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Lilien TA, Brinkman P, Fenn DW, van Woensel JBM, Bos LDJ, Bem RA. Breath Markers of Oxidative Stress in Children with Severe Viral Lower Respiratory Tract Infection. Am J Respir Cell Mol Biol 2024; 70:392-399. [PMID: 38315815 DOI: 10.1165/rcmb.2023-0349oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/05/2024] [Indexed: 02/07/2024] Open
Abstract
Severe viral lower respiratory tract infection (LRTI), resulting in both acute and long-term pulmonary disease, constitutes a substantial burden among young children. Viral LRTI triggers local oxidative stress pathways by infection and inflammation, and supportive care in the pediatric intensive care unit may further aggravate oxidative injury. The main goal of this exploratory study was to identify and monitor breath markers linked to oxidative stress in children over the disease course of severe viral LRTI. Exhaled breath was sampled during invasive ventilation, and volatile organic compounds (VOCs) were analyzed using gas chromatography and mass spectrometry. VOCs were selected in an untargeted principal component analysis and assessed for change over time. In addition, identified VOCs were correlated with clinical parameters. Seventy breath samples from 21 patients were analyzed. A total of 15 VOCs were identified that contributed the most to the explained variance of breath markers. Of these 15 VOCs, 10 were previously linked to pathways of oxidative stress. Eight VOCs, including seven alkanes and methyl alkanes, significantly decreased from the initial phase of ventilation to the day of extubation. No correlation was observed with the administered oxygen dose, whereas six VOCs showed a poor to strong positive correlation with driving pressure. In this prospective study of children with severe viral LRTI, the majority of VOCs that were most important for the explained variance mirrored clinical improvement. These breath markers could potentially help monitor the pulmonary oxidative status in these patients, but further research with other objective measures of pulmonary injury is required.
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Affiliation(s)
- Thijs A Lilien
- Department of Pediatric Intensive Care Medicine, Emma Children's Hospital
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | | | | | - Job B M van Woensel
- Department of Pediatric Intensive Care Medicine, Emma Children's Hospital
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Lieuwe D J Bos
- Department of Pulmonology, and
- Department of Intensive Care Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands; and
| | - Reinout A Bem
- Department of Pediatric Intensive Care Medicine, Emma Children's Hospital
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
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2
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Müller-Wirtz LM, Kiefer D, Knauf J, Floss MA, Doneit J, Wolf B, Maurer F, Sessler DI, Volk T, Kreuer S, Fink T. Differential Response of Pentanal and Hexanal Exhalation to Supplemental Oxygen and Mechanical Ventilation in Rats. Molecules 2021; 26:2752. [PMID: 34067078 PMCID: PMC8124567 DOI: 10.3390/molecules26092752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/17/2022] Open
Abstract
High inspired oxygen during mechanical ventilation may influence the exhalation of the previously proposed breath biomarkers pentanal and hexanal, and additionally induce systemic inflammation. We therefore investigated the effect of various concentrations of inspired oxygen on pentanal and hexanal exhalation and serum interleukin concentrations in 30 Sprague Dawley rats mechanically ventilated with 30, 60, or 93% inspired oxygen for 12 h. Pentanal exhalation did not differ as a function of inspired oxygen but increased by an average of 0.4 (95%CI: 0.3; 0.5) ppb per hour, with concentrations doubling from 3.8 (IQR: 2.8; 5.1) ppb at baseline to 7.3 (IQR: 5.0; 10.8) ppb after 12 h. Hexanal exhalation was slightly higher at 93% of inspired oxygen with an average difference of 0.09 (95%CI: 0.002; 0.172) ppb compared to 30%. Serum IL-6 did not differ by inspired oxygen, whereas IL-10 at 60% and 93% of inspired oxygen was greater than with 30%. Both interleukins increased over 12 h of mechanical ventilation at all oxygen concentrations. Mechanical ventilation at high inspired oxygen promotes pulmonary lipid peroxidation and systemic inflammation. However, the response of pentanal and hexanal exhalation varies, with pentanal increasing by mechanical ventilation, whereas hexanal increases by high inspired oxygen concentrations.
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Affiliation(s)
- Lukas M. Müller-Wirtz
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
- Outcomes Research Consortium, Cleveland, OH 44195, USA;
| | - Daniel Kiefer
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
| | - Joschua Knauf
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
| | - Maximilian A. Floss
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
| | - Jonas Doneit
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
| | - Beate Wolf
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
| | - Felix Maurer
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
- Outcomes Research Consortium, Cleveland, OH 44195, USA;
| | - Daniel I. Sessler
- Outcomes Research Consortium, Cleveland, OH 44195, USA;
- Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Thomas Volk
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
- Outcomes Research Consortium, Cleveland, OH 44195, USA;
| | - Sascha Kreuer
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
- Outcomes Research Consortium, Cleveland, OH 44195, USA;
| | - Tobias Fink
- CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (J.K.); (M.A.F.); (J.D.); (B.W.); (F.M.); (T.V.); (S.K.); (T.F.)
- Outcomes Research Consortium, Cleveland, OH 44195, USA;
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3
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Reiterer C, Kabon B, von Sonnenburg MF, Starlinger P, Taschner A, Zotti O, Goshin J, Drlicek G, Fleischmann E. The effect of supplemental oxygen on perioperative brain natriuretic peptide concentration in cardiac risk patients - a protocol for a prosprective randomized clinical trial. Trials 2020; 21:400. [PMID: 32398119 PMCID: PMC7218565 DOI: 10.1186/s13063-020-04336-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Elevated postoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations are predictive for cardiac adverse events in noncardiac surgery. Studies indicate that supplemental oxygen decreases sympathetic nerve activity and might, therefore, improve cardiovascular function. Thus, we will test the effect of perioperative supplemental oxygen administration on NT-proBNP release after surgery. METHODS/DESIGN We will conduct a single-center, double-blinded, randomized trial at the Medical University of Vienna, including 260 patients with increased cardiac risk factors undergoing moderate- to high-risk noncardiac surgery. Patients will be randomly assigned to receive 80% versus 30% oxygen during surgery and for 2 h postoperatively. The primary outcome will be the difference in maximum NT-proBNP release after surgery. As secondary outcomes we will assess the effect of supplemental oxygen on postoperative maximum troponin T concentration, oxidation-reduction potential, von Willebrand factor concentration and perioperative fluid requirements. We will perform outcome measurements 2 h after surgery, on postoperative day 1 and on postoperative day 3. The NT-proBNP concentration and the oxidation-reduction potential will also be measured within 72 h before discharge. DISCUSSION Our trial should determine whether perioperative supplemental oxygen administration will reduce the postoperative release of NT-proBNP in patients with preoperative increased cardiovascular risk factors undergoing noncardiac surgery. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03366857. Registered on 8th December 2017.
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Affiliation(s)
- Christian Reiterer
- Department of Anaesthesia, General Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Barbara Kabon
- Department of Anaesthesia, General Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
| | - Markus Falkner von Sonnenburg
- Department of Anaesthesia, General Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Patrick Starlinger
- Department of Surgery, Medical University of Vienna, 1090, Vienna, Austria
| | - Alexander Taschner
- Department of Anaesthesia, General Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Oliver Zotti
- Department of Anaesthesia, General Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Julius Goshin
- Department of Anaesthesia, General Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Gregor Drlicek
- Franziskus Spital, Anaesthesia and Intensive Care, 1050, Vienna, Austria
| | - Edith Fleischmann
- Department of Anaesthesia, General Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
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Perioperative Hyperoxyphobia: Justified or Not? Benefits and Harms of Hyperoxia during Surgery. J Clin Med 2020; 9:jcm9030642. [PMID: 32121051 PMCID: PMC7141263 DOI: 10.3390/jcm9030642] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/18/2020] [Accepted: 02/26/2020] [Indexed: 12/12/2022] Open
Abstract
The use of an inspiratory oxygen fraction of 0.80 during surgery is a topic of ongoing debate. Opponents claim that increased oxidative stress, atelectasis, and impaired oxygen delivery due to hyperoxic vasoconstriction are detrimental. Proponents point to the beneficial effects on the incidence of surgical site infections and postoperative nausea and vomiting. Also, hyperoxygenation is thought to extend the safety margin in case of acute intraoperative emergencies. This review provides a comprehensive risk-benefit analysis for the use of perioperative hyperoxia in noncritically ill adults based on clinical evidence and supported by physiological deduction where needed. Data from the field of hyperbaric medicine, as a model of extreme hyperoxygenation, are extrapolated to the perioperative setting. We ultimately conclude that current evidence is in favour of hyperoxia in noncritically ill intubated adult surgical patients.
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5
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Ottolenghi S, Sabbatini G, Brizzolari A, Samaja M, Chiumello D. Hyperoxia and oxidative stress in anesthesia and critical care medicine. Minerva Anestesiol 2020; 86:64-75. [DOI: 10.23736/s0375-9393.19.13906-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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6
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Cronin WA, Forbes AS, Wagner KL, Kaplan P, Cataneo R, Phillips M, Mahon R, Hall A. Exhaled Volatile Organic Compounds Precedes Pulmonary Injury in a Swine Pulmonary Oxygen Toxicity Model. Front Physiol 2019; 10:1297. [PMID: 31849689 PMCID: PMC6901787 DOI: 10.3389/fphys.2019.01297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/27/2019] [Indexed: 11/20/2022] Open
Abstract
Purpose Inspiring high partial pressure of oxygen (FiO2 > 0.6) for a prolonged duration can lead to lung damage termed pulmonary oxygen toxicity (PO2T). While current practice is to limit oxygen exposure, there are clinical and military scenarios where higher FiO2 levels and partial pressures of oxygen are required. The purpose of this study is to develop a non-invasive breath-based biomarker to detect PO2T prior to the onset of clinical symptoms. Methods Male Yorkshire swine (20–30 kg) were placed into custom airtight runs and randomized to air (0.209 FiO2, n = 12) or oxygen (>0.95 FiO2, n = 10) for 72 h. Breath samples, arterial blood gases, and vital signs were assessed every 12 h. After 72 h of exposure, animals were euthanized and the lungs processed for histology and wet-dry ratios. Results Swine exposed to hyperoxia developed pulmonary injury consistent with PO2T. Histology of oxygen-exposed swine showed pulmonary lymphatic congestion, epithelial sloughing, and neutrophil transmigration. Pulmonary injury was also evidenced by increased interstitial edema and a decreased PaO2/FiO2 ratio in the oxygen group when compared to the air control group. Breath volatile organic compound (VOC) sample analysis identified six VOCs that were combined into an algorithm which generated a breath score predicting PO2T with a ROC/AUC curve of 0.72 defined as a of PaO2/FiO2 ratio less than 350 mmHg. Conclusion Exposing swine to 72 h of hyperoxia induced a pulmonary injury consistent with human clinical endpoints of PO2T. VOC analysis identified six VOCs in exhaled breath that preceded PO2T. Results show promise that a simple, non-invasive breath test could potentially predict the risk of pulmonary injury in humans exposed to high partial pressures of oxygen.
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Affiliation(s)
- William A Cronin
- Walter Reed National Military Medical Center, Bethesda, MD, United States.,Undersea Medicine Department, Naval Medical Research Center, Silver Spring, MD, United States
| | - Angela S Forbes
- Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Kari L Wagner
- Walter Reed National Military Medical Center, Bethesda, MD, United States
| | - Peter Kaplan
- Breath Research Laboratory, Menssana Research, Inc., Newark, NJ, United States
| | - Renee Cataneo
- Breath Research Laboratory, Menssana Research, Inc., Newark, NJ, United States
| | - Michael Phillips
- Breath Research Laboratory, Menssana Research, Inc., Newark, NJ, United States
| | - Richard Mahon
- Undersea Medicine Department, Naval Medical Research Center, Silver Spring, MD, United States.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
| | - Aaron Hall
- Undersea Medicine Department, Naval Medical Research Center, Silver Spring, MD, United States
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7
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Sarbach C, Dugas B, Postaire E. Evidence of variations of endogenous halogenated volatile organic compounds in alveolar breath after mental exercise-induced oxidative stress. ANNALES PHARMACEUTIQUES FRANÇAISES 2019; 78:34-41. [PMID: 31796267 DOI: 10.1016/j.pharma.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/03/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The effect of oxygen on markers of oxidative stress has not been totally elucidated because previous studies have yielded conflicting results. METHODS A method for the collection and gas chromatography-mass spectrometry of the halogenated volatile organic compounds in human alveolar breath is described. A transportable apparatus sampled specifically alveolar breath; the volatile organic compounds were captured in a thermal desorption tube, Carbotrap 200®. The sample was thermally desorbed from the trap in an automated gas chromatography with mass spectrometry detection and peak fragmentation. Compounds were identified by reference to a computer-based library of mass spectra. RESULTS Trichlorotrifluoroethane, tetrafluoroethane, dichlorodifluoromethane were identified in alveolar breath of healthy volunteers after mental exercise-induced oxidative stress. The effects of halogenated alkanes were investigated on electron transport chain activity. These agents impaired the NADH oxidation suggesting an inhibition of the complex I (NADH: ubiquinone oxidoreductase) of the electron transport chain. These inhibitory effects are suspected likely to fight against oxidative stress deleterious reactions. CONCLUSION Chemical inhibition of the oxidative burst in human body trough these halogenated inhibitors is a new concept of significant practical, medical, biological and scientific interest.
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Affiliation(s)
- C Sarbach
- Ar2i, 20/22 avenue Edouard Herriot, 92350, Le Plessis Robinson, France
| | - B Dugas
- Inserm, U 511, Hôpital Pitié-Salpétière, Boulevard de l'Hôpital, 75013, Paris, France
| | - E Postaire
- Académie des sciences, 23, quai Conti, 75006, Paris, France.
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8
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Wingelaar TT, Brinkman P, van Ooij PJAM, Hoencamp R, Maitland-van der Zee AH, Hollmann MW, van Hulst RA. Markers of Pulmonary Oxygen Toxicity in Hyperbaric Oxygen Therapy Using Exhaled Breath Analysis. Front Physiol 2019; 10:475. [PMID: 31068838 PMCID: PMC6491850 DOI: 10.3389/fphys.2019.00475] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/04/2019] [Indexed: 12/16/2022] Open
Abstract
Introduction Although hyperbaric oxygen therapy (HBOT) has beneficial effects, some patients experience fatigue and pulmonary complaints after several sessions. The current limits of hyperbaric oxygen exposure to prevent pulmonary oxygen toxicity (POT) are based on pulmonary function tests (PFT), but the limitations of PFT are recognized worldwide. However, no newer modalities to detect POT have been established. Exhaled breath analysis in divers have shown volatile organic compounds (VOCs) of inflammation and methyl alkanes. This study hypothesized that similar VOCs might be detected after HBOT. Methods Ten healthy volunteers of the Royal Netherlands Navy underwent six HBOT sessions (95 min at 253 kPa, including three 5-min “air breaks”), i.e., on five consecutive days followed by another session after 2 days of rest. At 30 min before the dive, and at 30 min, 2 and 4 h post-dive, exhaled breath was collected and followed by PFT. Exhaled breath samples were analyzed using gas chromatography-mass spectrometry (GC-MS). After univariate tests and correlation of retention times, ion fragments could be identified using a reference database. Using these fragments VOCs could be reconstructed, which were clustered using principal component analysis. These clusters were tested longitudinally with ANOVA. Results After GC-MS analysis, eleven relevant VOCs were identified which could be clustered into two principal components (PC). PC1 consisted of VOCs associated with inflammation and showed no significant change over time. The intensities of PC2, consisting of methyl alkanes, showed a significant decrease (p = 0.001) after the first HBOT session to 50.8%, remained decreased during the subsequent days (mean 82%), and decreased even further after 2 days of rest to 58% (compared to baseline). PFT remained virtually unchanged. Discussion Although similar VOCs were found when compared to diving, the decrease of methyl alkanes (PC2) is in contrast to the increase seen in divers. It is unknown why emission of methyl alkanes (which could originate from the phosphatidylcholine membrane in the alveoli) are reduced after HBOT. This suggests that HBOT might not be as damaging to the pulmonary tract as previously assumed. Future research on POT should focus on the identified VOCs (inflammation and methyl alkanes).
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Affiliation(s)
- T T Wingelaar
- Diving Medical Centre, Royal Netherlands Navy, Den Helder, Netherlands.,Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - P Brinkman
- Department of Pulmonology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - P J A M van Ooij
- Diving Medical Centre, Royal Netherlands Navy, Den Helder, Netherlands.,Department of Pulmonology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - R Hoencamp
- Department of Surgery, Alrijne Hospital Leiderdorp, Leiderdorp, Netherlands.,Defense Healthcare Organisation, Ministry of Defence, Utrecht, Netherlands.,Leiden University Medical Center, Leiden, Netherlands
| | | | - M W Hollmann
- Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - R A van Hulst
- Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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9
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Wingelaar TT, van Ooij PJAM, Brinkman P, van Hulst RA. Pulmonary Oxygen Toxicity in Navy Divers: A Crossover Study Using Exhaled Breath Analysis After a One-Hour Air or Oxygen Dive at Nine Meters of Sea Water. Front Physiol 2019; 10:10. [PMID: 30740057 PMCID: PMC6355711 DOI: 10.3389/fphys.2019.00010] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/08/2019] [Indexed: 12/23/2022] Open
Abstract
Introduction: Exposure to hyperbaric hyperoxic conditions can lead to pulmonary oxygen toxicity. Although a decrease in vital capacity has long been the gold standard, newer diagnostic modalities may be more accurate. In pulmonary medicine, much research has focussed on volatile organic compounds (VOCs) associated with inflammation in exhaled breath. In previous small studies after hyperbaric hyperoxic exposure several methyl alkanes were identified. This study aims to identify which VOCs mark the development of pulmonary oxygen toxicity. Methods: In this randomized crossover study, 12 divers of the Royal Netherlands Navy made two dives of one hour to 192.5 kPa (comparable to a depth of 9 msw) either with 100% oxygen or compressed air. At 30 min before the dive, and at 30 min and 1, 2, 3, and 4 h post-dive, exhaled breath was collected and followed by pulmonary function tests (PFT). Exhaled breath samples were analyzed using gas chromatography–mass spectrometry (GC–MS). After univariate tests and correlation of retention times, ion fragments could be identified using a standard reference database [National Institute of Standards and Technology (NIST)]. Using these fragments VOCs could be reconstructed, which were then tested longitudinally with analysis of variance. Results: After GC–MS analysis, seven relevant VOCs (generally methyl alkanes) were identified. Decane and decanal showed a significant increase after an oxygen dive (p = 0.020 and p = 0.013, respectively). The combined intensity of all VOCs showed a significant increase after oxygen diving (p = 0.040), which was at its peak (+35%) 3 h post-dive. Diffusion capacity of nitric oxide and alveolar membrane capacity showed a significant reduction after both dives, whereas no other differences in PFT were significant. Discussion: This study is the largest analysis of exhaled breath after in water oxygen dives to date and the first to longitudinally measure VOCs. The longitudinal setup showed an increase and subsequent decrease of exhaled components. The VOCs identified suggest that exposure to a one-hour dive with a partial pressure of oxygen of 192.5 kPa damages the phosphatidylcholine membrane in the alveoli, while the spirometry and diffusion capacity show little change. This suggests that exhaled breath analysis is a more accurate method to measure pulmonary oxygen toxicity.
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Affiliation(s)
- Thijs T Wingelaar
- Diving Medical Center, Royal Netherlands Navy, Den Helder, Netherlands.,Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Paul Brinkman
- Department of Pulmonology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Rob A van Hulst
- Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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10
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van Ooij PJAM, Sterk PJ, van Hulst RA. Oxygen, the lung and the diver: friends and foes? Eur Respir Rev 2017; 25:496-505. [PMID: 27903670 PMCID: PMC9487554 DOI: 10.1183/16000617.0049-2016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/03/2016] [Indexed: 12/31/2022] Open
Abstract
Worldwide, the number of professional and sports divers is increasing. Most of them breathe diving gases with a raised partial pressure of oxygen (PO2). However, if the PO2 is between 50 and 300 kPa (375–2250 mmHg) (hyperoxia), pathological pulmonary changes can develop, known as pulmonary oxygen toxicity (POT). Although in its acute phase, POT is reversible, it can ultimately lead to non-reversible pathological changes. Therefore, it is important to monitor these divers to prevent them from sustaining irreversible lesions. This review summarises the pulmonary pathophysiological effects when breathing oxygen with a PO2 of 50–300 kPa (375–2250 mmHg). We describe the role and the limitations of lung function testing in monitoring the onset and development of POT, and discuss new techniques in respiratory medicine as potential markers in the early development of POT in divers. To prevent the early development of pulmonary oxygen toxicity divers must be properly monitoredhttp://ow.ly/RVJL301fySb
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Affiliation(s)
- Pieter-Jan A M van Ooij
- Diving Medical Center, Royal Netherlands Navy Den Helder, The Netherlands .,Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam
| | - Peter J Sterk
- Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam
| | - Robert A van Hulst
- Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Centre, University of Amsterdam
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11
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Dowman LM, McDonald CF, Bozinovski S, Vlahos R, Gillies R, Pouniotis D, Hill CJ, Goh NS, Holland AE. Greater endurance capacity and improved dyspnoea with acute oxygen supplementation in idiopathic pulmonary fibrosis patients without resting hypoxaemia. Respirology 2017; 22:957-964. [DOI: 10.1111/resp.13002] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 12/10/2016] [Accepted: 12/26/2016] [Indexed: 02/01/2023]
Affiliation(s)
- Leona M. Dowman
- Discipline of Physiotherapy; La Trobe University, Alfred Centre; Melbourne Victoria Australia
- Department of Respiratory & Sleep Medicine; Austin Health; Melbourne Victoria Australia
- Institute for Breathing and Sleep; Austin Health; Melbourne Victoria Australia
- Department of Physiotherapy; Austin Health; Melbourne Victoria Australia
| | - Christine F. McDonald
- Department of Respiratory & Sleep Medicine; Austin Health; Melbourne Victoria Australia
- Institute for Breathing and Sleep; Austin Health; Melbourne Victoria Australia
- Department of Medicine; University of Melbourne; Melbourne Victoria Australia
| | - Steven Bozinovski
- School of Health and Biomedical Sciences; RMIT University; Melbourne Victoria Australia
| | - Ross Vlahos
- School of Health and Biomedical Sciences; RMIT University; Melbourne Victoria Australia
| | - Rebecca Gillies
- Discipline of Physiotherapy; La Trobe University, Alfred Centre; Melbourne Victoria Australia
- Institute for Breathing and Sleep; Austin Health; Melbourne Victoria Australia
| | - Dodie Pouniotis
- Institute for Breathing and Sleep; Austin Health; Melbourne Victoria Australia
- School of Health and Biomedical Sciences; RMIT University; Melbourne Victoria Australia
| | - Catherine J. Hill
- Institute for Breathing and Sleep; Austin Health; Melbourne Victoria Australia
- Department of Physiotherapy; Austin Health; Melbourne Victoria Australia
| | - Nicole S.L. Goh
- Department of Respiratory & Sleep Medicine; Austin Health; Melbourne Victoria Australia
- Institute for Breathing and Sleep; Austin Health; Melbourne Victoria Australia
| | - Anne E Holland
- Discipline of Physiotherapy; La Trobe University, Alfred Centre; Melbourne Victoria Australia
- Institute for Breathing and Sleep; Austin Health; Melbourne Victoria Australia
- Department of Physiotherapy; Alfred Health; Melbourne Victoria Australia
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12
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Nagato AC, Bezerra FS, Talvani A, Aarestrup BJ, Aarestrup FM. Hyperoxia promotes polarization of the immune response in ovalbumin-induced airway inflammation, leading to a TH17 cell phenotype. Immun Inflamm Dis 2015; 3:321-37. [PMID: 26417446 PMCID: PMC4578530 DOI: 10.1002/iid3.71] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/16/2015] [Accepted: 05/19/2015] [Indexed: 12/15/2022] Open
Abstract
Previous studies have demonstrated that hyperoxia-induced stress and oxidative damage to the lungs of mice lead to an increase in IL-6, TNF-α, and TGF-β expression. Together, IL-6 and TGF-β have been known to direct T cell differentiation toward the TH17 phenotype. In the current study, we tested the hypothesis that hyperoxia promotes the polarization of T cells to the TH17 cell phenotype in response to ovalbumin-induced acute airway inflammation. Airway inflammation was induced in female BALB/c mice by intraperitoneal sensitization and intranasal introduction of ovalbumin, followed by challenge methacholine. After the methacholine challenge, animals were exposed to hyperoxic conditions in an inhalation chamber for 24 h. The controls were subjected to normoxia or aluminum hydroxide dissolved in phosphate buffered saline. After 24 h of hyperoxia, the number of macrophages and lymphocytes decreased in animals with ovalbumin-induced airway inflammation, whereas the number of neutrophils increased after ovalbumin-induced airway inflammation. The results showed that expression of Nrf2, iNOS, T-bet and IL-17 increased after 24 of hyperoxia in both alveolar macrophages and in lung epithelial cells, compared with both animals that remained in room air, and animals with ovalbumin-induced airway inflammation. Hyperoxia alone without the induction of airway inflammation lead to increased levels of TNF-α and CCL5, whereas hyperoxia after inflammation lead to decreased CCL2 levels. Histological evidence of extravasation of inflammatory cells into the perivascular and peribronchial regions of the lungs was observed after pulmonary inflammation and hyperoxia. Hyperoxia promotes polarization of the immune response toward the TH17 phenotype, resulting in tissue damage associated with oxidative stress, and the migration of neutrophils to the lung and airways. Elucidating the effect of hyperoxia on ovalbumin-induced acute airway inflammation is relevant to preventing or treating asthmatic patients that require oxygen supplementation to reverse the hypoxemia.
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Affiliation(s)
- Akinori C Nagato
- Laboratory of Immunopathology and Experimental Pathology, Center for Reproductive Biology-CRB, Federal University of Juiz de Fora Juiz de Fora, Minas Gerais, Brazil
| | | | - André Talvani
- Laboratory of Immunobiology of Inflammation, Department of Biological Sciences (DECBI), Center of Research in Biological Sciences (NUPEB), Federal University of Ouro Preto (UFOP) Ouro Preto, Minas Gerais, Brazil
| | - Beatriz J Aarestrup
- Laboratory of Immunopathology and Experimental Pathology, Center for Reproductive Biology-CRB, Federal University of Juiz de Fora Juiz de Fora, Minas Gerais, Brazil
| | - Fernando M Aarestrup
- Laboratory of Immunopathology and Experimental Pathology, Center for Reproductive Biology-CRB, Federal University of Juiz de Fora Juiz de Fora, Minas Gerais, Brazil
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13
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Hyperbaric oxygen diving affects exhaled molecular profiles in men. Respir Physiol Neurobiol 2014; 198:20-4. [DOI: 10.1016/j.resp.2014.03.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 03/22/2014] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
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14
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Sliman SM, Patel RB, Cruff JP, Kotha SR, Newland CA, Schrader CA, Sherwani SI, Gurney TO, Magalang UJ, Parinandi NL. Adiponectin protects against hyperoxic lung injury and vascular leak. Cell Biochem Biophys 2014; 67:399-414. [PMID: 22183615 DOI: 10.1007/s12013-011-9330-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Adiponectin (Ad), an adipokine exclusively secreted by the adipose tissue, has emerged as a paracrine metabolic regulator as well as a protectant against oxidative stress. Pharmacological approaches of protecting against clinical hyperoxic lung injury during oxygen therapy/treatment are limited. We have previously reported that Ad inhibits the NADPH oxidase-catalyzed formation of superoxide from molecular oxygen in human neutrophils. Based on this premise, we conducted studies to determine whether (i) exogenous Ad would protect against the hyperoxia-induced barrier dysfunction in the lung endothelial cells (ECs) in vitro, and (ii) endogenously synthesized Ad would protect against hyperoxic lung injury in wild-type (WT) and Ad-overexpressing transgenic (AdTg) mice in vivo. The results demonstrated that exogenous Ad protected against the hyperoxia-induced oxidative stress, loss of glutathione (GSH), cytoskeletal reorganization, barrier dysfunction, and leak in the lung ECs in vitro. Furthermore, the hyperoxia-induced lung injury, vascular leak, and lipid peroxidation were significantly attenuated in AdTg mice in vivo. Also, AdTg mice exhibited elevated levels of total thiols and GSH in the lungs as compared with WT mice. For the first time, our studies demonstrated that Ad protected against the hyperoxia-induced lung damage apparently through attenuation of oxidative stress and modulation of thiol-redox status.
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Affiliation(s)
- Sean M Sliman
- Lipid Signaling, Lipidomics, and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Dorothy M. Davis Heart & Lung Research Institute, Department of Internal Medicine, The Ohio State University College of Medicine, 473 W. 12th Avenue, Columbus, OH, 43210, USA
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15
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van Ooij PJAM, Hollmann MW, van Hulst RA, Sterk PJ. Assessment of pulmonary oxygen toxicity: relevance to professional diving; a review. Respir Physiol Neurobiol 2013; 189:117-28. [PMID: 23886638 DOI: 10.1016/j.resp.2013.07.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 07/08/2013] [Accepted: 07/09/2013] [Indexed: 01/07/2023]
Abstract
When breathing oxygen with partial oxygen pressures PO₂ of between 50 and 300 kPa pathological pulmonary changes develop after 3-24h depending on the PO₂. This kind of injury (known as pulmonary oxygen toxicity) is not only observed in ventilated patients but is also considered an occupational hazard in oxygen divers or mixed gas divers. To prevent these latter groups from sustaining irreversible lesions adequate prevention is required. This review summarizes the pathophysiological effects on the respiratory tract when breathing oxygen with PO₂ of 50-300 kPa (hyperoxia). We discuss to what extent the most commonly used lung function parameters change after exposure to hyperoxia and its role in monitoring the onset and development of pulmonary oxygen toxicity in daily practice. Finally, new techniques in respiratory medicine are discussed with regard to their usefulness in monitoring pulmonary oxygen toxicity in divers.
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Affiliation(s)
- P J A M van Ooij
- Diving Medical Center, Royal Netherlands Navy, The Netherlands; Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.
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16
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Sarbach C, Stevens P, Whiting J, Puget P, Humbert M, Cohen-Kaminsky S, Postaire E. Evidence of endogenous volatile organic compounds as biomarkers of diseases in alveolar breath. ANNALES PHARMACEUTIQUES FRANÇAISES 2013; 71:203-15. [PMID: 23835018 DOI: 10.1016/j.pharma.2013.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 04/17/2013] [Accepted: 05/13/2013] [Indexed: 11/26/2022]
Abstract
The effect of oxygen on markers of oxidative stress has been partially elucidated. Volatile organic compounds (VOCs) are created during the oxidative burst and excreted in the human alveolar breath, which indeed contains biomarkers. A general concept including collection, separation, detection and clinical biomakers validation is presented in this article: (i) a method for the collection and GC-MS of halogenated VOCs in human alveolar breath is described: a transportable apparatus which sampled specifically alveolar breath; the VOCs were captured in a thermal desorption tube, Carbotrap 200® and each sample was thermally desorbed from the trap in an automated GC-MS apparatus; (ii) the inhibitory effects of halogenated alkanes on mitochondria are suspected likely to fight against oxidative stress deleterious reactions; (iii) two-dimensional gas chromatography occurs by the repeated and re-injection of effluent from one chromatographic column into a second column of orthogonal phase. A new commercial GCxGC system is presented; it is accomplished with a dual-stage, quad-jet thermal modulator positioned between the two columns; (iv) the affinity-based sensors usually used in connection with the GCxGC system face a difficulty to take into account different biases coming from different sources of drifting. Compared to other affinity-based sensing modes like electrical ones, gravimetric sensors enable a better decoupling. Nano Electro Mechanical Systems (NEMS)-based resonators are a particular type of gravimetric gas sensors. They are coated with a sensitive layer of polymer where gases of interest present in the atmosphere adsorb, generating an additional mass load which is measured through a frequency shift; (v) examination of exhaled breath has the potential to change the existing routine approaches in human medicine. Breath sampling to identify volatile biomarkers in diseases has been proposed in several respiratory diseases. Several VOCs have been identified in these patients by GC-MS. However, the use of traditional analytical instruments such as GC-MS to detect biomarkers of diseases has not become a routine for clinical applications. Consequently the electronic nose was the logical instrument of choice for disease diagnosis due to the capability of identifying complex mixtures of VOCs (as a whole) within sampled air using pattern-recognition algorithms.
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Affiliation(s)
- C Sarbach
- Ar2i, immeuble Le Carnot, 20-22, avenue Edouard-Herriot, Le Plessis-Robinson, France
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17
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Yan H, Chang H. Antioxidant and antitumor activities of selenium- and zinc-enriched oyster mushroom in mice. Biol Trace Elem Res 2012; 150:236-41. [PMID: 22639385 DOI: 10.1007/s12011-012-9454-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 05/14/2012] [Indexed: 01/07/2023]
Abstract
Selenium and zinc are well-known essential trace elements with potent biological functions. However, the possible health benefits of the combined administration of dietary selenium and zinc have not been studied extensively. In this study, we prepared selenium- and zinc-enriched mushrooms (SZMs) containing increased levels of selenium and zinc. The effects of SZMs on antioxidant and antitumor activities were evaluated. Mice were fed with either a control diet or a diet supplemented with SZMs or sodium selenite and zinc sulfate for 6 weeks. Antioxidant capacity was investigated by measuring the activities of antioxidant enzymes and the levels of lipid peroxide products. Results showed that treatment with SZMs significantly increased the activities of glutathione peroxidase (GPx) and superoxide dismutase and decreased the levels of malondialdehyde and lipofuscin. Furthermore, using a mouse model of lung tumors, we found that SZMs significantly decreased the number of tumor nodes with an increase in the activity of GPx. SZMs had a greater effect on the increase in both antioxidant and antitumor activities than did sodium selenite and zinc sulfate. These findings suggest that SZMs may be effective for improving antioxidant capacity and preventing tumors.
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Affiliation(s)
- Huimin Yan
- Department of Central Laboratory, Fifth Hospital of Shijiazhuang, Shijiazhuang, Hebei, 050021, China
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18
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Brerro-Saby C, Delliaux S, Steinberg JG, Boussuges A, Gole Y, Jammes Y. Combination of two oxidant stressors suppresses the oxidative stress and enhances the heat shock protein 27 response in healthy humans. Metabolism 2010; 59:879-86. [PMID: 20005545 DOI: 10.1016/j.metabol.2009.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 10/01/2009] [Accepted: 10/13/2009] [Indexed: 11/19/2022]
Abstract
We tested the hypothesis that the combination of 2 oxidant stressors (hyperoxia and fatiguing exercise) might reduce or suppress the oxidative stress. We concomitantly measured the plasma concentration of heat shock proteins (Hsp) that protect the cells against the deleterious effects of reactive oxygen species. Healthy humans breathed pure oxygen under normobaric condition for 50-minute periods during which they stayed at rest or executed maximal static handgrip sustained until exhaustion. They also repeated handgrip bouts in normoxic condition. We performed venous blood measurements of 2 markers of the oxidative stress (thiobarbituric acid reactive substances and reduced ascorbic acid) and Hsp27. Under normoxic condition, the handgrip elicited an oxidative stress and a modest increase in plasma Hsp27 level (+7.1 +/- 5.4 ng/mL). Under hyperoxic condition, (1) at rest, compared with the same time schedule in normoxic condition, we measured an oxidative stress (increased thiobarbituric acid reactive substances and decreased reduced ascorbic acid levels) and the plasma Hsp27 level increased (maximal variation, +12.5 +/- 6.0 ng/mL); and (2) after the handgrip, the oxidative stress rapidly disappeared. The combination of both hyperoxia and handgrip bout doubled the Hsp27 response (maximal variation, +24.8 +/- 9.2 ng/mL). Thus, the combination of 2 hits eliciting an oxidative stress seems to induce an adaptive Hsp27 response that might counterbalance an excessive production of reactive oxygen species.
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Affiliation(s)
- Christelle Brerro-Saby
- UMR MD2 P2COE, Faculté de Médecine, Université de la Méditerranée, 13916 cedex 20 Marseille, France
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19
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Sobocanec S, Balog T, Sarić A, Sverko V, Zarković N, Gasparović AC, Zarković K, Waeg G, Macak-Safranko Z, Kusić B, Marotti T. Cyp4a14 overexpression induced by hyperoxia in female CBA mice as a possible contributor of increased resistance to oxidative stress. Free Radic Res 2010; 44:181-90. [PMID: 19905990 DOI: 10.3109/10715760903390820] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The beneficial effects of hyperoxia have been noted in treatment of several diseases and pathological states. However, the excessive production of ROS under hyperoxic conditions can directly damage cellular macromolecules if the imbalance in antioxidant status exists. Cytochrome P450 (Cyp) 4a14 has an important role in the metabolism of lipids and as a source of ROS in oxidative stress. This study investigated the oxidant/antioxidant status as a response to hyperoxia treatment in liver of young CBA/Hr mice of both sexes and whether the observed response is mediated by Cyp4a14 via PPAR isoforms in a sex-dependent manner. The overexpression of Cyp4a14, lack of both LPO and of 4-hydroxynonenal(HNE)-protein adducts revealed by immunohistochemical analysis in hyperoxia-treated females indicates their greater resistance to hyperoxia compared to males, which is parallelled to changes in PPARbeta/delta and PPARgamma expression. These results suggest the presence of sex-dependent changes in all investigated parameters, which points out sex-related susceptibility towards oxidative stress and hyperoxia treatment of various pathological conditions and diseases.
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Affiliation(s)
- Sandra Sobocanec
- Division of Molecular Medicine, Ruder Bosković Institute, Bijenicka 54, 10000 Zagreb, Croatia.
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20
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Brerro-Saby C, Delliaux S, Steinberg JG, Jammes Y. The changes in neuromuscular excitability with normobaric hyperoxia in humans. Exp Physiol 2009; 95:153-9. [DOI: 10.1113/expphysiol.2009.049460] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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D'Agostino DP, Olson JE, Dean JB. Acute hyperoxia increases lipid peroxidation and induces plasma membrane blebbing in human U87 glioblastoma cells. Neuroscience 2009; 159:1011-22. [PMID: 19356685 DOI: 10.1016/j.neuroscience.2009.01.062] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 01/26/2009] [Accepted: 01/27/2009] [Indexed: 11/28/2022]
Abstract
Atomic force microscopy (AFM), malondialdehyde (MDA) assays, and amperometric measurements of extracellular hydrogen peroxide (H(2)O(2)) were used to test the hypothesis that graded hyperoxia induces measurable nanoscopic changes in membrane ultrastructure and membrane lipid peroxidation (MLP) in cultured U87 human glioma cells. U87 cells were exposed to 0.20 atmospheres absolute (ATA) O(2), normobaric hyperoxia (0.95 ATA O(2)) or hyperbaric hyperoxia (HBO(2), 3.25 ATA O(2)) for 60 min. H(2)O(2) (0.2 or 2 mM; 60 min) was used as a positive control for MLP. Cells were fixed with 2% glutaraldehyde immediately after treatment and scanned with AFM in air or fluid. Surface topography revealed ultrastructural changes such as membrane blebbing in cells treated with hyperoxia and H(2)O(2). Average membrane roughness (R(a)) of individual cells from each group (n=35 to 45 cells/group) was quantified to assess ultrastructural changes from oxidative stress. The R(a) of the plasma membrane was 34+/-3, 57+/-3 and 63+/-5 nm in 0.20 ATA O(2), 0.95 ATA O(2) and HBO(2), respectively. R(a) was 56+/-7 and 138+/-14 nm in 0.2 and 2 mM H(2)O(2). Similarly, levels of MDA were significantly elevated in cultures treated with hyperoxia and H(2)O(2) and correlated with O(2)-induced membrane blebbing (r(2)=0.93). Coapplication of antioxidant, Trolox-C (150 microM), significantly reduced membrane R(a) and MDA levels during hyperoxia. Hyperoxia-induced H(2)O(2) production increased 189%+/-5% (0.95 ATA O(2)) and 236%+/-5% (4 ATA O(2)) above control (0.20 ATA O(2)). We conclude that MLP and membrane blebbing increase with increasing O(2) concentration. We hypothesize that membrane blebbing is an ultrastructural correlate of MLP resulting from hyperoxia. Furthermore, AFM is a powerful technique for resolving nanoscopic changes in the plasma membrane that result from oxidative damage.
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Affiliation(s)
- D P D'Agostino
- Department of Molecular Pharmacology and Physiology, Hyperbaric Biomedical Research Laboratory, College of Medicine, MDC 8, University of South Florida, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
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Abstract
The state of wound oxygenation is a key determinant of healing outcomes. From a diagnostic standpoint, measurements of wound oxygenation are commonly used to guide treatment planning such as amputation decision. In preventive applications, optimizing wound perfusion and providing supplemental O(2) in the perioperative period reduces the incidence of postoperative infections. Correction of wound pO(2) may, by itself, trigger some healing responses. Importantly, approaches to correct wound pO(2) favorably influence outcomes of other therapies such as responsiveness to growth factors and acceptance of grafts. Chronic ischemic wounds are essentially hypoxic. Primarily based on the tumor literature, hypoxia is generally viewed as being angiogenic. This is true with the condition that hypoxia be acute and mild to modest in magnitude. Extreme near-anoxic hypoxia, as commonly noted in problem wounds, is not compatible with tissue repair. Adequate wound tissue oxygenation is required but may not be sufficient to favorably influence healing outcomes. Success in wound care may be improved by a personalized health care approach. The key lies in our ability to specifically identify the key limitations of a given wound and in developing a multifaceted strategy to specifically address those limitations. In considering approaches to oxygenate the wound tissue it is important to recognize that both too little as well as too much may impede the healing process. Oxygen dosing based on the specific need of a wound therefore seems prudent. Therapeutic approaches targeting the oxygen sensing and redox signaling pathways are promising.
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Affiliation(s)
- Chandan K Sen
- The Comprehensive Wound Center, Department of Surgery and Davis Heart and Lung Research Institute, The Ohio State University Medical Center, Columbus, Ohio, USA.
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Abstract
Since the introduction of oxygen as a therapeutic agent 70 years ago, much has been learned regarding the detrimental effects of hypoxemia and the beneficial impact of oxygen therapy. It is projected that there are close to 800,000 patients receiving long-term oxygen therapy (LTOT) in the United States, at a cost of approximately $1.8 billion annually. The large numbers of patients receiving supplemental oxygen as treatment and the high costs incurred in providing oxygen therapy necessitate the practitioner to know the indications for LTOT as well its effects on survival, pulmonary hemodynamics, sleep, and exercise capacity. It is now recognized that the basis for LTOT prescription for all patients is founded on data that are over 25 years old and that only involve a very select cohort of patients. It is clear that further studies are required to assess the effects of oxygen on patients with chronic obstructive pulmonary disease with only mild hypoxemia, not only survival but also on neurocognitive function, quality of life, exercise physiology, and sleep quality. In addition, although proven to be safe when prescribed long term to individuals with lung disease, there are some concerns about worsening carbon dioxide retention and increased oxidant injury. The goals of this article are to briefly describe the indications for chronic oxygen administration, the physiologic effects of treatment, and potential toxicities, as well as its effect on morbidity and mortality.
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Croxton TL, Bailey WC. Long-term oxygen treatment in chronic obstructive pulmonary disease: recommendations for future research: an NHLBI workshop report. Am J Respir Crit Care Med 2006; 174:373-8. [PMID: 16614349 PMCID: PMC2648117 DOI: 10.1164/rccm.200507-1161ws] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Long-term oxygen treatment (LTOT) prolongs life in patients with chronic obstructive pulmonary disease (COPD) and severe resting hypoxemia. Although this benefit is proven by clinical trials, scientific research has not provided definitive guidance regarding who should receive LTOT and how it should be delivered. Deficiencies in knowledge and in current research activity related to LTOT are especially striking in comparison to the importance of LTOT in the management of COPD and the associated costs. The National Heart, Lung, and Blood Institute, in collaboration with the Centers for Medicare and Medicaid Services, convened a working group to discuss research on LTOT. Participants in this meeting identified specific areas in which further investigation would likely lead to improvements in the care of patients with COPD or reductions in the cost of their care. The group recommended four clinical trials in subjects with COPD: (1) efficacy of ambulatory O(2) supplementation in subjects who experience oxyhemoglobin desaturation during physical activity but are not severely hypoxemic at rest; (2) efficacy of LTOT in subjects with severe COPD and only moderate hypoxemia; (3) efficacy of nocturnal O(2) supplementation in subjects who show episodic desaturation during sleep that is not attributable to obstructive sleep apnea; and (4) effectiveness of an activity-dependent prescription for O(2) flow rate that is based on clinical tests performed at rest, during exercise, and during sleep.
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Affiliation(s)
- Thomas L Croxton
- NHLBI, NIH, Room 10208, 6701 Rockledge Drive, Bethesda, MD 20892-7952, USA.
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van Helvoort HAC, Heijdra YF, Heunks LMA, Meijer PLM, Ruitenbeek W, Thijs HMH, Dekhuijzen PNR. Supplemental oxygen prevents exercise-induced oxidative stress in muscle-wasted patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006; 173:1122-9. [PMID: 16514109 DOI: 10.1164/rccm.200512-1957oc] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Although oxygen therapy is of clear benefit in patients with severe chronic obstructive pulmonary disease (COPD), recent studies have shown that short-term supplementary oxygen may increase oxidative stress and inflammation within the airways. OBJECTIVE We investigated whether systemic inflammation and oxidative stress at rest and during exercise in patients with COPD are influenced by supplemental oxygen. METHODS Nine normoxemic, muscle-wasted patients with moderate to very severe COPD were studied. Plasma markers of systemic inflammation (leukocyte counts, interleukin 6 [IL-6]) and oxidative stress (lipid peroxidation, protein oxidation, antioxidant capacity) were measured after treatment with either supplemental oxygen (nasal, 4 L . min(-1)) or compressed air, both at rest (1 h treatment) and after submaximal exercise (40 W, constant work rate). In addition, free-radical production by neutrophils and ATP-degradation products were determined before and after exercise. RESULTS Short-term oxygen breathing at rest did not influence systemic low-grade inflammation and oxidative stress. The IL-6 response to exercise was attenuated during cycling with supplemental oxygen. Exercise-induced lipid and protein oxidation were prevented by treatment with supplemental oxygen. This was associated with both decreased free-radical production by neutrophils and reduced formation of (hypo)xanthine and uric acid. CONCLUSION Short-term supplementary oxygen does not affect basal systemic inflammation and oxidative stress but prevents exercise-induced oxidative stress in normoxemic, muscle-wasted patients with COPD, and attenuates plasma IL-6 response. Inhibition of neutrophil activation and ATP degradation appears to be involved in this effect.
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Affiliation(s)
- Hanneke A C van Helvoort
- Radboud University Nijmegen Medical Centre, Department of Pulmonary Diseases (454), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Atalay H, Aybek H, Koseoglu M, Demir S, Erbay H, Bolaman AZ, Avci A. The effects of amifostine and dexamethasone on brain tissue lipid peroxidation during oxygen treatment of carbon monoxide-poisoned rats. Adv Ther 2006; 23:332-41. [PMID: 16751165 DOI: 10.1007/bf02850138] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The mechanisms of injury of, and methods of treating patients with, carbon monoxide (CO) poisoning are poorly understood. Besides the hypoxic degenerative effects of CO, reoxygenation injury may play an important role. Amifostine (Ami), which is most often used in radiotherapy for its tissue protective characteristics, may offer benefits. In this study, investigators evaluated the effectiveness of various treatments in a CO-poisoned rat model. A total of 36 Wistar rats were randomly assigned to 1 of 6 groups (n=6 each), including control and poisoned groups exposed to CO at 2000 ppm (v/v) for 1 h, followed by various 1-h treatments: group C (control), group COair (ambient air), group CO-NBO (normobaric 100% oxygen), group CO-HBO (hyperbaric oxygen with 3 atmospheres absolute [3 ATA]), group CO-NBO-Ami (normobaric oxygen with intraperitoneal [i.p.] injection of amifostine 250 mg/kg body weight [bw]), and group CO-70O (70% O2 and 5% CO2 with dexamethasone 10 mg/kg bw, i.p.). Blood gas analysis, carboxyhemoglobin determination, brain tissue lipid peroxidation, and glutathione peroxidase (GSHPx), superoxide dismutase (SOD), lactate dehydrogenase (LDH), and creatine kinase (CK) activities were evaluated. Carboxyhemoglobin concentration in the air-treated group was 44+/-2%; it decreased to the control level with all oxygen treatments. Brain tissue GSH-Px and SOD measurements did not change. The activity of LDH in group CO-HBO and the activities of LDH and CK in group CO-70O were similar to those of group C. Lipid peroxides were high in ambient air and normobaric oxygen, but HBO, amifostine with oxygen, or 70% O2 reduced these to control levels (P<.05).
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Affiliation(s)
- Habip Atalay
- Department of Anesthesiology and Reanimation, University of Pamukkale School of Medicine, Denizli, Turkey
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Fessel JP, Jackson Roberts L. Isofurans: novel products of lipid peroxidation that define the occurrence of oxidant injury in settings of elevated oxygen tension. Antioxid Redox Signal 2005; 7:202-9. [PMID: 15650408 DOI: 10.1089/ars.2005.7.202] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We recently reported the discovery of isofurans, novel products of free radical-induced peroxidation of arachidonic acid that exhibit favored formation with increasing oxygen concentrations. In this review, the biochemistry of isofuran formation is compared with that of isoprostanes, with an emphasis on the mechanistic basis for the favored formation of isofurans at elevated oxygen tensions. In addition, the formation of isofurans in various disease states in vivo is also discussed. Parkinson's disease is presented as a disease model involving mitochondrial dysfunction, a situation in which quantification of isofurans can provide a uniquely sensitive indicator of oxidant injury. Measurement of isofurans has also provided unexpected insights into the earliest events in hyperoxic lung injury, an important clinical problem in which measurement of isofurans might prove to be uniquely valuable in the evaluation of approaches to limit this injury. These two settings are then used as models to suggest a variety of other pathological settings in which measurement of isofurans together with isoprostanes could provide a complete and robust picture of oxidative stress status in ongoing and future investigations.
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Affiliation(s)
- Joshua P Fessel
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232-6602, USA
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Davies SS, Talati M, Wang X, Mernaugh RL, Amarnath V, Fessel J, Meyrick BO, Sheller J, Roberts LJ. Localization of isoketal adducts in vivo using a single-chain antibody. Free Radic Biol Med 2004; 36:1163-74. [PMID: 15082070 DOI: 10.1016/j.freeradbiomed.2004.02.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2003] [Revised: 02/02/2004] [Accepted: 02/06/2004] [Indexed: 11/24/2022]
Abstract
Isoketals are highly reactive gamma-ketoaldehydes formed by the oxidation of arachidonic acid that rapidly adduct to proteins. To investigate the formation of isoketal adducts in vivo, we isolated and characterized a single-chain antibody from a phage displayed recombinant ScFv library that bound a model peptide adducted with synthetic 15-E2-isoketal. Recognition of isoketal adduct by this anti-isoketal adduct single-chain antibody was essentially independent of the amino acid sequence of adducted peptides or proteins. The antibody did not cross-react with 4-hydroxynonenal or 4-oxononanal adducts or with 15-F2t-isoprostane (8-iso-prostaglandin F2alpha). We investigated the formation of isoketal adducts in a well-established model of oxidative injury, hyperoxia. Exposure to >98% oxygen for 7 h dramatically increased both the number of immunoreactive airway epithelial cells and the intensity of immunoreactivity compared with animals exposed to normal room air (21% oxygen). We conclude that isoketal adducts form in epithelial cells as a result of high oxygen exposure and that this single-chain antibody provides a valuable tool to localize the formation of isoketal adducts in tissues in vivo.
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Affiliation(s)
- Sean S Davies
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232-6602, USA.
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Abstract
The importance of respiratory muscle fatigue, particularly of the diaphragm, has become well recognized in the last decade. If the diaphragm muscle fails, so does effective ventilation and tissue respiration. Balance between energy supply and demand determines diaphragmatic endurance. An imbalance between energy supply and demand leads to the development of diaphragmatic fatigue. It has become clear that the process of fatigue is a complex phenomenon with multiple mechanisms accounting for changes in muscle performance. The various mechanisms involved are probably interdependent, synergistic, and integrative in nature. This article focuses on the concept of diaphragm fatigue and explores the mechanisms occurring with diaphragm fatigue including sodium-potassium derangements, which cause a decrease in velocity of propagation of muscle action; inhibition of calcium release from the sacroplasmic reticulum; and increased oxygen free radical formation related to cellular energetics. Additionally, review of therapeutic approaches to the treatment of diaphragm fatigue are presented.
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Affiliation(s)
- Nan Smith-Blair
- Eleanor Mann School of Nursing, University of Arkansas, Fayetteville 72701, USA.
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