheart.1993.265.5.H1523. View

15.

Kharitonov S, Yates D, Robbins R, Shinebourne E, Barnes P . Increased nitric oxide in exhaled air of asthmatic patients. Lancet. 1994; 343(8890):133-5. DOI: 10.1016/s0140-6736(94)90931-8. View

16.

Persson M, Zetterstrom O, Agrenius V, Ihre E, Gustafsson L . Single-breath nitric oxide measurements in asthmatic patients and smokers. Lancet. 1994; 343(8890):146-7. DOI: 10.1016/s0140-6736(94)90935-0. View

17.

Nathan C, Xie Q . Regulation of biosynthesis of nitric oxide. J Biol Chem. 1994; 269(19):13725-8. View

18.

Kovacs E, DiPietro L . Fibrogenic cytokines and connective tissue production. FASEB J. 1994; 8(11):854-61. DOI: 10.1096/fasebj.8.11.7520879. View

19.

SCHLESINGER M . How the cell copes with stress and the function of heat shock proteins. Pediatr Res. 1994; 36(1 Pt 1):1-6. DOI: 10.1203/00006450-199407001-00001. View

20.

Kim Y, Bergonia H, Muller C, Pitt B, Watkins W, Lancaster Jr J . Loss and degradation of enzyme-bound heme induced by cellular nitric oxide synthesis. J Biol Chem. 1995; 270(11):5710-3. DOI: 10.1074/jbc.270.11.5710. View