PMID- 31257017 OWN - NLM STAT- MEDLINE DCOM- 20210101 LR - 20210101 IS - 1531-5037 (Electronic) IS - 0022-3468 (Linking) VI - 55 IP - 8 DP - 2020 Aug TI - The relationship between oxidative stress markers in exhaled breath condensate and respiratory problems in patients with repaired esophageal atresia. PG - 1516-1521 LID - S0022-3468(19)30404-X [pii] LID - 10.1016/j.jpedsurg.2019.06.007 [doi] AB - AIM: To evaluate the relationship between respiratory problems and oxidative stress markers in exhaled breath condensate (EBC) of patients with esophageal atresia (EA). METHODS: EA cases with respiratory problems were evaluated retrospectively for age, gender, the type of atresia, surgical treatment, outcome and respiratory symptoms. The results of gastroesophageal reflux (GER) treatment including the use of proton pump inhibitor (PPI) and fundoplication were also documented. EBC samples of 500-1000 mul were obtained by Ecoscreen machine in all cases. The levels of Glutathione (Glut), 8-isoprostane (8-iso), cysteinyl-leukotriene (Cys-LT) were measured with ELISA. Results were compared with healthy control subjects (CG, n = 26) and the relationship between oxidative stress markers and respiratory symptoms was evaluated. The results of GER treatment and oxidative stress markers in EBC were also correlated. RESULTS: Twenty-nine patients with a mean age of 8.8 years (3-14 years) were included. The male/female ratio was 16:13. The EA presented with distal fistula in 27 cases. While no fistula was observed in 1 case, both proximal and distal fistulae were present in another single case. Associated anomalies, most of which were cardiovascular anomalies, were observed in 65.5% (n = 19) of cases. The median Glut level was 1.03 mM/ml (0.93-1.15), iso-8 was 38.8 pg/mL (32.03-76.2) and Cys-LT was 0.44 pg/mL (20.17-61.3) in patients with EA. The median levels of oxidative markers in CG were 1.23 mM/mL (1.13-1.36), 66.3 pg/mL (33.5-106.7), and 56.9 pg/mL (27.4-80.1), respectively. Glut levels were significantly lower in EA cases compared to CG (p = 0.01). There was no significant difference between the groups regarding 8-iso and CYS-LT levels (p = 0.9, p = 1.0). Cys-LT levels were significantly lower in patients with PPI treatment [21.7 pg/mL (18.6-48.1)], when compared to patients without PPI treatment [41.1 pg/mL (22.5-83.1)] (p = 0.04) and healthy subjects [56.9 pg/mL (27.4-80.1)] (p = 0.017). The 8-iso levels were significantly decreased in cases with fundoplication compared to the patients without fundoplication (p = 0.02). CONCLUSION: Glut - an antioxidant agent - levels were significantly lower in EBC of EA cases. The decrease in Cys-LT levels in cases with PPI treatment and in 8-iso levels in patients with fundoplication suggests that the oxidative damage in EBC of EA cases may be correlated with GER and its management. TYPE OF STUDY: Case control study LEVEL OF EVIDENCE: Level III. CI - Copyright (c) 2019 Elsevier Inc. All rights reserved. FAU - Soyer, Tutku AU - Soyer T AD - Hacettepe University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey. Electronic address: soyer.tutku@gmail.com. FAU - Turer, Ozlem Boybeyi AU - Turer OB AD - Hacettepe University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey. FAU - Birben, Esra AU - Birben E AD - Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey. FAU - Kahveci, Melike AU - Kahveci M AD - Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey. FAU - Tugcu, Gokcen Dilsa AU - Tugcu GD AD - Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey. FAU - Soyer, Ozge Uysal AU - Soyer OU AD - Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey. FAU - Yalcin, Ebru AU - Yalcin E AD - Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey. FAU - Dogru, Deniz AU - Dogru D AD - Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey. FAU - Ozcelik, Ugur AU - Ozcelik U AD - Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey. FAU - Kiper, Nural AU - Kiper N AD - Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey. FAU - Sekerel, Bulent AU - Sekerel B AD - Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey. FAU - Tanyel, Feridun Cahit AU - Tanyel FC AD - Hacettepe University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey. LA - eng PT - Journal Article DEP - 20190621 PL - United States TA - J Pediatr Surg JT - Journal of pediatric surgery JID - 0052631 RN - 0 (Biomarkers) SB - IM MH - Adolescent MH - Biomarkers/analysis MH - *Breath Tests MH - Child MH - Child, Preschool MH - *Esophageal Atresia/complications/metabolism/surgery MH - Exhalation/physiology MH - Fundoplication MH - Gastroesophageal Reflux MH - Humans MH - Oxidative Stress/*physiology MH - *Respiratory Tract Diseases/complications/metabolism MH - Retrospective Studies OTO - NOTNLM OT - Children OT - Esophageal atresia OT - Exhaled breath condensate OT - Gastroesophageal reflux OT - Oxidative stress OT - Tracheoesophageal fistula EDAT- 2019/07/02 06:00 MHDA- 2021/01/02 06:00 CRDT- 2019/07/02 06:00 PHST- 2019/04/26 00:00 [received] PHST- 2019/05/29 00:00 [revised] PHST- 2019/06/04 00:00 [accepted] PHST- 2019/07/02 06:00 [pubmed] PHST- 2021/01/02 06:00 [medline] PHST- 2019/07/02 06:00 [entrez] AID - S0022-3468(19)30404-X [pii] AID - 10.1016/j.jpedsurg.2019.06.007 [doi] PST - ppublish SO - J Pediatr Surg. 2020 Aug;55(8):1516-1521. doi: 10.1016/j.jpedsurg.2019.06.007. Epub 2019 Jun 21.