Interleukin-6 is increased in breath condensate of patients with non-small cell lung cancer.

Despite recent advances in the diagnosis and treatment of non-small cell lung cancer (NSCLC), most patients still present with advanced stage disease at the time of diagnosis. Recent studies suggest that IL-6 is involved in the development of lung cancer. The aim of the present study was to investigate whether the measurement of IL-6 levels in the breath condensate of NSCLC patients could be used to bring forward the moment of diagnosis and to monitor the progression of the disease. Twenty patients with histological evidence of NSCLC (14 men and 6 women, age 63+/-8 years) and 15 healthy controls (8 men and 7 women, age 45+/-6 years) were enrolled in the study. IL6 was measured in the exhaled breath condensate of patients and controls by means of a specific enzyme immunoassay kit. Higher concentrations of exhaled IL-6 were found in NSCLC patients (9.6+/-0.3 pg/mL) than in controls (3.5+/-0.2 pg/mL). A statistically significant difference was observed between patients with NSCLC at different stages: higher concentrations of IL-6 (10.9+/-0.5 pg/mL) were found in patients with metastatic disease than in those with stage III (9.7+/-0.4 pg/mL), stage II (8.9+/-0.3 pg/mL) and stage I disease (7.9+/-0.3 pg/mL). These findings suggest that the measurement of IL-6 in the breath condensate of patients with NSCLC could be proposed as a parameter to take into account in early diagnosis and disease monitoring.

[Pulmonary surfactants]. / I surfactanti polmonari

Reference is made to classic studies pointing to the existence of lung surfactants in the alveolar lining layer and more recent investigations of their chemical nature. Attention is also given to work on biochemical and lung elasticity modifications caused by the employment of various drugs.

[Position of cyticholine in pneumologic therapy]. / La posizione della citicolina nella terapia pneumologica

The position of cyticholine in lung lipid metabolism and hence in pneumological therapy (the subject of a personal hypothesis) is discussed. A summary is given of personal experimental work and papers read at the 1974 Padua meeting (11th December) held by the Societas Europae Physiologiae Clinicae Respiratoriae. It is shown that cyticholine may: 1) prevent the onset of acute neonatal respiratory distress; 2) improve chronic pneumogenous respiratory insufficiency; 3) prevent postoperative hypoventilation; 4) improve ventilation mechanics in hyperelastic lung syndromes; 5) increase the gas permeability of the air-blood barrier; 6) counterbalance the loss of surfactants caused by endobronchial aspiration in patients with tracheal tubes.

[Use of 48/80 in the diagnosis and therapy of allergic asthma]. / L'impiego del 48/80 nella diagnosi e nella terapia dell'asma allergica

A review of the relevant literature is followed by the presentation of experimental and clinical results obtained with intradermal administration of the histamine releaser 48/80. The value of this substance in the diagnosis and treatment of bronchial asthma is stressed.

[Prognostic evaluation of cardiorespiratory insufficiency in chronic bronchitis]. / Valutazione prognostica della insufficienza cardiorespiratoria nella bronchite cronica

The course of chronic bronchitis is examined with particular stress on the most important clinical and functional factors for the purposes of the prognostic judgment on the disease. Phenomena of reoccurrence of cardiorespiratory insufficiency are also examined.

Chlamydia pneumoniae infection in Italian patients.

Of 91 adult patients with respiratory tract infections, 13 (14%) had serological evidence of recent infection with Chlamydia pneumoniae. The clinical picture was consistent with asthmatic bronchitis in three patients, whilst exacerbations of chronic obstructive pulmonary disease were present in five subjects and, pneumonia was diagnosed in the remaining five. Our findings provide evidence of an aetiological association between C. pneumoniae and respiratory infections in our region (Bari, South Italy).

[Epidemiology and diagnosis of tuberculosis]. / Epidemiologia e diagnosi della tubercolosi.

Major epidemiological aspects of tuberculosis, a worldwide diffuse disease, are examined with regard to socio-economical consequences in different countries. These data are compared with the latest statistical informations collected in Italy. Although incidence and prevalence of tuberculosis in our country are constantly decreasing, the disease is still a problem both from the diagnostic and therapeutic point of view and from the social one, also in view of the diminished surveillance on the disease. Diagnostic aspects of tuberculosis are also discussed, and the present rarity of some clinical forms (miliary tbc, caseating pneumonia) is emphasized.

[The place of citicolin in pulmonological therapy (author's transl)]. / Citicolin in der pulmonologischen Therapie

Citicolin, a psychodrug, is usually used for the treatment of ischemic cerebropathies. Its introduction into pulmonological therapy is suggested because Citicolin has the following properties: 1. Prevention of "acute respiratory distress syndrome" in neonates. 2. Improvement of chronic respiratory insufficiency. 3. Prevention of postoperative hypoventilation syndrome. 4. Improvment of respiratoy mechanics in syndromes with hyperelasticity of the lungs. 5. Recovery of permeability of the alveolo-capillary barrier for gases. 6. Compensation of the loss of surface-active substances after endobronchial aspiration of intubated patients.

[Changes in spirometric values induced by nasally administered beclomethasone dipropionate in patients with perennial allergic rhinitis]. / Modificazione dei valori spirometrici indotti dal beclometasone dipropionato per via nasale in pazienti con rinite allergica perenne.

Authors showed that it's possible to control the asthmatic component in patients with persistent allergical rhinitis without bronchodilatory drugs. AA. compared two groups of ten patients: Group A has been treated with antihystaminical drugs or ketotifen per os and Disodium chromoglycate per nasal spray, Group B has been treated with the same drugs and Beclomethasone Dipropionate per nasal spray more (400 mcg a day). Respiratory functionality tests (FEV1 and MEF75) have been carried out at the beginning and at the end of the trial and the subsequent clinical parameters have been considered: dispnoea attacks, rhinorrhaea, sneezes, lost working or school days. The results of the study showed after three months of therapy a statistically significant improvement of FEV1 and MEF75 in Group B only; moreover the patients of the Group B had lower number of asthmatic attacks then patients of the Group A.

Endothelin-1 is increased in the breath condensate of patients with non-small-cell lung cancer.

UNLABELLED: One recent line of cancer research is currently directed to the study of growth factors. Of increasing interest is endothelin-1 (ET-1), a mitogenic factor already investigated in several human cancer cell lines, which has been found to participate in the development and progression of tumours. This peptide has an important role also in non-small-cell lung cancer (NSCLC) where ET-1 expression has been found in 100% of cell lines. OBJECTIVES: The aim of this study was to measure ET-1 concentrations in the airways of patients with NSCLC using a completely non-invasive procedure--the breath condensate--and to verify the involvement of this peptide in the growth of lung tumours. METHODS: We enrolled 30 patients (17 men, median age 63 years; range 53-74) with histological evidence of NSCLC and 15 healthy controls (9 men, median age 59 years; range 52-70). ET-1 was measured in the exhaled breath condensate by means of a specific enzyme immunoassay kit. RESULTS: Higher concentrations of exhaled ET-1 were found in NSCLC patients (8.3 +/- 0.7 pg/ml) compared to controls (5.2 +/- 0.5 pg/ml, p < 0.0001). A statistically significant difference was observed between patients with distant metastases (stage IV) of NSCLC (8.9 +/- 0.6 pg/ml) and those with locoregional disease (stage I-III) (7.9 +/- 0.5 pg/ml). A significant reduction in ET-1 levels was found in 14 patients after surgical removal of the tumour either associated with or without adjuvant chemotherapy (6.3 +/- 0.5 vs. 7.9 +/- 0.4 pg/ml, p < 0.0001). CONCLUSIONS: These findings suggest that the measurement of ET-1 in the breath condensate of patients with NSCLC could be proposed as a marker for early detection of NSCLC as well as for monitoring reduction or progression of the neoplasm in the follow-up of treated patients.

Supplementary oxygen in healthy subjects and those with COPD increases oxidative stress and airway inflammation.

BACKGROUND: Hyperoxia increases oxidative stress through the generation of reactive oxygen species and may therefore enhance inflammation in the lungs. The aim of this study was to investigate whether short term supplementary oxygen (28%) increases oxidative stress and inflammation in the airways by measuring 8-isoprostane and interleukin 6 (IL-6) concentrations in exhaled breath condensate. METHODS: Twenty three healthy subjects (12 men, mean (SD) age 48 (7) years) and 23 patients with chronic obstructive pulmonary disease (COPD; 15 men, mean (SD) age 56 (5) years) were studied. 8-isoprostane and IL-6 concentrations were measured by immunoassay. RESULTS: Increased concentrations of 8-isoprostane and IL-6 were found in all subjects after breathing 28% oxygen for 1 hour. In healthy subjects the concentrations of 8-isoprostane and IL-6 were 10.9 (2.9) pg/ml and 4.9 (0.8) pg/ml, respectively, compared with baseline concentrations of 6.1 (1.3) pg/ml and 2.9 (0.6) pg/ml, and in patients with COPD the concentrations were 27.9 (3.1) pg/ml and 8.3 (1.2) pg/ml), respectively, compared with baseline concentrations of 18.9 (3.6) pg/ml and 6.3 (0.6) pg/ml. By contrast, breathing air through the same face mask for 1 hour had no significant effects on 8-isoprostane or IL-6 concentrations in normal subjects or those with COPD. CONCLUSIONS: These findings suggest that short term supplementary oxygen may enhance oxidative stress and inflammation in the airways. Whether this happens with long term oxygen therapy needs to be determined.

Increased inflammatory markers in the exhaled breath condensate of cigarette smokers.

Cigarette smoking induces an inflammatory response in the airways that may play a key role in the pathogenesis of chronic obstructive pulmonary disease. Noninvasive markers of inflammation may, therefore, be useful in monitoring the airways of smokers as well as in the screening of subjects at high risk of developing airway obstruction. The aim of the present study was to determine whether the concentrations of the pro-inflammatory cytokine, interleukin (IL)-6, is increased in the exhaled breath condensate of smokers and whether the number of cigarettes smoked has any influence on the exhaled concentrations. The possibility that exhaled IL-6 levels are related to exhaled carbon monoxide (CO) and lung function has also been explored. Another inflammatory marker, leukotriene (LT), was also measured. Twenty-one smokers (39+/-7 yrs, 13 male) and 14 nonsmokers (45+/-6 yrs, eight male) were recruited. IL-6 and LTB4 levels in the breath condensate were measured with an immunoassay kit and exhaled CO examined by means of a modified electrochemical sensor. Higher IL-6 and exhaled CO concentrations were found in current smokers (5.6+/-1.4 pg x mL(-1) and 16.7+/-5.5 parts per million (ppm)) than in nonsmokers (2.6+/-0.2 pg x mL(-1) and 2.1+/-0.6 ppm). Elevated concentrations of LTB4 were also observed in smokers compared to nonsmokers (9.4+/-0.4 pg x mL(-1) versus 6.1+/-0.3 pg x mL(-1)). In addition, there was a correlation between IL-6 concentrations, the number of cigarettes smoked per day, exhaled CO, LTB4 and lung function. Exhaled interleukin-6 and leukotriene B4 levels may be useful noninvasive markers of airway inflammation in cigarette smokers.