呼出气冷凝液标本用于检测运动时气道的健康状况

Exhaled breath condensate specimens for testing airway health during exercise

背景:运动是造成气道高水平氧化应激的重要诱因,精英运动员运动性哮喘和运动性支气管狭窄的发生与气道炎症有关。在运动和运动医学中,准确监测各种心理生理应激后的体内平衡扰动是必不可少的,探索非侵入性收集和分析生物标记物的方法,能够提供关于运动诱发的生理和心理应激的准确信息,显然具有重要的现实意义。目的:梳理总结使用呼出气冷凝液检测识别气道在激烈运动、比赛、过度训练时氧化应激水平、炎症反应程度及酸碱度的变化特征。方法:以“呼出气冷凝液,运动”“气道,氧化应激”“气道,炎症反应”“运动性支气管狭窄”“运动性哮喘”“exhaled breath condensate,exercise”“airway inflammation”“airway oxidative stress”“exercise-induced bronchoconstriction,EIB”“exercise-induced asthma,EIA”等关键词,在中国知网、百度学术、PubMed等数据库,检索1980年6月至2022年9月国内外有关检测健康人和呼吸系统疾病患者运动时气道健康状况的呼出气冷凝液中生物标志物应用的相关文献,进行梳理和总结,为构建运动人群气道健康的无创、便捷监控手段和保障奠定前期基础。结果与结论:(1)适度运动会升高不同人群呼出气冷凝液pH值,而重复剧烈运动可导致气道的酸化,运动导致呼出气冷凝液中促氧化剂水平的升高,且持续时间和强度与促氧化剂的生成有关。(2)特定环境(污染、低温、干燥和高原)下运动会升高气道的氧化应激水平和炎症程度。呼出气冷凝液中的细胞因子、炎症递质的升高和气道酸碱度的急性变化与运动性支气管狭窄的发生相关联。(3)鉴于临床上呼出气冷凝液技术在采样、处理、储存和数据分析方面存在的标准化问题,运动科学领域对这一技术的应用在标准化收集过程和处理过程及确定敏感检测指标时应建立与运动负荷和应激水平相对应的评价标准。

BACKGROUND:Exercise is an important trigger of the high level of oxidative stress in the airway.In elite athletes,sports asthma and exercise-induced bronchial stenosis are related to airway inflammation.Accurate monito ring of homeostatic perturbations following various psychophysiological stressors is essential in sports and exe rcise medicine.It is of great practical impo rtance to explore non-invasive methods of collecting and analyzing biomarke rs that are capable of providing accurate information regarding exe rcise-induced physiological and psychological stress.OBJECTIVE:To summarize the characte ristics of oxidative stress,inflammatory response and acid-base changes in the airway detected by exhaled breath condensate detection during intense exercise,competition and overtraining.METHODS:CNKI,Baidu Schola r,and PubMed were retrieved for relevant literature on the application of biomarkers in exhaled breath condensate for detecting the airway health status of healthy people and patients with respiratory diseases during exe rcise at home and abroad from June 1980 to September 2022 using the keywords of "exhaled breath condensate,exercise," "airway inflammation" "airway oxidative stress," "exercise-induced bro nchoconstriction,EIB," "exerciseinduced asthma,EIA." Retrieved literature was summarized to lay a preliminary foundation for constructing non-invasive and co nvenient monitoring means and guarantee of airway health in exercise population.RESULTS AND CONCLUSION:Moderate exercise increases the pH value of exhaled breath condensate in different populations,while repeated strenuous exercise can lead to airway acidification.Exercise increases the levels of pro-oxidants in exhaled breath condensate,and the duration and intensity are related to the generation of pro-oxidants.Exercise under special environmental conditions(pollution,cold,dehydration and altitude) exacerbates oxidative stress levels and inflammation degree in the airway.Elevated cytokines,inflammatory mediators,and acute changes in airway pH in exhaled breath condensate are associated with the development of exercise-induced bronchoconstriction.In view of the clinical standardization of specimen collection,processing,storage and data analysis,the application of exhaled breath condensate technique in the field of sports science should standardize the collection and processing process,determine sensitive biomarkers and establish evaluation criteria corresponding to exercise load and stress level.