Exhaled 8-isoprostane and prostaglandin E2 in patients with stable and unstable cystic fibrosis

We measured 8-isoprostane, a biomarker of oxidative stress, and prostaglandin (PG) E2 in exhaled breath condensate in 36 stable and 14 unstable cystic fibrosis (CF) patients, and in 15 healthy age-matched controls. We studied the relationships of these eicosanoids with clinical, radiological, and systemic inflammatory parameters. Compared with controls [15.5 (11.5–17.0) pg/ml] exhaled 8-isoprostane was increased in stable CF patients [30.5 (25.3–36.0) pg/ml, P < 0.001]. Unstable CF patients had higher exhaled 8-isoprostane levels [47.5 (44.0–50.0) pg/ml, P < 0.001] than stable CF patients. Unlike PGE2, exhaled 8-isoprostane was negatively correlated with FEV1 (r = −0.67; P < 0.0001; r = −0.63; P < 0.02) and Shwachman score (r = −0.43, P = 0.012; r = −0.58, P = 0.031) and positively correlated with Chrispin-Norman score (r = 0.51, P < 0.002; r = 0.56, P = 0.039) in stable and unstable CF patients, respectively. No correlation was observed with C-reactive protein. Compared with controls [41.0 (29.0–50.0) pg/ml], exhaled PGE2 was also elevated in stable [72.0 (64.3–81.8) pg/ml, P < 0.001) and, to a greater extent, in unstable CF patients [83.0 (74.3–91.3) pg/ml, P < 0.001). In patients with CF, exhaled 8-isoprostane and PGE2 could be a useful marker of disease severity.