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Cordiano R, Di Gioacchino M, Mangifesta R, Panzera C, Gangemi S, Minciullo PL. Malondialdehyde as a Potential Oxidative Stress Marker for Allergy-Oriented Diseases: An Update. Molecules 2023; 28:5979. [PMID: 37630231 PMCID: PMC10457993 DOI: 10.3390/molecules28165979] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Malondialdehyde (MDA) is a compound that is derived from the peroxidation of polyunsaturated fatty acids. It has been used as a biomarker to measure oxidative stress in various biological samples in patients who are affected by a wide range of diseases. The aim of our work is to provide an updated overview of the role of MDA as a marker of oxidative stress in allergy-related diseases. We considered studies involving both paediatric and adult patients affected by rhinitis, asthma, urticaria and atopic dermatitis. The measurement of MDA was performed on different types of samples. The reported data highlight the role of serum MDA in inflammatory airway diseases. According to the literature review, the oxidative stress status in asthmatic patients, assessed via MDA determination, appears to worsen in the presence of other allergic airway diseases and in relation to the disease severity. This suggests that MDA can be a suitable marker for monitoring the disease status. However, there are several limitations in the considered studies due to the different samples used and the lack of phenotyping and description of the clinical period of patients examined. In cutaneous allergic diseases, the role of MDA is controversial because of the smallness of the studies and the heterogeneity of the samples and patients.
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Affiliation(s)
- Raffaele Cordiano
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.C.); (C.P.); (S.G.); (P.L.M.)
| | - Mario Di Gioacchino
- Center of Advanced Science and Technology (CAST), G. D’Annunzio University, 66100 Chieti, Italy;
- YDA—Institute of Clinical Immunotherapy and Advanced Biological Treatments, 65121 Pescara, Italy
| | - Rocco Mangifesta
- Center of Advanced Science and Technology (CAST), G. D’Annunzio University, 66100 Chieti, Italy;
| | - Claudia Panzera
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.C.); (C.P.); (S.G.); (P.L.M.)
| | - Sebastiano Gangemi
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.C.); (C.P.); (S.G.); (P.L.M.)
| | - Paola Lucia Minciullo
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.C.); (C.P.); (S.G.); (P.L.M.)
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2
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Urs R, Ni Chin R, Hemy N, Wilson AC, Pillow JJ, Hall GL, Simpson SJ. Elevated leukotriene B4 and 8-isoprostane in exhaled breath condensate from preterm-born infants. BMC Pediatr 2023; 23:386. [PMID: 37543578 PMCID: PMC10403823 DOI: 10.1186/s12887-023-04210-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/24/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Inflammation and oxidative stress play a key role in the development of bronchopulmonary dysplasia (BPD), possibly contributing to persistent respiratory morbidity after preterm birth. We aimed to assess if inflammatory markers were elevated in exhaled breath condensate (EBC) of infants born very prematurely (< 32 weeks gestation) at 12-16 corrected months of age, and if increased levels were associated with BPD diagnosis and respiratory morbidity. METHODS EBC samples and respiratory questionnaires were collected from 15 term-born infants and 33 preterm-born infants, 12 with a neonatal BPD diagnosis. EBC samples were analysed for leukotriene B4 (inflammation) and 8-isoprostane (oxidative stress) concentrations using enzyme-linked immune-assays. Differences between groups were analysed by Kruskal-Wallis Test with post-hoc comparisons, independent samples t-test or Mann-Whitney U test depending on normality of the data. RESULTS Leukotriene B4 and 8-isoprostane levels were elevated in exhaled breath condensate of preterm-born infants compared to those born at term (mean difference [95% CI]; 1.52 [0.45, 2.59], p = 0.02; 0.77 [0.52, 1.02], p < 0.001, respectively). Leukotriene B4 and 8-isoprostane levels were independent of BPD diagnosis and respiratory morbidity over the first year of life. CONCLUSIONS Infants born very prematurely exhibit elevated markers of airway neutrophilic inflammation and oxidative stress beyond the first year of life, regardless of a neonatal diagnosis of chronic lung disease or respiratory morbidity during infancy. These findings may have implications for future lung health. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Rhea Urs
- School of Allied Health, Curtin University, Perth, WA, Australia.
- Wal-yan Respiratory Centre, Telethon Kids Institute, Perth, WA, Australia.
| | - Rubi Ni Chin
- Wal-yan Respiratory Centre, Telethon Kids Institute, Perth, WA, Australia
| | - Naomi Hemy
- Wal-yan Respiratory Centre, Telethon Kids Institute, Perth, WA, Australia
| | - Andrew C Wilson
- School of Allied Health, Curtin University, Perth, WA, Australia
- Wal-yan Respiratory Centre, Telethon Kids Institute, Perth, WA, Australia
- Perth Children's Hospital, Perth, WA, Australia
| | - J Jane Pillow
- Wal-yan Respiratory Centre, Telethon Kids Institute, Perth, WA, Australia
- School of Human Sciences, University of Western Australia, Perth, WA, Australia
| | - Graham L Hall
- School of Allied Health, Curtin University, Perth, WA, Australia
- Wal-yan Respiratory Centre, Telethon Kids Institute, Perth, WA, Australia
| | - Shannon J Simpson
- School of Allied Health, Curtin University, Perth, WA, Australia
- Wal-yan Respiratory Centre, Telethon Kids Institute, Perth, WA, Australia
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3
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Soyer T, Birben E, Akıncı SM, Göllü G, Türer ÖB, Soyer Ö, Çakmak M, Şekerel BE, Tanyel FC. The miRNA-24, miRNA-21 expressions and matrix metalloproteinase-7 level in exhaled breath condensate of children with primary spontaneous pneumothorax. J Breath Res 2022; 17. [PMID: 36541451 DOI: 10.1088/1752-7163/aca928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
Bullous lung diseases may cause primary spontaneous pneumothorax (PSP) in children. The microRNAs (miRNAs) are non-coding RNAs that participate in regulation of inflammation and cancer. We hypothesized that children with bullous lung disease and PSP may have altered miRNA expressions in their exhaled breath condensates (EBCs). Therefore, a prospective study was performed to evaluate the miRNA-24 and 21 expression, and the matrix metalloproteinase-7 (MMP-7) levels in EBC of children with PSP. Children with PSP were evaluated for age, gender, clinical features and results of surgical treatment. EBC samples (500-1000 ml) were collected to evaluate the miRNA-21, 24 expressions, and MMP-7, and tissue-inhibitor-MMP-1 (TIMP-1) levels. miRNA expressions and MMP levels of patients were compared with healthy controls (control group (CG),n= 12). Subjects (n= 16) with a mean age of 15 years (10-19 years), and a male-to-female ratio of 14:2 were enrolled in this study. The most common presenting symptom was sudden chest pain (n= 14). In 62.5% of the cases an underlying bullous lung disease were detected. During an average of 16.6 months (1-60 months) follow up period, four subjects relapsed. The mean MMP-7 (1.74-1.57 ng ml-1), and TIMP-1 (1.92-1.84 ng ml-1) levels were similar between both groups (p> 0.05). miRNA-24 expression was significantly decreased in the PSP group, when compared to the CG (0.16-1 2-ΔΔCT,p< 0.05). In addition, the miRNA-21 expression was not different between the two groups (p> 0.05). In conclusion, the miRNA-24 levels were significantly decreased in children with PSP. Taken together, children with PSP, especially those with bullous disease, should be closely monitored in the long-term period.
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Affiliation(s)
- Tutku Soyer
- Faculty of Medicine, Departments of Pediatric Surgery, Hacettepe University, Ankara, Turkey
| | - Esra Birben
- Faculty of Science, Department of Biology, Hacettepe University, Ankara, Turkey
| | - Servet Melike Akıncı
- Faculty of Medicine, Departments of Pediatric Surgery, Hacettepe University, Ankara, Turkey
| | - Gülnur Göllü
- Faculty of Medicine, Departments of Pediatric Surgery, Ankara University, Ankara, Turkey
| | - Özlem Boybeyi Türer
- Faculty of Medicine, Departments of Pediatric Surgery, Hacettepe University, Ankara, Turkey
| | - Özge Soyer
- Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey
| | - Murat Çakmak
- Faculty of Medicine, Departments of Pediatric Surgery, Ankara University, Ankara, Turkey
| | - Bülent Enis Şekerel
- Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey
| | - Feridun Cahit Tanyel
- Faculty of Medicine, Departments of Pediatric Surgery, Hacettepe University, Ankara, Turkey
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4
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Nwanochie E, Linnes JC. Review of non-invasive detection of SARS-CoV-2 and other respiratory pathogens in exhaled breath condensate. J Breath Res 2022; 16:10.1088/1752-7163/ac59c7. [PMID: 35235925 PMCID: PMC9104940 DOI: 10.1088/1752-7163/ac59c7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/02/2022] [Indexed: 11/12/2022]
Abstract
In 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged to cause high viral infectivity and severe respiratory illness in humans (COVID-19). Worldwide, limited pandemic mitigation strategies, including lack of diagnostic test availability, resulted in COVID-19 overrunning health systems and spreading throughout the global population. Currently, proximal respiratory tract (PRT) specimens such as nasopharyngeal swabs are used to diagnose COVID-19 because of their relative ease of collection and applicability in large scale screening. However, localization of SARS-CoV-2 in the distal respiratory tract (DRT) is associated with more severe infection and symptoms. Exhaled breath condensate (EBC) is a sample matrix comprising aerosolized droplets originating from alveolar lining fluid that are further diluted in the DRT and then PRT and collected via condensation during tidal breathing. The COVID-19 pandemic has resulted in recent resurgence of interest in EBC collection as an alternative, non-invasive sampling method for the staging and accurate detection of SARS-CoV-2 infections. Herein, we review the potential utility of EBC collection for detection of SARS-CoV-2 and other respiratory infections. While much remains to be discovered in fundamental EBC physiology, pathogen-airway interactions, and optimal sampling protocols, EBC, combined with emerging detection methods, presents a promising non-invasive sample matrix for detection of SARS-CoV-2.
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Affiliation(s)
- Emeka Nwanochie
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America
| | - Jacqueline C Linnes
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America
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5
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Marpole R, Ohn M, O'Dea CA, von Ungern-Sternberg BS. Clinical utility of preoperative pulmonary function testing in pediatrics. Paediatr Anaesth 2022; 32:191-201. [PMID: 34875135 DOI: 10.1111/pan.14356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/28/2022]
Abstract
Perioperative respiratory adverse events pose a significant risk in pediatric anesthesia, and identifying these risks is vital. Traditionally, this is assessed using history and examination. However, the perioperative risk is multifactorial, and children with complex medical backgrounds such as chronic lung disease or obesity may benefit from additional objective preoperative pulmonary function tests. This article summarizes the utility of available pulmonary function assessment tools as preoperative tests in improving post-anesthetic outcomes. Currently, there is no evidence to support or discourage any pulmonary function assessment as a routine preoperative test for children undergoing anesthesia. In addition, there is uncertainty about which patients with the known or suspected respiratory disease require preoperative pulmonary function tests, what time period prior to surgery these are required, and whether spirometry or more sophisticated tests are indicated. Therefore, the need for any test should be based on information obtained from the history and examination, the child's age, and the complexity of the surgery.
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Affiliation(s)
- Rachael Marpole
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, WA, Australia.,Division of Paediatrics, School of Medical, University of Western Australia, Crawley, WA, Australia
| | - Mon Ohn
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, WA, Australia.,Division of Paediatrics, School of Medical, University of Western Australia, Crawley, WA, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, WA, Australia
| | - Christopher A O'Dea
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, WA, Australia
| | - Britta S von Ungern-Sternberg
- Perioperative Medicine Team, Telethon Kids Institute, Nedlands, WA, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, School of Medical, University of Western Australia, Crawley, WA, Australia.,Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, WA, Australia
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6
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Tereshchenko SY, Malinchik MA, Smolnikova MV. Inflammatory markers in exhaled breath condensate in bronchial asthma. MEDITSINSKIY SOVET = MEDICAL COUNCIL 2021. [DOI: 10.21518/2079-701x-2021-16-212-223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Chronic respiratory diseases are among the most common non- infection diseases. In particular, it is bronchial asthma (BA), characterized by bronchial hyperreactivity and varying degrees of airway obstruction that is the cause of morbidity and mortality. The methods available for the information about the presence of inflammation in the airways, such as bronchoscopy and bronchial biopsy to be obtained have currently been invasive and difficult in everyday clinical practice, especially for children and seriously ill patients. In this regard, recently there has been an increase in the development of non-invasive methods for diagnosing the respiratory system, being comfortable and painless for trial subjects, especially children, also providing the inflammatory process control in the lungs, the severity assessment and monitoring the treatment process. The exhaled breath condensate (EBC) is of great attention, which is a source of various biomolecules, including nitric oxide (NO), leukotrienes, 8-isoprostane, prostaglandins, etc., being locally or systemically associated with disease processes in the body. Of particular interest is the presence of cytokines in EBC, namely the specific proteins produced by various cells of the body that play a key role in inflammatory processes in AD and provide cell communication (cytokine network). Thereby, it becomes possible for the severity and control level of childhood bronchial asthma using only the EBC analysis to be assessed. In addition, the non-invasiveness of this method allows it to be reused for monitoring lung diseases of even the smallest patients, including infants. Thus, the field of metabolite analysis in EBC has been developing and, in the near future, the given method is likely to be the most common for diagnosing the respiratory system diseases in both children and adults.
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Affiliation(s)
- S. Yu. Tereshchenko
- Scientific Research Institute of Medical Problems of the North, Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences
| | - M. A. Malinchik
- Scientific Research Institute of Medical Problems of the North, Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences
| | - M. V. Smolnikova
- Scientific Research Institute of Medical Problems of the North, Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences
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7
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Seifi M, Rastkari N, Hassanvand MS, Naddafi K, Nabizadeh R, Nazmara S, Kashani H, Zare A, Pourpak Z, Hashemi SY, Yunesian M. Investigating the relationship between particulate matter and inflammatory biomarkers of exhaled breath condensate and blood in healthy young adults. Sci Rep 2021; 11:12922. [PMID: 34155256 PMCID: PMC8217428 DOI: 10.1038/s41598-021-92333-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/08/2021] [Indexed: 12/15/2022] Open
Abstract
Inflammatory biomarkers in exhaled breath condensate (EBC) are measured to estimate the effects of air pollution on humans. The present study was conducted to investigate the relationship between particulate matter and inflammatory biomarkers in blood plasma and exhaled air in young adults. The obtained results were compared in two periods; i.e., winter and summer. GRIMM Dust Monitors were used to measure PM10, PM2.5, and PM1 in indoor and outdoor air. A total of 40 healthy young adults exhaling air condensate were collected. Then, biomarkers of interleukin-6 (IL-6), Nitrosothiols (RS-NOs), and Tumor necrosis factor-soluble receptor-II (sTNFRII) were measured by 96 wells method ELISA and commercial kits (HS600B R&D Kit and ALX-850–037-KI01) in EBC while interleukin-6 (IL-6), sTNFRII and White Blood Cell (WBC) were measured in blood plasma in two periods of February 2013 (winter) and May 2013 (summer). Significant association was found between particulate matter and the white blood cell count (p < 0.001), as well as plasma sTNFRII levels (p-value = 0.001). No significant relationship was found between particulate matter with RS-NOs (p = 0.128), EBC RSNOs (p-value = 0.128), and plasma IL-6 (p-value = 0.167). In addition, there was no significant relationship between interleukin-6 of exhaled air with interleukin-6 of plasma (p-value < 0.792 in the first period and < 0.890 in the second period). sTNFRII was not detected in EBC. Considering the direct effect between increasing some biomarkers in blood and EBC and particulate matter, it is concluded that air pollution causes this increasing.
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Affiliation(s)
- Morteza Seifi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Rastkari
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrokh Nazmara
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahad Zare
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pourpak
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Yaser Hashemi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
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8
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Połomska J, Bar K, Sozańska B. Exhaled Breath Condensate-A Non-Invasive Approach for Diagnostic Methods in Asthma. J Clin Med 2021; 10:jcm10122697. [PMID: 34207327 PMCID: PMC8235112 DOI: 10.3390/jcm10122697] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/04/2021] [Accepted: 06/15/2021] [Indexed: 01/08/2023] Open
Abstract
The pathophysiology of asthma has been intensively studied, but its underlying mechanisms such as airway inflammation, control of airway tone, and bronchial reactivity are still not completely explained. There is an urgent need to implement novel, non-invasive diagnostic tools that can help to investigate local airway inflammation and connect the molecular pathways with the broad spectrum of clinical manifestations of asthma. The new biomarkers of different asthma endotypes could be used to confirm diagnosis, predict asthma exacerbations, or evaluate treatment response. In this paper, we briefly describe the characteristics of exhaled breath condensate (EBC) that is considered to be an interesting source of biomarkers of lung disorders. We look at the composition of EBC, some aspects of the collection procedure, the proposed biomarkers for asthma, and its clinical implications. We also indicate the limitations of the method and potential strategies to standardize the procedure of EBC collection and analytical methods.
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9
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Soyer T, Birben E, Türer ÖB, Kahveci M, Tuğcu GD, Soyer ÖU, Yalçın E, Doğru D, Özçelik U, Kiper N, Şekerel BE, Tanyel FC. MicroRNA Levels in Exhaled Breath Condensate of Patients with Esophageal Atresia. Dis Esophagus 2021; 34:5899730. [PMID: 32869085 DOI: 10.1093/dote/doaa082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/23/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022]
Abstract
MicroRNAs (miRNAs) are noncoding RNAs that play an important role in the regulation of inflammation and have not been evaluated in exhaled breath condensates (EBC) of patients with esophageal atresia and tracheoesophageal fistula (EA-TEF). It is aimed to evaluate the levels of miRNA-21 and miRNA-24 in EBC of patients with EA-TEF. Patients who received surgery for EA-TEF (EA) were assessed for age, sex, types of anomaly, surgical treatments, and respiratory problems. A 500-1000 mL of EBC was obtained from each participant with EcoScreen. The levels of miRNA-21 and miRNA-24 in the EBC were analyzed by real-time polymerase chain reaction and compared between the EA group and the control group consisting of healthy children with no history of respiratory problems (n = 17). The levels of miRNAs in relation to respiratory problems and gastroesophageal reflux (GER) were also assessed. A total of 19 patients were enrolled in the EA group with a mean age of 7.8 ± 3.2 years and a male-to-female ratio of 10:9 EA cases had significantly lower levels of miRNA-21 (P < 0.05) compared to that in control group. The miRNA-24 levels did not differ between groups (P > 0.05). EA patients with positive pH testing for GER (n = 6) and fundoplication (n = 6) had higher levels of miRNA-21 than those with normal pH testing and without fundoplication, respectively (n = 13, P < 0.05). The levels of miRNA-21 and miRNA-24 did not differ between patients with and without proton pump inhibitor treatment (P > 0.05). The lower levels of miRNA-21 in the EBC of EA patients suggest a hyperreactive airway problem, which may be associated with GER and its surgical treatment.
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Affiliation(s)
- T Soyer
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - E Birben
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ö B Türer
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - M Kahveci
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - G D Tuğcu
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ö U Soyer
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - E Yalçın
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - D Doğru
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - U Özçelik
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - N Kiper
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - B E Şekerel
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - F C Tanyel
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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10
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Abstract
Colorimetric sensing technologies have been widely used for both quantitative detection of specific analyte and recognition of a large set of analytes in gas phase, ranging from environmental chemicals to biomarkers in breath. However, the accuracy and reliability of the colorimetric gas sensors are threatened by the humidity interference in different application scenarios. Though substantial progress has been made toward new colorimetric sensors development, unless the humidity interference is well addressed, the colorimetric sensors cannot be deployed for real-world applications. Although there are comprehensive and insightful review articles about the colorimetric gas sensors, they have focused more on the progress in new sensing materials, new sensing systems, and new applications. There is a need for reviewing the works that have been done to solve the humidity issue, a challenge that the colorimetric gas sensors commonly face. In this review paper, we analyzed the mechanisms of the humidity interference and discussed the approaches that have been reported to mitigate the humidity interference in colorimetric sensing of environmental gases and breath biomarkers. Finally, the future perspectives of colorimetric sensing technologies are also discussed.
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Affiliation(s)
- Jingjing Yu
- Center for Bioelectronics and Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona 85287, United States
| | - Di Wang
- Center for Bioelectronics and Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona 85287, United States
| | - Vishal Varun Tipparaju
- Center for Bioelectronics and Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona 85287, United States
| | - Francis Tsow
- Center for Bioelectronics and Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona 85287, United States
| | - Xiaojun Xian
- Center for Bioelectronics and Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona 85287, United States
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11
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Soyer T, Türer ÖB, Birben E, Kahveci M, Tuğcu GD, Soyer ÖU, Yalçın E, Doğru D, Özçelik U, Kiper N, Şekerel B, Tanyel FC. The relationship between oxidative stress markers in exhaled breath condensate and respiratory problems in patients with repaired esophageal atresia. J Pediatr Surg 2020; 55:1516-1521. [PMID: 31257017 DOI: 10.1016/j.jpedsurg.2019.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/29/2019] [Accepted: 06/04/2019] [Indexed: 12/21/2022]
Abstract
AIM To evaluate the relationship between respiratory problems and oxidative stress markers in exhaled breath condensate (EBC) of patients with esophageal atresia (EA). METHODS EA cases with respiratory problems were evaluated retrospectively for age, gender, the type of atresia, surgical treatment, outcome and respiratory symptoms. The results of gastroesophageal reflux (GER) treatment including the use of proton pump inhibitor (PPI) and fundoplication were also documented. EBC samples of 500-1000 μl were obtained by Ecoscreen machine in all cases. The levels of Glutathione (Glut), 8-isoprostane (8-iso), cysteinyl-leukotriene (Cys-LT) were measured with ELISA. Results were compared with healthy control subjects (CG, n = 26) and the relationship between oxidative stress markers and respiratory symptoms was evaluated. The results of GER treatment and oxidative stress markers in EBC were also correlated. RESULTS Twenty-nine patients with a mean age of 8.8 years (3-14 years) were included. The male/female ratio was 16:13. The EA presented with distal fistula in 27 cases. While no fistula was observed in 1 case, both proximal and distal fistulae were present in another single case. Associated anomalies, most of which were cardiovascular anomalies, were observed in 65.5% (n = 19) of cases. The median Glut level was 1.03 mM/ml (0.93-1.15), iso-8 was 38.8 pg/mL (32.03-76.2) and Cys-LT was 0.44 pg/mL (20.17-61.3) in patients with EA. The median levels of oxidative markers in CG were 1.23 mM/mL (1.13-1.36), 66.3 pg/mL (33.5-106.7), and 56.9 pg/mL (27.4-80.1), respectively. Glut levels were significantly lower in EA cases compared to CG (p = 0.01). There was no significant difference between the groups regarding 8-iso and CYS-LT levels (p = 0.9, p = 1.0). Cys-LT levels were significantly lower in patients with PPI treatment [21.7 pg/mL (18.6-48.1)], when compared to patients without PPI treatment [41.1 pg/mL (22.5-83.1)] (p = 0.04) and healthy subjects [56.9 pg/mL (27.4-80.1)] (p = 0.017). The 8-iso levels were significantly decreased in cases with fundoplication compared to the patients without fundoplication (p = 0.02). CONCLUSION Glut - an antioxidant agent - levels were significantly lower in EBC of EA cases. The decrease in Cys-LT levels in cases with PPI treatment and in 8-iso levels in patients with fundoplication suggests that the oxidative damage in EBC of EA cases may be correlated with GER and its management. TYPE OF STUDY Case control study LEVEL OF EVIDENCE: Level III.
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Affiliation(s)
- Tutku Soyer
- Hacettepe University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey.
| | - Özlem Boybeyi Türer
- Hacettepe University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey
| | - Esra Birben
- Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey
| | - Melike Kahveci
- Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey
| | - Gökçen Dilşa Tuğcu
- Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey
| | - Özge Uysal Soyer
- Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey
| | - Ebru Yalçın
- Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey
| | - Deniz Doğru
- Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey
| | - Uğur Özçelik
- Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey
| | - Nural Kiper
- Hacettepe University Faculty of Medicine, Department of Pediatric Pulmonology, Ankara, Turkey
| | - Bülent Şekerel
- Hacettepe University Faculty of Medicine, Department of Pediatric Allergy, Ankara, Turkey
| | - Feridun Cahit Tanyel
- Hacettepe University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey
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12
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Upendran Y, Leach ST, Singh H, McBride J, Thomas PS, Belessis Y, Krishnan U. Pepsin as a Marker of Reflux Aspiration in Children With Esophageal Atresia: A Pilot Study. Front Pediatr 2020; 8:94. [PMID: 32266182 PMCID: PMC7096381 DOI: 10.3389/fped.2020.00094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background: Reflux aspiration secondary to gastroesophageal reflux disease (GERD) is one of the causes of chronic gastrointestinal and respiratory morbidity in children with esophageal atresia (EA). Currently there are no simple, validated non-invasive tests for the diagnosis of reflux aspiration in children. Objectives: The aim of this pilot study was to investigate pepsin detected in exhaled breath condensate (EBC) and saliva as a potential non-invasive marker of reflux aspiration in children with EA. Methods: EBC and saliva samples were prospectively collected from children with EA aged between 5 and 18 years attending a multidisciplinary EA Clinic. Pepsin in the samples was assayed by two methods, a commercial lateral flow device, the Peptest™ and an enzyme-linked immunosorbent assay (ELISA) and correlated with validated gastrointestinal and respiratory symptom questionnaires and objective measures of GERD and respiratory function. Results: EBC were collected from 18 children with EA, 15/18 also provided salivary samples. Pepsin was not detected in any of the EBC samples using the Peptest™ and only 1/14 (7.1%) samples by the ELISA. However, pepsin was detected in 33 and 83% of saliva samples when analyzed with Peptest™ and the ELISA respectively. Salivary pepsin levels were significantly higher in children with reflux symptoms or wheeze. Pepsin was detected by the Peptest™ in the saliva of 5/5 (100%) children with histological evidence of reflux esophagitis compared with 0/2 (0%) in children with normal histology (p = 0.048). Conclusions: Salivary pepsin was detected in a large proportion of children with EA and was significantly associated with GERD symptoms or wheeze. The role of salivary pepsin as a potential non-invasive marker of reflux aspiration in children with EA needs further validation in future studies with larger cohorts.
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Affiliation(s)
- Yadhavan Upendran
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Steven T Leach
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Harveen Singh
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.,Department of Gastroenterology, Sydney Children's Hospital, Sydney, NSW, Australia
| | - James McBride
- Department of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Paul S Thomas
- Department of Respiratory Medicine, Prince of Wales' Clinical School, Prince of Wales' Hospital, UNSW, Sydney, NSW, Australia
| | - Yvonne Belessis
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.,Department of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Usha Krishnan
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.,Department of Gastroenterology, Sydney Children's Hospital, Sydney, NSW, Australia
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13
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Zang X, Monge ME, Gaul DA, McCarty NA, Stecenko A, Fernández FM. Early Detection of Cystic Fibrosis Acute Pulmonary Exacerbations by Exhaled Breath Condensate Metabolomics. J Proteome Res 2019; 19:144-152. [PMID: 31621328 DOI: 10.1021/acs.jproteome.9b00443] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The most common cause of death in cystic fibrosis (CF) patients is progressive lung function decline, which is punctuated by acute pulmonary exacerbations (APEs). A major challenge is to discover biomarkers for detecting an oncoming APE and allow for pre-emptive clinical interventions. Metabolic profiling of exhaled breath condensate (EBC) samples collected from CF patients before, during, and after APEs and under stable conditions (n = 210) was performed using ultraperformance liquid chromatography (UPLC) coupled to Orbitrap mass spectrometry (MS). Negative ion mode MS data showed that classification between metabolic profiles from "pre-APE" (pending APE before the CF patient had any signs of illness) and stable CF samples was possible with good sensitivities (85.7 and 89.5%), specificities (88.4 and 84.1%), and accuracies (87.7 and 85.7%) for pediatric and adult patients, respectively. Improved classification performance was achieved by combining positive with negative ion mode data. Discriminant metabolites included two potential biomarkers identified in a previous pilot study: lactic acid and 4-hydroxycyclohexylcarboxylic acid. Some of the discriminant metabolites had microbial origins, indicating a possible role of bacterial metabolism in APE progression. The results show promise for detecting an oncoming APE using EBC metabolites, thus permitting early intervention to abort such an event.
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Affiliation(s)
- Xiaoling Zang
- School of Chemistry and Biochemistry , Georgia Institute of Technology , Atlanta , Georgia 30332 , United States
| | - María Eugenia Monge
- Centro de Investigaciones en Bionanociencias (CIBION) , Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) , Godoy Cruz 2390 , Ciudad de Buenos Aires C1425FQD , Argentina
| | - David A Gaul
- School of Chemistry and Biochemistry , Georgia Institute of Technology , Atlanta , Georgia 30332 , United States
| | - Nael A McCarty
- Emory + Children's Center for Cystic Fibrosis and Airways Disease Research and Department of Pediatrics , Emory University School of Medicine and Children's Healthcare of Atlanta , Atlanta , Georgia 30322 , United States
| | - Arlene Stecenko
- Emory + Children's Center for Cystic Fibrosis and Airways Disease Research and Department of Pediatrics , Emory University School of Medicine and Children's Healthcare of Atlanta , Atlanta , Georgia 30322 , United States
| | - Facundo M Fernández
- School of Chemistry and Biochemistry , Georgia Institute of Technology , Atlanta , Georgia 30332 , United States
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14
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Yen E, Weinberger BI, Laumbach RJ, Ohman-Strickland PA, Vetrano AM, Gow AM, Ramagopal M. Exhaled breath condensate nitrite in premature infants with bronchopulmonary dysplasia. J Neonatal Perinatal Med 2019; 11:399-407. [PMID: 30040745 DOI: 10.3233/npm-17106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Tracheal aspirate is the conventional method to measure biomarkers of inflammation and oxidation from premature infants on mechanical ventilation at risk for bronchopulmonary dysplasia (BPD), but this method is invasive. Exhaled breath condensate (EBC) is a novel, non-invasive method that has been used in older populations. Nitrite, a stable metabolite of nitric oxide (NO), is elevated in inflammatory conditions. We aim to investigate the feasibility of EBC nitrite collection from ventilated premature infants and to quantify EBC nitrite in infants with and without BPD. We hypothesize that EBC nitrite correlates with TA nitrite, and that EBC nitrite in the first week of life is higher in infants who will develop BPD than those without BPD. METHODS In a pilot prospective cohort study, TA and EBC were collected in the first week of life from mechanically ventilated premature infants. Nitrite levels were measured using chemiluminescence. RESULTS EBC nitrite significantly correlated with TA nitrite (r = 0.45, p = 0.025). Of 40 infants, 33 (82.5%) developed BPD. EBC and TA nitrite levels collected in the first week of life had a higher trend in infants with BPD than those without BPD (p = 0.23 and 0.38 respectively). CONCLUSIONS Higher trend of EBC nitrite in the first week of life was associated with the development of BPD. Correlation of nitrite level in EBC with that in TA (conventional method) highlights the utility of EBC as an alternative, non-invasive method to measure inflammation. Further refinement of conditions and timing may optimize the predictive value of EBC nitrite.
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Affiliation(s)
- E Yen
- Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA.,Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (RWJMS), New Brunswick, NJ, USA
| | - B I Weinberger
- Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - R J Laumbach
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - P A Ohman-Strickland
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - A M Vetrano
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (RWJMS), New Brunswick, NJ, USA
| | - A M Gow
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - M Ramagopal
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (RWJMS), New Brunswick, NJ, USA
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15
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Peterová E, Chládek J, Kohoutová D, Knoblochová V, Morávková P, Vávrová J, Řezáčová M, Bureš J. Exhaled Breath Condensate: Pilot Study of the Method and Initial Experience in Healthy Subjects. ACTA MEDICA (HRADEC KRÁLOVÉ) 2018; 61:8-16. [PMID: 30012244 DOI: 10.14712/18059694.2018.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Analysis of Exhaled breath condensate (EBC) is a re-discovered approach to monitoring the course of the disease and reduce invasive methods of patient investigation. However, the major disadvantage and shortcoming of the EBC is lack of reliable and reproducible standardization of the method. Despite many articles published on EBC, until now there is no clear consensus on whether the analysis of EBC can provide a clue to diagnosis of the diseases. The purpose of this paper is to investigate our own method, to search for possible standardization and to obtain our own initial experience. Thirty healthy volunteers provided the EBC, in which we monitored the density, pH, protein, chloride and urea concentration. Our results show that EBC pH is influenced by smoking, and urea concentrations are affected by the gender of subjects. Age of subjects does not play a role. The smallest coefficient of variation between individual volunteers is for density determination. Current limitations of EBC measurements are the low concentration of many biomarkers. Standardization needs to be specific for each individual biomarker, with focusing on optimal condensate collection. EBC analysis has a potential become diagnostic test, not only for lung diseases.
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Affiliation(s)
- Eva Peterová
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Czech Republic. .,Department of Medical Biochemistry, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic.
| | - Jaroslav Chládek
- Department of Pharmacology, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Darina Kohoutová
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Czech Republic
| | - Veronika Knoblochová
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Czech Republic
| | - Paula Morávková
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Czech Republic
| | - Jaroslava Vávrová
- Institute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Czech Republic
| | - Martina Řezáčová
- Department of Medical Biochemistry, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Jan Bureš
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Czech Republic
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16
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Rahimpour E, Khoubnasabjafari M, Jouyban-Gharamaleki V, Jouyban A. Non-volatile compounds in exhaled breath condensate: review of methodological aspects. Anal Bioanal Chem 2018; 410:6411-6440. [PMID: 30046867 DOI: 10.1007/s00216-018-1259-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 07/10/2018] [Indexed: 12/27/2022]
Abstract
In contrast to bronchial and nasal lavages, the analysis of exhaled breath condensate (EBC) is a promising, simple, non-invasive, repeatable, and diagnostic method for studying the composition of airway lining fluid with the potential to assess lung inflammation, exacerbations, and disease severity, and to monitor the effectiveness of treatment regimens. Recent investigations have revealed the potential applications of EBC analysis in systemic diseases. In this review, we highlight the analytical studies conducted on non-volatile compounds/biomarkers in EBC. In contrast to other related articles, this review is classified on the basis of analytical techniques and includes almost all the applied methods and their methodological limitations for quantification of non-volatile compounds in EBC samples, providing a guideline for further researches. The studies were identified by searching the SCOPUS database with the keywords "biomarkers," "non-volatile compounds," "determination method," and "EBC."
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Affiliation(s)
- Elaheh Rahimpour
- Pharmaceutical Analysis Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Khoubnasabjafari
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Jouyban-Gharamaleki
- Liver and Gastrointestinal Diseases 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 Azarbayjan (KIPA) Science Based Company, Tabriz University of Medical Sciences, Tabriz, Iran.
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17
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A technology roadmap of smart biosensors from conventional glucose monitoring systems. Ther Deliv 2017; 8:411-423. [DOI: 10.4155/tde-2017-0012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The objective of this review article is to focus on technology roadmap of smart biosensors from a conventional glucose monitoring system. The estimation of glucose with commercially available devices involves analysis of blood samples that are obtained by pricking finger or extracting blood from the forearm. Since pain and discomfort are associated with invasive methods, the non-invasive measurement techniques have been investigated. The non-invasive methods show advantages like non-exposure to sharp objects such as needles and syringes, due to which there is an increase in testing frequency, improved control of glucose concentration and absence of pain and biohazard materials. This review study is aimed to describe recent invasive techniques and major noninvasive techniques, viz. biosensors, optical techniques and sensor-embedded contact lenses for glucose estimation.
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18
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Kwak BO, Park YM. Assessment of leukotriene E4 in exhaled breath condensate as a marker of inflammation and therapeutic effect in allergic rhinitis children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2017. [DOI: 10.4168/aard.2017.5.1.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Byung Ok Kwak
- Department of Microbiology, Konkuk University School of Medicine, Seoul, Korea
| | - Yong Mean Park
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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19
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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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20
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Hayes SA, Haefliger S, Harris B, Pavlakis N, Clarke SJ, Molloy MP, Howell VM. Exhaled breath condensate for lung cancer protein analysis: a review of methods and biomarkers. J Breath Res 2016; 10:034001. [PMID: 27380020 DOI: 10.1088/1752-7155/10/3/034001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Lung cancer is a leading cause of cancer-related deaths worldwide, and is considered one of the most aggressive human cancers, with a 5 year overall survival of 10-15%. Early diagnosis of lung cancer is ideal; however, it is still uncertain as to what technique will prove successful in the systematic screening of high-risk populations, with the strongest evidence currently supporting low dose computed tomography (LDCT). Analysis of exhaled breath condensate (EBC) has recently been proposed as an alternative low risk and non-invasive screening method to investigate early-stage neoplastic processes in the airways. However, there still remains a relative paucity of lung cancer research involving EBC, particularly in the measurement of lung proteins that are centrally linked to pathogenesis. Considering the ease and safety associated with EBC collection, and advances in the area of mass spectrometry based profiling, this technology has potential for use in screening for the early diagnosis of lung cancer. This review will examine proteomics as a method of detecting markers of neoplasia in patient EBC with a particular emphasis on LC, as well as discussing methodological challenges involving in proteomic analysis of EBC specimens.
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Affiliation(s)
- Sarah A Hayes
- Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, Northern Sydney Local Health District, St. Leonards, New South Wales, Australia. Sydney Medical School Northern, University of Sydney, New South Wales, Australia
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21
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Peters S, Kronseder A, Karrasch S, Neff PA, Haaks M, Koczulla AR, Reinhold P, Nowak D, Jörres RA. Hydrogen peroxide in exhaled air: a source of error, a paradox and its resolution. ERJ Open Res 2016; 2:00052-2015. [PMID: 27730191 PMCID: PMC5005174 DOI: 10.1183/23120541.00052-2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 04/15/2016] [Indexed: 11/05/2022] Open
Abstract
The concentration of hydrogen peroxide (H2O2) in exhaled air has been reported to be elevated in asthma and chronic obstructive pulmonary disease (COPD), but results are inconsistent and difficult to reproduce. As H2O2 occurs in ambient air, we examined its association with exhaled H2O2 in human subjects. Exhaled breath condensate (EBC) of 12 COPD patients and nine healthy control subjects was collected either with an inhalation filter (efficiency 81%) or without. Ambient air condensate (AAC) was collected in parallel and samples were analysed for H2O2. Additionally, ambient H2O2 was recorded by an atmospheric measuring device (online fluorometric measurement). H2O2 concentration in AAC was significantly higher (p<0.001) than in EBC. AAC variations were concordant with the data from the atmospheric measuring instrument. In both subjects' groups, the inhalation filter reduced H2O2 values (p<0.01). Despite generally low levels in exhaled air, analysis by a mathematical model revealed a contribution from endogenous H2O2 production. The low H2O2 levels in exhaled air are explained by the reconditioning of H2O2-containing inhaled air in the airways. Inhaled H2O2 may be one factor in the heterogeneity and limited reproducibility of study results. A valid determination of endogenous H2O2 production requires inhalation filters.
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Affiliation(s)
- Stefan Peters
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Angelika Kronseder
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Stefan Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany; Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Matz Haaks
- Aero-Laser GmbH, Garmisch-Partenkirchen, Germany
| | - Andreas R Koczulla
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-University, Marburg, Germany
| | - Petra Reinhold
- Institute of Molecular Pathogenesis at the Friedrich-Loeffler-Institute, Jena, Germany
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Rudolf A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
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22
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Abstract
The pathogenesis of bronchopulmonary dysplasia (BPD) is multifactorial, and the clinical phenotype of BPD is extremely variable. Several clinical and laboratory biomarkers have been proposed for the early identification of infants at higher risk of BPD and for determination of prognosis of infants with a diagnosis of BPD. The authors review available literature on prediction tools and biomarkers of BPD, using clinical variables and biomarkers based on imaging, lung function measures, and measurements of various analytes in different body fluids that have been determined to be associated with BPD either in a targeted manner or by unbiased omic profiling.
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Affiliation(s)
- Charitharth Vivek Lal
- Division of Neonatology, Department of Pediatrics, Women and Infants Center, University of Alabama at Birmingham, 176F Suite 9380, 619 South 19th Street, Birmingham, AL 35249-7335, USA
| | - Namasivayam Ambalavanan
- Division of Neonatology, Department of Pediatrics, Women and Infants Center, University of Alabama at Birmingham, 176F Suite 9380, 619 South 19th Street, Birmingham, AL 35249-7335, USA.
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23
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Walsh BK, Davis MD, Hunt JF, Kheir JN, Smallwood CD, Arnold JH. The effects of lung recruitment maneuvers on exhaled breath condensate pH. J Breath Res 2015; 9:036009. [PMID: 26333431 DOI: 10.1088/1752-7155/9/3/036009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Exhaled breath condensate (EBC) pH serves as a surrogate marker of airway lining fluid (ALF) pH and can be used to evaluate airway acidification (AA). AA is known to be present in acute respiratory distress syndrome (ARDS) and can be evaluated via continuous EBC pH measurement during mechanical ventilation. Lung recruitment maneuvers (LRMs) are utilized in the treatment of ARDS, however, their impact on EBC pH has never been explored. Here we described the acute effects of two commonly used LRMs on EBC pH. In a prospective, non-randomized, serial exposure study, 10 intubated pediatric subjects with acute respiratory distress syndrome sequentially underwent: a period of baseline ventilation, sustained inflation (SI) maneuver of 40 cm H2O for 40 s, open lung ventilation, staircase recruitment strategy (SRS) (which involves a systematic ramping of plateau pressures in 5 cm H2O increments, starting at 30 cm H2O), and PEEP titration. Maximum lung recruitment during the SRS is defined as a PaO2 + PaCO2 of >400 mmHg. Following lung recruitment, PEEP titration was conducted from 20 cm H2O in 2 cm H2O decrements until a PaO2 + PaCO2 was <380 and then increased by 2 cm H2O. EBC pH, arterial blood gases, lung mechanics, hemodynamics, and function residual capacity were obtained following each phase of the LRM and observational period. Seven out of 10 patients were able to reach maximum lung recruitment. Baseline EBC pH (6.38 ± 0.37) did not correlate with disease severity defined by PaO2/FiO2 ratio or oxygenation index (OI). Average EBC pH differed between phases and decreased after LRM (p = 0.001). EBC pH is affected by LRMs. EBC acidification following LRMs may represent a washout effect of opening acidic lung units and ventilating them or acute AA resulting from LRM.
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Affiliation(s)
- Brian K Walsh
- Boston Children's Hospital, 300 Longwood Ave, Farley 019, Boston, MA 02115, USA
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Ramsey KA, Schultz A, Stick SM. Biomarkers in Paediatric Cystic Fibrosis Lung Disease. Paediatr Respir Rev 2015; 16:213-8. [PMID: 26051089 DOI: 10.1016/j.prrv.2015.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 01/15/2023]
Abstract
Biomarkers in cystic fibrosis are used i. for the measurement of cystic fibrosis transmembrane regulator function in order to diagnose cystic fibrosis, and ii. to assess aspects of lung disease severity (e.g. inflammation, infection). Effective biomarkers can aid disease monitoring and contribute to the development of new therapies. The tests of cystic fibrosis transmembrane regulator function each have unique strengths and weaknesses, and biomarkers of inflammation, infection and tissue destruction have the potential to enhance the management of cystic fibrosis through the early detection of disease processes. The development of biomarkers of cystic fibrosis lung disease, in particular airway inflammation and infection, is influenced by the challenges of obtaining relevant samples from infants and children for whom early detection and treatment of disease might have the greatest long term benefits.
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Affiliation(s)
- Kathryn A Ramsey
- Telethon Kids Institute, University of Western Australia, Australia; Cystic Fibrosis/Pulmonary Research and Treatment Center, University of North Carolina at Chapel Hill, North Carolina, USA
| | - André Schultz
- Telethon Kids Institute, University of Western Australia, Australia; Princess Margaret Hospital for Children, Western Australia, Australia; School of Paediatric and Child Health, University of Western Australia, Australia
| | - Stephen M Stick
- Telethon Kids Institute, University of Western Australia, Australia; Princess Margaret Hospital for Children, Western Australia, Australia; School of Paediatric and Child Health, University of Western Australia, Australia.
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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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Muccilli V, Saletti R, Cunsolo V, Ho J, Gili E, Conte E, Sichili S, Vancheri C, Foti S. Protein profile of exhaled breath condensate determined by high resolution mass spectrometry. J Pharm Biomed Anal 2014; 105:134-149. [PMID: 25555262 DOI: 10.1016/j.jpba.2014.11.050] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/27/2014] [Accepted: 11/29/2014] [Indexed: 11/30/2022]
Abstract
A method based on liquid chromatography/high resolution tandem mass spectrometry coupled with electrophoretic separation, for determination and relative quantification of the protein composition of exhaled breath condensate (EBC), was developed. Application of the procedure to a sample of EBC, pooled from nine healthy subjects, resulted in the identification of 167 unique gene products, 113 of which not previously reported in EBC samples. The abundance of the protein identified was estimated by means of the exponentially modified protein abundance index protocol (emPAI). Cytokeratins were by far the most abundant proteins in EBC samples. Many of the identified proteins were associated with multiple cellular location with cytoplasm constituting the largest group. Cytosol, nucleus, membrane, cytoskeleton and extracellular were other abundantly represented locations. No amylase was detected, suggesting the absence of saliva protein contamination. The profile obtained represents the most comprehensive protein characterization of EBC so far reported and demonstrates that this approach provides a powerful tool for investigating the protein profile of EBC samples. Compared with analogous investigations, this study also shows that the protein profile of EBC is strongly affected by the sampling method adopted.
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Affiliation(s)
- Vera Muccilli
- Department of Chemical Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy
| | - Rosaria Saletti
- Department of Chemical Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy.
| | - Vincenzo Cunsolo
- Department of Chemical Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy
| | - Jenny Ho
- ThermoFisher Scientific, Stafford House, Boundary Way, Hemel Hempstead HP2 7GE, United Kingdom
| | - Elisa Gili
- Department of Clinical and Molecular Biomedicine, University Hospital Policlinico-Vittorio Emanuele, Via Santa Sofia 78, 95123 Catania, Italy
| | - Enrico Conte
- Department of Clinical and Molecular Biomedicine, University Hospital Policlinico-Vittorio Emanuele, Via Santa Sofia 78, 95123 Catania, Italy
| | - Stefania Sichili
- Department of Clinical and Molecular Biomedicine, University Hospital Policlinico-Vittorio Emanuele, Via Santa Sofia 78, 95123 Catania, Italy
| | - Carlo Vancheri
- Department of Clinical and Molecular Biomedicine, University Hospital Policlinico-Vittorio Emanuele, Via Santa Sofia 78, 95123 Catania, Italy
| | - Salvatore Foti
- Department of Chemical Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy
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Motta A, Paris D, D'Amato M, Melck D, Calabrese C, Vitale C, Stanziola AA, Corso G, Sofia M, Maniscalco M. NMR metabolomic analysis of exhaled breath condensate of asthmatic patients at two different temperatures. J Proteome Res 2014; 13:6107-20. [PMID: 25393672 DOI: 10.1021/pr5010407] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Exhaled breath condensate (EBC) collection is a noninvasive method to investigate lung diseases. EBC is usually collected with commercial/custom-made condensers, but the optimal condensing temperature is often unknown. As such, the physical and chemical properties of exhaled metabolites should be considered when setting the temperature, therefore requiring validation and standardization of the collecting procedure. EBC is frequently used in nuclear magnetic resonance (NMR)-based metabolomics, which unambiguously recognizes different pulmonary pathological states. Here we applied NMR-based metabolomics to asthmatic and healthy EBC samples collected with two commercial condensers operating at -27.3 and -4.8 °C. Thirty-five mild asthmatic patients and 35 healthy subjects were included in the study, while blind validation was obtained from 20 asthmatic and 20 healthy different subjects not included in the primary analysis. We initially analyzed the samples separately and assessed the within-day, between-day, and technical repeatabilities. Next, samples were interchanged, and, finally, all samples were analyzed together, disregarding the condensing temperature. Partial least-squares discriminant analysis of NMR spectra correctly classified samples, without any influence from the temperature. Input variables were either integral bucket areas (spectral bucketing) or metabolite concentrations (targeted profiling). We always obtained strong regression models (95%), with high average-quality parameters for spectral profiling (R(2) = 0.84 and Q(2) = 0.78) and targeted profiling (R(2) = 0.91 and Q(2) = 0.87). In particular, although targeted profiling clustering is better than spectral profiling, all models reproduced the relative metabolite variations responsible for class differentiation. This warrants that cross comparisons are reliable and that NMR-based metabolomics could attenuate some specific problems linked to standardization of EBC collection.
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Affiliation(s)
- Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council , Via Campi Flegrei 34, Pozzuoli (Naples) 80078, Italy
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Roberts K, Liu I, Jaffe A, Verge CF, Thomas PS. Markers of pancreatic function in the breath. J Breath Res 2014; 8:046009. [DOI: 10.1088/1752-7155/8/4/046009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Bibi H, Reany O, Waisman D, Keinan E. Prophylactic treatment of asthma by an ozone scavenger in a mouse model. Bioorg Med Chem Lett 2014; 25:342-6. [PMID: 25499435 DOI: 10.1016/j.bmcl.2014.11.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/10/2014] [Accepted: 11/12/2014] [Indexed: 10/24/2022]
Abstract
Our hypothesis that inflammation in asthma involves production of ozone by white blood cells and that ozone could be an inflammatory mediator suggests that scavengers of reactive oxygen species (ROS), for example, electron-rich olefins, could serve for prophylactic treatment of asthma. Olefins could provide chemical protection against either exogenous or endogenous ozone and other ROS. BALB/c mice pretreated by inhalation of d-limonene before an ovalbumin challenge exhibited significant attenuation of the allergic asthma symptoms. Diminution of the inflammatory process was evident by reduced levels of aldehydes, reduced counts of neutrophils in the BAL fluid and by histological tests. A surprising systemic effect was observed by decreased levels of aldehydes in the spleen, suggesting that the examination of tissues and organs that are remote from the inflammation foci could provide valuable information on the distribution of the oxidative stress and may serve as guide for targeted treatment.
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Affiliation(s)
- Haim Bibi
- Department of Pediatrics, Barzilai Medical Center, Hahistadrout St. 2, Ashkelon 78278, Israel; Faculty of Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ofer Reany
- Department of Natural Sciences, The Open University of Israel, 1 University Road, PO Box 808, Ra'anana 43537, Israel
| | - Dan Waisman
- Department of Neonatology, Carmel Medical Center, Michal St. 7, Haifa 3436212, Israel; Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ehud Keinan
- Schulich Faculty of Chemistry, Technion-Israel Institute of Technology, Technion City, Haifa 32000, Israel.
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Detection of bloodstream infections and prediction of bronchopulmonary dysplasia in preterm neonates with an electronic nose. J Pediatr 2014; 165:622-4. [PMID: 24929333 DOI: 10.1016/j.jpeds.2014.04.049] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 03/21/2014] [Accepted: 04/28/2014] [Indexed: 11/20/2022]
Abstract
We show that smellprints of volatile organic components measured with an electronic nose (Cyranose 320; Smiths Detection Group Ltd, Watford, United Kingdom) differ between tracheal aspirates from preterm neonates with or without laboratory-confirmed bloodstream infections and with or without subsequent development of bronchopulmonary dysplasia. Tracheal aspirate smellprints could be useful noninvasive diagnostic markers for preterm neonates.
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Angelis N, Porpodis K, Zarogoulidis P, Spyratos D, Kioumis I, Papaiwannou A, Pitsiou G, Tsakiridis K, Mpakas A, Arikas S, Tsiouda T, Katsikogiannis N, Kougioumtzi I, Machairiotis N, Argyriou M, Kessisis G, Zarogoulidis K. Airway inflammation in chronic obstructive pulmonary disease. J Thorac Dis 2014; 6 Suppl 1:S167-72. [PMID: 24672691 DOI: 10.3978/j.issn.2072-1439.2014.03.07] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 03/04/2014] [Indexed: 11/14/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is an inflammatory airway disease whose incidence and mortality increases every year. It is associated with an abnormal inflammatory response of the lung to toxic particles or gases (usually cigarette smoke). A central role in the pathophysiology has been shown to play a chronic inflammation of the airways that is expressed primarily by hypersecretion of mucus, stenosis of the smaller airways and the establishment of pulmonary emphysema. There is an increasing trend for assessing the inflammatory pattern of inflammatory airway diseases through mediators measured by noninvasive techniques. Markers in biological fluids and exhaled air have been the subject of intense evaluation over the past few years, with some of them reaching their introduction into clinical practice, while others remain as research tools. Of particular interest for the scientific community is the discovery of clinically exploitable biomarkers associated with specific phenotypes of the disease. Studying the effects of therapeutic interventions in these biomarkers may lead to targeted therapy based on phenotype and this is perhaps the future of therapeutics in COPD.
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Affiliation(s)
- Nikolaos Angelis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Konstantinos Porpodis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Paul Zarogoulidis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Dionysios Spyratos
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Ioannis Kioumis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Antonis Papaiwannou
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Georgia Pitsiou
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Kosmas Tsakiridis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Andreas Mpakas
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Stamatis Arikas
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Theodora Tsiouda
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Nikolaos Katsikogiannis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Ioanna Kougioumtzi
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Nikolaos Machairiotis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Michael Argyriou
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - George Kessisis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
| | - Konstantinos Zarogoulidis
- 1 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2 Cardiology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece ; 3 Internal Medicine Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece ; 5 2nd Cardiac Surgery Department, "Evangelismos" General Hospital, Athens, Greece ; 6 Oncology Department, "Saint Luke" Private Clinic, Thessaloniki, Panorama, Greece
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Félix PM, Almeida SM, Franco C, Almeida AB, Lopes C, Claro MI, Fragoso E, Teles C, Wolterbeek HT, Pinheiro T. The suitability of EBC-Pb as a new biomarker to assess occupational exposure to lead. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2014; 25:67-80. [PMID: 24670229 DOI: 10.1080/09603123.2014.893569] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Occupational exposure to lead (Pb) requires continuous surveillance to assure, as much as possible, safe and healthful working conditions. This study addresses the suitability of assessing Pb exposure in relevant workers using their exhaled breath condensate (EBC). This study enrolled workers of two different Pb processing industries characterized by moderate and high Pb exposure levels in the work environment, and a group of non-exposed individuals working in offices who served as baseline for Pb exposure. The EBC-Pb of workers reflected the Pb levels in the work environment of all three settings, although the relationship with B-Pb was not clear. The lack of correlation between EBC-Pb and B-Pb most probably indicates the time lag for Pb to enter in the two body pools. The EBC-Pb seems to reflect immediate exposure, providing a prompt signature of Pb in the environmental that may interact directly with the organ. By delivering short-term evaluation of exposure, EBC-Pb represents a clear advantage in biomonitoring and may become an interesting tool for estimating organ burden.
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Affiliation(s)
- Pedro M Félix
- a Campus Tecnológico e Nuclear, Dpt Física, Instituto Superior Técnico , Universidade Técnica de Lisboa , Lisboa , Portugal
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Abstract
BACKGROUND The ISAAC (the International Study of Asthma and Allergies in Childhood) questionnaire has been used to standardize research on the prevalence of asthma in children since 1991. AIM In this Phase I study, the prevalence of asthma, other allergic diseases and atopy was evaluated in North Cyprus. METHODS The ISAAC questionnaire was distributed to grades I-V schoolchildren. Data were obtained from parents of 580 schoolchildren aged between 7 and 12 years attending a primary school in Nicosia, the capital of North Cyprus. Of those, a sub-group of 97 (16.7%) randomly selected children were evaluated by skin prick test (SPT) and lung function test (LFT). RESULTS The prevalence rates of asthma ever, current wheezing and SPT-positivity were 20.8%, 10% and 68%, respectively. The prevalence of atopy was significantly higher in the randomly selected subgroup of 97 (68%) patients subjected to SPT and LFT, and the house dust mite (HDM) was the allergen to which children were most frequently sensitized. CONCLUSIONS In northern Cyprus, the prevalence rates of asthma, allergic diseases and atopic sensitization in 7-12-year-old children are extremely high. Sensitization to HDM is a risk factor for the development of asthma.
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Kubáň P, Foret F. Exhaled breath condensate: Determination of non-volatile compounds and their potential for clinical diagnosis and monitoring. A review. Anal Chim Acta 2013; 805:1-18. [DOI: 10.1016/j.aca.2013.07.049] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 07/16/2013] [Accepted: 07/20/2013] [Indexed: 12/31/2022]
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Xu H, Wei Y, Zhu L, Huang J, Li Y, Liu F, Wang S, Liu S. Bifunctional magnetic nanoparticles for analysis of aldehyde metabolites in exhaled breath of lung cancer patients. J Chromatogr A 2013; 1324:29-35. [PMID: 24315678 DOI: 10.1016/j.chroma.2013.11.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 11/21/2013] [Accepted: 11/21/2013] [Indexed: 01/15/2023]
Abstract
We report here the preparation of dual-functionalized magnetic nanoparticles, with the nanoparticles as extraction sorbents, a magnetic solid phase extraction method was developed and applied for the analysis of trace amount of aldehydes in human exhaled breath condensate. In the material, octyl-functionalized internal surface provided hydrophobic groups for extraction, non-ionic surfactant (Tween-20)-coated outer surface offered hydrophilic network structure to prevent the access of macromolecules, strong magnetic property of nanoparticles simplified the analytical procedure. The experimental results showed that the prepared nanoparticles exhibited good dispersibility in aqueous solution and excellent extraction efficiency toward aldehydes. Six aldehydes were derivatized with 2,4-dinitrophenylhydrazine and then the formed hydrazones were extracted by the nanoparticles and analyzed by high-performance liquid chromatography-photo diode array detector. Under the optimal conditions, the method provided low limits of detection (2.9-21.5 nmol L(-1)), satisfactory reproducibility (relative standard deviations, 2.9-13.1%) and acceptable recoveries (73.7-133.1%). The developed method was applied successfully to determine the aldehydes metabolites in the exhaled breath condensate samples of healthy people and lung cancer patients. The dual-functionalized material is suitable for biological sample analysis. The proposed method provides an alternative approach for quantification of aldehyde metabolites in complex biological samples.
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Affiliation(s)
- Hui Xu
- Key Laboratory of Pesticide & Chemical Biology, Ministry of Education, Institute of Environmental Chemistry, College of Chemistry, Central China Normal University, Wuhan 430079, China.
| | - Yanling Wei
- Key Laboratory of Pesticide & Chemical Biology, Ministry of Education, Institute of Environmental Chemistry, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Linli Zhu
- Key Laboratory of Pesticide & Chemical Biology, Ministry of Education, Institute of Environmental Chemistry, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Jing Huang
- Key Laboratory of Pesticide & Chemical Biology, Ministry of Education, Institute of Environmental Chemistry, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Yu Li
- Key Laboratory of Pesticide & Chemical Biology, Ministry of Education, Institute of Environmental Chemistry, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Feilong Liu
- Key Laboratory of Pesticide & Chemical Biology, Ministry of Education, Institute of Environmental Chemistry, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Shuling Wang
- Key Laboratory of Pesticide & Chemical Biology, Ministry of Education, Institute of Environmental Chemistry, College of Chemistry, Central China Normal University, Wuhan 430079, China
| | - Shi Liu
- Key Laboratory of Pesticide & Chemical Biology, Ministry of Education, Institute of Environmental Chemistry, College of Chemistry, Central China Normal University, Wuhan 430079, China
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Félix PM, Franco C, Barreiros MA, Batista B, Bernardes S, Garcia SM, Almeida AB, Almeida SM, Wolterbeek HT, Pinheiro T. Biomarkers of exposure to metal dust in exhaled breath condensate: methodology optimization. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2013; 68:72-79. [PMID: 23428056 DOI: 10.1080/19338244.2011.638951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In occupational assessments where workers are exposed to metal dust, the liquid condensate of exhaled breath (EBC) may provide unique indication of pulmonary exposure. The main goal of this study was to demonstrate the quality of EBC to biological monitoring of human exposure. A pilot study was performed in a group of metal dust-exposed workers and a group of nonexposed individuals working in offices. Only metal dust-exposed workers were followed along the working week to determine the best time of collection. Metal analyses were performed with inductively coupled plasma mass spectrometry (ICP-MS). Analytical methodology was tested using an EBC sample pool for several occupationally exposed metals: potassium, chromium, manganese, copper, zinc, strontium, cadmium, antimony, and lead. Metal contents in EBC of exposed workers were higher than controls at the beginning of the shift and remained augmented throughout the working week. The results obtained support the establishment of EBC as an indicator of pulmonary exposure to metals.
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Affiliation(s)
- P M Félix
- IST/ITN, Instituto Superior Técnico, Sacavém, Portugal
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Barreiros MA, Pinheiro T, Félix PM, Franco C, Santos M, Araújo F, Freitas MC, Almeida SM. Exhaled breath condensate as a biomonitor for metal exposure: a new analytical challenge. J Radioanal Nucl Chem 2012. [DOI: 10.1007/s10967-012-2366-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Caffarelli C, Calcinai E, Rinaldi L, Povesi Dascola C, Terracciano L, Corradi M. Hydrogen peroxide in exhaled breath condensate in asthmatic children during acute exacerbation and after treatment. ACTA ACUST UNITED AC 2012; 84:291-8. [PMID: 23018317 DOI: 10.1159/000341969] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 07/10/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND In asthmatics, the concentration of hydrogen peroxide (H(2)O(2)) in exhaled breath condensate (EBC) has been found to be increased and to be related to airway inflammation. OBJECTIVE The aim of this study was to determine whether in children with acute exacerbation, exhaled H(2)O(2) levels could be influenced by treatment and linked to airway obstruction. METHODS Twenty-two asthmatic children (mean age 9.4 years, range 6-14) with asthma exacerbation and 12 healthy children (mean age 11.7 years, range 7-15) were enrolled. Concentrations of exhaled H(2)O(2) before and after standard treatment for asthma attack were compared with those of controls and with clinical observation. Asthmatic children and controls underwent spirometry and skin prick tests to common aeroallergens. RESULTS Exhaled H(2)O(2) concentrations were significantly higher in children with asthma both before (median 0.273 µM; p < 0.001) and after pharmacologic treatment (median 0.303 µM; p = 0.001) compared to control values (median 0.045 µM). After treatment, exhaled H(2)O(2) concentrations remained significantly higher in children with and without auscultatory wheezing than in controls (p = 0.034 and p < 0.001, respectively). EBC H(2)O(2) levels in asthmatics before treatment did not differ from those after treatment. No correlation was found between H(2)O(2) and forced expiratory volume in 1 s values. All asthmatics but one were atopics. CONCLUSIONS In children with acute asthma exacerbation, exhaled H(2)O(2) concentrations in EBC are significantly elevated. In the short-term follow-up, H(2)O(2) levels remain at high levels and are not correlated with lung function or improvement in symptoms.
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Affiliation(s)
- Carlo Caffarelli
- UO Clinica Pediatrica, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Parma, Via Gramsci 14 IT-43100 Parma, Italy.
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Peroni DG, Bodini A, Corradi M, Coghi A, Boner AL, Piacentini GL. Markers of oxidative stress are increased in exhaled breath condensates of children with atopic dermatitis. Br J Dermatol 2012; 166:839-43. [PMID: 22175656 DOI: 10.1111/j.1365-2133.2011.10771.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Airway inflammation may be present in subjects affected by atopic dermatitis (AD) but still without asthma symptoms. Exhaled breath condensate (EBC) reflects the composition of bronchoalveolar extracellular lining fluid that contains a large number of mediators of airway inflammation and oxidative damage. OBJECTIVES We assessed inflammatory markers in the EBC of patients with AD. Fifty-six children (34 girls and 22 boys) were enrolled: 33 affected by AD and 23 healthy controls. METHODS EBC was collected using a condenser device. We measured EBC pH and concentrations of leukotriene B4 (LTB4), 8-isoprostane, H(2) O(2) , malondialdehyde and 4-hydroxynoneal. Respiratory resistance was also evaluated. RESULTS EBC pH in patients with AD was significantly lower than in healthy children, median (range) being 8·02 (7·94-8·12) in AD vs. 8·11 (8·05-8·16) (P = 0·02). The values of exhaled 8-isoprostane and LTB4 were significantly increased in subjects with AD compared with normal controls (P < 0·01 and P < 0·001, respectively). There was increased 4-hydroxynoneal in patients with AD but this did not reach statistical significance. Evaluating respiratory resistance, no bronchoreversibility was demonstrated in the children with AD. CONCLUSIONS pH, LTB4 and 8-isoprostane in EBC could be sensitive markers of airway inflammation in children with AD. Prospective studies would be of interest to evaluate if airway inflammation, not yet clinically evident, could predict the development of asthma later in life in children with AD.
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Affiliation(s)
- D G Peroni
- Paediatric Department, Ospedale G.B. Rossi, University of Verona, 37134 Verona, Italy.
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van de Kant KDG, Klaassen EMM, van Aerde KJ, Damoiseaux J, Bruggeman CA, Stelma FF, Stobberingh EE, Muris JWM, Jöbsis Q, van Schayck OCP, Dompeling E. Impact of bacterial colonization on exhaled inflammatory markers in wheezing preschool children. J Breath Res 2012; 6:046001. [PMID: 22990010 DOI: 10.1088/1752-7155/6/4/046001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Wheeze is a common symptom in preschool children. The role of bacteria, regulatory T (T(reg)) cells and their association with airway inflammation in preschool wheeze is largely unknown. We evaluated inflammatory markers in exhaled breath condensate (EBC), bacterial colonization and circulating T(reg) cells in preschool children with and without recurrent wheeze. We recruited 252 children (aged two to four years) with (N = 202) and without (N = 50) recurrent wheeze. EBC was collected using an efficient closed glass condenser. Inflammatory markers in EBC (Interleukin(IL)-2, IL-4, IL-8, IL-10, IL-13) were assessed using multiplex immunoassay. Nasal and throat swabs were analysed for presence of Streptococcus pneumoniae, Haemophilus (para)influenzae and Staphylococcus aureus. Proportions of T(reg) cells (CD4(+)CD25(high)CD127(-)) were quantified by flow cytometry. Recurrent wheezing children had elevated EBC levels of IL-2, IL-4, IL-10 and IL-13 compared to non-wheezers (odds ratio (95% confidence interval): 1.67 (1.23-2.27): 1.58 (1.15-2.18): 1.47 (1.14-1.90): 1.55 (1.16-2.06), p <0.05, respectively). Bacteria were frequently present in children with and without wheeze, with no difference in prevalence (16-52% versus 16-50%, respectively). Moreover, the proportion of T(reg) cells did not differ between both groups. Wheezing children with bacterial colonization did not significantly differ in exhaled levels of inflammatory markers or proportion of T(reg) cells compared to wheezing children without colonization. The analysis of EBC might serve as a helpful non-invasive tool to early assess airway inflammation in wheezing children. The various elevated exhaled inflammatory markers indicate increased airway inflammation in wheezing preschool children. In the presence of wheeze, we found no evidence for bacterial induced airway inflammation.
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Affiliation(s)
- Kim D G van de Kant
- Department of Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC), PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
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Abstract
Monitoring of blood glucose levels is clinically important in the management of diseases affecting insulin secretion and resistance, most notably diabetes mellitus and cystic fibrosis. Typically, blood glucose monitoring is an invasive technique that may cause distress and discomfort, particularly in the pediatric population. Development of noninvasive methods of monitoring blood glucose is therefore indicated, particularly for use in children. Using respiratory fluids (the liquid present in the lumen of the airways and alveoli) to estimate blood glucose levels indirectly is one potential method. Glucose concentrations in respiratory fluids are typically low, maintained by the equilibrium between paracellular leakage of glucose from the lung interstitium and active cotransport of glucose by epithelial cells. Measurement of glucose in respiratory fluid by collection of exhaled breath condensate is therefore a potentially clinically useful method of estimating blood glucose levels if it can be shown that there is good agreement between these values. This article reviews the research in this area.
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Affiliation(s)
- Kiera Roberts
- Faculty of Medicine, University of New South WalesSydney, Australia
| | - Adam Jaffe
- Faculty of Medicine, University of New South WalesSydney, Australia
- Department of Respiratory Medicine, Sydney Children's HospitalRandwick, Australia
| | - Charles Verge
- Faculty of Medicine, University of New South WalesSydney, Australia
- Department of Endocrinology, Sydney Children's HospitalRandwick, Australia
| | - Paul S. Thomas
- Faculty of Medicine, University of New South WalesSydney, Australia
- Department of Respiratory Medicine, Prince of Wales HospitalRandwick, Australia
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Abstract
The collection and analysis of exhaled breath condensate (EBC) may be useful for the management of patients with chronic respiratory disease at all ages. It is a promising technique due to its apparent simplicity and non-invasiveness. EBC does not disturb an ongoing respiratory inflammation. However, the methodology remains controversial, as it is not yet standardized. The current diversity of the methods used to collect and preserve EBC, the analytical pitfalls and the high degree of within-subject variability are the main issues that hamper further development into a clinical useful technique. In order to facilitate the process of standardization, a simplified schematic approach is proposed. An update of available data identified open issues on EBC methodology. These issues were then classified into three separate conditions related to their influence before, during or after the condensation process: (1) pre-condenser conditions related to subject and/or environment; (2) condenser conditions related to condenser equipment; and (3) post-condenser conditions related to preservation and/or analysis. This simplified methodological approach highlights the potential influence of the many techniques used before, during and after condensation of exhaled breath. It may also serve as a methodological checklist for a more systematical approach of EBC research and development.
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Affiliation(s)
- Philippe Rosias
- Department of Paediatrics, Orbis Medical Center, Sittard, The Netherlands.
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Tateosian NL, Costa MJ, Guerrieri D, Barro A, Mazzei JA, Eduardo Chuluyan H. Inflammatory mediators in exhaled breath condensate of healthy donors and exacerbated COPD patients. Cytokine 2012; 58:361-7. [PMID: 22469918 DOI: 10.1016/j.cyto.2012.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 12/27/2011] [Accepted: 03/08/2012] [Indexed: 12/25/2022]
Abstract
Samples of exhaled breath condensate (EBC) provide a convenient and non-invasive method to study inflammation in lung diseases. The aim of the present study was to evaluate and compare the inflammatory protein mediator levels in EBC from healthy donors (HD) and from patients with exacerbation of chronic obstructive pulmonary disease (COPD) using an EBC collection device with and without a coating of albumin as a carrier. We studied 13 HD and 26 patients with exacerbation of COPD. The concentrations of myeloperoxidase (MPO), IFNγ and secretory leukocyte protease inhibitor (SLPI) in EBC were measured by immunoassays. The EBC samples from HD and COPD patients showed higher concentrations of MPO when samples were recovered with an albumin-coated device. Furthermore, levels of MPO in COPD patients were significantly higher than in HD. An inverse correlation was observed between MPO and spirometric parameters (FVC and FEV1). Almost all samples collected with the albumin-coated device showed higher amounts of IFNγ and SLPI than those collected with the uncoated device. The levels of SLPI in COPD patients were significantly higher than in HD. A direct correlation was observed between FVC% predicted and SLPI. We concluded that coating the collection device with albumin increased the sensitivity of the technique, at least for measurements of MPO, SLPI and IFNγ. Furthermore, the higher levels of MPO and SLPI and lower levels of IFNγ in EBC from COPD patients could reflect the immunological status and the response of lung parenchyma to treatment during the exacerbation of the illness.
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Affiliation(s)
- Nancy L Tateosian
- 3ra Cátedra de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
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Gunay O, Onur E, Yilmaz O, Dundar PE, Tikiz C, Var A, Yuksel H. Effects of physical exercise on lung injury and oxidant stress in children with asthma. Allergol Immunopathol (Madr) 2012; 40:20-4. [PMID: 21334801 DOI: 10.1016/j.aller.2010.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 10/26/2010] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of this study was to investigate the influence of exercise training on oxidative stress and markers of lung inflammation in children with asthma. METHODS Thirty children aged 8-13 years diagnosed with asthma were enrolled in the study as well as 13 healthy children. One group received only pharmacological treatment and the other group was also enrolled in an exercise programme. Venous blood and 24-hour urine samples were obtained from the children enrolled in the study at the beginning and end of the study. Leukotriene E4 and creatinine levels were measured in the urine and matrix metallopeptidase (MMP-9), endothelin-1(ET-1), malnodialdehyde (MDA), IgE and specific IgE levels were measured in blood samples. RESULTS Leukotriene E4, MDA and MMP9 levels decreased significantly with treatment in both groups (p < 0.001). However, ET-1 levels decreased significant only in the exercise group (26.5 ± 3.6 vs 21.3 ± 2.4 pg/ml respectively, p = 0.001). Moreover, ET-1 levels were found to be significantly lower in the exercise group compared to the only pharmacotherapy group (24.2 ± 3.1 vs 21.3 ± 2.4 pg/ml, p=0.007). CONCLUSIONS Positive influences of exercise training in children with asthma may be mediated by decrease in ET-1 levels.
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Affiliation(s)
- Ozlem Gunay
- Celal Bayar University Medical Faculty, Dept of Biochemistry, Manisa, Turkey.
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Bredberg A, Gobom J, Almstrand AC, Larsson P, Blennow K, Olin AC, Mirgorodskaya E. Exhaled endogenous particles contain lung proteins. Clin Chem 2011; 58:431-40. [PMID: 22156667 DOI: 10.1373/clinchem.2011.169235] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND We recently developed a novel, noninvasive method for sampling nonvolatile material from the distal airways. The method is based on the collection of endogenous particles in exhaled air (PEx). The aim of this study was to characterize the protein composition of PEx and to verify that the origin of PEx is respiratory tract lining fluid (RTLF). METHOD Healthy individuals exhaled into the sampling device, which collected PEx onto a silicon plate inside a 3-stage impactor. After their extraction from the plates, PEx proteins were separated by SDS-PAGE and then analyzed by LC-MS. Proteins were identified by searching the International Protein Index human database with the Mascot search engine. RESULTS Analysis of the pooled samples identified 124 proteins. A comparison of the identified PEx proteins with published bronchoalveolar lavage (BAL) proteomic data showed a high degree of overlap, with 103 (83%) of the PEx proteins having previously been detected in BAL. The relative abundances of the proteins were estimated according to the Mascot exponentially modified protein abundance index protocol and were in agreement with the expected protein composition of RTLF. No amylase was detected, indicating the absence of saliva protein contamination with our sampling technique. CONCLUSIONS Our data strongly support that PEx originate from RTLF and reflect the composition of undiluted RTLF.
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Affiliation(s)
- Anna Bredberg
- Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden.
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Inci D, Basek P, Wildhaber JH, Moeller A. Leptin levels in exhaled breath condensate from asthmatic children: a pilot study. Clin Chem Lab Med 2011; 50:593-4. [PMID: 22107135 DOI: 10.1515/cclm.2011.801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 11/07/2011] [Indexed: 11/15/2022]
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Paleari D, Rossi GA, Nicolini G, Olivieri D. Ambroxol: a multifaceted molecule with additional therapeutic potentials in respiratory disorders of childhood. Expert Opin Drug Discov 2011; 6:1203-14. [PMID: 22646987 DOI: 10.1517/17460441.2011.629646] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Mucoactive drugs are currently used to cleanse the respiratory tract following disturbance of the normal mucociliary clearance due to mucous hyperproduction and/or modification of its physicochemical characteristics. However, in addition to possessing the ability to perform specific actions on airway secretion, these compounds have the capability to modulate the mechanisms involved in abnormal secretions. Indeed, over the years, in the postmarketing phase, a large number of studies have been published showing interesting pharmacological activities in addition to their secretagogue activity. AREAS COVERED This article collates available data on ambroxol (2-amino-3,5-dibromo-N-[trans-4-hydroxycyclohexyl]benzylamine), a metabolite of bromhexine, used as a secretagogue in the treatment of childhood airway diseases. This article goes beyond the mucoactive aspects of the drug covering its multiple pharmacological properties. EXPERT OPINION The non-mucoactive functions exhibited by the compound may provide beneficial effects on airway structure and function in health and disease. Beyond the mucokinetic and secretagogue effects, ambroxol showed great antioxidant, anti-inflammatory, local anesthetic and surfactant synthesis stimulatory activities. Moreover, some antiviral and antibacterial activities were shown. These findings may better explain the clinical results observed in a variety of airway disorders and suggest additional therapeutic potential. Further studies are needed to better define the clinical relevance of these non-mucolytic activities.
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Affiliation(s)
- Davide Paleari
- Medical Department , Chiesi Farmaceutici , Parma , Italy
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Clinical Applications of Pediatric Pulmonary Function Testing: Lung Function in Recurrent Wheezing and Asthma. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2011; 24:69-76. [DOI: 10.1089/ped.2010.0060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Bloemen K, Koppen G, Govarts E, Colles A, Van Den Heuvel R, Nelen V, Witters E, Desager K, Schoeters G. Application of non-invasive biomarkers in a birth cohort follow-up in relation to respiratory health outcome. Biomarkers 2010; 15:583-93. [PMID: 20662605 DOI: 10.3109/1354750x.2010.504307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Asthma-related symptoms can manifest in children during the early years, but only some of the children will develop the disease. This feasibility study showed that it is possible to apply non-invasive markers (in urine, exhaled nitric oxide (FENO) and exhaled breath condensate (EBC)) in 3-year-old children, and evaluated the biomarkers in relation to health outcomes and potential modifiers. FENO was correlated with respiratory allergy, and was borderline significantly correlated with wheezing, but not with the asthma predictive index (mAPI). EBC pH and urinary 8-oxo-deoxyguanosine were not significantly correlated with these clinical outcomes. An EBC proteolytic peptide pattern was developed, which could distinguish between mAPI-positive and -negative children. Non-invasive biomarkers may become a promising tool for investigating respiratory health in children but further research is needed.
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Affiliation(s)
- Karolien Bloemen
- Flemish Institute for Technological Research, Boeretang, Mol, Belgium.
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Zetterquist W, Marteus H, Hedlin G, Alving K. Increased exhaled nitrite in children with allergic asthma is not related to nitric oxide formation. CLINICAL RESPIRATORY JOURNAL 2010; 2:166-74. [PMID: 20298325 DOI: 10.1111/j.1752-699x.2008.00057.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Nitrite sampled from the upper airways could originate from inflammation-induced nitric oxide (NO), as reports of elevated nitrite in exhaled breath condensate (EBC) from asthmatics suggest, but also through bacterial action in the pharyngo-oral tract. OBJECTIVES To correlate EBC nitrite and nitrate to exhaled NO (FENO, fraction of expired NO) and other markers of disease activity in children with allergic asthma and thereby further investigate their role and origin. MATERIALS AND METHODS EBC was collected from 27 asthmatic subjects (ages 6-17 years, all immunoglobulin E-positive for aeroallergens) and 21 age-matched non-atopic healthy controls for fluorometric analysis of nitrite and nitrate. These markers were compared with measurements of FENO, blood eosinophil count (EOS), methacholine reactivity (PD(20)) and baseline spirometry. RESULTS EBC nitrite, in contrast to nitrate, was significantly increased (P < 0.01) in the asthmatic children. They also had increased levels of FENO (P < 0.001) and EOS (P < 0.001) along with decreased PD(20) (P < 0.001) and FEV1/FVC (P < 0.01). However, there was no correlation between EBC nitrite and FENO (r = 0.05) or any other marker of disease activity in the asthmatic children, whereas between the other markers correlations could be established. CONCLUSION EBC nitrite is elevated in childhood asthma but the lack of correlation to FENO and other markers, together with simultaneously normal levels of nitrate, make its origin as a metabolite of inflammation-induced NO questionable.
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Affiliation(s)
- Wilhelm Zetterquist
- Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
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