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Airway Antioxidants and Oxidative Stress as Predictors of Sputum Atypia and Airflow Obstruction*

Russell P. Bowler, MD, PhD; Beth Duda, MS; Kieu O. Vu, PhD; Tim Byers, MD, MPH; Wilbur Franklin, MD; Edward D. Chan, MD; York E. Miller, MD
Author and Funding Information

*From the National Jewish Medical and Research Center (Drs. Bowler and Chan, and Ms. Duda), Denver; University of Colorado Health Sciences Center (Drs. Vu, Byers, and Franklin), Denver; and Veterans Affairs Medical Center (Dr. Miller), Denver, CO.

Correspondence to: Russell P. Bowler, MD, PhD, National Jewish Medical and Research Center, K736A 1400 Jackson St, Denver, CO 80206; e-mail: BowlerR@njc.org



Chest. 2004;125(5_suppl):127S-128S. doi:10.1378/chest.125.5_suppl.127S
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Extract

Redox imbalance is thought to contribute to the pathogenesis of both lung cancer and obstructive airways disease. We hypothesized that airway antioxidants would be associated with high-grade sputum dysplasia and a higher risk of airflow obstruction. One hundred seventeen research subjects (41 never-smokers, 40 former smokers, and 36 current smokers) underwent BAL, spirometry, and venous blood sampling. The antioxidants urate, glutathione (reduced and oxidized), and ascorbate were measured by high-pressure liquid chromatography with electrochemical detection. Total protein and total nitrites were assayed by colorimetric detection. Median concentrations (10th and 90th percentile) for selected BAL markers are listed in Table 1 . There was a statistically significant correlation between airflow obstruction and BAL protein (p = 0.03), total nitrite (p = 0.02), and oxidized glutathione (p = 0.01). In a stepwise multiple regression model with age and pack-years of smoking, only total nitrites and oxidized glutathione remained in the model for airflow obstruction. Carcinoma or high-grade dysplasia on sputum cytology was associated with higher concentrations of protein (p = 0.03), total nitrites (p = 0.01), and urate (p = 0.02), but not in a stepwise logistic regression model. Antioxidants and markers of oxidative stress are elevated in persons with airflow obstruction and high-grade sputum dysplasia; however, these measurements are not as good predictors as pack-years of smoking. The increase in airways antioxidants may be a response to elevated oxidative stress from tobacco smoke.

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