ABSTRACT
BACKGROUND: Induced sputum cytology and protein biomarkers can be used to assess airways inflammation. Increases in sputum iron have been described in inflammatory lung disease. We hypothesized that other sputum metals may be affected by airways inflammation and investigated their potential value as biomarkers. METHODS: Sputum was obtained from 20 healthy control subjects and from patients with inflammatory pulmonary diseases (23 with cystic fibrosis [CF], 16 with bronchiectasis, 17 with asthma, and 23 with COPD), and iron, zinc, manganese, and copper were measured. Fourteen patients with CF were also studied through an exacerbation cycle. RESULTS: Sputum zinc and iron were elevated in CF and non-CF bronchiectasis vs controls (P < .001, zinc; P < .01 iron). Manganese was elevated in asthma (P < .01) and bronchiectasis (P < .05) vs controls. Copper was elevated in CF vs controls (P < .05). Zinc decreased (P < .01) following treatment of CF exacerbation. In subjects with CF zinc levels correlated with other biomarkers. CONCLUSIONS: These results suggest a relationship of high concentrations of total zinc and iron with airways inflammation in CF and non-CF bronchiectasis, with longitudinal changes being observed in CF. Further work is required to elucidate potential inflammatory mechanisms related to these observations.
Subject(s)
Asthma/diagnosis , Biomarkers/analysis , Bronchiectasis/diagnosis , Cystic Fibrosis/diagnosis , Pulmonary Disease, Chronic Obstructive/diagnosis , Sputum/chemistry , Trace Elements/analysis , Adult , Aged , Asthma/metabolism , Bronchiectasis/metabolism , Copper/analysis , Cystic Fibrosis/metabolism , Diagnosis, Differential , Female , Humans , Iron/analysis , Male , Manganese/analysis , Middle Aged , Pulmonary Disease, Chronic Obstructive/metabolism , Reproducibility of Results , Spectrum Analysis , Suppuration , Zinc/analysisABSTRACT
This report describes a 37-year-old female patient who after seven years on intermittent overnight enteral feeding supplementation was noted to have an increased whole blood manganese concentration. Manganese toxicity is well documented after pathological absorption through inhalation via the lungs, or after intravenous administration to patients on long-term total parenteral nutrition. A dietary history revealed high tea consumption. The association between high blood manganese concentrations and enteral/oral nutrition does not appear to have previously been described.
