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Disease Markers in Exhaled Breath FREE TO VIEW

Michelle Harkins
Chest. 2003;124(2):773-774. doi:10.1378/chest.124.2.773-a
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By Nandor Marczin, Sergei A. Kharitonov, Sir Magdi H. Yacoub, and Peter J. Barnes, eds. New York, NY: Marcel Dekker, 2003; 534 pp; $195

This multiauthored text, the latest in the Lung Biology in Health and Disease series, outlines the biochemical aspects, pathologic consequences, and suggested clinical utility of measuring a variety of components in exhaled breath, including nitric oxide, carbon monoxide, breath condensates, and other volatile organic compounds. The predominant focus is on nitric oxide, the pathologic consequences of excess or deficiency, and its utilization as a marker of inflammation in a variety of disease processes. The authors and editors are experts in this field, and their efforts in this text clearly open our eyes to the wave of the future with respect to noninvasive breath analysis in different disease states.

The book is divided into three components: physiologic aspects of disease markers in exhaled gases, methodologic and technical concerns, and pathologic aspects. Each of the 20 chapters is well written and brief. The text and writing styles of the respective authors are cohesive and blend well with the entire format, although some repetition becomes evident if read from cover to cover at one sitting. The most current peer-reviewed studies pertinent to each section are discussed to make specific points, although several unpublished observations are also cited. There is an even balance between basic science and clinical study, including animal and human data.

The first section of the book is heavily weighted toward explaining the cellular sources of, and biochemical reactions involving, the markers in exhaled breath. This section also provides information on the consequences of oxidative stress in the lung, particularly regarding nitric oxide. Thus, this component of the book would most likely appeal to either the basic or clinical researcher. The explosive growth in the field of exhaled breath analysis over the last few years is well reflected in the remainder of the text, which identifies a host of clinical applications. These applications are supported with animal and human data and generally relate to the study of inflammation in diseases such as asthma, lung transplantation, and rheumatologic disorders. Throughout the book, appropriate graphs, tables, and figures complement the text and enhance its readability, increasing its utility to a wide audience.

Overall, this book is well written and covers a variety of aspects important in understanding the basic science and clinical implications of nitric oxide, carbon monoxide, and other markers of disease activity in exhaled breath. Though the specific topics and measurements remain in the realm of basic and clinical research, there may be a role for routine bedside clinical applications in the near future. Consequently, Disease Markers in Exhaled Breath is useful as a concise outline of the biochemistry of several components of exhaled breath, as a resource for explaining some of the pathophysiology of specific lung disorders, and as an introduction to the roles that selected components of exhaled breath may play as noninvasive markers of disease.




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