Exhaled particles as markers of small airway inflammation in subjects with asthma

Clin Physiol Funct Imaging. 2017 Sep;37(5):489-497. doi: 10.1111/cpf.12323. Epub 2015 Dec 9.


Exhaled breath contains suspended particles of respiratory tract lining fluid from the small airways. The particles are formed when closed airways open during inhalation. We have developed a method called Particles in Exhaled air (PExA® ) to measure and sample these particles in the exhaled aerosol. Here, we use the PExA® method to study the effects of birch pollen exposure on the small airways of individuals with asthma and birch pollen allergy. We hypothesized that birch pollen-induced inflammation could change the concentrations of surfactant protein A and albumin in the respiratory tract lining fluid of the small airways and influence the amount of exhaled particles. The amount of exhaled particles was reduced after birch pollen exposure in subjects with asthma and birch pollen allergy, but no significant effect on the concentrations of surfactant protein A and albumin in exhaled particles was found. The reduction in the number of exhaled particles may be due to inflammation in the small airways, which would reduce their diameter and potentially reduce the number of small airways that open and close during inhalation and exhalation.

Keywords: aerosol; airway opening; albumin; asthma; birch pollen; exhaled breath condensate; exhaled particles; inflammation; surfactant protein A.

MeSH terms

  • Adult
  • Aerosols
  • Asthma / diagnosis
  • Asthma / metabolism*
  • Asthma / physiopathology
  • Betula / adverse effects
  • Biomarkers / metabolism
  • Breath Tests*
  • Exhalation*
  • Female
  • Humans
  • Lung / immunology
  • Lung / metabolism*
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Nitric Oxide / metabolism
  • Particle Size
  • Pneumonia / diagnosis
  • Pneumonia / immunology
  • Pneumonia / metabolism*
  • Pneumonia / physiopathology
  • Pollen / adverse effects
  • Predictive Value of Tests
  • Pulmonary Surfactant-Associated Protein A / metabolism
  • Rhinitis, Allergic, Seasonal / diagnosis
  • Rhinitis, Allergic, Seasonal / immunology
  • Rhinitis, Allergic, Seasonal / metabolism*
  • Rhinitis, Allergic, Seasonal / physiopathology
  • Serum Albumin, Human / metabolism
  • Spirometry
  • Young Adult


  • ALB protein, human
  • Aerosols
  • Biomarkers
  • Pulmonary Surfactant-Associated Protein A
  • Nitric Oxide
  • Serum Albumin, Human