| 1. |
- Bake, Björn, 1939, et al.
(författare)
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Effects of pollen season on central and peripheral nitric oxide production in subjects with pollen asthma
- 2014
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111. ; 108:9, s. 1277-1283
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pollen exposure of allergic subjects with asthma causes increased nitric oxide (NO) in exhaled air (FENO) suggestive of increased airway inflammation. It is, however, unclear to what extent NO production in peripheral airways and alveoli are involved. Objectives: The aim of the present investigation was to analyze the relationship between central and peripheral components of FENO to clarify the distribution of pollen induced inflammation in asthma. Subjects and methods: 13 pollen allergic non-smoking subjects with mild-intermittent asthma and 12 healthy non-smoking control subjects were examined with spirometry and FENO at flows between 50 and 270 mL/s during and out of pollen season. Results: Spirometry was normal and unaffected by season in subjects with asthma as well as controls. Out of season subjects with asthma had significantly higher FENO, elevated airway production (JawNO) and preacinar/acinar production (CANO) than controls. Pollen exposure resulted in significantly increased FENO and JawNO but not CANO. FENO among controls were not affected by season. Individual results showed, however, that CANO increased substantially in a few subjects with asthma. The increased CANO in subjects with asthma may be explained by increased NO production in preacinar/acinar airways and back diffusion towards the alveoli. Conclusions: The findings may indicate that subjects with allergic asthma have airway inflammation without alveolar involvement outside the pollen season and pollen exposure causes a further increase of airway inflammation and in a few subjects obstruction of intra acinar airways causing impeded back diffusion. Increased NO production in central airways, unassociated with airway obstruction could be an alternative explanation. These effects were not disclosed by spirometry.
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| 2. |
- Baxter, Rebecca, et al.
(författare)
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COVID-19 : Opportunities for interdisciplinary research to improve care for older people in Sweden
- 2021
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 49:1, s. 29-32
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Tidskriftsartikel (refereegranskat)abstract
- The emergence of COVID-19 has changed the world as we know it, arguably none more so than for older people. In Sweden, the majority of COVID-19-related fatalities have been among people aged ⩾70 years, many of whom were receiving health and social care services. The pandemic has illuminated aspects within the care continuum requiring evaluative research, such as decision-making processes, the structure and organisation of care, and interventions within the complex public-health system. This short communication highlights several key areas for future interdisciplinary and multi-sectorial collaboration to improve health and social care services in Sweden. It also underlines that a valid, reliable and experiential evidence base is the sine qua non for evaluative research and effective public-health systems.
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| 3. |
- Ericson, Petrea, 1966, et al.
(författare)
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Low Levels of Exhaled Surfactant Protein A Associated With BOS After Lung Transplantation
- 2016
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Ingår i: Transplantation Direct. - : Ovid Technologies (Wolters Kluwer Health). - 2373-8731. ; 2:9
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Tidskriftsartikel (refereegranskat)abstract
- Background. There is no clinically available marker for early detection or monitoring of chronic rejection in the form of bronchiolitis obliterans syndrome (BOS), the main long-term complication after lung transplantation. Sampling and analysis of particles in exhaled air is a valid, noninvasive method for monitoring surfactant protein A (SP-A) and albumin in the distal airways. Methods. We asked whether differences in composition of exhaled particles can be detected when comparing stable lung transplant recipients (LTRs) (n = 26) with LTRs who develop BOS (n = 7). A comparison between LTRs and a matching group of healthy controls (n = 33) was also conducted. Using a system developed in-house, particles were collected from exhaled air by the principal of inertial impaction before chemical analysis by immunoassays. Results. Surfactant protein A in exhaled particles and the SP-A/albumin ratio were lower (P = 0.002 and P = 0.0001 respectively) in the BOS group compared to the BOS-free group. LTRs exhaled higher amount of particles (P < 0.0001) and had lower albumin content (P < 0.0001) than healthy controls. Conclusions. We conclude that low levels of SP-A in exhaled particles are associated with increased risk of BOS in LTRs. The possibility that this noninvasive method can be used to predict BOS onset deserves further study with prospective and longitudinal approaches.
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| 4. |
- Kjellberg, Sanna, et al.
(författare)
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Utility of single versus multiple breath washout in adult asthma
- 2018
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Ingår i: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961. ; 38:6, s. 936-943
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Tidskriftsartikel (refereegranskat)abstract
- Nitrogen multiple breath washout (N-2 MBW) is a sensitive method to identify peripheral airway involvement in asthma, but is a time-consuming test. The N-2 vital capacity single breath (VC SBW) test offers greater time efficiency, but concordance with N-2 MBW is poorly understood. The prevalence of peripheral airway abnormality was determined by N-2 MBW and N-2 SBW tests in 194 asthmatic subjects aged 18-1years. N-2 MBW data were related to findings in 400 healthy controls, aged 17-71years, while N-2 SBW data were compared to findings in 224 healthy controls, aged 15-65years, to derive equipment-specific reference values. Amongst asthmatic subjects, relationships between N-2 SBW and N-2 MBW outcomes were studied. N-2 SBW relationship with clinical history, spirometry, blood eosinophils and fraction exhaled nitric oxide (FENO) data was also explored. The prevalence of peripheral airway involvement (i.e. abnormal ventilation distribution) determined by N-2 SBW-derived phase III slope (N-2 S-III) was 247%, compared to 44% determined by N-2 MBW-derived lung clearance index (LCI) (P<0001). Predictors of abnormal N-2 S-III were older age, smoking history and lower FEV1. N-2 SBW offers lower sensitivity than N-2 MBW to detect small airway dysfunction in adult asthma, but may be a marker of more severe disease.
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| 5. |
- Ljungkvist, Göran, 1949, et al.
(författare)
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Exploring a new method for the assessment of metal exposure by analysis of exhaled breath of welders
- 2022
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 95:6, s. 1255-1265
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Air monitoring has been the accepted exposure assessment of toxic metals from, e.g., welding, but a method characterizing the actual dose delivered to the lungs would be preferable. Sampling of particles in exhaled breath can be used for the biomonitoring of both endogenous biomarkers and markers of exposure. We have explored a new method for the sampling of metals in exhaled breath from the small airways in a study on welders. Methods Our method for particle sampling, Particles in Exhaled Air (PExA (R)), is based on particle counting and inertial impaction. We applied it on 19 stainless steel welders before and after a workday. In parallel, air monitoring of chromium, manganese and nickel was performed as well as blood sampling after work. Results Despite substantial exposure to welding fumes, we were unable to show any significant change in the metal content of exhaled particles after, compared with before, exposure. However, the significance might be obscured by a substantial analytical background noise, due to metal background in the sampling media and possible contamination during sampling, as an increase in the median metal contents were indicated. Conclusions If efforts to reduce background and contamination are successful, the PExA (R) method could be an important tool in the investigations of metals in exhaled breath, as the method collects particles from the small airways in contrast to other methods. In this paper, we discuss the discrepancy between our findings and results from studies, using the exhaled breath condensate (EBC) methodology.
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| 6. |
- Ljungkvist, Göran, 1949, et al.
(författare)
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Two techniques to sample non-volatiles in breath-exemplified by methadone.
- 2018
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Ingår i: Journal of breath research. - : IOP Publishing. - 1752-7163. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- The particles in exhaled breath provide a promising matrix for the monitoring of pathological processes in the airways, and also allow exposure to exogenous compounds to be to assessed. The collection is easy to perform and is non-invasive. The aim of the present study is to assess if an exogenous compound-methadone-is distributed in the lining fluid of small airways, and to compare two methods for collecting methadone in particles in exhaled breath. Exhaled particles were collected from 13 subjects receiving methadone maintenance treatment. Two different sampling methods were applied: one based on electret filtration, potentially collecting exhaled particles of all sizes, and one based on impaction, collecting particles in the size range of 0.5-7 μm, known to reflect the respiratory tract lining fluid from the small airways. The collected samples were analyzed by liquid chromatography mass spectrometry, and the impact of different breathing patterns was also investigated. The potential contribution from the oral cavity was investigated by rinsing the mouth with a codeine solution, followed by codeine analysis of the collected exhaled particles by both sampling methods. The results showed that methadone was present in all samples using both methods, but when using the method based on impaction, the concentration of methadone in exhaled breath was less than 1% of the concentration collected by the method based on filtration. Optimizing the breathing pattern to retrieve particles from small airways did not increase the amount of exhaled methadone collected by the filtration method. The contamination from codeine present in the oral cavity was only detected in samples collected by the impaction method. We conclude that methadone is distributed in the respiratory tract lining fluid of small airways. The samples collected by the filtration method most likely contained a contribution from the upper airways/oral fluid in contrast to the impaction method.
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| 7. |
- Ljungqvist, Göran, et al.
(författare)
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Lipid composition of particles in exhaled air (PEx) from workers exposed to welding fumes
- 2016
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Ingår i: The European respiratory journal. Vol. 48, Suppl 60. PA385. - 0904-1850.
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Konferensbidrag (refereegranskat)abstract
- More than two million workers are exposed to pneumotoxic welding aerosols and there is a need for biomarkers of effects on the respiratory system. The lipid composition of the respiratory tract lining fluid (RTLF) is such a potential marker. The most abundant pulmonary surfactant phospholipid is dipalmitoylphosphocholine (DPPC). It is specific for the airways, while palmitoyloleoylphosphatidylcholine (POPC) is a common lipid in tissues and body fluids. We hypothesize that the amounts of or ratio between DPPC and DOPC are changed due to short term and/or long term exposure to welding fumes. We have developed a method for the collection of PEx, based on counting of the exhaled particles and subsequent collection by impaction on a teflon membrane. We have also developed a method for analysis of lipids in PEx based on LC/MS. We measured the exposure to iron, manganese, chromium and nickel of 18 stainless steel welders and also analyzed DPPC and DOPC in PEx samples taken at the end of the exposure measurement day. The welders working history was also recoded and summarized as welding years. Spirometry and nitrogen multiple breath wash out were also measured but the results are not yet evaluated. There were no significant correlations between the short term exposure to either iron, manganese, chromium or nickel and the fraction of DPPC in PEx or the ratio DPPC/DOPC. However, there was a tendency of correlation (Spearman correlation coefficient= 0.407 with p-value 0.09) between welding years and the DPPC/DOPC ratio. In this pilot study we could not establish short term effects of welding exposure on the RTFL lipid composition but a tendency of change due the long time exposure.
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| 8. |
- Soares, M., et al.
(författare)
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Particles in exhaled air (PExA): non-invasive phenotyping of small airways disease in adult asthma
- 2018
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Ingår i: Journal of Breath Research. - : IOP Publishing. - 1752-7155 .- 1752-7163. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Asthma is often characterised by inflammation, damage and dysfunction of the small airways, but no standardised biomarkers are available. Objectives: Using a novel approach-particles in exhaled air (PExA)-we sought to (a) sample and analyse abundant protein biomarkers: surfactant protein A (SPA) and albumin in adult asthmatic and healthy patients and (b) relate protein concentrations with physiological markers using phenotyping. Methods: 83 adult asthmatics and 21 healthy volunteers were recruited from a discovery cohort in Leicester, UK, and 32 adult asthmatics as replication cohort from Sweden. Markers of airways closure/small airways dysfunction were evaluated using forced vital capacity, impulse oscillometry and multiple breath washout. SPA/albumin from PEx (PExA sample) were analysed using ELISA and corrected for acquired particle mass. Topological data analysis (TDA) was applied to small airway physiology and PExA protein data to identify phenotypes. Results: PExA manoeuvres were feasible, including severe asthmatic subjects. TDA identified a clinically important phenotype of asthmatic patients with multiple physiological markers of peripheral airway dysfunction, and significantly lower levels of both SPA and albumin. Conclusion: We report that the PExA method is feasible across the spectrum of asthma severity and could be used to identify small airway disease phenotypes.
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| 9. |
- Tinglev, A. D., et al.
(författare)
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Characterization of exhaled breath particles collected by an electret filter technique
- 2016
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Ingår i: Journal of Breath Research. - : IOP Publishing. - 1752-7155 .- 1752-7163. ; 10:2
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Tidskriftsartikel (refereegranskat)abstract
- Aerosol particles that are present in exhaled breath carry nonvolatile components and have gained interest as a specimen for potential biomarkers. Nonvolatile compounds detected in exhaled breath include both endogenous and exogenous compounds. The aim of this study was to study particles collected with a new, simple and convenient filter technique. Samples of breath were collected from healthy volunteers from approximately 30 l of exhaled air. Particles were counted with an optical particle counter and two phosphatidylcholines were measured by liquid chromatography-tandem mass spectrometry. In addition, phosphatidylcholines and methadone was analysed in breath from patients in treatment with methadone and oral fluid was collected with the Quantisal device. The results demonstrated that the majority of particles are <1 mu m in size and that the fraction of larger particle contributes most to the total mass. The phosphatidylcholine PC(16 : 0/16 : 0) dominated over PC(16 : 0/18 : 1) and represented a major constituent of the particles. The concentration of the PC(16 : 0/16 : 0) homolog was significantly correlated (p < 0.001) with total mass. From the low concentration of the two phosphatidylcholines and their relative abundance in oral fluid a major contribution from the oral cavity could be ruled out. The concentration of PC(16 : 0/16 : 0) in breath was positively correlated with age (p < 0.01). An attempt to use PC(16 : 0/16 : 0) as a sample size indicator for methadone was not successful, as the large intra-individual variability between samplings even increased after normalization. In conclusion, it was demonstrated that exhaled breath sampled with the filter device represents a specimen corresponding to surfactant. The possible use of PC(16 : 0/16 : 0) as a sample size indicator was supported and deserves further investigations. We propose that the direct and selective collection of the breath aerosol particles is a promising strategy for measurement of nonvolatiles in breath.
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| 10. |
- Vaartio-Rajalin, Heli, et al.
(författare)
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Understanding health, subjective aging, and participation in social activities in later life : a regional Finnish survey
- 2024
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Ingår i: Journal of Applied Gerontology. - : Sage Publications. - 0733-4648 .- 1552-4523. ; 43:6, s. 638-649
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Tidskriftsartikel (refereegranskat)abstract
- To understand health and well-being in later life, it is vital to consider the meaning of subjective aging. This study aimed to explore how perceived health, self-perceptions of aging, and participation in social activities relate to each other among older persons in the Bothnia region and Åland islands in Finland. Data were analyzed using Spearman’s and polychoric correlation and multinomial logistic regression analyses. The perceived good health and the younger physical, psychological, and social dimensions of subjective age were found to be associated with each other and with participation in social activities outside one's home.
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| 11. |
- Viklund, Emilia, et al.
(författare)
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Current smoking alters phospholipid- and surfactant protein A levels in small airway lining fluid: An explorative study on exhaled breath
- 2021
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 16:6
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Tidskriftsartikel (refereegranskat)abstract
- Small airways are difficult to access. Exhaled droplets, also referred to as particles, provide a sample of small airway lining fluid and may reflect inflammatory responses. We aimed to explore the effect of smoking on the composition and number of exhaled particles in a smoker-enriched study population. We collected and chemically analyzed exhaled particles from 102 subjects (29 never smokers, 36 former smokers and 37 current smokers) aged 39 to 83 years (median 63). A breathing maneuver maximized the number exhaled particles, which were quantified with a particle counter. The contents of surfactant protein A and albumin in exhaled particles was quantified with immunoassays and the contents of the phospholipids dipalmitoyl- and palmitoyl-oleoyl- phosphatidylcholine with mass spectrometry. Subjects also performed spirometry and nitrogen single breath washout. Associations between smoking status and the distribution of contents in exhaled particles and particle number concentration were tested with quantile regression, after adjusting for potential confounders. Current smokers, compared to never smokers, had higher number exhaled particles and more surfactant protein A in the particles. The magnitude of the effects of current smoking varied along the distribution of each PEx-variable. Among subjects with normal lung function, phospholipid levels were elevated in current smokers, in comparison to no effect of smoking on these lipids at abnormal lung function. Smoking increased exhaled number of particles and the contents of lipids and surfactant protein A in the particles. These findings might reflect early inflammatory responses to smoking in small airway lining fluid, also when lung function is within normal limits.
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| 12. |
- Viklund, Emilia
(författare)
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Exploring small airways using breath analyses
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Airway irritants such as allergens, tobacco smoke and viruses may cause damage in the small airways, usually undetected with routine diagnostic methods. Analyses of endogenously produced nitric oxide (NO) and endogenously produced small droplets (i.e. particles) in breath (PEx), have the potential to reflect exposure related changes in the small airways. Furthermore, in PEx, both exposure and effect markers can potentially be analyzed. Aim: The overall aim of this thesis was to explore small airway effects of exposure to airway irritants in healthy subjects, in subjects with asthma, in cigarette smokers and in subjects with COVID-19 infection, by examining exhaled breath. Methods: We explored methods to model alveolar NO (CANO), the number of PEx as well as content of major surfactant lipids and proteins in PEx. In addition, we explored if COVID-19 infection could be detected in PEx. Results: Pollen season was not associated with an increase in CANO, although it was markedly increased in some subjects with asthma. Small airways ventilation inhomogeneity in subjects with asthma was associated with slightly increased CANO on group level, and markedly increased in some subjects, with no difference on levels of surface active lipids in PEx but markedly decreased number of PEx. Current compared to never smokers were associated with higher levels of lipids in PEx in subjects with normal lung function. Current smokers were associated with higher levels of surfactant protein A in PEx and number PEx in subjects with impaired lung function. Detection of SARS-CoV-2 RNA was possible in PEx, in some but not all subjects early in disease course of COVID-19. RT-PCR analyses were performed on PEx-samples generated from as little as 20 relaxed breaths, 10 deep breaths and 3 coughs. Conclusions: These results of breath analyses including endogenously produced particles and alveolar NO highlight the potential of these methods to reveal effects of airway irritants in small airways prior to lung function decline. Furthermore, PEx are shown to contain SARS-CoV-2 RNA in subjects with confirmed COVID-19, highlighting the potential of detecting respiratory virus infection in exhaled breath.
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| 13. |
- Viklund, Emilia, et al.
(författare)
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Severe acute respiratory syndrome coronavirus 2 can be detected in exhaled aerosol sampled during a few minutes of breathing or coughing
- 2022
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Ingår i: Influenza and other Respiratory Viruses. - : Wiley. - 1750-2640 .- 1750-2659. ; 16:3, s. 402-10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The knowledge on the concentration of viral particles in exhaled breath is limited. The aim of this study was to explore if severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be detected in aerosol from subjects with the coronavirus disease 2019 (COVID-19) during various types of breathing and coughing and how infection with SARS-CoV-2 may influence the number and size of exhaled aerosol particles. Methods: We counted and collected endogenous particles in exhaled breath in subjects with COVID-19 disease by two different impaction-based methods, during 20 normal breaths, 10 airway opening breaths, and three coughs, respectively. Breath samples were analyzed with reverse transcription real-time polymerase chain reaction (RT-PCR). Results: Detection of RNA in aerosol was possible in 10 out of 25 subjects. Presence of virus RNA in aerosol was mainly found in cough samples (n = 8), but also in airway opening breaths (n = 3) and in normal breaths (n = 4), with no overlap between the methods. No association between viral load in aerosol and number exhaled particles <5μm was found. Subjects with COVID-19 exhaled less particles than healthy controls during normal breathing and airway opening breaths (all P < 0.05), but not during cough. Conclusion: SARS-CoV-2 RNA can be detected in exhaled aerosol, sampled during a limited number of breathing and coughing procedures. Detection in aerosol seemed independent of viral load in the upper airway swab as well as of the exhaled number of particles. The infectious potential of the amount of virus detected in aerosol needs to be further explored.
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| 14. |
- Viklund, Emilia W.E., et al.
(författare)
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Nordic population-based study on internet use and perceived meaningfulness in later life: How they are linked and why it matters
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 50, s. 381-388
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim was to explore the association between internet use, the use of specific internet-based activities and perceiving life as meaningful, among older adults in two regions in Finland and Sweden.Methods: The data was collected through a population-based survey (N = 9386) as part of the GERDA project conducted in 2016. In order to analyse the associations between perceiving life as meaningful and internet use and related activities, odds ratios with a 95% confidence interval were calculated using binary logistic regression analysis, where socio-demographic factors and health status were controlled for.Results: Statistically significant associations were found between perceiving life as meaningful and internet use in later life. When looking further at the specific internet-based activities under study, activities related to leisure and entertainment showed a statistically significant connection to perceived meaningfulness in later life, after controlling for socio-demographic factors and health status.Conclusions: The results indicated that there was a statistically significant positive association between internet use and perceiving life as meaningful in later life. Online activities related to leisure and entertainment seem to be especially associated with perceived meaningfulness. Although causal direction could not be determined, the results suggest that internet use may support the experience of wellbeing in everyday life among older persons, through the unlimited access to interest-driven activities that it provides.
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| 15. |
- Viklund, Emilia W.E., et al.
(författare)
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The perks and struggles of participatory approaches : exploring older persons’ experiences of participating in designing and developing an application
- 2023
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Ingår i: Gerontechnology. - : International Society for Gerontechnology (ISG). - 1569-1101 .- 1569-111X. ; 22:1, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Innovative multidisciplinary and person-centred initiatives are needed to promote well-being among older persons. In order to approach these goals, both health promotion and the field of innovation studies recognise the importance of the meaningful engagement of older persons in development processes. Participatory approaches are applied within technology development, but previous studies highlight a lack of knowledge about how they matter—especially for the persons who are participating in the co-creation process. Objective: The study explores older persons’ experiences of participating in an innovation project. Method: The study is part of the @geing Online project. Semi-structured interviews were conducted at several intervals during and after the project in two regions in Finland and were analysed using thematic analysis. In total, 38 older individuals participated.Results: The older persons perceived that participating in an innovation project can be an uplifting experience that increases their interest and confidence in digital technology use by combating stereotypes. Additionally, being able to make one’s own and other older persons’ voices heard regarding services targeting older persons in collaboration with local universities was also perceived as valuable. However, the participation did not fully live up to all the older participants’ expectations. Feelings of disappointment emerged in relation to their own performance with the prototypes being developed, as well as the fear of failing the project team. Additional sources of disappointment were related to the fact that the participants did not increase their knowledge of new and familiar digital technology to the extent that they had hoped. Conclusion: The findings of this study highlight experiences of taking part in an innovation project focusing on technology design with a participatory approach, depicting the benefits, motivators, and challenges. This kind of knowledge is important in order to improve future participatory practice in gerontechnology endeavours.
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| 16. |
- Östling, Jörgen, et al.
(författare)
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A novel non-invasive method allowing for discovery of pathologically relevant proteins from small airways
- 2022
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Ingår i: Clinical Proteomics. - : Springer Science and Business Media LLC. - 1542-6416 .- 1559-0275. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a lack of early and precise biomarkers for personalized respiratory medicine. Breath contains an aerosol of droplet particles, which are formed from the epithelial lining fluid when the small airways close and re-open during inhalation succeeding a full expiration. These particles can be collected by impaction using the PExA (R) method (Particles in Exhaled Air), and are derived from an area of high clinical interest previously difficult to access, making them a potential source of biomarkers reflecting pathological processes in the small airways. Research question: Our aim was to investigate if PExA method is useful for discovery of biomarkers that reflect pathology of small airways. Methods and analysis: Ten healthy controls and 20 subjects with asthma, of whom 10 with small airway involvement as indicated by a high lung clearance index (LCI >= 2.9 z-score), were examined in a cross-sectional design, using the PExA instrument. The samples were analysed with the SOMAscan proteomics platform (SomaLogic Inc.). Results: Two hundred-seven proteins were detected in up to 80% of the samples. Nine proteins showed differential abundance in subjects with asthma and high LCI as compared to healthy controls. Two of these were less abundant (ALDOA4, C4), and seven more abundant (FIGF, SERPINA1, CD93, CCL18, F10, IgM, IL1RAP). sRAGE levels were lower in ex-smokers (n = 14) than in never smokers (n = 16). Gene Ontology (GO) annotation database analyses revealed that the PEx proteome is enriched in extracellular proteins associated with extracellular exosome-vesicles and innate immunity. Conclusion: The applied analytical method was reproducible and allowed identification of pathologically interesting proteins in PEx samples from asthmatic subjects with high LCI. The results suggest that PEx based proteomics is a novel and promising approach to study respiratory diseases with small airway involvement.
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