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Original Research: BIOMARKERS |

Sputum Trace Metals Are Biomarkers of Inflammatory and Suppurative Lung Disease

Robert D. Gray, MB ChB; Andrew Duncan, PhD; Donald Noble, MD; Margaret Imrie, BSc; Dennis St. J. O’Reilly, MD; J. Alastair Innes, PhD; David J. Porteous, PhD; Andrew P. Greening, MD; A. Christopher Boyd, PhD
Author and Funding Information

From the School of Molecular and Clinical Medicine (Drs Gray, Noble, Innes, Porteous, Greening, and Boyd and Ms Imrie), University of Edinburgh, Western General Hospital, Edinburgh; and the Scottish Trace Element and Micronutrient Reference Laboratory, Department of Clinical Biochemistry (Drs Duncan and O’Reilly), Glasgow Royal Infirmary, Scotland.

Correspondence: R. D. Gray, MB, ChB, Medical Genetics, Molecular Medicine Centre, University of Edinburgh, Western General Hospital, Edinburgh, Scotland; e-mail: r.d.gray@ed.ac.uk


Funding/Support: This study was funded by the Cystic Fibrosis Trust (R.D.G. and A.C.B.). R.D.G. was supported in part by the Medical Research Council (Programme Grant G9313618). D.N. was supported by an unrestricted grant from GlaxoSmithKline.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(3):635-641. doi:10.1378/chest.09-1047
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Background:  Induced sputum cytology and protein biomarkers can be used to assess airways inflammation. Increases in sputum iron have been described in inflammatory lung disease. We hypothesized that other sputum metals may be affected by airways inflammation and investigated their potential value as biomarkers.

Methods:  Sputum was obtained from 20 healthy control subjects and from patients with inflammatory pulmonary diseases (23 with cystic fibrosis [CF], 16 with bronchiectasis, 17 with asthma, and 23 with COPD), and iron, zinc, manganese, and copper were measured. Fourteen patients with CF were also studied through an exacerbation cycle.

Results:  Sputum zinc and iron were elevated in CF and non-CF bronchiectasis vs controls (P < .001, zinc; P < .01 iron). Manganese was elevated in asthma (P < .01) and bronchiectasis (P < .05) vs controls. Copper was elevated in CF vs controls (P < .05). Zinc decreased (P < .01) following treatment of CF exacerbation. In subjects with CF zinc levels correlated with other biomarkers.

Conclusions:  These results suggest a relationship of high concentrations of total zinc and iron with airways inflammation in CF and non-CF bronchiectasis, with longitudinal changes being observed in CF. Further work is required to elucidate potential inflammatory mechanisms related to these observations.

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