Todor A. Popov

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Exhaled Breath Temperature andRespiratory
Disease

• Todor A. Popov
• Medical University Sofia, Bulgaria

tedpop_at_rtb-mu.com
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Asthma monitoring routine approach

• Asthma symptoms
• Daytime
• Nighttime
• Rescue medication need
• Objective measurements
• Spirometry
• PEFR monitoring

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Mechanisms Underlying the Definition of Asthma

• Risk Factors
• (for development of asthma)

INFLAMMATION
Airway Hyperresponsiveness
Airflow Obstruction
Symptoms
Risk Factors (for exacerbations)
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Classification of methodsfor assessment of
inflammation in asthma
Pizzichini et al., 2005
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Inflammation characteristic features

• Rubor
• Tumor
• Calor
• Dolor
• Function lesa

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McFadden ER Jr, Pichurko BM, Bowman HF et al.
Thermal mapping of the airways in humans.J Appl
Physiol. 1985 58 564-70.
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Paredi P, Kharitonov SA, Barnes PJ. Faster rise
of exhaled breath temperature in asthma a novel
marker of airway inflammation? Am J Respir Crit
Care Med 2001 165 181184.
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Paredi P, Kharitonov SA, Barnes PJ.Correlation
of exhaled breath temperature with bronchial
blood flow in asthma. Respiratory Research
2005 6, 15 1-10.
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Paredi P, Kharitonov SA, Barnes PJ.Correlation
of exhaled breath temperature with bronchial
blood flow in asthma. Respiratory Research
2005 6, 15 1-10.
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Paredi P, Kharitonov SA, Barnes PJ.Correlation
of exhaled breath temperature with bronchial
blood flow in asthma. Respiratory Research
2005 6, 15 1-10.
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Piacentini GL, Peroni D, Crestani E, et al..
Exhaled air temperature in asthma methods and
relationship with markers of disease. Clin
Exper Allergy 2007 37 415419.
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Piacentini GL, Peroni D, Crestani E, et al..
Exhaled air temperature in asthma methods and
relationship with markers of disease. Clin
Exper Allergy 2007 37 415419.
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Piacentini GL, Peroni D, Crestani E, et al..
Exhaled air temperature in asthma methods and
relationship with markers of disease. Clin
Exper Allergy 2007 37 415419.
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Popov TA, Dunev S, Kralimarkova T, Kraeva S, Du
Buske LM.Evaluation of a Simple, Potentially
Individual Device for Exhaled Breath Temperature
Measurement. Respiratory Medicine 2007
(in press)
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Exhaled breath temperature device (EBTD)
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Popov TA, Dunev S, Kralimarkova T, Kraeva S, Du
BuskeLM.Evaluation of a Simple, Potentially
Individual Device for Exhaled Breath Temperature
Measurement. Respiratory Medicine 2007
(in press)

• Essence
• Device and method to measure exhaled breath
  temperature.
• Objectives of the study
• To evaluated the repeatability / reliablity of
  the measurements.
• To discrminate between asthmatics and
  non-asthmatics.
• To assess changes in the asthmatic airways under
  anti-inflammatory treatment.

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Popov TA et al., Respiratory mMedicine 2007 (in
press)
Study Design (1) Reliability study

• Association between EBT and indoor air
  characteristics (room temperature, atmospheric
  pressure, relative humidity)
• Association between EBT and body characteristics
  (age, gender, height, weight, pulse, systolic and
  diastolic blood pressure, otic and axillary
  temperature)
• Repeatability of EBT measurements on consecutive
  days (17 non-smoking healthy subjects).

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Popov TA et al., Respiratory mMedicine 2007 (in
press)
Study Design (2) Discriminative study

• EBT of 17 healthy subjects was compared with EBT
  of 14 patients with uncontrolled asthma as
  defined according to Level of control in the
  latest edition of GINA 2006

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Popov TA et al., Respiratory mMedicine 2007 (in
press)
Study Design (3) Treatment study

• EBT and spirometry were assessed in the same 14
  patients with uncontrolled asthma after one week
  of anti-inflammatory treatment with inhaled
  corticosteroid (ICS) or systemic steroid (SCS) as
  prescribed by the treating physician

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Popov TA et al., JACI 2006
Exhaled Breath Temperature Study Results 1

• Multiple regression analysis
• ? EBT as dependent variable
• Indoor characteristics - ?
• Human physiologic characteristics - ?

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Popov TA et al., JACI 2006
Exhaled Breath Temperature Study Results 1

• Correlations

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Bland Altman plot of day-to-day EBT measurements
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EBT and relationship with otic and axillary T
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EBT and FEV1 of uncontrolled asthmatics before
and after antiinflammatory treatment
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Onset of symptoms
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Popov TA et al., JACI 2006
Exhaled Breath Temperature device
Study Conclusions

• The device we constructed can measure the
  temperature of exhaled breath in human subjects
  in a simple and user-friendly way.
• Further experiments are warranted to find out if
  it can be applied as individual device for
  asthmatics to assess the degree of control of
  their airway inflammation.

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GARDGlobal Alliance against Chronic Respiratory
Diseases
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