Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Int Arch Allergy Immunol 2008;146(suppl 1):67–72 DOI: 10.1159/000126064 Increase in Reactive Oxygen Metabolite Level in Acute Exacerbations of Asthma Shintaro Suzuki a Satoshi Matsukura a Hiroko Takeuchi a Mio Kawaguchi a Koushi Ieki a Miho Odaka a Shin Watanabe a Tetsuya Homma a Kenji Dohi b Tohru Aruga b Masayuki Sato a Masatsugu Kurokawa a Fumio Kokubu c Mitsuru Adachi a a First Department of Internal Medicine and b Department of Emergency and Critical Care Medicine, Showa University School of Medicine, Tokyo, and c Department of Respiratory Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan clear elastase were increased in acute exacerbation and moderately correlated to ROM levels. Levels of ROM were significantly decreased after treatment with systemic ste- roids and bronchodilators. Conclusion: These findings sug- gest that acute exacerbation of asthma is associated with increased oxidative stress. Serum ROM levels would partly reflect the inflammation with eosinophils and neutrophils and may be useful as biomarkers of asthma. Copyright © 2008 S. Karger AG, Basel Introduction Bronchial asthma is characterized by airway inflam- mation as well as subsequent airway hypersensitivity and remodeling [1, 2]. Cells causing inflammation in the air- way produce a variety of mediators including reactive ox- ygen species (ROS) in asthma [3–7]. ROS such as super- oxide radical, hydroxyl radical and hydrogen peroxide are known to exacerbate inflammation, vascular perme- ability, epithelial damage and airway hyperresponsive- ness. Eosinophils and neutrophils are known to infiltrate the airway in acute exacerbations of asthma. These cells are also known to produce ROS [8–11] . Key Words Asthma  Free radical  Oxidative stress  Reactive oxygen metabolite Abstract Background: Oxidants including reactive oxygen species have been indicated to play an important role in the patho- genesis of asthma. Objective: We investigated oxidative sta- tus in patients with acute exacerbations of asthma and eval- uated the therapeutic response using the D-ROM test which is simple to use and quick. Methods: We measured reactive oxygen metabolite (ROM) levels in the serum of 42 outpa- tients with acute exacerbations of asthma, 11 outpatients with stable asthma and 40 healthy subjects using the D-ROM test. Seven inpatients admitted due to acute exacerbations of asthma were also enrolled to evaluate the effects of treat- ment. Serum eosinophil cationic protein and plasma poly- morphonuclear elastase were also measured by EIA or ELISA to evaluate the correlation between inflammation and oxi- dative status. Results: Serum ROM levels were significantly higher in patients with acute exacerbation of asthma than in patients with stable asthma or healthy subjects. Levels of se- rum eosinophil cationic protein and plasma polymorphonu- Published online: May 27, 2008 Correspondence to: Dr. Shintaro Suzuki First Department of Internal Medicine Showa University School of Medicine 1-5-8 Hatanodai, Shinagawa-ku Tokyo 142-8666 (Japan) Tel. +81 3 3784 8532, Fax +81 3 3784 8742, E-Mail szshin@hotmail.com © 2008 S. Karger AG, Basel 1018–2438/08/1465–0067$24.50/0 Accessible online at: www.karger.com/iaa