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Maniscalco M, Cutignano A, Paris D, Melck DJ, Molino A, Fuschillo S, Motta A. Metabolomics of Exhaled Breath Condensate by Nuclear Magnetic Resonance Spectroscopy and Mass Spectrometry: A Methodological Approach. Curr Med Chem 2020; 27:2381-2399. [DOI: 10.2174/0929867325666181008122749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 12/15/2022]
Abstract
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Respiratory diseases present a very high prevalence in the general population, with an
increase in morbidity, mortality and health-care expenses worldwide. They are complex and heterogeneous
pathologies that may present different pathological facets in different subjects, often
with personal evolution. Therefore, there is a need to identify patients with similar characteristics,
prognosis or treatment, defining the so-called phenotype, but also to mark specific differences
within each phenotype, defining the endotypes.
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Biomarkers are very useful to study respiratory phenotypes and endotypes. Metabolomics, one of
the recently introduced “omics”, is becoming a leading technique for biomarker discovery. For the
airways, metabolomics appears to be well suited as the respiratory tract offers a natural matrix, the
Exhaled Breath Condensate (EBC), in which several biomarkers can be measured. In this review,
we will discuss the main methodological issues related to the application of Nuclear Magnetic
Resonance (NMR) spectroscopy and Mass Spectrometry (MS) to EBC metabolomics for investigating
respiratory diseases.
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Affiliation(s)
- Mauro Maniscalco
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA IRCCS, Via Bagni Vecchi 1, 82037 Telese Terme (Benevento), Italy
| | - Adele Cutignano
- Institute of Biomolecular Chemistry, National Research Council, Via Campi Flegrei 34, Comprensorio Olivetti Edificio A, 80078 Pozzuoli (Naples), Italy
| | - Debora Paris
- Institute of Biomolecular Chemistry, National Research Council, Via Campi Flegrei 34, Comprensorio Olivetti Edificio A, 80078 Pozzuoli (Naples), Italy
| | - Dominique J. Melck
- Institute of Biomolecular Chemistry, National Research Council, Via Campi Flegrei 34, Comprensorio Olivetti Edificio A, 80078 Pozzuoli (Naples), Italy
| | - Antonio Molino
- Department of Respiratory Medicine, University Federico II, 80131 Naples, Italy
| | - Salvatore Fuschillo
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA IRCCS, Via Bagni Vecchi 1, 82037 Telese Terme (Benevento), Italy
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, Via Campi Flegrei 34, Comprensorio Olivetti Edificio A, 80078 Pozzuoli (Naples), Italy
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D'Amato M, Paris D, Molino A, Cuomo P, Fulgione A, Sorrentino N, Palomba L, Maniscalco M, Motta A. The Immune-Modulator Pidotimod Affects the Metabolic Profile of Exhaled Breath Condensate in Bronchiectatic Patients: A Metabolomics Pilot Study. Front Pharmacol 2019; 10:1115. [PMID: 31632269 PMCID: PMC6785784 DOI: 10.3389/fphar.2019.01115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/30/2019] [Indexed: 01/16/2023] Open
Abstract
Introduction: Pidotimod, a synthetic dipeptide molecule with biological and immunological activities, is used to reduce the number of exacerbations or pneumonitis in patients with inflammatory diseases. In the present study, we investigated whether Pidotimod modifies the metabolomic pathways measured in the exhaled breath condensate (EBC) of non-cystic fibrosis bronchiectatic patients (NCFB). Materials and Methods: We analyzed 40 adult patients affected by NCFB. They were randomly selected to receive Pidotimod 800 mg b/d for 21 consecutive days (3 weeks) per month for 6 months (20 patients, V1 group) or no drug (20 patients, V0 group), with a 1:1 criterion and then followed as outpatients. Results: EBC samples were collected from all patients at baseline and after 6 months. They were investigated by combined nuclear magnetic resonance (NMR) spectroscopy and multivariate statistical analysis to uncover metabolic differences between EBC from NCFB patients before and after therapy with Pidotimod. Pulmonary function test and pulmonary exacerbations were analyzed at baseline and at the end of Pidotimod therapy. The EBC metabolites were all identified, and through statistical evaluation, we were able to discriminate the two samples' classes, with acetate, acetoin, lactate, and citrate as statistically significant discriminatory metabolites. The model vas validated by using a blind set of 20 NCFB samples, not included in the primary analysis. No differences were observed in PFT after 6 months. At the end of the study, there was a significant decrease of exacerbation rate in V1 group as compared with V0 group, with a substantial reduction of the number of mild or severe exacerbations (p < 0.001). Discussion: Pidotimod modifies the respiratory metabolic phenotype ("metabotype") of NCFB patients and reduces the number of exacerbations.
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Affiliation(s)
- Maria D'Amato
- Division of Pneumology, Department of Respiratory Diseases, University of Naples Federico II, AORN dei Colli-Monaldi Hospital, Naples, Italy
| | - Debora Paris
- Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Italy
| | - Antonio Molino
- Division of Pneumology, Department of Respiratory Diseases, University of Naples Federico II, AORN dei Colli-Monaldi Hospital, Naples, Italy
| | - Paola Cuomo
- Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Italy
| | - Andrea Fulgione
- Department of Agriculture, University of Naples Federico II, Portici, Italy
| | - Nunzia Sorrentino
- Division of Pneumology, Department of Respiratory Diseases, University of Naples Federico II, AORN dei Colli-Monaldi Hospital, Naples, Italy
| | - Letizia Palomba
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Mauro Maniscalco
- Pulmonary Rehabilitation Unit, ICS Maugeri SPA, IRCCS, Telese Terme, Italy
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Italy
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Fuschillo S, Molino A, Stellato C, Motta A, Maniscalco M. Blood eosinophils as biomarkers of therapeutic response to chronic obstructive pulmonary disease: Still work in progress. Eur J Intern Med 2019; 68:1-5. [PMID: 31307853 DOI: 10.1016/j.ejim.2019.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/01/2019] [Accepted: 07/09/2019] [Indexed: 01/21/2023]
Abstract
Disease phenotyping is a key step towards an increasingly personalized approach to chronic obstructive pulmonary disease (COPD), leading to a more precise assessment, treatment and definition of disease outcomes. The search for biomarkers able to guide the identification of COPD phenotypes are of great importance for both researchers and clinicians. However, while several biomarkers of inflammation [e.g., peripheral blood eosinophils and fractional expired nitric oxide] have been identified and applied in asthma, none has been successfully linked to discrete clinical parameters of COPD such as exacerbations, natural progression, and treatment response or mortality risk. Recently, several studies have shown that blood eosinophils are a potential biomarker for patient subset stratification in COPD therapy. Here we reviewed the value of blood eosinophils in predicting the response of COPD patients to treatment.
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Affiliation(s)
- Salvatore Fuschillo
- Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Division of the Telese Terme Institute, Italy
| | - Antonio Molino
- Respiratory Division, Department of Respiratory Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Naples, Italy
| | - Mauro Maniscalco
- Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Division of the Telese Terme Institute, Italy.
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Maniscalco M, Paris D, Melck DJ, Molino A, Carone M, Ruggeri P, Caramori G, Motta A. Differential diagnosis between newly diagnosed asthma and COPD using exhaled breath condensate metabolomics: a pilot study. Eur Respir J 2018; 51:13993003.01825-2017. [PMID: 29348154 DOI: 10.1183/13993003.01825-2017] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 12/28/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Mauro Maniscalco
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA, IRCCS, Telese Terme, Italy.,M. Maniscalco, D. Paris and D.J. Melck contributed equally to this manuscript
| | - Debora Paris
- Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Italy.,M. Maniscalco, D. Paris and D.J. Melck contributed equally to this manuscript
| | - Dominique J Melck
- Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Italy.,M. Maniscalco, D. Paris and D.J. Melck contributed equally to this manuscript
| | - Antonio Molino
- Dept of Respiratory Medicine, Monaldi Hospital (Naples), Naples, Italy
| | - Mauro Carone
- Pulmonary Rehabilitation Unit, ICS Maugeri SpA, IRCCS, Cassano delle Murge, Italy
| | - Paolo Ruggeri
- Unità Operativa Complessa di Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Gaetano Caramori
- Unità Operativa Complessa di Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Italy
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