Hydrogen peroxide content and pH of expired breath condensate from patients with asthma and COPD

COPD. 2014 Feb;11(1):81-7. doi: 10.3109/15412555.2013.830094. Epub 2013 Oct 10.


Background: Oxidative stress is implicated in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD). Analysis of the expired breath condensate (EBC) has been suggested to provide non-invasive inflammatory markers that reflect oxidative stress in the airways.

Objective: The present study attempts to elucidate whether the hydrogen peroxide (H2O2) levels and pH values in EBC may be useful as biomarkers of the activity or severity of asthma and COPD.

Methods: We measured the H2O2 levels and pH values using a derivatives of reactive oxygen metabolites exhalation test kit (Diacron) and a pH analyser, respectively, in EBC obtained using an EcoScreen from 29 patients with asthma, 33 with COPD, and 33 healthy individuals (all non-smokers). We then examined the relationships among oxidative stress and the asthma control test (ACT) or COPD assessment test (CAT) scores, pulmonary function, fractional exhaled nitric oxide (FeNO), and the extent of low attenuation areas on HRCT.

Results: The H2O2 levels were elevated and pH was lower in both asthma (H2O2; 8.75 ± 0.88 μM, p < 0.01, pH; 7.14 ± 0.07, p < 0.05) and COPD (H2O2; 7.44 ± 0.89 μM, p < 0.01, pH; 6.87 ± 0.10, p < 0.01) compared with control subjects (H2O2; 3.42 ± 0.66 μM, pH; 7.35 ± 0.04). Neither the H2O2 levels nor pH correlated with the ACT scores and FeNO in asthma patients. Neither the H2O2 levels nor pH significantly correlated with the pulmonary function in asthma and COPD. However, the CAT scores significantly correlated with the H2O2 levels in patients with COPD (r = 0.52, p < 0.01).

Conclusions: These findings suggest that oxidative stress is involved in the pathogenesis of asthma and COPD and that the H2O2 levels in EBC might reflect the health status in COPD.

MeSH terms

  • Adult
  • Aged
  • Asthma / diagnostic imaging
  • Asthma / metabolism*
  • Asthma / physiopathology
  • Biomarkers / metabolism
  • Breath Tests
  • Case-Control Studies
  • Female
  • Humans
  • Hydrogen Peroxide / metabolism*
  • Hydrogen-Ion Concentration
  • Lung / diagnostic imaging
  • Lung / metabolism*
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Nitric Oxide / metabolism
  • Oxidative Stress
  • Pulmonary Disease, Chronic Obstructive / diagnostic imaging
  • Pulmonary Disease, Chronic Obstructive / metabolism*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Respiratory Function Tests
  • Tomography, X-Ray Computed


  • Biomarkers
  • Nitric Oxide
  • Hydrogen Peroxide