Gabriella Guarnieri a, Silvia Ferrazzoni a, Maria Cristina Scarpa a, Alberto Lalli b, Piero Maestrelli a a Department of Environmental Medicine and Public Health, University of Padova, and b Centro Studi Termali Pietro d’Abano, Montegrotto Terme-Abano Terme, Padova , Italy
Key Words Lung function _ Normal saline _ Aerosol therapy _Leukotriene B 4 _ ulmonary inflammation Inhalation of thermal water (TW) is traditionally used as part of the treatment of chronic obstructive pulmonary disease (COPD), but its benefit and mechanisms are controversial.We previously observed a reduced proportion of neutrophils in induced sputum after treatment with TW. The aim of this study was to determine whether inhalation of TW in COPD patients is associated with biochemical changes of airway lining fluid, including a reduction in the neutrophil chemoattractant leukotriene B 4 (LTB 4). Thirteen COPD patients were randomly assigned to receive a 2-week course of TW and normal saline inhalation in a cross-over, single-blind study design. Exhaled breath condensate (EBC) was collected before and after treatments. LTB 4 concentrations in EBC were determined by ELISA, and EBC pH was measured before and after argon deaeration. No significant differences in LTB 4 concentrations in EBC were detected with either treatment. A significant decrease in pH of non- eaerated EBC was observed after a standard course of TW (median 7.45, interquartile range 6.93–7.66, vs. median 6.99, interquartile range 6.57–7.19; p = 0.05), which disappeared after argon deaeration. In conclusion, there is no evidence that TW treatment affects LTB 4 concentration in EBC. The results of EBC pH measurements suggest that TW inhalation induces an imbalance of volatile components of the buffer system in airway lining fluid.