Review Article

Biomarkers in Exhaled Breath Condensate and Serum of Chronic Obstructive Pulmonary Disease and Non-Small-Cell Lung Cancer

Table 1

Summary of EBC markers of oxidative stress and antioxidant capacity including S100 proteins in COPD and lung cancer (legend: “↑”: elevated, “”: decreased, “”: no difference, “×”: undetectable).

CategoryBiomarkersCOPD patientsLung cancer patients
EBC (compared to healthy volunteers)EBC (compared to smokers or ex-smokers)EBC (compared to healthy volunteers)EBC (compared to specific controls)

Markers of oxidative stress
Reactive oxygen speciesHydrogen peroxide↑ [34, 135138]↑ [34]↑ [135]

Reactive nitrogen speciesNitric oxide↑ [139144]↑ [139, 141]↑ [140]↑ (controls = cancer patients) [142]
Nitrite↑ [145]↑ [145]↑ (controls = cancer patients) [142]
NitrateHigh variability [146] (controls = cancer patients) [142]
[141, 147]
Peroxynitrite↑ [148, 149]↑ [148, 149]

Lipid peroxidation products/eicosanoids (arachidonic acid derivatives)8-isoprostane↑ [137, 148, 150, 151]↑ [34, 148, 150]↑ [135]
(controls = healthy smokers) [152]
Malondialdehyde↑ [138, 153]↑ [153] ↑ [154]
[137, 155] [137]
Leukotrienes B4↑ [156158]↑ [159]↑ (controls = patients without pulmonary disease) [156]
Leukotriene C4 ↑ [160]
Leukotriene D4 ↑ [160]
Leukotriene E4 [158]↑ [160]
Prostaglandin E2↑ [158]
Thromboxane B2 (the stable form of thromboxane A2) [158]
Prostaglandin D2-methoxime [158]
Prostaglandin F2α↑ [158]

Cytokines and proteinsTumour necrosis Factor-α [47]↑ [161]↑ (controls = smokers without COPD or lung cancer) [152]
Interleukin-6↑ [162] ↑ [163]
[47]
Interleukin-8 [47, 164] [164]↑ (controls = patients without pulmonary diseases) [156]
Metaloproteinase-9↑ [134]↑ (controls = patients without pulmonary diseases) [165]
Vascular endothelial growth factor↑ (controls = healthy smokers) [152]
Endothelin-1 ↑ [166]↑ [167]
↑ [168]

Volatile organic compoundsAlkanes, alkane derivatives, benzene derivatives↑ (exhaled ethane) [169]↑ [170, 171]

Heme breakdown product Carbon monoxide ↑ [144]↑ [144]

pH [164, 172175] [173] [172]

Deoxyribonucleic acid mutations3p microsatellite alterations↑ [176]
Tumour suppressor gene P53 mutations↑ [177]
Oncogene KRAS↑ [178]
Epidermal growth factor receptor (EGFR) gene mutations↑ (in small number of heavy smokers with squamous cell carcinoma) [179]
Gene promoter methylation mutations↑ [180]
Mitochondrial DNA mutations↑ (controls = smokers, exsmokers without chronic respiratory diseases, respiratory illnesses, or lung cancer) [70]

VirusesHuman papilloma virus↑ (controls = patients suspected of lung cancer but with negative cytology) [181]

Markers measuring antioxidant capacity
EnzymesSuperoxide dismutase↑ (controls = patients without pulmonary diseases) [182]

Nonenzymatic antioxidants Ascorbic acid/vitamin C (↑ in percentage degradation/oxidation rate) [161]
Urate × [175]× [175]
Ferritin↑ (controls = patients affected by transudative pleural effusion and without pulmonary diseases) [182]
Bilirubin [175] [175]