Sara Sánchez-Vidaurre

University Hospital Vall d'Hebron, Barcino, Catalonia, Spain

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Publications (8)19.79 Total impact

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    ABSTRACT: Studies on inflammation biomarkers in serum and in exhaled breath condensate (EBC) in obstructive sleep apnea (OSA) have shown conflicting results. The objective of this study is to assess EBC and serum biomarkers in OSA patients at baseline and after continuous positive airway pressure (CPAP) or upper airway surgery (UAS).
    Archivos de bronconeumologia. 06/2014;
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    ABSTRACT: Introduction Studies on inflammation biomarkers in serum and in exhaled breath condensate (EBC) in obstructive sleep apnea (OSA) have shown conflicting results. The objective of this study is to assess EBC and serum biomarkers in OSA patients at baseline and after continuous positive airway pressure (CPAP) or upper airway surgery (UAS). Patients and methods Nine OSA patients referred for UAS were matched for anthropometric characteristics and apnea-hypopnea index with 20 patients receiving CPAP. pH, nitrite (NO2−), nitrate and interleukin 6 in EBC and NO2−, nitrate, leukotriene B4 and interleukin 6 in serum were determined. EBC and serum samples were collected at baseline and 3 months after CPAP or UAS. Results Patients’ mean body mass index was 30 (range 24.9-40) kg/m2. EBC biomarker levels at baseline were within normal range and did not differ significantly after CPAP or UAS. No significant changes were observed in the serum concentration of the biomarkers determined after CPAP but the serum concentration of NO2− increased significantly at 3 months after UAS (P = .0078). Conclusion In mildly obese OSA patients, EBC biomarkers of inflammation or oxidative stress were normal at baseline and remained unchanged 3 months after UAS or CPAP. Although UAS was not effective in terms of reducing OSA severity, it was associated with an increase in serum NO2−.
    Archivos de Bronconeumología. 01/2014;
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    ABSTRACT: The aim of this study was to establish the sputum inflammatory profile and changes in levels of leukotriene B4 (LTB4) and a panel of Th1/Th2 cytokines in subjects with suspected occupational asthma (OA) following specific inhalation challenge (SIC) to high-molecular-weight (HMW) and low-molecular-weight (LMW) agents. Fifty-one consecutive subjects undergoing SIC for suspected OA were enrolled. Sputum induction was performed the day before and 24 h after exposure to the offending agent. Total and differential cell counts were assessed. LTB4 and a 10 Th1/Th2 cytokines were measured in sputum supernatant. Thirty-four patients tested positive to SIC and were diagnosed with OA (in 10 due to HMW agents and in 24 to LMW agents). SIC was negative in 17 subjects. As compared to baseline an increase was found in the percentage of sputum eosinophils and neutrophils, and in IL-10 concentration after SIC (p = 0.0078, p = 0.0195, and p = 0.046, respectively), and a decrease was seen in LTB4 level (p = 0.0078) in patients with OA due to HMW agents. An increase in the percentage of sputum neutrophils after SIC (p = 0.0040) was observed in subjects without OA exposed to LMW agents. IL-8 levels after SIC were higher in patients without OA compared with patients with OA (p = 0.0146). When conducting airway inflammation studies in OA, patients should be divided according to the causal agent (HMW or LMW). In OA patients exposed to HMW agents, an increase in the number of neutrophils can be found in parallel to the increase of eosinophils, although this does not contradict an IgE-mediated mechanism. Exposure to LMW agents can result in increased neutrophilic inflammation in patients with airway diseases unrelated to OA. There is variability in the responses observed in patients with OA exposed to LMW agents.
    PLoS ONE 01/2013; 8(11):e78304. · 3.53 Impact Factor
  • X Muñoz, S Sanchez-Vidaurre, O Roca, F Torres, F Morell, M J Cruz
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    ABSTRACT: Little research has been devoted to the characteristics of bronchial inflammation in patients with stable, well controlled asthma. The aim of this study was to assess the degree and type of airway inflammation and to investigate the relationship between inflammation and bronchial hyperresponsiveness in patients with well controlled asthma. A cross-sectional study was conducted in 84 adult patients (43 men, mean age 43 years) with documented well controlled asthma. Induced sputum samples were obtained and cell types determined by differential cell count. Spirometry and methacholine challenge testing were performed. Asthma Control Questionnaire (ACQ) was used to assess symptoms. Patients were included if their ACQ score was < 0.75. A total of 59 patients had persistent bronchial inflammation: 28 cases were considered eosinophilic, 28 neutrophilic, and 3 mixed. Median (range) percentage of eosinophils was 4% (0-64) in patients testing positive to methacholine challenge (n = 66) and 1% (0-3) in those testing negative (n = 18) (P = 0.003). A positive correlation was found between eosinophil percentage and the methacholine dose/response ratio (r = 0.477, P = 0.0001). The geometric mean (95% CI) of the methacholine PC20 was 1.74 mg/mL (1.04-2.93) in patients with eosinophilic inflammation and 4.14 mg/mL (2.5-6.84) in those with neutrophilic inflammation (P = 0.03). Inflammation and bronchial hyperresponsiveness persist in most patients with well controlled asthma. The study demonstrates that eosinophilic or neutrophilic inflammation persisted in most well controlled asthma patients despite the fact that their condition was controlled and therefore, measurement of bronchial inflammation seems essential to achieve proper asthma control.
    Clinical & Experimental Allergy 09/2012; 42(9):1321-8. · 4.79 Impact Factor
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    ABSTRACT: Establishing the role of exhaled breath condensate (EBC) analysis in work-related asthma (WRA), and more specifically, in conjunction with specific inhalation challenge (SIC), is difficult. To measure EBC pH, and nitrite/nitrate concentrations before and after SIC in individuals with suspected WRA exposed to either high-molecular-weight (HMW) or low-molecular-weight (LMW) agents and evaluate whether these changes are useful to distinguish between occupational asthma (OA) and work-exacerbated asthma (WEA). One hundred twenty-five consecutive workers undergoing SIC were enrolled. Exhaled breath condensate was collected at the end of the baseline day and 24 hours after exposure to the offending agent. In all EBC samples, pH was measured, and nitrite and nitrate concentrations were determined. Specific inhalation challenge was positive in 66 individuals, who were then diagnosed with OA. Work-exacerbated asthma was diagnosed in 14, and in 45 patients establishing a direct relationship between the symptoms and work exposure was not possible. In patients with WEA, EBC pH values after SIC were significantly lower than those before SIC (P = .0047). Using the receiver operating characteristic (ROC) curve, we found that an EBC pH decrease of greater than 0.4 units after SIC achieved the most satisfactory sensitivity 79% (confidence interval [CI]: 49-94) and specificity of 100% (CI: 68-100), considering only patients with asthma and without OA. A decrease in EBC pH of 0.4 or more common in those exposed to HMW agents (8/19, 42%) than in those exposed to LMW agents (7/47, 15%). Exhaled breath condensate pH in conjunction with SIC may be useful for diagnosing WEA.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 03/2012; 108(3):151-6. · 3.45 Impact Factor
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    ABSTRACT: Background Induced sputum is a non-invasive method for studying pulmonary inflammation.Objectives To assess pulmonary inflammation by analysis of induced sputum specimens in patients with systemic sclerosis and lung involvement, and to determine whether there is a correlation with the pulmonary function alterations in these patients.Methods Twenty-five patients with systemic sclerosis were included (20 women). Patients were divided into 3 groups according to the type of lung involvement: group 1, diffuse interstitial lung disease (n = 10); group 2, those with pulmonary arterial hypertension (n = 7), and group 3, patients with systemic sclerosis without lung involvement (n = 8). All patients underwent a complete lung function study. Induced sputum samples were obtained and differential cell count was performed by optic microscopy.ResultsThe mean percentage of sputum neutrophils was 85%, 71%, and 75% for groups 1, 2, and 3, respectively. A significant negative correlation between sputum total cell count and DLCO was seen in group 1 and group 3 (r = – 0.733, P = .016; and r = – 0.893, P = .007, respectively). This negative correlation was not observed in group 2.Conclusions Pulmonary inflammation was present in all patients with systemic sclerosis included in the study, regardless of the presence of documented signs of pulmonary involvement. This finding suggests that induced sputum could be helpful for detecting early abnormalities indicative of subclinical pulmonary involvement in patients with systemic sclerosis.
    Archivos de Bronconeumología. 01/2012; 48(1):8–13.
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    ABSTRACT: Induced sputum is a non-invasive method for studying pulmonary inflammation. To assess pulmonary inflammation by analysis of induced sputum specimens in patients with systemic sclerosis and lung involvement, and to determine whether there is a correlation with the pulmonary function alterations in these patients. Twenty-five patients with systemic sclerosis were included (20 women). Patients were divided into 3 groups according to the type of lung involvement: group 1, diffuse interstitial lung disease (n=10); group 2, those with pulmonary arterial hypertension (n=7), and group 3, patients with systemic sclerosis without lung involvement (n=8). All patients underwent a complete lung function study. Induced sputum samples were obtained and differential cell count was performed by optic microscopy. The mean percentage of sputum neutrophils was 85%, 71%, and 75% for groups 1, 2, and 3, respectively. A significant negative correlation between sputum total cell count and DLCO was seen in group 1 and group 3 (r=-0.733, P=.016; and r=-0.893, P=.007, respectively). This negative correlation was not observed in group 2. Pulmonary inflammation was present in all patients with systemic sclerosis included in the study, regardless of the presence of documented signs of pulmonary involvement. This finding suggests that induced sputum could be helpful for detecting early abnormalities indicative of subclinical pulmonary involvement in patients with systemic sclerosis.
    Archivos de Bronconeumología 11/2011; 48(1):8-13. · 2.17 Impact Factor
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    ABSTRACT: Few studies have addressed the effects of aging on levels of inflammatory markers in exhaled breath condensate (EBC). The aim of this study was to determine whether there are significant age-associated differences in pH, 8-isoprostane, and nitrogen oxide values in EBC from a population of healthy adults. EBC samples were obtained from 75 healthy volunteers aged 18 to 80 years and stratified into five groups according to age (n = 15): 18 to 29, 30 to 39 years, 40 to 49 years, 50 to 59 years, and 60 to 80 years. The following were measured in the samples collected: pH before and after deaeration, nitrite, nitrate, and 8-isoprostane. Differences between the groups were assessed by the Kruskal-Wallis test. Significant differences in deaerated pH (p < 0.0001) were found in the group of individuals 60 to 80 years of age as compared to the remaining groups. Significant differences were also found in 8-isoprostane levels between the younger and older groups (18 to 29 years and 30 to 39 years of age; p = 0.006 and p = 0.034, respectively). There were no significant differences in nitrite or nitrate values between younger and older individuals. The results of this study indicate that pH and 8-isoprostane levels in EBC show a relationship with age. Thus, values obtained in studies with control groups may require adjustment for these factors.
    Chest 11/2008; 135(2):462-7. · 5.85 Impact Factor