1
|
Freund R, Sauvain JJ, Suarez G, Wild P, Charreau T, Debatisse A, Sakthithasan K, Jouannique V, Pralong JA, Guseva Canu I. Discriminative potential of exhaled breath condensate biomarkers with respect to chronic obstructive pulmonary disease. J Occup Med Toxicol 2024; 19:10. [PMID: 38576000 PMCID: PMC10993619 DOI: 10.1186/s12995-024-00409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) affecting 334 million people in the world remains a major cause of morbidity and mortality. Proper diagnosis of COPD is still a challenge and largely solely based on spirometric criteria. We aimed to investigate the potential of nitrosative/oxidative stress and related metabolic biomarkers in exhaled breath condensate (EBC) to discriminate COPD patients. METHODS Three hundred three participants were randomly selected from a 15,000-transit worker cohort within the Respiratory disease Occupational Biomonitoring Collaborative Project (ROBoCoP). COPD was defined using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria as post-bronchodilator ratio of Forced Expiratory Volume in 1st second to Forced Vital Capacity < 0.7 in spirometry validated by an experienced pulmonologist. Discriminative power of biomarker profiles in EBC was analyzed using linear discriminant analyses. RESULTS Amongst 300 participants with validated spirometry, 50.3% were female, 52.3 years old in average, 36.0% were current smokers, 12.7% ex-smokers with mean tobacco exposure of 15.4 pack-years. Twenty-one participants (7.0%) were diagnosed as COPD, including 19 new diagnoses, 12 of which with a mild COPD stage (GOLD 1). Amongst 8 biomarkers measured in EBC, combination of 2 biomarkers, Lactate and Malondialdehyde (MDA) significantly discriminated COPD subjects from non-COPD, with a 71%-accuracy, area under the receiver curve of 0.78 (p-value < 0.001), and a negative predictive value of 96%. CONCLUSIONS These findings support the potential of biomarkers in EBC, in particular lactate and MDA, to discriminate COPD patients even at a mild or moderate stage. These EBC biomarkers present a non-invasive and drugless technique, which can improve COPD diagnosis in the future.
Collapse
Affiliation(s)
- Romain Freund
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
| | - Jean-Jacques Sauvain
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Guillaume Suarez
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Pascal Wild
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Thomas Charreau
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | | | | | | | - Jacques A Pralong
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- SwissMedPro Health Services, Geneva, Switzerland
- Hôpital de La Tour, Geneva, Switzerland
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
2
|
Turcu V, Wild P, Hemmendinger M, Sauvain JJ, Bergamaschi E, Hopf NB, Canu IG. Towards Reference Values for Malondialdehyde on Exhaled Breath Condensate: A Systematic Literature Review and Meta-Analysis. TOXICS 2022; 10:258. [PMID: 35622671 PMCID: PMC9147097 DOI: 10.3390/toxics10050258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 01/07/2023]
Abstract
Many pathological conditions and certain airway exposures are associated with oxidative stress (OS). Malondialdehyde (MDA) is an end-product of the oxidation of lipids in our cells and is present in all biological matrices including exhaled breath condensate (EBC). To use MDA as a biomarker of OS in EBC, a reference interval should be defined. Thus, we sought to summarize reference values reported in healthy adult populations by performing a systematic review and meta-analysis using a standardized protocol registered in PROSPERO (CRD42020146623). Articles were retrieved from four major databases and 25 studies with 28 subgroups were included. Defining the distribution of MDA measured in reference populations with a detection combined with a separation technique still represents a challenge due to the low number of studies available, different analytical methods used, and questionable methodological qualities of many studies. The most salient methodological drawbacks have been in data collection and reporting of methods and study results by the researchers. The lack of compliance with the recommendations of the European Respiratory Society and American Thoracic Society was the major limitation in the current research involving EBC. Consequently, we were unable to establish a reference interval for MDA in EBC.
Collapse
Affiliation(s)
- Veronica Turcu
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland; (V.T.); (P.W.); (M.H.); (J.-J.S.); (N.B.H.)
| | - Pascal Wild
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland; (V.T.); (P.W.); (M.H.); (J.-J.S.); (N.B.H.)
| | - Maud Hemmendinger
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland; (V.T.); (P.W.); (M.H.); (J.-J.S.); (N.B.H.)
| | - Jean-Jacques Sauvain
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland; (V.T.); (P.W.); (M.H.); (J.-J.S.); (N.B.H.)
| | - Enrico Bergamaschi
- Department of Public Health and Pediatrics, University of Turin, Via Zuretti 29, 10125 Turin, Italy;
| | - Nancy B. Hopf
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland; (V.T.); (P.W.); (M.H.); (J.-J.S.); (N.B.H.)
| | - Irina Guseva Canu
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 2, 1066 Epalinges, Switzerland; (V.T.); (P.W.); (M.H.); (J.-J.S.); (N.B.H.)
| |
Collapse
|
3
|
Sauvain JJ, Hemmendinger M, Suárez G, Creze C, Hopf NB, Jouannique V, Debatisse A, Pralong JA, Wild P, Canu IG. Malondialdehyde and anion patterns in exhaled breath condensate among subway workers. Part Fibre Toxicol 2022; 19:16. [PMID: 35216613 PMCID: PMC8876786 DOI: 10.1186/s12989-022-00456-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/14/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Underground transportation systems can contribute to the daily particulates and metal exposures for both commuter and subway workers. The redox and metabolic changes in workers exposed to such metal-rich particles have yet to be characterized. We hypothesize that the distribution of nitrosative/oxidative stress and related metabolic biomarkers in exhaled breath condensate (EBC) are modified depending on exposures. RESULTS Particulate number and size as well as mass concentration and airborne metal content were measured in three groups of nine subway workers (station agents, locomotive operators and security guards). In parallel, pre- and post-shift EBC was collected daily during two consecutive working weeks. In this biological matrix, malondialdehyde, lactate, acetate, propionate, butyrate, formate, pyruvate, the sum of nitrite and nitrate (ΣNOx) and the ratio nitrite/nitrate as well as metals and nanoparticle concentrations was determined. Weekly evolution of the log-transformed selected biomarkers as well as their association with exposure variables was investigated using linear mixed effects models with the participant ID as random effect. The professional activity had a strong influence on the pattern of anions and malondialdehyde in EBC. The daily number concentration and the lung deposited surface area of ultrafine particles was consistently and mainly associated with nitrogen oxides variations during the work-shift, with an inhibitory effect on the ΣNOx. We observed that the particulate matter (PM) mass was associated with a decreasing level of acetate, lactate and ΣNOx during the work-shift, suggestive of a build-up of these anions during the previous night in response to exposures from the previous day. Lactate was moderately and positively associated with some metals and with the sub-micrometer particle concentration in EBC. CONCLUSIONS These results are exploratory but suggest that exposure to subway PM could affect concentrations of nitrogen oxides as well as acetate and lactate in EBC of subway workers. The effect is modulated by the particle size and can correspond to the body's cellular responses under oxidative stress to maintain the redox and/or metabolic homeostasis.
Collapse
Affiliation(s)
- Jean-Jacques Sauvain
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University Lausanne, Route de la Corniche 2, 1066, Epalinges, Switzerland.
| | - Maud Hemmendinger
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University Lausanne, Route de la Corniche 2, 1066, Epalinges, Switzerland
| | - Guillaume Suárez
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University Lausanne, Route de la Corniche 2, 1066, Epalinges, Switzerland
| | - Camille Creze
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University Lausanne, Route de la Corniche 2, 1066, Epalinges, Switzerland
| | - Nancy B Hopf
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University Lausanne, Route de la Corniche 2, 1066, Epalinges, Switzerland
| | - Valérie Jouannique
- Service Santé-Travail, Autonomous Paris Transport Authority (RATP), 88 Boulevard Sébastopol, 75003, Paris, France
| | - Amélie Debatisse
- Service Santé-Travail, Autonomous Paris Transport Authority (RATP), 88 Boulevard Sébastopol, 75003, Paris, France
| | - Jacques A Pralong
- Division of Pulmonary Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Rue Gabrielle Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Pascal Wild
- Division of Research Management, National Research and Safety Institute (INRS), Rue du Morvan, CS 60027, 54519, Vandoeuvre Cedex, France
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (Unisanté), University Lausanne, Route de la Corniche 2, 1066, Epalinges, Switzerland
| |
Collapse
|
4
|
Ghosh N, Choudhury P, Joshi M, Bhattacharyya P, Roychowdhury S, Banerjee R, Chaudhury K. Global metabolome profiling of exhaled breath condensates in male smokers with asthma COPD overlap and prediction of the disease. Sci Rep 2021; 11:16664. [PMID: 34404870 PMCID: PMC8370999 DOI: 10.1038/s41598-021-96128-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 07/30/2021] [Indexed: 02/07/2023] Open
Abstract
Asthma-chronic obstructive pulmonary disease (COPD) overlap, termed as ACO, is a complex heterogeneous disease characterised by persistent airflow limitation, which manifests features of both asthma and COPD. These patients have a worse prognosis, in terms of more frequent and severe exacerbations, more frequent symptoms, worse quality of life, increased comorbidities and a faster lung function decline. In absence of clear diagnostic or therapeutic guidelines, ACO presents as a challenge to clinicians. The present study aims to investigate whether ACO patients have a distinct exhaled breath condensate (EBC) metabolic profile in comparison to asthma and COPD. A total of 132 age and BMI matched male smokers were recruited in the exploratory phase which consisted of (i) controls = 33 (ii) asthma = 34 (iii) COPD = 30 and (iv) ACO = 35. Using nuclear magnetic resonance (NMR) metabolomics, 8 metabolites (fatty acid, propionate, isopropanol, lactate, acetone, valine, methanol and formate) were identified to be significantly dysregulated in ACO subjects when compared to both, asthma and COPD. The expression of these dysregulated metabolites were further validated in a fresh patient cohort consisting of (i) asthma = 32 (ii) COPD = 32 and (iii) ACO = 40, which exhibited a similar expression pattern. Multivariate receiver operating characteristic (ROC) curves generated using these metabolites provided a robust ACO classification model. The findings were also integrated with previously identified serum metabolites and inflammatory markers to develop a robust predictive model for differentiation of ACO. Our findings suggest that NMR metabolomics of EBC holds potential as a platform to identify robust, non-invasive biomarkers for differentiating ACO from asthma and COPD.
Collapse
Affiliation(s)
- Nilanjana Ghosh
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Priyanka Choudhury
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India
| | - Mamata Joshi
- National Facility for High-Field NMR, Tata Institute of Fundamental Research, Mumbai, India
| | | | | | - Rintu Banerjee
- Department of Agricultural and Food Engineering, Indian Institute of Technology Kharagpur, Kharagpur, India
| | - Koel Chaudhury
- School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, 721302, India.
| |
Collapse
|
5
|
Guseva Canu I, Hemmendinger M, Sauvain JJ, Suarez G, Hopf NB, Pralong JA, Ben Rayana T, Besançon S, Sakthithasan K, Jouannique V, Debatisse A. Respiratory Disease Occupational Biomonitoring Collaborative Project (ROBoCoP): A longitudinal pilot study and implementation research in the Parisian transport company. J Occup Med Toxicol 2021; 16:22. [PMID: 34167564 PMCID: PMC8222705 DOI: 10.1186/s12995-021-00312-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/08/2021] [Indexed: 12/19/2022] Open
Abstract
The ROBoCoP project is launched within the EU COST Action CA16113 "CliniMARK" aiming to increase the number of clinically validated biomarkers and focused on chronic obstructive pulmonary disease (COPD) biomarker development and validation. ROBoCoP encompasses two consecutive studies consisting of a pilot study followed by a field study. The pilot study is a longitudinal exposure assessment and biomarker study aiming at: 1-understanding the suitability of the candidate biomarkers in surveying populations at risk such as workers exposed to COPD causing agents; 2-determining the best sampling plan with respect to the half-life of the candidate biomarkers; 3-implementing and validating the sampling procedures and analytical methods; 4-selecting the best suitable biomarkers to be measured in the field. Each study participant is surveyed every day during the 6-8 h work-shifts for two consecutive weeks. The field study has an implementation research designe that enabled us to demonstrate the applicability of the standardized protocol for biomarker measurements in occupational settings while also assessing the biomarkers' validity. ROBoCoP will focus on particulate matter (PM) exposure measurements, exposure biomarkers and a series of effect biomarkers, including markers of lipoperoxidation: 8-isoprostane, malondialdehyd in exhaled breath condensate (EBC) and urine, potential markers of nitrosative stress: NO2-, NO3- and formate anion in EBC; markers of DNA oxidation: 8-hydroxy-2'deoxyguanosine in EBC and urine, marker of genotoxicity: micronuclei in buccal cells, and oxidative potential in exhaled air (OPEA). OPEA appears particularly promising as a clinical biomarker for detecting COPD, and will be tested independently and as part of a biomarker panel. COPD diagnosis will be performed by an experienced occupational physician according to international diagnostic standards and confirmed by a pulmonologist.This research will include approximatively 300 underground subway workers randomly selected from the personnel registry of a large Parisian transport company. Underground subways are suggested as the most PM polluted urban transport environment. We believe this occupational exposure is relevant for biomonitoring of workers and early detection of respiratory diseases.
Collapse
Affiliation(s)
- I Guseva Canu
- 1Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
| | - M Hemmendinger
- 1Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - J J Sauvain
- 1Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - G Suarez
- 1Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - N B Hopf
- 1Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - J A Pralong
- Division of Pulmonary Diseases, Geneva University Hospitals and Faculty of Medicine and University of Geneva, Geneva, Switzerland
| | - T Ben Rayana
- 1Department of Occupational and Environmental Health (DSTE), Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Autonomous Paris Transport Authority (RATP), Paris, France
| | - S Besançon
- Autonomous Paris Transport Authority (RATP), Paris, France
| | - K Sakthithasan
- Autonomous Paris Transport Authority (RATP), Paris, France
| | - V Jouannique
- Autonomous Paris Transport Authority (RATP), Paris, France
| | - A Debatisse
- Autonomous Paris Transport Authority (RATP), Paris, France
| |
Collapse
|