PURPOSE: To assess of some products of anaerobic-aerobic glucose oxidation (lactic and pyruvic acids) and Krebs cycle (oxaloacetic and succinic acids) during COPD progression across in exhaled breath condensate (EBC) and blood.
METHODS: 88 in-patients with COPD exacerbation were divided into the 3 groups: COPD1-2-3 (mild-moderate-severe with decompensated cor pulmonale respectively). We collected EBC of patients in first day of admission by the way of cooling with a special apparatus in the morning. For receiving 5 ml condensate 15 minutes intermittent respiration was usually necessary. These products were measured spectrophotometrically in the blood serum and EBC.
RESULTS: The level of lactate in EBC was elevated according to disease severity (by 18%; 40%; 50% in COPD1-2-3 respectively vs. the control; p<0,05). The significant hyperlactatemia (by 15% only in COPD3) was lower than in EBC. The pyruvate concentration in EBC exceeded the control values by 30%, 68%, 82% (p<0,05) in COPD1,2,3 respectively and less in blood (by 18%,45% in COPD2,3; p<0,05). The value of oxalic-acetic acid in COPD2,3 increased by 27%, 42% and 14%, 23% vs control (p<0,05) in EBC and blood respectively.The level of succinic acid in EBC rose by 16%, 18%, 27% vs. the control in COPD1,2,3 respectively. The changes of succinic acid level in serum were similar.
CONCLUSION: The intermediate substrates of carbohydrates metabolism are detectable in EBC. The changes of these parameters were a great extend marked in EBC (than in serum) as well as correlated with the severity of COPD and were related with poor tissue perfusion and disorders of ventilation.
CLINICAL IMPLICATIONS: The significant rose of succinic acid in EBC and blood may be explained more slow of it’s utilisation in Krebs cycle and could be marker for tissue hypoxia and oxygen dept. These substrates in EBC may be a useful markers of disorders of carbohydrates metabolism in COPD patients.
DISCLOSURE: Alexander Makarevich, None.