Bronchopulmonary disease in cystic fibrosis (CF) is coupled with neutrophilic inflammation. Leukotriene (LT) B4 is an important chemoattractant for neutrophilic leukocytes.
Supplementation with n-3 polyunsaturated fatty acids (PUFA) leads to synthesis of biologically less active LTB5. The aim of this study was to compare inflammatory markers (pH and LTB4) in exhaled breath condensate (EBC) in stable CF and healthy controls, to evaluate their relation to lung function, nutritional status and systemic inflammatory markers, and also to assess the effect of supplementation with n-3 PUFA.
Twelve stable CF patients (5 males) with a mean age of 25.6 years had higher concentrations of EBC LTB4 (174.6 vs. 82.6 pg/ml; p = 0.011) and insignificantly lower values of EBC pH (5.95 VS. 6.13) when compared with healthy controls (n = 12; 4 males; mean age 27.3 years). In CF patients, EBC LTB4 concentration correlated with serum C-reactive protein concentration (r = 0.629; p = 0.028) and EBC pH value correlated with the body mass index (r = 0.639; p = 0.025) and blood neutrophil granulocytes count (r = -0.686; p = 0.014).
After six weeks of n-3 PUFA supplementation (doses corresponding to 1.3 % of calorie intake), nine CF patients had higher EBC pH values (6.08 vs. 6.32; p = 0.042) and insignificantly lower EBC LTB4 concentration (173.0 vs. 120.5 pg/ml). We conclude that CF patients have more pronounced inflammatory parameters in EBC when compared with healthy controls.
EBC inflammatory parameters correlated with systemic inflammatory markers. After n-3 PUFA treatment, EBC LTB4 concentration tended to be lower and EBC was significantly less acid, which may reflect less intense neutrophilic inflammation.