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The Effect Of Envıronmental Tobacco Smoke On The Quantıty Of Oxıdant/Antıoxıdant Markers In Exhaled Breath Condensate

The Effect Of Envıronmental Tobacco Smoke On The Quantıty Of Oxıdant/Antıoxıdant Markers In Exhaled Breath Condensate 1 Doruk S, 2 Ozyurt H, 1 Inonu H, 3 Erkorkmaz U, 2 Saylan O, 1 Seyfikli Z Gaziosmanpasa University Departmant of 1 Pulmonary Medicine,

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The Effect Of Envıronmental Tobacco Smoke On The Quantıty Of Oxıdant/Antıoxıdant Markers In Exhaled Breath Condensate

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  1. The Effect Of Envıronmental Tobacco Smoke On The Quantıty Of Oxıdant/Antıoxıdant Markers In Exhaled Breath Condensate 1Doruk S, 2Ozyurt H, 1Inonu H, 3Erkorkmaz U, 2Saylan O, 1Seyfikli Z Gaziosmanpasa University Departmant of 1Pulmonary Medicine, 2Biochemistry, 3Bioistatistics ,Tokat, Turkey *Supportedbythe ‘Committe of ScientificInvestigation of GaziosmanpasaUniversity’

  2. Cigarette smoking most common type of tobacco use In 2020; expected to nine million deaths annually World Health 2002, 2003 Report

  3. Cigarette smoke (CS) is a complex mixture of chemical compounds, in which high concentrations of free radicals and other oxidants contain more than 1016-1017 oxidant molecules per puff and affects antioxidant defense of the lungs Inbalance between oxidant and antioxidant activities; increased oxidative stress in the lungs Macnee and Rahman 1999, Reddy 2002, Puri 2008, Mak 2008, Mates 1999

  4. Enzymatic antioxidants; Superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) Nonenzymatic antioxidants; Vitamin C (Vit C), Vitamin E (Vit E) Toxic products associated with lipid peroxidation; Malondialdehyde (MDA) and nitric oxid (NO) (They react with protein and DNA. NO is also one of the major reactive oxygen species in CS) Mak 2008, Mccall and Frei 1999, Abuja and Albertini 2001, Kanabrocki 2006, Rahman 2005

  5. 8-OHdG; An alternative biomarker of oxidative DNA damage associated with chemical exposure demonstrates the balance between DNA formation and repair Kanabrocki 2006, Pilger and Rüdiger 2006, Halliwell 1999

  6. Oxidative stress in smokers may be critical for the inflammatory response to CS The detection of oxidant/antioxidant markers may reflect the affect of CS on the oxidative-antioxidative balance in lungs Macnee and Rahman 1999,Morrow 1995

  7. Oxidative stress markers; in the epithelial lining fluid (ELF), breath, urine and blood Several antioxidants (SOD, GSH-Px, vitamins) are present in the lungs. These antioxidants provide a first line defense against inhaled, also endogenously produced oxidants Macnee and Rahman 1999, Mak and Chan-Yeung 2006, Cross 1994, van der Viliet 1999, Abuja and Albertini 2001

  8. AIM To investigate the oxidative and antioxidative activities in lungs associated with TS exposure via measurement of the levels of MDA, NO, 8-OHdG, SOD, GSH-Px, Vit E and Vit C in EBC samples

  9. Group I: Current smokers who were defined by a history of cigarette smoking ≥ 7 pack/years (n=26) Group II: Nonsmokers, but had ETS more than 3 hours in a day in his/her house/workplace/Turkish coffeehouse (n=21) Group III: Nonsmokers, without ETS exposure in any where (n=22) Fidan 2005

  10. EXCLUSION CRITERIA • Atopy • Chronic pulmonary diseases (asthma, COPD, bronchiectasis) • Systemic diseases • (diabetes mellitus regulated with insulin, chronic renal failure, • collagen vasculary disases, inflamatory bowel diseases • Gastroeosephagial reflux • Upper respiratory tract infection within in the last 2 weeks • Previous or concurrent use of vitamins • Cancer

  11. Exhaled Breath Condansate (EBC) To breath at a normal frequency and tidal volume, wearing a noseclip, for a period of 15 minutes through a mouthpiece and a two way non-rebreathing valve The collected condensate samples was at least 2 ml and stored at –70°C Breath condensate collector

  12. Measurements of Oxidative and Antioxidative Markers Total SOD(U/mL); Sun et al. GSH-Px (U/L); Paglia and Valentine MDA (µmol/L); Esterbaur and Cheeseman NO (µmol/L); Cortas and Wakid 8-OHdG (ng/ml); ELISA Vit C (µgram/dl); Chromsystems Diagnostic Test, HPLC (High Performance Liquid Chromatography) Vit E (µmol/L); HPLC Sun 1988, Paglia and Valentine 1967, Esterbaur and Cheeseman 1990, Cortas and Wakid 1990

  13. Pulmonary Functıon Tests (PFTs): to exclude obstructive pulmonary diseases, to determine differences between the groups Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, maxium mean expiratory flow (MMEF) rates were expressed Quanjer 1993

  14. *p=0.005 **p=0.126 FEV1 and FVC were lower in smokers than nonsmokers, FEV1/FVC and MMEF similar

  15. p<0,001 p<0,001

  16. p=0,760 p<0,001

  17. p<0,001 p<0,001

  18. p<0,05 p<0,05

  19. A positive correlation (0.241); SOD and FEV1(L) A negative correlation (-0.305); 8-OHdG and FEV1 (L) A negative correlation (-0.298); 8-OHdG and MMEF (%) (p<0.05)

  20. Induced sputum, BAL fluid or bronchial biopsy are used for direct assesments of airway inflammation EBC is the liquid phase of the exhaled air sampled by cooling. Collection of EBC is noninvasive method andcan reflect acid/oxidative stress and inflammation ATS/ERS 2003, Hoffmeyer 2009

  21. Acute smoke exposure; increases the products of lipid peroxidation MDA is the most mutagenic product of lipid peroxidation and can be determined in serum, BALF, and tissues Increased levels of MDA may be associated with current smoking status Bloomer ; higher MDA levels in smokers than nonsmokers MDA levels were higher in smokers than nonsmokers. The levels of MDA in ETS exposed group were higher than that ETS nonexposed group ETS exposure may cause the initiation of oxidant damage in lungs van der Vaart 2004, Kanabrocki 2006, Petruska 1990, Kelly 1996, Rumley 2004, Bloomer 2007

  22. NO levels decrease in smokers. This reduction is reversible, NO levels increase after smoking cessation In our study the highest NO levels were determined in Group III, the lowest NO levels were detected in smokers We did not detect any correlation between NO levels and PFT’s. This result could be associated with reverseble decrease in NO levels Kharitonov 1995, Robbins 1997

  23. Smoking; increased level of 8-OHdGin lung tissue Howard; 8-OHdG increases in blood in subjects with ETS exposure 8-OHdG levels in smokers were significiantly higher than nonsmokers, ETS exposure did not affect 8-OHdG levels. A negative correlation was revealed between FEV1, MMEF and 8-OHdG levels This outcome may be indicated the development of DNA damage in healthy individuals with normal PFTs Asami 1997, Chen 2007, Howard 1998

  24. Patel; GSH-Px levels were higher in smokers than nonsmokers Hilbert; smoking is associated with increased activities of GSH-Px in BALF cells Valenca; GSH-Px activity in BAL fluid/blood increases with TS exposure Yildiz; GSH-Px activity is higher in healty control than active/passive smokers GSH-Px activity were higher than nonsmokers. We did not dedect difference between groups with or without ETS exposure Patel 2005, Hilbert and Mohsenin 1996, Valenca 2008, Yildiz 2002

  25. ▪Vit C; the most abundant antioxidant substance in the extracellular lining fluid of the lung and inhibits lipid peroxidation ▪ Repine, Lykkesfeldt; smokers have lower serum levels of Vit C and Vit E ▪ Hilbert, Pacth; smokers have higher Vit E levels in BALF ▪ Rahman; reduced levels of Vit E in the BALF of smokers ▪Pacht; Vit E levels was undetectable (<2 ng/ml) in the BALF of smokers Martin and Frei 1997, Slade 1993, Eiserich 1995, Repine 1997, Lykkesfeldt 1997, Hilbert and Mohsenin 1996, Pacth 1986, Rahman and Macnee 1996

  26. The cut-off value was foe Vit E was 0.58 µmol/L in this study, we could not determine Vit E levels Schock; the cut-off value for Vit E in BALF was 0.0028 µmol/L Inability of measurement Vit E levels might be due to high cut-off value Hilbert, Rahman; increase in Vit C levels in the BALF of smokers We did not find difference between the groups Schock 2003, Hilbert and Mohsenin 1996, Rahman and Macnee 1996

  27. Valenca; SOD activity is higher in BALF and lung homogenates of the mice exposed to CS Melloni; ≤ normal SOD in BALF from smokers DiSilvistro; SOD activity is lower in smokers Valence 2008, DiSilvistro 1998, Melloni 1996, Yildiz 2002

  28. In present study; SOD activity was highest in smokers SOD activity was higher in cases with ETS exposure than nonexposed group but this difference is not significiant A positive correlation between SOD levels and FEV1 were detected This finding might demonstrate the contribution of decrease in the activity of the antioxidant marker SOD on decrease in FEV1

  29. CONCLUSION ▪ SOD, MDA and GSH-Px may be useful markers of oxidative stress in the lung inflammation induced by exposure to CS ▪ ETS exposure alters the levels of NO and MDA which reflect oxidative state ▪ Increased levels of 8-OHdG which reflect DNA damage developed as a result of CS exposure in cases with normal PFTs. These higher levels of 8-OHdG may be an early of respiratory tract diseases in the future

  30. BALLICA CAVE, TOKAT, TURKIYE

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