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Kezeminasab S, Emamalizadeh B, Khoubnasabjafari M, Jouyban A. Exhaled Breath Condensate: A Non-Invasive Source for Tracking of Genetic and Epigenetic Alterations in Lung Diseases. PHARMACEUTICAL SCIENCES 2020. [DOI: 10.34172/ps.2020.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Lung diseases have been recognized as an extensive cause of morbidity and mortality in the worldwide. The high degree of clinical heterogeneity and nonspecific initial symptoms of lung diseases contribute to a delayed diagnosis. So, the molecular and genomic profiling play a pivotal role in promoting the pulmonary diseases. Exhaled breath condensate (EBC) as a novel and potential method for sampling the respiratory epithelial lining fluid is to assess the inflammatory and oxidative stress biomarkers, drugs and genetic alterations in the pathophysiologic processes of lung diseases. The recent studies on the analysis of EBC from both a genetic and epigenetic point of view were searched from database and reviewed. This review provides an overview of the current findings in the tracking of genomic and epigenetic alterations which are potentially effective in better management of cancer detection. In addition, respiratory microbiota DNA using EBC samples in association with pulmonary disease especially lung cancer were investigated. Various studies have concluded that EBC has a great potential for analysis of nuclear and mitochondrial DNA alterations as well as epigenetic modifications and identification of respiratory microbiome. Next-generation sequencing (NGS) based genomic profiling of EBC samples is recommended as a promising approach to establish personalized based prevention, diagnosis, treatment and post-treatment follow-ups for patients with lung diseases especially lung cancer.
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Affiliation(s)
- Somayeh Kezeminasab
- Pharmaceutical Analysis Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Emamalizadeh
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Khoubnasabjafari
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abolghasem Jouyban
- Pharmaceutical Analysis Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
- Kimia Idea Pardaz Azerbaijan (KIPA) Science-Based Company, Tabriz University of Medical Sciences, Tabriz, Iran
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Campanella A, De Summa S, Tommasi S. Exhaled breath condensate biomarkers for lung cancer. J Breath Res 2019; 13:044002. [PMID: 31282387 DOI: 10.1088/1752-7163/ab2f9f] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lung cancer is the main cause of cancer incidence and mortality worldwide and the identification of clinically useful biomarkers for lung cancer detection at both early and metastatic stage is a pressing medical need. Although many improvements have been made in the treatment and in the early screening of this cancer, most diagnosis are made at a late stage, when a lot of genetic and epigenetic changes have occurred. A promising source of biomarkers reflective of the pathogenesis of lung cancer is exhaled breath condensate (EBC), a biological fluid and a natural matrix of the respiratory tract. Molecules such as DNAs, RNAs, proteins, metabolites and volatile compounds are present in EBC, and their presence/absence or their variation in concentrations can be used as biomarkers. The aims of this review are to briefly describe exhaled breath composition, firstly, and then to document some of the EBC candidate biomarkers for lung cancer by dividing them according to their origin (genome, transcriptome, epigenome, metabolome, proteome and microbiota) in order to demonstrate the potential use of EBC as a helpful tool in cancer diagnostics, molecular profiling, therapy monitoring and screening of high risk individuals.
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Affiliation(s)
- Annalisa Campanella
- Pharmacogenetics and Molecular Diagnostic Unit, IRCCS Istituto Tumori 'Giovanni Paolo II', Bari, Italy
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3
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Carpagnano GE, Lacedonia D, Crisetti E, Martinelli D, Foschino-Barbaro MP. New panel of microsatellite alterations detectable in the EBC for lung cancer prognosis. J Cancer 2016; 7:2266-2269. [PMID: 27994663 PMCID: PMC5166536 DOI: 10.7150/jca.15921] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/30/2016] [Indexed: 01/11/2023] Open
Abstract
Our research group demonstrated, in a precedent study, the prognostic power of the 3p microsatellites alterations (MAs) detectable in exhaled breath condensate (EBC) in NSCLC patients. The analysis of genetic markers in the EBC might have precious clinical and economic consequences when inserted in diagnostic and follow up programs for lung cancer. The aim of this study was to evaluate the prognostic value of a new panel of MAs in the EBC of patients with NSCLC. We enrolled 45 NSCLC patients during a period of 36 months and the follow-up period was 156 weeks. We analyzed MAs for eight markers in EBC samples: D3S2338, D3S1266, D3S1300, D3S1304, D3S1289, D5S2094, D3S1313, and AFMa305ye1. Our study showed that the presence of more than 2 simultaneous MAs reduces outcome in NSCLC patients. The new panel of eight microsatellites markers proposed in EBC samples could have a potential clinical role in assessing survival in lung cancer patients.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Donato Lacedonia
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Elisabetta Crisetti
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Domenico Martinelli
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Maria P Foschino-Barbaro
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
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Youssef O, Sarhadi VK, Armengol G, Piirilä P, Knuuttila A, Knuutila S. Exhaled breath condensate as a source of biomarkers for lung carcinomas. A focus on genetic and epigenetic markers-A mini-review. Genes Chromosomes Cancer 2016; 55:905-914. [DOI: 10.1002/gcc.22399] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 12/12/2022] Open
Affiliation(s)
- Omar Youssef
- Faculty of Medicine; Department of Pathology, University of Helsinki; Helsinki Finland
| | - Virinder Kaur Sarhadi
- Faculty of Medicine; Department of Pathology, University of Helsinki; Helsinki Finland
| | - Gemma Armengol
- Unit of Biological Anthropology, Department of Animal Biology, Plant Biology and Ecology, Universitat Autònoma De Barcelona; Barcelona Catalonia Spain
| | - Päivi Piirilä
- Unit of Clinical Physiology, HUS-Medical Imaging Center, Helsinki University Hospital and Helsinki University; Helsinki Finland
| | - Aija Knuuttila
- Department of Pulmonary Medicine; University of Helsinki and Helsinki University Hospital, Heart and Lung Center; Helsinki Finland
| | - Sakari Knuutila
- Faculty of Medicine; Department of Pathology, University of Helsinki; Helsinki Finland
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Warth A, Körner S, Penzel R, Muley T, Dienemann H, Schirmacher P, von Knebel-Doeberitz M, Weichert W, Kloor M. Microsatellite instability in pulmonary adenocarcinomas: a comprehensive study of 480 cases. Virchows Arch 2015; 468:313-9. [PMID: 26637197 DOI: 10.1007/s00428-015-1892-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/27/2015] [Accepted: 11/25/2015] [Indexed: 02/06/2023]
Abstract
A major molecular pathway of genetic instability in cancer is DNA mismatch repair deficiency, leading to accumulation of numerous mutations at repetitive DNA sequence stretches (microsatellites), known as high-level microsatellite instability (MSI-H). In colorectal cancer, MSI-H tumors show a clinical behavior different from microsatellite-stable (MSS) tumors. Data about the prevalence of MSI among non-small cell lung cancer (NSCLC) are conflicting, and clinical relevance of MSI is largely unknown. We analyzed a series of 480 pulmonary adenocarcinomas (ADC) for MSI using a sensitive mononucleotide marker panel (BAT25, BAT26, and CAT25). Positive cases were further analyzed by immunohistochemical staining for DNA mismatch repair proteins. Results were correlated with clinicopathological variables. MSI-H was detected in 4/480 (0.8 %) cases. In none of these, a background of Lynch syndrome was found. Three of the patients developed a metachronous carcinoma (esophagus, pancreas, and kidney). All MSI-H cases were stage I and occurred in smokers/ex-smokers. Mutations were found in EGFR (n = 2), KRAS (n = 1), or BRAF (n = 1). MSI-H neoplasms had a higher proliferative activity (38.7 %) than MSS neoplasms (28.3 %). Mean overall survival for MSS and MSI-H cases was 64.8 (CI 60.4-69.1) and 47.1 (CI 21-73.2) months, respectively. When specific mononucleotide marker panels are applied, the MSI-H phenotype is rare and predominantly found in early stage ADC of smokers. However, the frequency of MSI-H is in the range of other relevant molecular alterations. In the era of precision therapy, associations with distinct clinicopathological variables merit further investigation.
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Affiliation(s)
- Arne Warth
- Institute of Pathology, Heidelberg University, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany.
| | - Sandrina Körner
- Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Roland Penzel
- Institute of Pathology, Heidelberg University, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Thomas Muley
- Translational Research Unit, Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | - Hendrik Dienemann
- Department of Thoracic Surgery, Thoraxklinik at Heidelberg University, Heidelberg, Germany
| | - Peter Schirmacher
- Institute of Pathology, Heidelberg University, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | | | - Wilko Weichert
- Institute of Pathology, Heidelberg University, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Institute of Pathology, Technical University Munich (TUM), Munich, Germany
| | - Matthias Kloor
- Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany.,Molecular Medicine Partnership Unit, University of Heidelberg and European Molecular Biology Laboratory, Heidelberg, Germany.,Clinical Cooperation Unit Applied Tumor Biology, DKFZ, Heidelberg, Germany
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Carper MB, Claudio PP. Clinical potential of gene mutations in lung cancer. Clin Transl Med 2015; 4:33. [PMID: 26603430 PMCID: PMC4658345 DOI: 10.1186/s40169-015-0074-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 10/15/2015] [Indexed: 12/11/2022] Open
Abstract
Lung cancer is the most common cancer type worldwide and the leading cause of cancer related deaths in the United States. The majority of newly diagnosed patients present with late stage metastatic lung cancer that is inoperable and resistant to therapies. High-throughput genomic technologies have made the identification of genetic mutations that promote lung cancer progression possible. Identification of the mutations that drive lung cancer provided new targets for non-small cell lung cancer (NSCLC) treatment and led to the development of targeted therapies such as tyrosine kinase inhibitors that can be used to combat the molecular changes that promote cancer progression. Development of targeted therapies is not the only clinical benefit of gene analysis studies. Biomarkers identified from gene analysis can be used for early lung cancer detection, determine patient’s prognosis and response to therapy, and monitor disease progression. Biomarkers can be used to identify the NSCLC patient population that would most benefit from treatment (targeted therapies or chemotherapies), providing clinicians tools that can be used to develop a personalized treatment plan. This review explores the clinical potential of NSCLC genetic studies on diagnosing and treating NSCLC.
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Affiliation(s)
- Miranda B Carper
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
| | - Pier Paolo Claudio
- Department of Radiation Oncology, The University of Mississippi Medical Center Cancer Institute, 350 W Woodrow Wilson Ave, Jackson, MS, 39213, USA. .,Department of Biomedical Sciences, University of Mississippi, National Center for Natural Products Research, Oxford, MS, USA.
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7
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Is the exhaled breath temperature in lung cancer influenced by airways neoangiogenesis or by inflammation? Med Oncol 2015; 32:237. [DOI: 10.1007/s12032-015-0681-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 08/17/2015] [Indexed: 12/13/2022]
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Exhaled Breath Condensate: Technical and Diagnostic Aspects. ScientificWorldJournal 2015; 2015:435160. [PMID: 26106641 PMCID: PMC4461795 DOI: 10.1155/2015/435160] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/21/2015] [Indexed: 01/18/2023] Open
Abstract
Purpose. The aim of this study was to evaluate the 30-year progress of research on exhaled breath condensate in a disease-based approach. Methods. We searched PubMed/Medline, ScienceDirect, and Google Scholar using the following keywords: exhaled breath condensate (EBC), biomarkers, pH, asthma, gastroesophageal reflux (GERD), smoking, COPD, lung cancer, NSCLC, mechanical ventilation, cystic fibrosis, pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnea (OSA), and drugs. Results. We found 12600 related articles in total in Google Scholar, 1807 in ScienceDirect, and 1081 in PubMed/Medline, published from 1980 to October 2014. 228 original investigation and review articles were eligible. Conclusions. There is rapidly increasing number of innovative articles, covering all the areas of modern respiratory medicine and expanding EBC potential clinical applications to other fields of internal medicine. However, the majority of published papers represent the results of small-scale studies and thus current knowledge must be further evaluated in large cohorts. In regard to the potential clinical use of EBC-analysis, several limitations must be pointed out, including poor reproducibility of biomarkers and absence of large surveys towards determination of reference-normal values. In conclusion, contemporary EBC-analysis is an intriguing achievement, but still in early stage when it comes to its application in clinical practice.
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Carpagnano GE, Lacedonia D, Crisetti E, Palladino GP, Saliani V, Zoppo LD, Antonetti R, Natalicchio I, Foschino-Barbaro MP. Exhaled HPV Infection in Lung Cancer: Role of MA at 3p. Arch Med Res 2014; 45:383-7. [DOI: 10.1016/j.arcmed.2014.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
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Dent AG, Sutedja TG, Zimmerman PV. Exhaled breath analysis for lung cancer. J Thorac Dis 2014; 5 Suppl 5:S540-50. [PMID: 24163746 DOI: 10.3978/j.issn.2072-1439.2013.08.44] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 08/19/2013] [Indexed: 12/30/2022]
Abstract
Early diagnosis of lung cancer results in improved survival compared to diagnosis with more advanced disease. Early disease is not reliably indicated by symptoms. Because investigations such as bronchoscopy and needle biopsy have associated risks and substantial costs, they are not suitable for population screening. Hence new easily applicable tests, which can be used to screen individuals at risk, are required. Biomarker testing in exhaled breath samples is a simple, relatively inexpensive, non-invasive approach. Exhaled breath contains volatile and non-volatile organic compounds produced as end-products of metabolic processes and the composition of such compounds varies between healthy subjects and subjects with lung cancer. Many studies have analysed the patterns of these compounds in exhaled breath. In addition studies have also reported that the exhaled breath condensate (EBC) can reveal gene mutations or DNA abnormalities in patients with lung cancer. This review has summarised the scientific evidence demonstrating that lung cancer has distinct chemical profiles in exhaled breath and characteristic genetic changes in EBC. It is not yet possible to accurately identify individuals with lung cancer in at risk populations by any of these techniques. However, analysis of both volatile organic compounds in exhaled breath and of EBC have great potential to become clinically useful diagnostic and screening tools for early stage lung cancer detection.
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Affiliation(s)
- Annette G Dent
- Department of Thoracic Medicine, The Prince Charles Hospital, Rode Road, Chermside, Queensland 4032, Australia; ; The University of Queensland, Brisbane, St Lucia, Queensland 4072, Australia
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Carpagnano GE, Palladino GP, Martinelli D, Lacedonia D, Orlando S, Foschino-Barbaro MP. Exhaled matrix metalloproteinase-9 in lung cancer. Rejuvenation Res 2013; 15:359-65. [PMID: 22877564 DOI: 10.1089/rej.2011.1254] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Matrix metalloproteinase-9 (MMP-9) has been recognized in several types of tumor development and progression, including lung cancer, for its role in the degradation and remodeling of lung tissue. Furthermore, increased MMP-9 has been commonly described in the serum and airways of non-small cell lung cancer (NSCLC) patients. OBJECTIVE The aim of this study was to investigate, for the first time, MMP-9 in the exhaled breath condensate (EBC) of NSCLC patients. PARTICIPANTS We enrolled 40 NSCLC patients and 40 controls affected by transudative pleural effusion. MEASUREMENTS MMP-9 concentrations were measured in the EBC, whole blood (WB), and pleural effusion (PE) of all the subjects under study using enzyme immunoassay (EIA) kits. RESULTS MMP-9 levels were found to be significantly higher in EBC, WB, and PE of NSCLC patients compared with controls. A positive correlation was observed between MMP-9 in EBC, cigarettes smoked, and stage of cancer. CONCLUSION Exhaled MMP-9 was elevated in NSCLC patients, especially during tumor progression, and could represent a suitable noninvasive marker in the diagnosis and monitoring of lung cancer.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Disease, Department of Medical and Occupational Sciences, Univeristy of Foggia, Italy.
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Kordiak J, Szemraj J, Hamara K, Bialasiewicz P, Nowak D. Complete surgical resection of lung tumor decreases exhalation of mutated KRAS oncogene. Respir Med 2012; 106:1293-300. [PMID: 22795503 DOI: 10.1016/j.rmed.2012.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 06/22/2012] [Accepted: 06/25/2012] [Indexed: 02/01/2023]
Abstract
Exhaled breath condensate (EBC) contains extracellular DNA that may originate from pathological lesions of the respiratory tract and can be a genetic marker of pulmonary malignancy. We tested whether complete surgical excision of lung cancer will decrease exhalation of mutated KRAS oncogene. Fifty seven patients with clinical diagnosis of lung cancer and detectable KRAS mutations in pre-surgery EBC-DNA were qualified for surgical treatment. Point mutations at codon 12 of KRAS oncogene were detected using mutant-enriched PCR technique in DNA from pre-surgery blood, EBC collected before, 7 and 30 days after surgery and from specimens of resected tumor and normal pulmonary parenchyma. The ratio of mutated to wild type KRAS DNA (R mut/wild KRAS) was calculated for each specimen after electrophoresis and densitometry of the final amplification and digestion product. In 46 patients non-small cell lung cancer (NSCLC) and in 11 benign lesion (BL) were confirmed. All blood and tumor specimens were positive for KRAS mutations, while 41 specimens of normal pulmonary parenchyma were negative. In NSCLC patients pre-surgery EBC R mut/wild KRAS of 0.20 ± 0.03 decreased by 1.3- and 3.7-times (p < 0.001) at 7th and 30th day and 10 EBC specimens at day 30th became negative. The highest R mut/wild KRAS was found in NSCLC specimens - 1.36 ± 0.29 while the lowest in pulmonary parenchyma - 0.02 ± 0.03 (p < 0.001). R mut/wild KRAS in EBC did not correlate with the blood and cancer ratios. Determination of mutated KRAS oncogene in EBC can be potentially helpful in the follow-up of surgical treatment of pulmonary malignancy.
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Affiliation(s)
- Jacek Kordiak
- Department of Chest Surgery, Oncologic and General Surgery, University Hospital No. 2, Zeromskiego St. 113, 91-647, Medical University of Lodz, Poland
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Carpagnano GE, Costantino E, Palladino GP, Lacedonia D, Martinelli D, Orlando S, Foschino-Barbaro MP. Microsatellite alterations and cell-free DNA analysis: could they increase the cytology sensitivity in the diagnosis of malignant pleural effusion? Rejuvenation Res 2012; 15:265-73. [PMID: 22551519 DOI: 10.1089/rej.2011.1260] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The exact diagnosis of malignant pleural effusions (PE) is difficult and often requires combined procedures, because the cytological examination of pleural fluid does not detect tumoral cells in 40% of malignant effusion cases. The aim of this study was to analyze microsatellite alterations (MA) in malignant PE and to determine their diagnostic value as an additional test to cytological examination. The increase in cell-free DNA levels was also evaluated as a signal of probable malignancy. METHODS A total of 84 patients with PE were enrolled and underwent PE and whole blood and exhaled breath condensate analyses. Free DNA was measured by spectrophotometer analyses. DNA was extracted from all samples and analyzed for MA, using the microsatellite markers at chromosomes 3p, 12p, 5q, and 17p. RESULTS The microsatellite analysis of PE exhibited a higher percentage of alterations in malignant PE than in benign PE. In addition to this, cell-free DNA in PE was seen to be significantly more elevated in malignant than in benign PE. The sensitivity of the sole cytology increased considerably when patients showed at least one MA or DNA>4 ng/μL in the PE. CONCLUSION In conclusion, it was seen that the combination of the cytological examination with microsatellite analyses and cell-free DNA in pleural fluid could increase the sensitivity of the diagnosis in patients with PE who have a suspected malignancy, obviating the need for other invasive diagnostic procedures.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Foggia, Italy.
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Carpagnano GE, Lacedonia D, Palladino GP, Koutelou A, Martinelli D, Orlando S, Foschino-Barbaro MP. Could exhaled ferritin and SOD be used as markers for lung cancer and prognosis prediction purposes? Eur J Clin Invest 2012; 42:478-86. [PMID: 21955247 DOI: 10.1111/j.1365-2362.2011.02603.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Today an increasing interest is being generated by the study of lung cancer markers in the exhaled breath condensate (EBC), precisely because this sample seems to lend itself to lung cancer early screening and follow-up. Indeed, ferritin and superoxide dismutase (SOD) have recently been recognized to play a role in lung cancerogenesis and patients' survival. The aim of this study was to evaluate the clinical value and the prognostic power of exhaled ferritin and exhaled SOD in patients with lung cancer. MATERIAL AND METHODS Forty patients with nonsmall cell lung cancer (NSCLC) and 15 controls were enrolled in the study. All subjects under study underwent EBC collection and analysis of ferritin and SOD. A total of 36 patients were either given a follow-up of at least 25.5 months or followed up until death. RESULTS Exhaled ferritin and SOD resulted as being higher in NSCLC than in controls and as being influenced by the stage of cancer. A pronounced survival difference was found in the presence of exhaled ferritin 300 ng/mL and exhaled SOD > 13.5 U/μL. CONCLUSIONS In conclusion, although the results need to be confirmed on a larger and homogeneous population, we hypothesized that the notion of using the measurement of ferritin and SOD in the EBC could, if deemed feasible, have clinical implications in the monitoring of lung cancer and as an outcome predictor.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Foggia, Italy.
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Carpagnano GE, Palladino GP, Lacedonia D, Koutelou A, Orlando S, Foschino-Barbaro MP. Neutrophilic airways inflammation in lung cancer: the role of exhaled LTB-4 and IL-8. BMC Cancer 2011; 11:226. [PMID: 21649887 PMCID: PMC3130703 DOI: 10.1186/1471-2407-11-226] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Accepted: 06/07/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent advances in lung cancer biology presuppose its inflammatory origin. In this regard, LTB-4 and IL-8 are recognized to play a crucial role in neutrophil recruitment into airways during lung cancer.Notwithstanding the intriguing hypothesis, the exact role of neutrophilic inflammation in tumour biology remains complex and not completely known.The aim of this study was to give our contribution in this field by investigating LTB-4 and IL-8 in the breath condensate of NSCLC patients and verifying their role in cancer development and progression. METHOD We enrolled 50 NSCLC patients and 35 controls. LTB-4 and IL-8 concentrations were measured in the breath condensate and the blood of all the subjects under study using EIA kits. Thirty NSCLC patients and ten controls underwent induced sputum collection and analysis. RESULTS LTB-4 and IL-8 resulted higher in breath condensate and the blood of NSCLC patients compared to controls. Significantly higher concentrations were found as the cancer stages progressed. A positive correlation was observed between exhaled IL-8 and LTB-4 and the percentage of neutrophils in the induced sputum. CONCLUSION The high concentrations of exhaled LTB-4 and IL-8 showed the presence of a neutrophilic inflammation in the airways of NSCLC patients and gave a further support to the inflammatory signalling in lung cancer. These exhaled proteins could represent a suitable non-invasive marker in the diagnosis and monitoring of lung cancer.
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Affiliation(s)
- Giovanna E Carpagnano
- Department of Medical and Occupational Sciences, Institute of Respiratory Disease, University of Foggia, Via degli Aviatori 1, Foggia 71100, Italy.
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Kuhlmann JD, Schwarzenbach H, Otterbach F, Heubner M, Wimberger P, Worm KH, Kimmig R, Kasimir-Bauer S. Loss of heterozygosity proximal to the M6P/IGF2R locus is predictive for the presence of disseminated tumor cells in the bone marrow of ovarian cancer patients before and after chemotherapy. Genes Chromosomes Cancer 2011; 50:598-605. [PMID: 21563231 DOI: 10.1002/gcc.20882] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 03/23/2011] [Indexed: 01/30/2023] Open
Abstract
Disseminated tumor cells (DTC) in the bone marrow (BM) are present in about 35% of ovarian cancers before surgery and after chemotherapy and are associated with worse prognosis. A molecular biomarker in the primary tumor predicting tumor cell spread would be highly desirable. The purpose of the study was to investigate loss of heterozygosity (LOH) in primary ovarian tumors at four ovarian cancer-relevant chromosomal loci involved in apoptosis, platinum sensitivity, or DNA-repair, to assess the prognostic value of LOH and to correlate LOH with DTC occurrence before surgery and after chemotherapy. Primary tumor DNA of 88 patients was analyzed for LOH at four polymorphic microsatellite markers using PCR-based fluorescence microsatellite analysis. BM aspirates were analyzed for DTC by immunocytochemistry using the pan-cytokeratin antibody A45-B/B3. LOH at the entire marker set correlated with tumor grading (P = 0.0001) and histology (P = 0.004). LOH at marker D10S1765 correlated with FIGO stage (P = 0.046) and grading (P = 0.05), whereas LOH at D17S855 significantly associated with grading (P = 0.023) and histology (P = 0.012), respectively. DTC were detected in 49% of patients before surgery and in 50% of patients after chemotherapy. Interestingly, LOH proximal to D6S1581 significantly correlated with DTC presence before surgery (P = 0.05) and after chemotherapy (P = 0.022). Conclusively, our data suggest that allelic loss at D6S1581 (proximal to M6P/IGF2R locus) serves as a molecular biomarker for the presence of DTC in the BM before and after chemotherapy.
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Affiliation(s)
- Jan Dominik Kuhlmann
- Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany
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Ding XJ, Liu MX, Ao L, Liang YR, Cao Y. Frequent loss of heterozygosity on chromosome 12q in non-small-cell lung carcinomas. Virchows Arch 2011; 458:561-9. [PMID: 21279520 DOI: 10.1007/s00428-011-1042-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 12/04/2010] [Accepted: 01/06/2011] [Indexed: 12/27/2022]
Abstract
Chromosomal aberrations in non-small-cell lung carcinomas (NSCLCs) are common events. In our study, the lung cancer cell lines (NCI-H446 and SPC-A-1) displayed numerous numerical and structural alterations in their chromosomes by G-banded karyotypic analysis, and abnormalities of chromosome 12 by fluorescence in situ hybridization. Sequentially, we used 14 microsatellite markers within 12q to analyze loss of heterozygosity (LOH) in lung cancer cell lines and NSCLCs. Possible LOH on 12q were statistically inferred to occur in five lung cell lines. Importantly, 17 out of 25 NSCLCs (68%) showed LOH at chromosome 12q. Frequencies of LOH for individual markers ranged from 18% to 44%. Several deletions which were marked with D12S1301, D12S2196, D12S398, D12S90, D12S1056, D12S1713, D12S375, D12S1040, D12S326, and D12S106 were newly detected. Allelic loss on 12q15-q21 detected with D12S1040 occurred at the later stages of NSCLC progression (p < 0.05, Fisher's exact test). LOH on 12q marked with D12S2196, D12S398, D12S326, and D12S106 were frequently found in NSCLCs from the patients without smoking history (p < 0.05, Fisher's exact test). These findings indicated that allelic loss on 12q is commonly involved in NSCLCs, and new tumor suppressor genes may occur within 12q.
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Affiliation(s)
- Xiao-Jie Ding
- Key Laboratory of Animal Models and Human Disease Mechanisms of CAS and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, 32 Jiaochang Donglu, Kunming, Yunnan, China
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Current world literature. Curr Opin Allergy Clin Immunol 2010; 10:161-6. [PMID: 20357579 DOI: 10.1097/aci.0b013e32833846d5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Use of exhaled breath condensate to investigate occupational lung diseases. Curr Opin Allergy Clin Immunol 2010; 10:93-8. [PMID: 19996962 DOI: 10.1097/aci.0b013e3283357fb7] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The present study reviews recent data concerning the assessment of exhaled breath condensate (EBC) pulmonary biomarkers in the field of occupational medicine. RECENT FINDINGS EBC is a suitable matrix to assess respiratory health status in workers exposed to pneumotoxic substances, due to its ability to quantify lung tissue dose and consequent pulmonary effects. Published data show that toxic metals and trace elements are detectable in EBC, raising the possibility of using this medium to quantify the lung tissue dose of metals occurring in occupational settings. EBC analysis of biomarkers of exposure highlighted the potential use of EBC as completion of the biological monitoring of pneumotoxic compounds. Different biomarkers of effect, such as oxidative stress and inflammatory-derived biomarkers have been applied in the investigation of occupational asthma and pneumoconiosis, suggesting that the collection of EBC may contribute to studying the pathological state of the airways of workers with acute and chronic exposure to pollutants. EBC measurements also seem to be reliable to detect the presence of carcinogenic processes in the respiratory system, by the analysis of various markers of oxidative stress, angiogenesis and DNA alterations related to lung cancer. This approach may open new frontiers in the study of workers currently or previously exposed to pulmonary carcinogenic agents. SUMMARY The analysis of EBC is one of the most promising methods currently available for the study of pulmonary biomarkers of exposure, effect and susceptibility in occupational settings; being collected in a totally noninvasive way, it is particularly suitable to be applied in field studies and for longitudinal assessments of pulmonary biology.
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Abstract
IMPORTANCE OF THE FIELD Despite many efforts to improve early detection, lung cancer remains the leading cause of cancer deaths. Stage is the main determinant of prognosis and the basis for deciding treatment options. Screening tests for lung cancer have not been successful so far. AREAS COVERED IN THE REVIEW The article reviews the available literature related to biomarkers in use at present and those that could be used for early diagnosis, staging, prognosis, response to therapy and prediction of recurrence. The single biomarkers are analysed, divided according to the technological methods used and the locations of sampling. WHAT THE READER WILL GAIN The reader will gain knowledge on biomarkers in use and those now under study. The reader will also gain insights into the difficulties pertaining to the development of biomarkers, results reproducibility and clinical application. TAKE HOME MESSAGE Although some markers seem to be promising, at present there is no consensus on the proven value of their clinical use in lung cancer. The future lies probably in a panel of biomarkers instead of individual assays, or in predictive models derived from the integration of clinical variables and gene expression profiles.
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Affiliation(s)
- Massimiliano Paci
- Division of Thoracic Surgery, Azienda Santa Maria Nuova di Reggio Emilia, Viale Risorgimento 80, 42100 Reggio Emilia, Italy +39 0522 296929 ; +39 0522 296191 ;
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Carpagnano GE, Palladino GP, Gramiccioni C, Foschino Barbaro MP, Martinelli D. Exhaled ERCC-1 and ERCC-2 microsatellite alterations in NSCLC patients. Lung Cancer 2010; 68:305-7. [PMID: 20188432 DOI: 10.1016/j.lungcan.2010.01.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 01/29/2010] [Accepted: 01/30/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND The excision repair cross-complementation (ERCC) enzyme plays a rate-limiting role in nucleotide excision repair pathway. Microsatellite alterations (MAs) at the long arm of chromosome 19, where are located the ERCC genes, have recently been associated with non-small cell lung cancer (NSCLC) pathogenesis and reduced survival. The aim of the present study was to explore MAs at 19q in DNA from exhaled breath condensate (EBC) of NSCLC patients investigating their possible correlation with the smoking habit, with the biological behaviour of the tumour and their predictive survival power. METHODS 34 NSCLC patients and 33 healthy controls (19 non-smokers and 14 smokers) were enrolled. All the subjects underwent 19q microsatellite analysis of their EBC. A total of 25 patients were either given a follow-up of at least 102 weeks, or were followed up until death. RESULTS No MAs were found in EBC or WB in the healthy non-smokers, while 16% of exhaled MAs were found in healthy smokers and 25% of exhaled MAs in NSCLC patients. The number of MAs resulted related with tobacco consumption and with NSCLC patients' survival. CONCLUSIONS In conclusion, the study of MAs at 19q resulted feasible in EBC-DNA. These genetic alterations are specific for lung cancer and predictive of survival in NSCLC patients. Our results suggest interesting clinical perspectives for the analysis of exhaled MAs at 19q in NSCLC patients.
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Chan HP, Lewis C, Thomas PS. Oxidative Stress and Exhaled Breath Analysis: A Promising Tool for Detection of Lung Cancer. Cancers (Basel) 2010; 2:32-42. [PMID: 24281031 PMCID: PMC3827589 DOI: 10.3390/cancers2010032] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 01/29/2010] [Accepted: 02/01/2010] [Indexed: 12/12/2022] Open
Affiliation(s)
- Hiang Ping Chan
- Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Respiratory Medicine, Prince of Wales Hospital, Randwick, NSW 2031, Australia; E-Mail: (H.P.C.)
| | - Craig Lewis
- Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW 2031, Australia; E-Mail: (C.L.)
| | - Paul S. Thomas
- Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Department of Respiratory Medicine, Prince of Wales Hospital, Randwick, NSW 2031, Australia; E-Mail: (H.P.C.)
- Author to whom correspondence should be addressed; E-Mail: (P.T.); Tel.: +61 2 9382 4620; Fax: +61 2 9382 4627
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