Sputum zinc concentration and clinical outcome in older asthmatics


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Abstract

Background and objective:Mouse models of asthma show that zinc deficiency is associated with airway inflammation (AI), which is attenuated by zinc supplements. Whether zinc has a similar role in the human airway remains controversial, with studies demonstrating both high and low plasma zinc concentrations [Zn] in asthmatic patients compared with control subjects. This variability may reflect the inability of plasma measurements to accurately assess airway zinc levels. Examination of induced sputum is an established technique for measuring AI and mediators of inflammation. Recent advances allow measurement of the rapidly exchangeable (labile) and total zinc pools in sputum. The aims of this study were to measure labile and total [Zn] in sputum and plasma of subjects with or without asthma, and second to correlate [Zn] with symptoms, asthma severity, lung function (FEV1) and airway hyper-responsiveness.Methods:A total of 163 subjects (114 with asthma) completed a single visit for sputum induction and a blood test. Labile and total [Zn] were measured by Zinquin fluorescence and atomic absorption spectrophotometry.Results:The mean (SD) age of subjects with and without asthma was 55 (14) and 57 (14) years, respectively. Baseline FEV1 was significantly lower in subjects with asthma (94.2 (16)%) than in those without asthma (103 (16.6)%). Sputum total and labile [Zn] were lower in subjects with asthma compared with control subjects, with median (interquartile range) values of 31.8 (117) versus 50 (188.5), P = 0.02 and 0 (48) versus 26 (84.5) μg/L, P = 0.05, respectively. Increased frequency of wheeze, as well as asthma severity and reduced FEV1, was associated with significantly lower labile sputum [Zn].Conclusions:These findings suggest that sputum [Zn] reflect clinical outcomes and underlying AI, suggesting a potential role for zinc as a biomarker in asthma.Zinc levels in sputum are lower in asthmatic compared with healthy subjects, and are associated with increased frequency of wheeze, severity of asthma and worse lung function. Sputum zinc may be a novel biomarker that reflects clinical status in asthma.Conflict of interest statement: Richard Ruffin received expert witness fees for GSK South Africa—paid to the University of Adelaide.

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