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Glöckler J, Mizaikoff B, Díaz de León-Martínez L. SARS CoV-2 infection screening via the exhaled breath fingerprint obtained by FTIR spectroscopic gas-phase analysis. A proof of concept. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 302:123066. [PMID: 37356392 PMCID: PMC10286574 DOI: 10.1016/j.saa.2023.123066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
The COVID-19 pandemic remains a global challenge now with the long-COVID arising. Mitigation measures focused on case counting, assessment and determination of variants and their likely targets of infection and transmission, the pursuit of drug treatments, use and enhancement of masks, social distancing, vaccination, post-infection rehabilitation, and mass screening. The latter is of utmost importance given the current scenario of infections, reinfections, and long-term health effects. Research on screening platforms has been developed to provide more sensitive, specific, and reliable tests that are accessible to the entire population and can be used to assess the prognosis of the disease as well as the subsequent health follow-up of patients with sequelae of COVID-19. Therefore, the aim of the present study was the simulation of exhaled breath of COVID-19 patients by evaluation of three identified COVID-19 indicator breath biomarkers (acetone (ACE), acetaldehyde (ACH) and nitric oxide (NO)) by gas-phase infrared spectroscopy as a proof-of-concept principle for the detection of infected patients' exhaled breath fingerprint and subsequent follow-up. The specific fingerprints of each of the compounds and the overall fingerprint were obtained. The synthetic exhaled breath evaluation concept revealed a linearity of r = 0.99 for all compounds, and LODs of 6.42, 13.81, 9.22 ppm, and LOQs of 42.26, 52.57, 69.23 ppm for NO, ACE, and ACH, respectively. This study proves the fundamental feasibility of gas-phase infrared spectroscopy for fingerprinting lung damage biomarkers in exhaled breath of patients with COVID-19. This analysis would allow faster and cheaper screening and follow-up of infected individuals, which could improve mass screening in POC settings.
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Affiliation(s)
- Johannes Glöckler
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Boris Mizaikoff
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany; Hahn-Schickard Institute for Microanalysis Systems, Sedanstrasse 14, 89077 Ulm, Germany
| | - Lorena Díaz de León-Martínez
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany.
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2
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Eckel SP, Garcia E, Gilliland FD. Predicting asthma exacerbations: is there utility in noninvasive assessment of distal airway inflammation using multiple flow FENO? Eur Respir J 2022. [DOI: 10.1183/13993003.00802-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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3
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Koskela K, Riitta S, Panu O, Jukka U, Eeva M, Lauri L. High alveolar nitric oxide is associated with steeper lung function decline in foundry workers. J Breath Res 2021; 15. [PMID: 33770784 DOI: 10.1088/1752-7163/abf272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/26/2021] [Indexed: 11/12/2022]
Abstract
Occupational dust exposure induces inflammatory responses that often precede the onset of clinical disease. Inflammation in the peripheral part of the lung can be demonstrated by measuring the alveolar NO concentration (CANO) in exhaled breath. The aim of the study was to assess whether cumulative dust exposure affects the change in CANO during follow-up and whether baseline CANO can predict an impairment in lung function during follow-up in foundry workers. We examined 74 dust-exposed and 42 nonexposed foundry workers and measured CANO and lung function at baseline and after 7 years of follow-up. An increase in CANO during the follow-up period was positively associated with cumulative dust exposure in foundry work (p= 0.035). Furthermore, a higher baseline CANO was associated with an accelerated decline in the forced vital capacity (FVC) during the follow-up period (absolute decrease in FVCp= 0.021, relative decrease in FVCp= 0.017). Higher cumulative dust exposure in foundry work is associated with a greater increase in CANO during follow-up, suggesting ongoing pulmonary inflammation in these subjects. Importantly, a high baseline CANO is associated with an accelerated decline in lung function, suggesting that CANO measurements might serve as a screening tool for high-risk workers.
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Affiliation(s)
- Kirsi Koskela
- Finnish Institute of Occupational Health, PO Box 486, FI-33101 Tampere, Finland.,The Outpatient Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland
| | - Sauni Riitta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Oksa Panu
- Finnish Institute of Occupational Health, PO Box 486, FI-33101 Tampere, Finland
| | - Uitti Jukka
- Finnish Institute of Occupational Health, PO Box 486, FI-33101 Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Moilanen Eeva
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University, and Tampere University Hospital, Tampere, Finland
| | - Lehtimäki Lauri
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Allergy Centre, Tampere University Hospital, Tampere, Finland
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4
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Kotsiou OS, Gourgoulianis KI, Zarogiannis SG. The role of nitric oxide in pleural disease. Respir Med 2021; 179:106350. [PMID: 33662805 DOI: 10.1016/j.rmed.2021.106350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 11/25/2022]
Abstract
Nitric oxide (NO) regulates various physiological and pathophysiological functions in the lungs. However, there is much less information about the effects of NO in the pleura. The present review aimed to explore the available evidence regarding the role of NO in pleural disease. NO, has a double-edged role in the pleural cavity. It is an essential signaling molecule mediating various physiological cell functions such as lymphatic drainage of the serous cavities, the immune response to intracellular multiplication of pathogens, and downregulation of neutrophil migration, but also induces genocytotoxic and mutagenic effects when present in excess. NO is implicated in the pathogenesis of asbestos-related or exudative pleural disease and mesothelioma. From a clinical point of view, the fraction of exhaled NO has been suggested as a potential non-invasive tool for the diagnosis of benign asbestos-related disorders. Under experimental conditions, NO-mimetics were found to attenuate hypoxia-induced therapy resistance in mesothelioma. Similarly, hybrid agents consisting of an NO donor coupled with a parent anti-inflammatory drug showed an enhancement of the anti-inflammatory activity of anti-inflammatory drugs. However, given the paucity of research work performed over the last years in this area, further research should be undertaken to establish reliable conclusions with respect to the feasibility of determining or targeting the NO signaling pathway for pleural disease diagnosis and therapeutic management.
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Affiliation(s)
- Ourania S Kotsiou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece; Department of Physiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Sotirios G Zarogiannis
- Department of Physiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece
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5
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Lehtimäki L, Karvonen T, Högman M. Clinical Values of Nitric Oxide Parameters from the Respiratory System. Curr Med Chem 2021; 27:7189-7199. [PMID: 32493184 DOI: 10.2174/0929867327666200603141847] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/24/2020] [Accepted: 03/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FENO) concentration reliably reflects central airway inflammation, but it is not sensitive to changes in the NO dynamics in the lung periphery. By measuring FENO at several different flow rates one can estimate alveolar NO concentration (CANO), bronchial NO flux (JawNO), bronchial wall NO concentration (CawNO) and the bronchial diffusivity of NO (DawNO). OBJECTIVE We aimed to describe the current knowledge and clinical relevance of NO parameters in different pulmonary diseases. METHODS We conducted a systematic literature search to identify publications reporting NO parameters in subjects with pulmonary or systemic diseases affecting the respiratory tract. A narrative review was created for those with clinical relevance. RESULTS Estimation of pulmonary NO parameters allows for differentiation between central and peripheral inflammation and a more precise analysis of central airway NO output. CANO seems to be a promising marker of parenchymal inflammation in interstitial lung diseases and also a marker of tissue damage and altered gas diffusion in chronic obstructive pulmonary disease and systemic diseases affecting the lung. In asthma, CANO can detect small airway involvement left undetected by ordinary FENO measurement. Additionally, CawNO and DawNO can be used in asthma to assess if FENO is increased due to enhanced inflammatory activity (increased CawNO) or tissue changes related to bronchial remodelling (altered DawNO). CONCLUSION NO parameters may be useful for diagnosis, prediction of disease progression and prediction of treatment responses in different parenchymal lung and airway diseases. Formal trials to test the added clinical value of NO parameters are needed.
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Affiliation(s)
- Lauri Lehtimäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland,Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - Tuomas Karvonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Marieann Högman
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, S-75185 Uppsala, Sweden
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6
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Cameli P, Bargagli E, Bergantini L, d’Alessandro M, Pieroni M, Fontana GA, Sestini P, Refini RM. Extended Exhaled Nitric Oxide Analysis in Interstitial Lung Diseases: A Systematic Review. Int J Mol Sci 2020; 21:E6187. [PMID: 32867116 PMCID: PMC7503828 DOI: 10.3390/ijms21176187] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022] Open
Abstract
Fractional exhaled nitric oxide (FeNO) is a well-known and widely accepted biomarker of airways inflammation that can be useful in the therapeutic management, and adherence to inhalation therapy control, in asthmatic patients. However, the multiple-flows assessment of FeNO can provide a reliable measurement of bronchial and alveolar production of NO, supporting its potential value as biomarker also in peripheral lung diseases, such as interstitial lung diseases (ILD). In this review, we first discuss the role of NO in the pathobiology of lung fibrosis and the technique currently approved for the measurement of maximum bronchial flux of NO (J'awNO) and alveolar concentration of NO (CaNO). We systematically report the published evidence regarding extended FeNO analysis in the management of patients with different ILDs, focusing on its potential role in differential diagnosis, prognostic evaluation and severity assessment of disease. The few available data concerning extended FeNO analysis, and the most common comorbidities of ILD, are explored too. In conclusion, multiple-flows FeNO analysis, and CaNO in particular, appears to be a promising tool to be implemented in the diagnostic and prognostic pathways of patients affected with ILDs.
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Affiliation(s)
- Paolo Cameli
- Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (E.B.); (L.B.); (M.d.); (M.P.); (P.S.); (R.M.R.)
| | - Elena Bargagli
- Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (E.B.); (L.B.); (M.d.); (M.P.); (P.S.); (R.M.R.)
| | - Laura Bergantini
- Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (E.B.); (L.B.); (M.d.); (M.P.); (P.S.); (R.M.R.)
| | - Miriana d’Alessandro
- Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (E.B.); (L.B.); (M.d.); (M.P.); (P.S.); (R.M.R.)
| | - Maria Pieroni
- Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (E.B.); (L.B.); (M.d.); (M.P.); (P.S.); (R.M.R.)
| | - Giovanni A. Fontana
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy;
| | - Piersante Sestini
- Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (E.B.); (L.B.); (M.d.); (M.P.); (P.S.); (R.M.R.)
| | - Rosa Metella Refini
- Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (E.B.); (L.B.); (M.d.); (M.P.); (P.S.); (R.M.R.)
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7
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Reference Ranges of 8-Isoprostane Concentrations in Exhaled Breath Condensate (EBC): A Systematic Review and Meta-Analysis. Int J Mol Sci 2020; 21:ijms21113822. [PMID: 32481492 PMCID: PMC7311981 DOI: 10.3390/ijms21113822] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Isoprostanes are physiopathologic mediators of oxidative stress, resulting in lipid peroxidation. 8-isoprostane seems particularly useful for measuring oxidative stress damage. However, no reference range values are available for 8-isoprosante in exhaled breath condensate (EBC) of healthy adults, enabling its meaningful interpretation as a biomarker. We conducted this systematic review and meta-analysis according to the protocol following PROSPERO (CRD42020146623). After searching and analyzing the literature, we included 86 studies. After their qualitative synthesis and risk of bias assessment, 52 studies were included in meta-analysis. The latter focused on studies using immunological analytical methods and investigated how the concentrations of 8-isoprostane differ based on gender. We found that gender had no significant effect in 8-isoprostane concentration. Among other studied factors, such as individual characteristics and factors related to EBC collection, only the device used for EBC collection significantly affected measured 8-isoprostane concentrations. However, adjustment for the factors related to EBC collection, yielded uncertainty whether this effect is due to the device itself or to the other factors. Given this uncertainty, we estimated the reference range values of 8-isoprostane stratified by gender and EBC collection device. A better standardization of EBC collection seems necessary; as well more studies using chemical analytical methods to extend this investigation.
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8
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Töreyin ZN, Ghosh M, Göksel Ö, Göksel T, Godderis L. Exhaled Breath Analysis in Diagnosis of Malignant Pleural Mesothelioma: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1110. [PMID: 32050546 PMCID: PMC7036862 DOI: 10.3390/ijerph17031110] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 12/12/2022]
Abstract
Malignant pleural mesothelioma (MPM) is mainly related to previous asbestos exposure. There is still dearth of information on non-invasive biomarkers to detect MPM at early stages. Human studies on exhaled breath biomarkers of cancer and asbestos-related diseases show encouraging results. The aim of this systematic review was to provide an overview on the current knowledge about exhaled breath analysis in MPM diagnosis. A systematic review was conducted on MEDLINE (PubMed), EMBASE and Web of Science databases to identify relevant studies. Quality assessment was done by the Newcastle-Ottawa Scale. Six studies were identified, all of which showed fair quality and explored volatile organic compounds (VOC) based breath profile using Gas Chromatography Coupled to Mass Spectrometry (GC-MS), Ion Mobility Spectrometry Coupled to Multi-capillary Columns (IMS-MCC) or pattern-recognition technologies. Sample sizes varied between 39 and 330. Some compounds (i.e, cyclohexane, P3, P5, P50, P71, diethyl ether, limonene, nonanal, VOC IK 1287) that can be indicative of MPM development in asbestos exposed population were identified with high diagnostic accuracy rates. E-nose studies reported breathprints being able to distinguish MPM from asbestos exposed individuals with high sensitivity and a negative predictive value. Small sample sizes and methodological diversities among studies limit the translation of results into clinical practice. More prospective studies with standardized methodologies should be conducted on larger populations.
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Affiliation(s)
- Zehra Nur Töreyin
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
| | - Manosij Ghosh
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
| | - Özlem Göksel
- Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Laboratory of Occupational and Environmental Respiratory Diseases, Bornova, 35100 Izmir, Turkey;
| | - Tuncay Göksel
- Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Bornova, 35100 Izmir, Turkey;
| | - Lode Godderis
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
- Idewe, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
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9
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Catino A, de Gennaro G, Di Gilio A, Facchini L, Galetta D, Palmisani J, Porcelli F, Varesano N. Breath Analysis: A Systematic Review of Volatile Organic Compounds (VOCs) in Diagnostic and Therapeutic Management of Pleural Mesothelioma. Cancers (Basel) 2019; 11:E831. [PMID: 31207975 PMCID: PMC6627570 DOI: 10.3390/cancers11060831] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 05/31/2019] [Accepted: 06/11/2019] [Indexed: 12/16/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare neoplasm related to asbestos exposure and with high mortality rate. The management of patients with MPM is complex and controversial, particularly with regard to early diagnosis. In the last few years, breath analysis has been greatly implemented with this aim. In this review the strengths of breath analysis and preliminary results in searching breath biomarkers of MPM are highlighted and discussed, respectively. Through a systematic electronic literature search, collecting papers published from 2000 until December 2018, fifteen relevant scientific papers were selected. All papers considered were prospective, comparative, observational case-control studies although every single one pilot and based on a relatively small number of samples. The identification of diagnostic VOCs pattern, through breath sample characterization and the statistical data treatment, allows to obtain a strategic information for clinical diagnostics. To date the collected data provide just preliminary information and, despite the promising results and diagnostic accuracy, conclusions cannot be generalized due to the limited number of individuals included in each cohort study. Furthermore none of studies was externally validated, although validation process is a necessary step towards clinical implementation. Breathomics-based biomarker approach should be further explored to confirm and validate preliminary findings and to evaluate its potential role in monitoring the therapeutic response.
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Affiliation(s)
- Annamaria Catino
- Thoracic Oncology Unit, Clinical Cancer Centre "Giovanni Paolo II", 70124 Bari, Italy.
| | | | | | - Laura Facchini
- Department of Biology, University of Bari, 70125 Bari, Italy.
| | - Domenico Galetta
- Thoracic Oncology Unit, Clinical Cancer Centre "Giovanni Paolo II", 70124 Bari, Italy.
| | | | | | - Niccolò Varesano
- Thoracic Oncology Unit, Clinical Cancer Centre "Giovanni Paolo II", 70124 Bari, Italy.
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10
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Hayton C, Terrington D, Wilson AM, Chaudhuri N, Leonard C, Fowler SJ. Breath biomarkers in idiopathic pulmonary fibrosis: a systematic review. Respir Res 2019; 20:7. [PMID: 30634961 PMCID: PMC6329167 DOI: 10.1186/s12931-019-0971-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/01/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Exhaled biomarkers may be related to disease processes in idiopathic pulmonary fibrosis (IPF) however their clinical role remains unclear. We performed a systematic review to investigate whether breath biomarkers discriminate between patients with IPF and healthy controls. We also assessed correlation with lung function, ability to distinguish diagnostic subgroups and change in response to treatment. METHODS MEDLINE, EMBASE and Web of Science databases were searched. Study selection was limited to adults with a diagnosis of IPF as per international guidelines. RESULTS Of 1014 studies screened, fourteen fulfilled selection criteria and included 257 IPF patients. Twenty individual biomarkers discriminated between IPF and controls and four showed correlation with lung function. Meta-analysis of three studies indicated mean (± SD) alveolar nitric oxide (CalvNO) levels were significantly higher in IPF (8.5 ± 5.5 ppb) than controls (4.4 ± 2.2 ppb). Markers of oxidative stress in exhaled breath condensate, such as hydrogen peroxide and 8-isoprostane, were also discriminatory. Two breathomic studies have isolated discriminative compounds using mass spectrometry. There was a lack of studies assessing relevant treatment and none assessed differences in diagnostic subgroups. CONCLUSIONS Evidence suggests CalvNO is higher in IPF, although studies were limited by small sample size. Further breathomic work may identify biomarkers with diagnostic and prognostic potential.
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Affiliation(s)
- Conal Hayton
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK.
| | | | - Andrew M Wilson
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Nazia Chaudhuri
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Colm Leonard
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Stephen J Fowler
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK
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11
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Brusselmans L, Arnouts L, Millevert C, Vandersnickt J, van Meerbeeck JP, Lamote K. Breath analysis as a diagnostic and screening tool for malignant pleural mesothelioma: a systematic review. Transl Lung Cancer Res 2018; 7:520-536. [PMID: 30450290 PMCID: PMC6204411 DOI: 10.21037/tlcr.2018.04.09] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/10/2018] [Indexed: 12/14/2022]
Abstract
Malignant pleural mesothelioma (MPM) is a tumour related to a historical exposure to asbestos fibres. Currently, the definite diagnosis is made only by the histological examination of a biopsy obtained through an invasive thoracoscopy. However, diagnosis is made too late for curative treatment because of non-specific symptoms mainly appearing at advanced stage disease. Hence, due to its biologic aggressiveness and the late diagnosis, survival rate is low and the patients' outcome poor. In addition, radiological imaging, like computed tomographic scans, and blood biomarkers are found not to be sensitive enough to be used as an early diagnostic tool. Detection in an early stage is assumed to improve the patients' outcome but is hampered due to non-specific and late symptomology. Hence, there is a need for a new screening and diagnostic test which could improve the patients' outcome. Despite extensive research has focused on blood biomarkers, not a single has been shown clinically useful, and therefore research recently shifted to "breathomics" techniques to recognize specific volatile organic compounds (VOCs) in the breath of the patient as potential non-invasive biomarkers for disease. In this review, we summarize the acquired knowledge about using breath analysis for diagnosing and monitoring MPM and asbestos-related disorders (ARD). Gas chromatography-mass spectrometry (GC-MS), the gold standard of breath analysis, appears to be the method with the highest accuracy (97%) to differentiate MPM patients from at risk asbestos-exposed subjects. There have already been found some interesting biomarkers that are significantly elevated in asbestosis (NO, 8-isoprostane, leukotriene B4, α-Pinene…) and MPM (cyclohexane) patients. Regrettably, the different techniques and the plethora of studies suffer some limitations. Most studies are pilot studies with the inclusion of a limited number of patients. Nevertheless, given the promising results and easy sampling methods, we can conclude that breath analysis may become a useful tool in the future to screen for MPM, but further research is warranted.
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Affiliation(s)
- Lisa Brusselmans
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
| | - Lieselot Arnouts
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
| | - Charissa Millevert
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
| | - Joyce Vandersnickt
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
| | - Jan P. van Meerbeeck
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
- Internal Medicine, Ghent University, Ghent, Belgium
- Department of Pneumology, Antwerp University Hospital, Edegem, Belgium
| | - Kevin Lamote
- Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium
- Internal Medicine, Ghent University, Ghent, Belgium
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12
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Chen H, Li J, Zhang X, Li X, Yao M, Zheng G. Automated in Vivo Nanosensing of Breath-Borne Protein Biomarkers. NANO LETTERS 2018; 18:4716-4726. [PMID: 29995423 DOI: 10.1021/acs.nanolett.8b01070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Toxicology and bedside medical condition monitoring is often desired to be both ultrasensitive and noninvasive. However, current biomarker analyses for these purposes are mostly offline and fail to detect low marker quantities. Here, we report a system called dLABer (detection of living animal's exhaled breath biomarker) that integrates living rats, breath sampling, microfluidics, and biosensors for the automated tracking of breath-borne biomarkers. Our data show that dLABer could selectively detect (online) and report differences (of up to 103-fold) in the levels of inflammation agent interleukin-6 (IL-6) exhaled by rats injected with different ambient particulate matter (PM). The dLABer system was further shown to have an up to 104 higher signal-to-noise ratio than that of the enzyme-linked immunosorbent assay (ELISA) when analyzing the same breath samples. In addition, both blood-borne IL-6 levels analyzed via ELISA in rats injected with different PM extracts and PM toxicity determined by a dithiothreitol (DTT) assay agreed well with those determined by the dLABer system. Video recordings further verified that rats exposed to PM with higher toxicity (according to a DTT assay and as revealed by dLABer) appeared to be less physically active. All the data presented here suggest that the dLABer system is capable of real-time, noninvasive monitoring of breath-borne biomarkers with ultrasensitivity. The dLABer system is expected to revolutionize pollutant health effect studies and bedside disease diagnosis as well as physiological condition monitoring at the single-protein level.
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Affiliation(s)
- Haoxuan Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering , Peking University , Beijing 100871 , China
| | - Jing Li
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering , Peking University , Beijing 100871 , China
| | - Xiangyu Zhang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering , Peking University , Beijing 100871 , China
| | - Xinyue Li
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering , Peking University , Beijing 100871 , China
| | - Maosheng Yao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering , Peking University , Beijing 100871 , China
| | - Gengfeng Zheng
- Laboratory of Advanced Materials, Department of Chemistry and State Key Laboratory of Medical Neurobiology , Fudan University , Shanghai 200438 , China
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Synthetic Lignan Secoisolariciresinol Diglucoside (LGM2605) Reduces Asbestos-Induced Cytotoxicity in an Nrf2-Dependent and -Independent Manner. Antioxidants (Basel) 2018; 7:antiox7030038. [PMID: 29498660 PMCID: PMC5874524 DOI: 10.3390/antiox7030038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/22/2018] [Accepted: 02/27/2018] [Indexed: 12/16/2022] Open
Abstract
Asbestos exposure triggers inflammatory processes associated with oxidative stress and tissue damage linked to malignancy. LGM2605 is the synthetic lignan secoisolariciresinol diglucoside (SDG) with free radical scavenging, antioxidant, and anti-inflammatory properties in diverse inflammatory cell and mouse models, including exposure to asbestos fibers. Nuclear factor-E2 related factor 2 (Nrf2) activation and boosting of endogenous tissue defenses were associated with the protective action of LGM2605 from asbestos-induced cellular damage. To elucidate the role of Nrf2 induction by LGM2605 in protection from asbestos-induced cellular damage, we evaluated LGM2605 in asbestos-exposed macrophages from wild-type (WT) and Nrf2 disrupted (Nrf2−/−) mice. Cells were pretreated with LGM2605 (50 µM and 100 µM) and exposed to asbestos fibers (20 µg/cm2) and evaluated 8 h and 24 h later for inflammasome activation, secreted cytokine levels (interleukin-1β (IL-1β), interleukin-18 (IL-18), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFα)), cytotoxicity and cell death, nitrosative stress, and Nrf2-regulated enzyme levels. Asbestos exposure induced robust oxidative and nitrosative stress, cell death and cytotoxicity, which were equally mitigated by LGM2605. Inflammasome activation was significantly attenuated in Nrf2−/− macrophages compared to WT, and the protective action of LGM2605 was seen only in WT cells. In conclusion, in a cell model of asbestos-induced toxicity, LGM2605 acts via protective mechanisms that may not involve Nrf2 activation.
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Karvonen T, Kankaanranta H, Saarelainen S, Moilanen E, Lehtimäki L. Comparison of feasibility and estimates of central and peripheral nitric oxide parameters by different mathematical models. J Breath Res 2017; 11:047102. [DOI: 10.1088/1752-7163/aa7cc0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Glycoprotein YKL-40 Levels in Plasma Are Associated with Fibrotic Changes on HRCT in Asbestos-Exposed Subjects. Mediators Inflamm 2017; 2017:1797512. [PMID: 28588347 PMCID: PMC5446868 DOI: 10.1155/2017/1797512] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 04/05/2017] [Accepted: 04/12/2017] [Indexed: 01/28/2023] Open
Abstract
YKL-40 is a chitinase-like glycoprotein produced by alternatively activated macrophages that are associated with wound healing and fibrosis. Asbestosis is a chronic asbestos-induced lung disease, in which injury of epithelial cells and activation of alveolar macrophages lead to enhanced collagen production and fibrosis. We studied if YKL-40 is related to inflammation, fibrosis, and/or lung function in subjects exposed to asbestosis. Venous blood samples were collected from 85 men with moderate or heavy occupational asbestos exposure and from 28 healthy, age-matched controls. Levels of plasma YKL-40, CRP, IL-6, adipsin, and MMP-9 were measured with enzyme-linked immunosorbent assay (ELISA). Plasma YKL-40 levels were significantly higher in subjects with asbestosis (n = 19) than in those with no fibrotic findings in HRCT following asbestos exposure (n = 66) or in unexposed healthy controls. In asbestos-exposed subjects, plasma YKL-40 correlated negatively with lung function capacity parameters FVC (Pearson's r −0.259, p = 0.018) and FEV1 (Pearson's r −0.240, p = 0.028) and positively with CRP (Spearman's rho 0.371, p < 0.001), IL-6 (Spearman's rho 0.314, p = 0.003), adipsin (Spearman's rho 0.459, p < 0.001), and MMP-9 (Spearman's rho 0.243, p = 0.025). The present finding suggests YKL-40 as a biomarker associated with fibrosis and inflammation in asbestos-exposed subjects.
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van 't Erve TJ, Kadiiska MB, London SJ, Mason RP. Classifying oxidative stress by F 2-isoprostane levels across human diseases: A meta-analysis. Redox Biol 2017; 12:582-599. [PMID: 28391180 PMCID: PMC5384299 DOI: 10.1016/j.redox.2017.03.024] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 02/07/2023] Open
Abstract
The notion that oxidative stress plays a role in virtually every human disease and environmental exposure has become ingrained in everyday knowledge. However, mounting evidence regarding the lack of specificity of biomarkers traditionally used as indicators of oxidative stress in human disease and exposures now necessitates re-evaluation. To prioritize these re-evaluations, published literature was comprehensively analyzed in a meta-analysis to quantitatively classify the levels of systemic oxidative damage across human disease and in response to environmental exposures. In this meta-analysis, the F2-isoprostane, 8-iso-PGF2α, was specifically chosen as the representative marker of oxidative damage. To combine published values across measurement methods and specimens, the standardized mean differences (Hedges’ g) in 8-iso-PGF2α levels between affected and control populations were calculated. The meta-analysis resulted in a classification of oxidative damage levels as measured by 8-iso-PGF2α across 50 human health outcomes and exposures from 242 distinct publications. Relatively small increases in 8-iso-PGF2α levels (g<0.8) were found in the following conditions: hypertension (g=0.4), metabolic syndrome (g=0.5), asthma (g=0.4), and tobacco smoking (g=0.7). In contrast, large increases in 8-iso-PGF2α levels were observed in pathologies of the kidney, e.g., chronic renal insufficiency (g=1.9), obstructive sleep apnoea (g=1.1), and pre-eclampsia (g=1.1), as well as respiratory tract disorders, e.g., cystic fibrosis (g=2.3). In conclusion, we have established a quantitative classification for the level of 8-iso-PGF2α generation in different human pathologies and exposures based on a comprehensive meta-analysis of published data. This analysis provides knowledge on the true involvement of oxidative damage across human health outcomes as well as utilizes past research to prioritize those conditions requiring further scrutiny on the mechanisms of biomarker generation. Oxidative damage is highly variable in human conditions as measured by F2-isoprostanes. Respiratory tract and urogenital diseases have the highest F2-isoprostanes. Cancer and cardiovascular diseases have surprisingly low F2-isoprostanes.
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Affiliation(s)
- Thomas J van 't Erve
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, 27709 NC, USA.
| | - Maria B Kadiiska
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, 27709 NC, USA
| | - Stephanie J London
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, 27709 NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, 27709 NC, USA
| | - Ronald P Mason
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, 27709 NC, USA
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Pelclova D, Zdimal V, Kacer P, Komarc M, Fenclova Z, Vlckova S, Zikova N, Schwarz J, Makes O, Navratil T, Zakharov S, Bello D. Markers of lipid oxidative damage among office workers exposed intermittently to air pollutants including nanoTiO2 particles. REVIEWS ON ENVIRONMENTAL HEALTH 2017; 32:193-200. [PMID: 27754970 DOI: 10.1515/reveh-2016-0030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 09/13/2016] [Indexed: 06/06/2023]
Abstract
Nanoscale titanium dioxide (nanoTiO2) is a commercially important nanomaterial used in numerous applications. Experimental studies with nanotitania have documented lung injury and inflammation, oxidative stress, and genotoxicity. Production workers in TiO2 manufacturing with a high proportion of nanoparticles and a mixture of other air pollutants, such as gases and organic aerosols, had increased markers of oxidative stress, including DNA and protein damage, as well as lipid peroxidation in their exhaled breath condensate (EBC) compared to unexposed controls. Office workers were observed to get intermittent exposures to nanoTiO2 during their process monitoring. The aim of this study was to investigate the impact of such short-term exposures on the markers of health effects in office workers relative to production workers from the same factory. Twenty-two office employees were examined. They were occupationally exposed to (nano)TiO2 aerosol during their daily visits of the production area for an average of 14±9 min/day. Median particle number concentration in office workers while in the production area was 2.32×104/cm3. About 80% of the particles were <100 nm in diameter. A panel of biomarkers of lipid oxidation, specifically malondialdehyde (MDA), 4-hydroxy-trans-hexenal (HHE), 4-hydroxy-trans-nonenal (HNE), 8-isoprostaglandin F2α (8-isoprostane), and aldehydes C6-C12, were studied in the EBC and urine of office workers and 14 unexposed controls. Nine markers of lipid oxidation were elevated in the EBC of office employees relative to controls (p<0.05); only 8-isoprostane and C11 were not increased. Significant association was found in the multivariate analysis between their employment in the TiO2 production plant and EBC markers of lipid oxidation. No association was seen with age, lifestyle factors, or environmental air contamination. The EBC markers in office employees reached about 50% of the levels measured in production workers, and the difference between production workers and office employees was highly significant (p<0.001). None of these biomarkers were elevated in urine. The approach presented here seems to be very sensitive and useful for non-invasive monitoring of employees exposed to air pollutants, including gases, organic aerosols, and nanoTiO2, and may prove useful for routine biomonitoring purposes. Among them, aldehydes C6, C8, C9, and C10 appear to be the most sensitive markers of lipid oxidation in similar occupational cohorts. One major challenge with sensitive biomonitoring techniques, however, is their non-specificity and difficulty in interpreting the meaning of their physiological values in the context of chronic disease development and damage-repair kinetics.
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Högman M, Lehtimäki L, Dinh-Xuan AT. Utilising exhaled nitric oxide information to enhance diagnosis and therapy of respiratory disease - current evidence for clinical practice and proposals to improve the methodology. Expert Rev Respir Med 2017; 11:101-109. [PMID: 28076986 DOI: 10.1080/17476348.2017.1281746] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION A non-invasive tool to diagnose respiratory diseases and to follow treatment has long been looked-for. Exhaled nitric oxide (NO) is a promising marker of inflammation in asthma but nearly 25-years of research has shown that it works in only certain endotypes of asthma. The modelling of NO dynamics of the lung can give more information than a single FENO value. Areas covered: The estimation of the NO production in the conducting airways and in the gas exchange area has given new insight of the NO production in diseases beyond asthma. In this article, we discuss the importance of methodology for NO measurement in the exhaled breath and the indication of applying this technique to detect respiratory disorders. This narrative review is an attempt to examine and discuss the physiological basis underlying exhaled NO measurements and the clinical evidence of the usefulness of this method in asthma and various other respiratory disorders. Expert commentary: Estimation of the NO parameters would aid in our understanding of the NO dynamics of the lung and thereby give more knowledge how to interpret the measured FENO value in clinical practice.
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Affiliation(s)
- Marieann Högman
- a Department of Medical Sciences, Lung- Allergy- and Sleep Research , Uppsala University , Uppsala , Sweden
| | - Lauri Lehtimäki
- b Allergy Centre , Tampere University Hospital , Tampere , Finland.,c Medical School , University of Tampere , Tampere , Finland
| | - Anh Tuan Dinh-Xuan
- d Department of Respiratory Physiology , Cochin Hospital & Paris Descartes University , Paris , France
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Pelclova D, Zdimal V, Kacer P, Fenclova Z, Vlckova S, Komarc M, Navratil T, Schwarz J, Zikova N, Makes O, Syslova K, Belacek J, Zakharov S. Leukotrienes in exhaled breath condensate and fractional exhaled nitric oxide in workers exposed to TiO
2
nanoparticles. J Breath Res 2016; 10:036004. [DOI: 10.1088/1752-7155/10/3/036004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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20
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Smith KF, Quinn RL, Rahilly LJ. Biomarkers for differentiation of causes of respiratory distress in dogs and cats: Part 2--Lower airway, thromboembolic, and inflammatory diseases. J Vet Emerg Crit Care (San Antonio) 2016; 25:330-48. [PMID: 26040815 DOI: 10.1111/vec.12317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 03/22/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To review the current veterinary and relevant human literature regarding biomarkers of respiratory diseases leading to dyspnea and to summarize the availability, feasibility, and practicality of using respiratory biomarkers in the veterinary setting. DATA SOURCES Veterinary and human medical literature: original research articles, scientific reviews, consensus statements, and recent textbooks. HUMAN DATA SYNTHESIS Numerous biomarkers have been evaluated in people for discriminating respiratory disease processes with varying degrees of success. VETERINARY DATA SYNTHESIS Although biomarkers should not dictate clinical decisions in lieu of gold standard diagnostics, their use may be useful in directing care in the stabilization process. Serum immunoglobulins have shown promise as an indicator of asthma in cats. A group of biomarkers has also been evaluated in exhaled breath. Of these, hydrogen peroxide has shown the most potential as a marker of inflammation in asthma and potentially aspiration pneumonia, but methods for measurement are not standardized. D-dimers may be useful in screening for thromboembolic disease in dogs. There are a variety of markers of inflammation and oxidative stress, which are being evaluated for their ability to assess the severity and type of underlying disease process. Of these, amino terminal pro-C-type natriuretic peptide may be the most useful in determining if antibiotic therapy is warranted. Although critically evaluated for their use in respiratory disorders, many of the biomarkers which have been evaluated have been found to be affected by more than one type of respiratory or systemic disease. CONCLUSION At this time, there are point-of-care biomarkers that have been shown to reliably differentiate between causes of dyspnea in dogs and cats. Future clinical research is warranted to understand of how various diseases affect the biomarkers and more bedside tests for their utilization.
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Bioanalytical techniques for detecting biomarkers of response to human asbestos exposure. Bioanalysis 2016; 7:1157-73. [PMID: 26039812 DOI: 10.4155/bio.15.53] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Asbestos exposure is known to cause lung cancer and mesothelioma and its health and economic impacts have been well documented. The exceptionally long latency periods of most asbestos-related diseases have hampered preventative and precautionary steps thus far. We aimed to summarize the state of knowledge on biomarkers of response to asbestos exposure. Asbestos is not present in human biological fluids; rather it is inhaled and trapped in lung tissue. Biomarkers of response, which reflect a change in biologic function in response to asbestos exposure, are analyzed. Several classes of molecules have been studied and evaluated for their potential utility as biomarkers of asbestos exposure. These studies range from small molecule oxidative stress biomarkers to proteins involved in immune responses.
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Abstract
OBJECTIVE To assess whether cumulative dust exposure in foundry work is associated with airway inflammation measured by the analysis of fractionated exhaled nitric oxide (NO) concentration, or by inflammatory markers in exhaled breath condensate or serum. METHODS We examined 476 dust-exposed and nonexposed foundry workers, and assessed the individual cumulative exposure to dusts and respirable quartz. Bronchial and alveolar NO production and inflammatory markers in exhaled breath condensate and in serum samples were also analyzed. RESULTS After adjusting for pack-years of smoking, increased levels of alveolar NO, serum C-reactive protein, and interleukin-8 were associated with a higher level of cumulative exposure to dust. The referents had higher serum myeloperoxidase levels, bronchial NO output, and 8-isoprostane levels in exhaled breath condensate than in the dust-exposed groups. CONCLUSIONS Dust exposure in foundry work may induce both systemic and alveolar inflammation.
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Xu J, Alexander DB, Iigo M, Hamano H, Takahashi S, Yokoyama T, Kato M, Usami I, Tokuyama T, Tsutsumi M, Tamura M, Oguri T, Niimi A, Hayashi Y, Yokoyama Y, Tonegawa K, Fukamachi K, Futakuchi M, Sakai Y, Suzui M, Kamijima M, Hisanaga N, Omori T, Nakae D, Hirose A, Kanno J, Tsuda H. Chemokine (C-C motif) ligand 3 detection in the serum of persons exposed to asbestos: A patient-based study. Cancer Sci 2015; 106:825-32. [PMID: 25940505 PMCID: PMC4520633 DOI: 10.1111/cas.12687] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/14/2015] [Accepted: 04/27/2015] [Indexed: 12/11/2022] Open
Abstract
Exposure to asbestos results in serious risk of developing lung and mesothelial diseases. Currently, there are no biomarkers that can be used to diagnose asbestos exposure. The purpose of the present study was to determine whether the levels or detection rate of chemokine (C-C motif) ligand 3 (CCL3) in the serum are elevated in persons exposed to asbestos. The primary study group consisted of 76 healthy subjects not exposed to asbestos and 172 healthy subjects possibly exposed to asbestos. The secondary study group consisted of 535 subjects possibly exposed to asbestos and diagnosed with pleural plaque (412), benign hydrothorax (10), asbestosis (86), lung cancer (17), and malignant mesothelioma (10). All study subjects who were possibly exposed to asbestos had a certificate of asbestos exposure issued by the Japanese Ministry of Health, Labour and Welfare. For the primary study group, levels of serum CCL3 did not differ between the two groups. However, the detection rate of CCL3 in the serum of healthy subjects possibly exposed to asbestos (30.2%) was significantly higher (P < 0.001) than for the control group (6.6%). The pleural plaque, benign hydrothorax, asbestosis, and lung cancer groups had serum CCL3 levels and detection rates similar to that of healthy subjects possibly exposed to asbestos. The CCL3 chemokine was detected in the serum of 9 of the 10 patients diagnosed with malignant mesothelioma. Three of the patients with malignant mesothelioma had exceptionally high CCL3 levels. Malignant mesothelioma cells from four biopsy cases and an autopsy case were positive for CCL3, possibly identifying the source of the CCL3 in the three malignant mesothelioma patients with exceptionally high serum CCL3 levels. In conclusion, a significantly higher percentage of healthy persons possibly exposed to asbestos had detectable levels of serum CCL3 compared to healthy unexposed control subjects.
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Affiliation(s)
- Jiegou Xu
- Nanotoxicology Project, Nagoya City University, Nagoya, Japan.,Department of Immunology, College of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | | | - Masaaki Iigo
- Nanotoxicology Project, Nagoya City University, Nagoya, Japan
| | - Hirokazu Hamano
- Nutritional Science Institute, Morinaga Milk Industry Co., Ltd., Zama, Japan
| | - Satoru Takahashi
- Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takako Yokoyama
- Department of Respiratory Medicine, Asahi Rosai Hospital, Owariasahi, Japan
| | - Munehiro Kato
- Department of Respiratory Medicine, Asahi Rosai Hospital, Owariasahi, Japan
| | - Ikuji Usami
- Department of Respiratory Medicine, Asahi Rosai Hospital, Owariasahi, Japan
| | - Takeshi Tokuyama
- Department of Internal Medicine, Saiseikai Chuwa Hospital, Sakura, Japan
| | | | - Mouka Tamura
- Department of Internal Medicine, Nara Medical Center, National Hospital Organization, Nara, Japan
| | - Tetsuya Oguri
- Diivision of Respiratory Medicine, Allergy and Rheumatology, Nagoya City University Hospital, Nagoya, Japan
| | - Akio Niimi
- Diivision of Respiratory Medicine, Allergy and Rheumatology, Nagoya City University Hospital, Nagoya, Japan
| | - Yoshimitsu Hayashi
- Department of Medicine, Nagoya-Shi Koseiin Medical Welfare Center, Nagoya, Japan
| | - Yoshifumi Yokoyama
- Department of Medicine, Nagoya-Shi Koseiin Medical Welfare Center, Nagoya, Japan
| | - Ken Tonegawa
- Department of Physical Medicine and Rehabilitation, Nagoya-Shi Koseiin Medical Welfare Center, Nagoya, Japan
| | - Katsumi Fukamachi
- Department of Molecular Toxicology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mitsuru Futakuchi
- Department of Molecular Toxicology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuto Sakai
- Department of Molecular Toxicology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masumi Suzui
- Department of Molecular Toxicology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Naomi Hisanaga
- Center for Campus Health and Environment, Aichi University of Education, Kariya, Japan
| | - Toyonori Omori
- Department of Health Care Policy and Management, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Dai Nakae
- Department of Nutritional Science and Food Safety, Faculty of Applied Biosciences, Tokyo University of Agriculture, Tokyo, Japan
| | - Akihiko Hirose
- Division of Risk Assessment, Biological Safety Research Center, Biological Safety Research Center, National Institute of Health Sciences, Tokyo, Japan
| | - Jun Kanno
- Division of Cellular and Molecular Toxicology, Biological Safety Research Center, National Institute of Health Sciences, Tokyo, Japan
| | - Hiroyuki Tsuda
- Nanotoxicology Project, Nagoya City University, Nagoya, Japan
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Modig L, Dahgam S, Olsson D, Nyberg F, Wass K, Forsberg B, Olin AC. Short-term exposure to ozone and levels of exhaled nitric oxide. Epidemiology 2014; 25:79-87. [PMID: 24213146 DOI: 10.1097/ede.0000000000000002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adverse effects of air pollution include respiratory inflammation. A few epidemiologic studies have shown elevations in the fraction of exhaled nitric oxide, a marker of airway inflammation, after exposure to traffic-related pollutants. METHODS We examined whether short-term exposures to ozone (O3), oxides of nitrogen (NOx), or particulate matter <10 μm (PM10) were associated with proximal and distal airway inflammation. The study included 5841 randomly selected Swedish adults from 25 to 75 years of age. Fraction of exhaled nitrogen was measured at two flow rates: 50 ml/s representing the proximal airways and 270 ml/s representing the distal airways. Air pollution data were obtained from an urban monitoring site. We applied linear regression to estimate short-term associations of O3, NOx, and PM10 with fractions of exhaled NO at 50 and 270 ml/s. RESULTS An interquartile range increase in 120-hour average O3 levels was associated with a 5.1% (95% confidence interval = 1.7% to 8.5%) higher level of fraction of exhaled NO at 270 ml/s and 3.6% (-0.4% to 3.4%) higher level of the fraction of exhaled NO at 50 ml/s. For NOx, a small effect was seen for the 24-hour average on the fraction of exhaled NO at 270 ml/s, while for PM10 no clear effects were seen. There was a tendency for a weaker effect of ozone and a stronger effect of NOx in subjects with asthma. CONCLUSIONS Exposure to O3 was associated with a marker of distal airway inflammation, while the association was less obvious for inflammation of the proximal airways.
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Affiliation(s)
- Lars Modig
- From the aOccupational and Environmental Medicine, Department of Public Health and Clinical Medicine, University of Umeå, Umeå, Sweden; bOccupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; and cAstraZeneca R&D, Mölndal, Sweden
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Lamote K, Nackaerts K, van Meerbeeck JP. Strengths, weaknesses, and opportunities of diagnostic breathomics in pleural mesothelioma-a hypothesis. Cancer Epidemiol Biomarkers Prev 2014; 23:898-908. [PMID: 24706728 DOI: 10.1158/1055-9965.epi-13-0737] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Past and present asbestos use will reflect in increasing numbers of mesothelioma cases in the next decades, diagnosed at a late stage and with a dismal prognosis. This stresses the need for early detection tools, which could improve patients' survival. Recently, breath analysis as a noninvasive and fast diagnostic tool has found its way into biomedical research. High-throughput breathomics uses spectrometric, chromatographic, and sensor techniques to diagnose asbestos-related pulmonary diseases based upon volatile organic compounds (VOC) in breath. This article reviews the state-of-the-art available breath analyzing techniques and provides the insight in the current use of VOCs as early diagnostic or prognostic biomarkers of mesothelioma to stimulate further research in this field. Cancer Epidemiol Biomarkers Prev; 23(6); 898-908. ©2014 AACR.
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Affiliation(s)
- Kevin Lamote
- Authors' Affiliations: Department of Respiratory Medicine, Ghent University Hospital, Ghent; Department of Internal Medicine, Ghent University, Ghent; Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven; and Thoracic Oncology/MOCA, Antwerp University Hospital, Edegem, BelgiumAuthors' Affiliations: Department of Respiratory Medicine, Ghent University Hospital, Ghent; Department of Internal Medicine, Ghent University, Ghent; Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven; and Thoracic Oncology/MOCA, Antwerp University Hospital, Edegem, Belgium
| | - Kristiaan Nackaerts
- Authors' Affiliations: Department of Respiratory Medicine, Ghent University Hospital, Ghent; Department of Internal Medicine, Ghent University, Ghent; Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven; and Thoracic Oncology/MOCA, Antwerp University Hospital, Edegem, Belgium
| | - Jan P van Meerbeeck
- Authors' Affiliations: Department of Respiratory Medicine, Ghent University Hospital, Ghent; Department of Internal Medicine, Ghent University, Ghent; Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven; and Thoracic Oncology/MOCA, Antwerp University Hospital, Edegem, BelgiumAuthors' Affiliations: Department of Respiratory Medicine, Ghent University Hospital, Ghent; Department of Internal Medicine, Ghent University, Ghent; Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven; and Thoracic Oncology/MOCA, Antwerp University Hospital, Edegem, Belgium
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Hiraku Y, Sakai K, Shibata E, Kamijima M, Hisanaga N, Ma N, Kawanishi S, Murata M. Formation of the nitrative DNA lesion 8-nitroguanine is associated with asbestos contents in human lung tissues: a pilot study. J Occup Health 2014; 56:186-96. [PMID: 24598051 DOI: 10.1539/joh.13-0231-oa] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Asbestos causes lung cancer and malignant mesothelioma, and chronic inflammation is considered to participate in carcinogenesis. However, biomarkers to evaluate its carcinogenic risk have not been established. Reactive oxygen/nitrogen species are generated in biological systems under inflammatory conditions and may contribute to carcinogenesis by causing DNA damage. In this study, we examined the relationship between the formation of 8-nitroguanine (8-nitroG), a mutagenic DNA lesion formed during inflammation, and asbestos contents in human lung tissues. METHODS We obtained non-tumor lung tissues from patients with (n=15) and without mesothelioma (n=21). The expression of 8-nitroG and related molecules was examined by immunohistochemistry, and their staining intensities were semiquantitatively evaluated. Asbestos contents in lung tissues were analyzed by analytical transmission electron microscopy. RESULTS In subjects without mesothelioma, staining intensities of 8-nitroG and apurinic/apyrimidinic endonuclease 1 (APE1) were significantly correlated with total asbestos and amphibole contents (p<0.05), but not with chrysotile content. In mesothelioma patients, their staining intensities were not correlated with asbestos contents. The double immunofluorescence technique revealed that APE1 was expressed in 8-nitroG-positive cells, suggesting that abasic sites were formed possibly due to the removal of 8-nitroG. The staining intensities of 8-oxo-7,8-dihydro-2'-deoxyguanosine, an oxidative DNA lesion, and its repair enzyme 8-oxoguanine DNA-glycosylase were correlated with age (p<0.05), but not with asbestos contents in subjects without mesothelioma. CONCLUSIONS This is the first study to demonstrate that 8-nitroG formation is associated with asbestos contents in human lung tissues. This finding raises a possibility that 8-nitroG serves as a biomarker that can be used to evaluate asbestos exposure and carcinogenic risk.
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Affiliation(s)
- Yusuke Hiraku
- Department of Environmental and Molecular Medicine, Mie University Graduate School of Medicine
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Scott JP, Peters-Golden M. Antileukotriene agents for the treatment of lung disease. Am J Respir Crit Care Med 2013; 188:538-44. [PMID: 23822826 DOI: 10.1164/rccm.201301-0023pp] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Leukotrienes (LTs) C4, D4, and E4, collectively termed cysteinyl LTs (cysLTs), are lipid mediators formed by the 5-lipoxygenase (5-LO) pathway of arachidonic acid metabolism. Originally recognized for their potent bronchoconstrictor actions, they were subsequently determined also to promote inflammation, microvascular permeability, and mucus secretion. These actions that are so central to asthma pathophysiology are mediated to a significant extent by ligation of the cysLT receptor 1 (CysLT1). Antagonism of CysLT1 and inhibition of 5-LO have both been shown to have clinical use in the management of asthma, but substantial interindividual heterogeneity is observed in the response to these agents. In this article, we review the biologic actions of LTs, their biosynthetic pathways and cognate receptors, the pharmacology of available anti-LT agents, and the clinical evidence for the use of anti-LT agents as monotherapy and combination therapy in asthma. We also consider heterogeneity of response, the possible roles of cysLT receptors other than CysLT1, the role of another class of LT, LTB4, and the potential role of LTs in lung diseases other than asthma.
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Affiliation(s)
- Jacob P Scott
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, USA
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Breath tests in respiratory and critical care medicine: from research to practice in current perspectives. BIOMED RESEARCH INTERNATIONAL 2013; 2013:702896. [PMID: 24151617 PMCID: PMC3789325 DOI: 10.1155/2013/702896] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 08/12/2013] [Accepted: 08/14/2013] [Indexed: 12/15/2022]
Abstract
Today, exhaled nitric oxide has been studied the most, and most researches have now focused on asthma. More than a thousand different volatile organic compounds have been observed in low concentrations in normal human breath. Alkanes and methylalkanes, the majority of breath volatile organic compounds, have been increasingly used by physicians as a novel method to diagnose many diseases without discomforts of invasive procedures. None of the individual exhaled volatile organic compound alone is specific for disease. Exhaled breath analysis techniques may be available to diagnose and monitor the diseases in home setting when their sensitivity and specificity are improved in the future.
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Leivo-Korpela S, Lehtimäki L, Nieminen R, Oksa P, Vierikko T, Järvenpää R, Uitti J, Moilanen E. Adipokine adipsin is associated with the degree of lung fibrosis in asbestos-exposed workers. Respir Med 2012; 106:1435-40. [PMID: 22832039 DOI: 10.1016/j.rmed.2012.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 06/28/2012] [Accepted: 07/02/2012] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Asbestos-exposure causes an inflammatory response driven by alveolar macrophages that can lead to pulmonary fibrosis. In addition to classical inflammatory cytokines, macrophages produce adipokines which regulate the inflammatory response. We studied if adipokines are related to the degree of parenchymal fibrosis, impaired lung function and inflammation in asbestos-exposed subjects. METHODS Eighty-five males with moderate to heavy occupational exposure to asbestos and unexposed controls were studied. We measured plasma levels of adipokines adiponectin, adipsin, leptin and resistin, IL-6, IL-8, erythrocyte sedimentation rate (ERS), spirometry and D(L,CO). Degree of interstitial lung fibrosis (septal thickening, subpleural lines, parenchymal bands or honeycombing) was scored in classes 0-5 according to a validated scoring system. The subjects were divided into three groups: normal parenchymal finding (fibrosis class 0), borderline changes (classes 0.5-1.5) and fibrosis (i.e. asbestosis; classes 2-5). RESULTS Adipsin correlated positively with parenchymal fibrosis (rho=0.412, p<0.001) and there was a linear increasing trend of mean plasma adipsin levels among the three groups of asbestos-exposed subjects (from normal parenchymal finding to borderline changes and to fibrosis) (p<0.0001). Accordingly, plasma adipsin levels correlated positively with the extent of pleural plaques (r=0.245, p=0.043), and negatively with D(L,CO) (r=-0.246, p=0.023). Also, a positive correlation was found between adipsin and inflammatory markers ESR (r=0.315, p=0.008) and IL-6 (r=0.256, p=0.018). CONCLUSIONS Adipsin was associated with the degree of parenchymal fibrosis, impairment of pulmonary diffusing capacity and with inflammatory activity in asbestos-exposed subjects suggesting that adipsin may have a role in the pathogenesis or as a biomarker in asbestos-induced lung disease.
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Affiliation(s)
- Sirpa Leivo-Korpela
- Department of Respiratory Medicine, Tampere University Hospital, PL 2000, 33521 Tampere, Finland.
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Pelclová D, Fenclová Z, Vlcková S, Lebedová J, Syslová K, Pecha O, Belácek J, Navrátil T, Kuzma M, Kacer P. Leukotrienes B4, C4, D4 and E4 in the exhaled breath condensate (EBC), blood and urine in patients with pneumoconiosis. INDUSTRIAL HEALTH 2012; 50:299-306. [PMID: 22785421 DOI: 10.2486/indhealth.ms1274] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Leukotrienes (LTs) are involved in the pathogenesis of lung fibrosis and were increased in exhaled breath condensate (EBC) of the patients with pneumoconiosis. However the possible influence of extra-pulmonary disorders on the EBC markers is not known. Therefore in parallel with EBC, LTs' levels in the plasma and urine were measured in patients with pneumoconiosis (45 × asbestos exposure, 37 × silica exposure) and in 27 controls. Individual LTs B4, C4, D4 and E4 were measured by liquid chromatography - electrospray ionization - tandem mass spectrometry (LC-ESI-MS/MS). In EBC, LT D4 and LT E4 were increased in both groups of patients (p<0.001 and p<0.05), comparing with the controls. Both LT B4 and cysteinyl LTs were elevated in asbestos-exposed subjects (p<0.05). Asbestosis with more severe radiological signs (s1/s2-t3/u2) and lung functions impairment has shown higher cysteinyl LTs and LT C4 in the EBC (p<0.05) than mild asbestosis (s1/s0-s1/s1). In addition, in the subjects with asbestosis, cysteinyl LTs in EBC correlated with TLC (-0.313, p<0.05) and TLCO/Hb (-0.307, p<0.05), and LT C4 with TLC (-0.358, p<0.05). In pneumoconioses, EBC appears the most useful from the 3 fluids studied.
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Affiliation(s)
- Daniela Pelclová
- Department of Occupational Medicine of the 1st Faculty of Medicine, Charles University in Prague, Czech Republic.
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Linkosalo L, Lehtimäki L, Holm K, Kaila M, Moilanen E. Relation of bronchial and alveolar nitric oxide to exercise-induced bronchoconstriction in atopic children and adolescents. Pediatr Allergy Immunol 2012; 23:360-6. [PMID: 22145648 DOI: 10.1111/j.1399-3038.2011.01223.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Exercise challenge test is widely used in diagnostics and follow-up of childhood asthma, but the method is complex, time consuming, and expensive. In this study, we aimed to find out whether flow-independent nitric oxide (NO) parameters (bronchial NO flux [J'aw(NO)] and alveolar NO concentration [CA(NO)]) predict exercise-induced bronchoconstriction (EIB) in atopic children and adolescents with asthma-like symptoms. Also, the respective NO parameters corrected for axial backward diffusion (J'aw(NO) [TMAD] and CA(NO) [TMAD]) were calculated and included in the analysis. METHODS Thirty patients (6-19 yr old) with confirmed atopy (positive skin prick tests or allergen-specific IgE) and asthma-like respiratory symptoms were included in the study. Before the current investigations, none of the patients had been diagnosed to have asthma and none were on inhaled corticosteroids. Exhaled NO was measured at multiple exhalation flow rates, and exercise challenge test was carried out. Bronchial NO flux and alveolar NO concentration were calculated according to the linear method with and without correction for axial backward diffusion. Sixty-six healthy school children served as controls. RESULTS The patients were divided into two groups according to EIB. Patients with EIB (EIB+ group, n = 18) had enhanced bronchial NO output as compared to patients without EIB (EIB- group, n = 12); but the EIB- group did not differ from healthy controls. EIB+ group had also higher alveolar NO concentration than EIB- group and healthy controls, but EIB- group did not differ from healthy controls. When bronchial NO flux and alveolar NO concentration were corrected for axial diffusion, J'aw(NO) (TMAD) had equal difference as J'aw(NO) between the groups as expected. However, only EIB+ had higher CA(NO) (TMAD) than healthy controls, and the patient groups did not differ from each other. In patients, bronchial NO output correlated with the magnitude of exercise-induced change in PEF (r(s) = -0.388, p = 0.034), FEV(1) (r(s) = -0.395, p = 0.031), and FEF(50%) (r(s) = -0.431, p = 0.020), i.e., the higher the bronchial NO output, the larger the decrease in PEF/FEV(1) /FEF(50%) . Alveolar NO concentrations correlated with the change in FEV(1) (r(s) = -0.439, p = 0.015), FEF(50%) (r(s) = -0.454, p = 0.013), FEF(75%) (r(s) = -0.447, p = 0.017), and FVC (r(s) = -0.375, p = 0.045). For J'aw(NO) (TMAD), the correlations and p-values were equal to those of J'aw(NO) , but, interestingly, CA(NO) (TMAD) had no significant correlations with any of the exercise-induced changes in lung function. CONCLUSION The results showed that in atopic children and adolescents, increased bronchial NO output as well as J'aw(NO) (TMAD) were associated with EIB, while alveolar NO concentration (but not CA(NO) [TMAD]) correlated with the degree of obstruction in smaller airways induced by exercise challenge.
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Affiliation(s)
- Laura Linkosalo
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
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Chow S, Thomas PS, Malouf M, Yates DH. Exhaled breath condensate (EBC) biomarkers in pulmonary fibrosis. J Breath Res 2012; 6:016004. [PMID: 22233623 DOI: 10.1088/1752-7155/6/1/016004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The diffuse parenchymal lung diseases (DPLDs) are a group of clinicopathological entities which have recently undergone reclassification. The commonest type of idiopathic DPLD is interstitial pulmonary fibrosis (PF), which is histologically characterized by usual interstitial pneumonia (UIP), with inflammatory changes in the alveoli and subsequent collagen deposition. A similar type of inflammatory change can also be seen with connective tissue disorders. Many mediators are involved, but it is difficult to study these in a non-invasive manner in patients. The aim of the study detailed in this paper was to investigate inflammatory and oxidative stress biomarkers in PF and correlate these with lung function. 20 PF patients and 20 controls participated in the study. Exhaled breath condensate (EBC) was collected over 10 min using a refrigerated condenser, after fractional exhaled nitric oxide (FeNO) and carbon monoxide (eCO) measurement. EBC total nitrogen oxides (NOx), hydrogen peroxide (H(2)O(2)), 8-isoprostane (8-iso), 3-nitrotyrosine (3-NT), pH and total protein were measured. EBC biomarkers were significantly raised in PF compared with controls: EBC 3-NT (2.5 (0.7-8.9) versus 0.3 (0.1-1.1) ng ml(-1), p = 0.02); pH (7.6 ± 0.3 versus 7.4 ± 0.2, p = 0.004); 8-isoprostane (0.2 (0.1-0.4) versus 0.08 (0.04-0.2) ng ml(-1), p = 0.04) and total protein (24.7 ± 21.1 versus 10.7 ± 7.0 µg ml(-1), p = 0.008). FeNO and eCO were also increased (8.6 (7.1-10.4) versus 6.6 (5.6-7.8) ppb, p = 0.04, and 4.5 ± 1.7 versus 2.7 ± 0.7 ppm, p = 0.001, respectively), but no significant differences were found for NOx or H(2)O(2). In conclusion, inflammatory and oxidative stress biomarkers are raised in patients with PF compared with controls. EBC may be useful for detecting and monitoring lung inflammation in PF.
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Affiliation(s)
- Sharron Chow
- Department of Pathology, Centre for Infection and Inflammation Research, School of Medical Sciences, University of New South Wales, Kensington, Australia
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Lung and pleural fibrosis in asbestos-exposed workers: a risk factor for pneumonia mortality. Epidemiol Infect 2012; 140:1987-92. [DOI: 10.1017/s0950268811002810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
SUMMARYLungs exposed to occupational dust may be especially vulnerable to fatal infections. We followed up asbestos-exposed workers (n=590) originally screened for lung cancer with computed tomography and scored for pleuropulmonary fibrosis. We checked these workers' influenza and pneumonia mortality data (ICD-10 codes J10–J18) in the national register. In total, 191 deaths, including 43 deaths from infectious pneumonia, occurred in 6158 person-years of follow-up (mean follow-up time 10·44 years). ‘Some interstitial fibrosis’ [hazard ratio (HR) 2·26, 95% confidence interval (CI) 0·98–5·19, P=0·06] and ‘definite interstitial fibrosis’ (HR 3·70, 95% CI 1·22–11·23, P=0·02) were associated with an increased risk of death from pneumonia compared to no fibrosis. Asbestosis patients, i.e. those with both asbestos exposure and lung fibrosis, therefore appear to be particularly at risk for death from pneumonia. These patients should be vaccinated against influenza and Pneumococcus.
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Pelclová D, Fenclová Z, Syslová K, Vlčková S, Lebedová J, Pecha O, Běláček J, Navrátil T, Kuzma M, Kačer P. Oxidative stress markers in exhaled breath condensate in lung fibroses are not significantly affected by systemic diseases. INDUSTRIAL HEALTH 2011; 49:746-754. [PMID: 22020018 DOI: 10.2486/indhealth.ms1237] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Exhaled breath condensate (EBC) is assumed to reflect processes in the lungs, yet it is unknown whether oxidative stress markers in EBC are affected by systemic disorders (atherosclerosis, hypertension, diabetes) or whether lung diseases increase markers in plasma and urine. 8-isoprostane, 4-hydroxy-trans-2-nonenale (HNE) and malondialdehyde (MDA) were measured using liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS/MS) in EBC, plasma and urine in 82 patients (45 with asbestosis and hyalinosis, and 37 with silicosis) and in 29 control subjects. 8-isoprostane and HNE in EBC, and HNE in urine were higher in both groups of patients. In addition, 8-isoprostane in plasma and urine, and MDA in urine were higher in asbestos-exposed patients and MDA in plasma in silicotics, with this marker in plasma correlated with the grade of silicosis. In all subjects, 8-isoprostane in EBC correlated with urine (r=0.38, p<0.001) and plasma levels (r=0.28, p=0.003), and HNE and MDA with urine levels (r=0.31, p<0.001; r=0.23, p=0.016, respectively). Most markers positively correlated with lung function impairment, EBC markers negatively with vitamin E supplementation. To conclude: The influence of satisfactorily controlled systemic disorders on markers in EBC in patients with pneumoconioses is not significant. In addition to oxidative stress markers in EBC, lung fibroses may increase oxidative stress markers in plasma and urine.
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Affiliation(s)
- Daniela Pelclová
- Charles University in Prague, 1st Faculty of Medicine, Department of Occupational Medicine of the 1st Faculty of Medicine, Prague, Czech Republic.
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Tsilioni I, Kostikas K, Kalomenidis I, Oikonomidi S, Tsolaki V, Minas M, Gourgoulianis KI, Kiropoulos TS. Diagnostic accuracy of biomarkers of oxidative stress in parapneumonic pleural effusions. Eur J Clin Invest 2011; 41:349-56. [PMID: 21121911 DOI: 10.1111/j.1365-2362.2010.02413.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The imbalance between oxidants and antioxidants is referred to as oxidative stress and has been associated with various respiratory disorders. The aim of this study was the assessment of 8-isoprostane (8-iso-PGF(2α)) and Cu/Zn superoxide dismutase (Cu/Zn SOD) in exudative pleural effusions in order to examine the diagnostic accuracy of these markers in the differentiation between complicated and uncomplicated parapneumonic effusions. METHODS The study included 214 consecutive patients with pleural effusions [68 parapneumonic (31 uncomplicated parapneumonic, 20 complicated parapneumonic, 17 empyemas), 24 tuberculous, 88 malignant and 34 transudates]. 8-Isoprostane and Cu/Zn SOD were determined by ELISA in pleural fluid and serum. RESULTS Parapneumonic effusions were characterized by higher pleural fluid 8-isoprostane levels compared to transudative, malignant and tuberculous effusions. Pleural fluid Cu/Zn SOD levels were lower in transudates, while serum levels were higher in transudative compared to all exudative pleural effusions. Both pleural fluid 8-isoprostane and Cu/Zn SOD were higher in complicated parapneumonic effusions and empyemas compared to uncomplicated parapneumonic effusions. Pleural fluid 8-isoprostane was the most accurate test to differentiate between complicated and uncomplicated parapneumonic pleural effusions with a sensitivity of 100% and a specificity of 58·1% at a cut-off point of 35·1 (AUC = 0·848). CONCLUSIONS Pleural fluid 8-isoprostane and Cu/Zn SOD may provide useful information for the differentiation between uncomplicated and complicated parapneumonic effusions and empyemas.
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Affiliation(s)
- Irene Tsilioni
- Respiratory Medicine Department, University of Thessaly Medical School, University Hospital of Larissa, Larissa, Greece.
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Lee JS, Shin JH, Lee JO, Lee KM, Kim JH, Choi BS. Levels of Exhaled Breath Condensate pH and Fractional Exhaled Nitric Oxide in Retired Coal Miners. Toxicol Res 2010; 26:329-37. [PMID: 24278541 PMCID: PMC3834506 DOI: 10.5487/tr.2010.26.4.329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 05/24/2010] [Accepted: 06/12/2010] [Indexed: 11/20/2022] Open
Abstract
Inhaled inorganic dusts, such as coal, can cause inflammation and fibrosis in the lungs, known as pneumoconiosis. Diagnosis of pneumoconiosis depends on morphological changes by radiological findings and functional change by pulmonary function test (PFT) . Unfortunately, current diagnostic findings are limited only to lung fibrosis, which is usually irreversibly progressive. Therefore, it is important that research on potential and prospective biomarkers for pneumoconiosis should be conducted prior to initiation of irreversible radiological or functional changes in the lungs. Analytical techniques using exhaled breath condensate (EBC) or exhaled gas are non-invasive methods for detection of various respiratory diseases. The objective of this study is to investigate the relationship between inflammatory biomarkers, such as EBC pH or fractional exhaled nitric oxide (FENO) , and pneumoconiosis among 120 retired coal miners (41 controls and 79 pneumoconiosis patients) . Levels of EBC pH and FENO did not show a statistically significant difference between the pneumoconiosis patient group and pneumoconiosis patients with small opacity classified by International Labor Organization (ILO) classification. The mean concentration of FENO in the low percentage FEV1 (< 80%) was lower than that in the high percentage (80% ≤) (p = 0.023) . The mean concentration of FENO in current smokers was lower than that in non smokers (never or past smokers) (p = 0.027) . Although there was no statistical significance, the levels of FENO in smokers tended to decrease, compared with non smokers, regardless of pneumoconiosis. In conclusion, there was no significant relationship between the level of EBC pH or FENO and radiological findings or PFT. The effects between exhaled biomarkers and pneumoconiosis progression, such as decreasing PFT and exacerbation of radiological findings, should be monitored.
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Affiliation(s)
- Jong Seong Lee
- Occupational Lung Diseases Institute, COMWEL, Ansan 426-858, Korea
| | - Jae Hoon Shin
- Occupational Lung Diseases Institute, COMWEL, Ansan 426-858, Korea
| | - Joung Oh Lee
- Occupational Lung Diseases Institute, COMWEL, Ansan 426-858, Korea
| | - Kyung Myung Lee
- Occupational Lung Diseases Institute, COMWEL, Ansan 426-858, Korea
| | - Ji Hong Kim
- Ansan Workers’ Compensation Hospital, COMWEL, Ansan 426-858, Korea
| | - Byung-Soon Choi
- Occupational Lung Diseases Institute, COMWEL, Ansan 426-858, Korea
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Chapman EA, Thomas PS, Yates DH. Breath analysis in asbestos-related disorders: a review of the literature and potential future applications. J Breath Res 2010; 4:034001. [PMID: 21383477 DOI: 10.1088/1752-7155/4/3/034001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Asbestos usage was very common worldwide in the last century and continues in several countries today. Several diseases occur due to asbestos exposure, including malignant tumours such as malignant mesothelioma of the pleura and lung cancer, which have a very poor prognosis. Asbestos inhalation may also result in more benign conditions such as asbestosis (or pulmonary fibrosis due to asbestos), pleural plaques and pleural thickening. It is predicted that asbestos-associated mortality and morbidity will continue to increase, but methods for diagnosing asbestos-related disease are currently invasive and unsuitable for an increasingly elderly population. New non-invasive methods such as analysis of exhaled breath biomarkers e.g. exhaled nitric oxide (F(E)NO), exhaled breath condensate or of exhaled volatile organic compounds could potentially be extremely useful in these conditions. This article reviews the current literature on this topic and suggests areas for their application in the future.
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Affiliation(s)
- Eleanor A Chapman
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Kensington, NSW 2052, Australia
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Tahvanainen A, Leskinen M, Koskela J, Ilveskoski E, Alanko J, Kähönen M, Kööbi T, Lehtimäki L, Moilanen E, Mustonen J, Pörsti I. Non-invasive measurement of the haemodynamic effects of inhaled salbutamol, intravenous L-arginine and sublingual nitroglycerin. Br J Clin Pharmacol 2010; 68:23-33. [PMID: 19660000 DOI: 10.1111/j.1365-2125.2009.03434.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIMS To examine the effects of salbutamol and L-arginine, two compounds acting largely on the endothelium, and the endothelium-independent agent nitroglycerin on blood pressure, arterial compliance, cardiac function and vascular resistance. METHODS Continuous radial pulse wave analysis, whole-body impedance cardiography, and plethysmographic blood pressure from fingers in the supine position and during head-up tilt were recorded in nine healthy subjects. Data were captured before and after L-arginine (10 mg mg(-1) min(-1)) or saline infusion, salbutamol (400 microg) or placebo inhalation, and sublingual nitroglycerin (0.25 mg) or placebo resoriblet. RESULTS The results of all measurements were comparable before drug administration. The effects of inhaled salbutamol were apparent in the supine position: systemic vascular resistance (-9.2 +/- 2.6%) and augmentation index (-4.0 +/- 1.5%) decreased, and heart rate (8.6 +/- 2.5%) and cardiac output (8.8 +/- 3.1%) increased. L-arginine had no clear effects on supine haemodynamics, but during head-up tilt blood pressure was moderately decreased and reduction in aortic reflection time prevented, indicating improved large arterial compliance. Nitroglycerin reduced supine vascular resistance (-6.7 +/- 1.8%) and augmentation index (-7.4 +/- 1.6%), and increased cardiac output (+9.2 +/- 2.7%). During head-up tilt, nitroglycerin increased cardiac output (+10.6 +/- 5.6%) and heart rate (+40 +/- 7.5%), decreased vascular resistance (-7.8 +/- 5.8%) and augmentation index (-18.7 +/- 3.2%), and prevented the decrease in aortic reflection time. CONCLUSIONS Inhaled salbutamol predominantly changed supine haemodynamics, whereas the moderate effects of L-arginine were observed during the head-up tilt. In contrast, small doses of nitroglycerin induced major changes in haemodynamics both supine and during the head-up tilt. Altogether, these results emphasize the importance of haemodynamic measurements in both the supine and upright positions.
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Affiliation(s)
- Anna Tahvanainen
- Department of Internal Medicine, University of Tampere, Tampere, Sweden.
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Pulmonary inflammation in asbestos-exposed subjects with borderline parenchymal changes on HRCT. Respir Med 2010; 104:1042-9. [PMID: 20163943 DOI: 10.1016/j.rmed.2010.01.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 12/23/2009] [Accepted: 01/27/2010] [Indexed: 11/21/2022]
Abstract
Many asbestos-exposed subjects have minor parenchymal changes on high resolution computed tomography (HRCT) that do not fulfil the diagnostic criteria for pulmonary fibrosis and asbestosis. We investigated if these borderline parenchymal changes in asbestos-exposed subjects are related to pulmonary inflammatory activity. Exhaled nitric oxide was measured, exhaled breath condensate collected and HRCT scanned in 104 subjects with moderate to high occupational asbestos exposure. Forty-one healthy unexposed subjects served as a comparison group. After excluding other pulmonary diseases, 35 asbestos-exposed subjects had normal parenchymal findings and 31 subjects had borderline parenchymal changes on HRCT. Lung function was poorer in the latter group, but there was no difference in the degree of asbestos exposure between these groups. As compared with the unexposed comparison group, asbestos-exposed subjects with borderline parenchymal changes had increased alveolar NO concentration (3.0 + or - 0.2 vs. 2.3 + or - 0.1 ppb, p = 0.008) and increased levels of leukotriene B(4) (12.2 + or - 1.1 vs. 3.3 + or - 0.8 pg/ml, p < 0.001) and 8-isoprostane (9.4 + or - 0.7 vs. 7.3 + or - 0.6 pg/ml, p = 0.021) in breath condensate. Asbestos-exposed subjects with normal parenchymal findings had only increased breath condensate levels of leukotriene B(4) (11.4 + or - 0.9, p < 0.001). Borderline parenchymal changes on HRCT in asbestos-exposed subjects are associated with increased markers of pulmonary inflammation. Such borderline parenchymal changes are likely a mild or early form of the same pathological process that leads to asbestosis.
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Syslová K, Kačer P, Kuzma M, Pankrácová A, Fenclová Z, Vlčková S, Lebedová J, Pelclová D. LC-ESI-MS/MS method for oxidative stress multimarker screening in the exhaled breath condensate of asbestosis/silicosis patients. J Breath Res 2010; 4:017104. [PMID: 21386209 DOI: 10.1088/1752-7155/4/1/017104] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The sensitive assay method was developed for a parallel, rapid and precise determination of the most prominent oxidative stress biomarkers: 8-iso-prostaglandin F(2α) a lipid oxidation biomarker, o-tyrosine an amino acid oxidation biomarker and 8-hydroxy-2'-deoxy-guanosine a nucleic acid oxidation biomarker. The method consisted of a pre-treatment part, freeze drying (lyophilization), serving the purpose of biomarkers concentration from the exhaled breath condensate and detection method LC-ESI-MS/MS, where the selected reaction-monitoring mode was used for its extremely high degree of selectivity and the stable-isotope-dilution assay for its high precision of quantification. The developed method is characterized by the following parameters: the precision was higher than 84.3% and the mean accuracy (relative error) was determined lower than 11.6%. The method was tested on samples obtained from patients diagnosed with asbestosis and silicosis, occupational diseases induced by oxidative stress, and then compared with samples from healthy subjects. The difference in biomarkers' concentration levels found between the two groups was statistically significant.
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Affiliation(s)
- K Syslová
- Institute of Chemical Technology, Technická 5, 166 28 Prague 6, Czech Republic. Institute of Microbiology, Vídeňská 1083, 142 20 Prague 4, Czech Republic
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Abba AA. Exhaled nitric oxide in diagnosis and management of respiratory diseases. Ann Thorac Med 2009; 4:173-81. [PMID: 19881162 PMCID: PMC2801041 DOI: 10.4103/1817-1737.56009] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Accepted: 07/10/2009] [Indexed: 11/05/2022] Open
Abstract
The analysis of biomarkers in exhaled breath constituents has recently become of great interest in the diagnosis, treatment and monitoring of many respiratory conditions. Of particular interest is the measurement of fractional exhaled nitric oxide (FENO) in breath. Its measurement is noninvasive, easy and reproducible. The technique has recently been standardized by both American Thoracic Society and European Respiratory Society. The availability of cheap, portable and reliable equipment has made the assay possible in clinics by general physicians and, in the near future, at home by patients. The concentration of exhaled nitric oxide is markedly elevated in bronchial asthma and is positively related to the degree of esinophilic inflammation. Its measurement can be used in the diagnosis of bronchial asthma and titration of dose of steroids as well as to identify steroid responsive patients in chronic obstructive pulmonary disease. In primary ciliary dyskinesia, nasal NO is diagnostically low and of considerable value in diagnosis. Among lung transplant recipients, FENO can be of great value in the early detection of infection, bronchioloitis obliterans syndrome and rejection. This review discusses the biology, factors affecting measurement, and clinical application of FENO in the diagnosis and management of respiratory diseases.
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Affiliation(s)
- Abdullah A Abba
- Department of Medicine, College of Medicine and King Khalid University Hospital, Riyadh, Saudi Arabia.
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Syslová K, Kacer P, Kuzma M, Najmanová V, Fenclová Z, Vlcková S, Lebedová J, Pelclová D. Rapid and easy method for monitoring oxidative stress markers in body fluids of patients with asbestos or silica-induced lung diseases. J Chromatogr B Analyt Technol Biomed Life Sci 2009; 877:2477-86. [PMID: 19574111 DOI: 10.1016/j.jchromb.2009.06.008] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 05/31/2009] [Accepted: 06/07/2009] [Indexed: 11/20/2022]
Abstract
Sensitive assay method was developed for a parallel, rapid and precise determination of the most prominent oxidative stress biomarkers: 8-iso-prostaglandin F(2alpha), malondialdehyde and 4-hydroxynonenal. The method consisted of a pre-treatment part a solid-phase extraction, for rapid and effective isolation of biomarkers from body fluids (exhaled breath condensate, plasma and urine) and the detection method LC-ESI-MS/MS, where the selected reaction monitoring mode was used for its extremely high degree of selectivity and the stable-isotope-dilution assay for its high precision of quantification. The developed method was characterized by the following parameters: the imprecision was below 14.3%, the mean inaccuracy was determined to be lower than 13.1%. The method was tested on samples obtained from patients diagnosed with asbestosis, pleural hyalinosis or silicosis, i.e. occupational lung diseases caused by fibrogenic dusts, inducing oxidative stress in the respiratory system, and then compared to samples from healthy subjects. The difference in concentration levels of biomarkers between the two groups was perceptible in all the body fluids (the difference observed in an exhaled breath condensate was statistically most significant).
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Affiliation(s)
- Kamila Syslová
- Institute of Chemical Technology, Technická 5, 166 28 Prague 6, Czech Republic
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44
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Chow S, Campbell C, Sandrini A, Thomas PS, Johnson AR, Yates DH. Exhaled breath condensate biomarkers in asbestos-related lung disorders. Respir Med 2009; 103:1091-7. [PMID: 19520561 DOI: 10.1016/j.rmed.2009.04.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 04/02/2009] [Accepted: 04/02/2009] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Asbestos induces generation of reactive oxygen and nitrogen species in laboratory studies. Several such species can be measured non-invasively in humans in exhaled breath condensate (EBC) but few have been evaluated. This study aimed to assess oxidative stress and lung inflammation in vivo. METHODS Eighty six men were studied: sixty subjects with asbestos-related disorders (asbestosis: 18, diffuse pleural thickening (DPT): 16, pleural plaques (PPs): 26) and twenty six age- and gender-matched normal individuals. RESULTS Subjects with asbestosis had raised EBC markers of oxidative stress compared with normal controls [8-isoprostane (geometric mean (95% CI) 0.51 (0.17-1.51) vs 0.07 (0.04-0.13) ng/ml, p<0.01); hydrogen peroxide (13.68 (8.63-21.68) vs 5.89 (3.99-8.69) microM, p<0.05), as well as increased EBC total protein (17.27 (10.57-28.23) vs 7.62 (5.13-11.34) microg/ml, p<0.05), and fractional exhaled nitric oxide (mean+/-SD) (9.67+/-3.26 vs 7.57+/-1.89ppb; p<0.05). EBC pH was lower in subjects with asbestosis compared with subjects with DPT (7.26+/-0.31 vs 7.53+/-0.24; p<0.05). There were no significant differences in exhaled carbon monoxide, EBC total nitrogen oxides and 3-nitrotyrosine between any of the asbestos-related disorders, or between these and controls. CONCLUSION In asbestos-related disorders, markers of inflammation and oxidative stress are significantly elevated in subjects with asbestosis compared with healthy individuals but not in pleural diseases.
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Affiliation(s)
- Sharron Chow
- Research and Education Unit, Workers' Compensation (Dust Diseases) Board of New South Wales, Sydney, Australia
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Liu L, Poon R, Chen L, Frescura AM, Montuschi P, Ciabattoni G, Wheeler A, Dales R. Acute effects of air pollution on pulmonary function, airway inflammation, and oxidative stress in asthmatic children. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:668-74. [PMID: 19440509 PMCID: PMC2679614 DOI: 10.1289/ehp11813] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Accepted: 11/28/2008] [Indexed: 04/14/2023]
Abstract
BACKGROUND Air pollution is associated with respiratory symptoms, lung function decrements, and hospitalizations. However, there is little information about the influence of air pollution on lung injury. OBJECTIVE In this study we investigated acute effects of air pollution on pulmonary function and airway oxidative stress and inflammation in asthmatic children. METHODS We studied 182 children with asthma, 9-14 years of age, for 4 weeks. Daily ambient concentrations of sulfur dioxide, nitrogen dioxide, ozone, and particulate matter < or = 2.5 microm in aerodynamic diameter (PM(2.5)) were monitored from two stations. Once a week we measured spirometry and fractional exhaled nitric oxide (FeNO), and determined thiobarbituric acid reactive substances (TBARS) and 8-isoprostane--two oxidative stress markers--and interleukin-6 (IL-6) in breath condensate. We tested associations using mixed-effects regression models, adjusting for confounding variables. RESULTS Interquartile-range increases in 3-day average SO2 (5.4 ppb), NO2 (6.8 ppb), and PM(2.5) (5.4 microg/m3) were associated with decreases in forced expiratory flow between 25% and 75% of forced vital capacity, with changes being -3.1% [95% confidence interval (CI), -5.8 to -0.3], -2.8% (95% CI, -4.8 to -0.8), and -3.0% (95% CI, -4.7 to -1.2), respectively. SO2, NO2, and PM(2.5) were associated with increases in TBARS, with changes being 36.2% (95% CI, 15.7 to 57.2), 21.8% (95% CI, 8.2 to 36.0), and 24.8% (95% CI, 10.8 to 39.4), respectively. Risk estimates appear to be larger in children not taking corticosteroids than in children taking corticosteroids. O3 (5.3 ppb) was not associated with health end points. FeNO, 8-isoprostane, and IL-6 were not associated with air pollutants. CONCLUSION Air pollution may increase airway oxidative stress and decrease small airway function of asthmatic children. Inhaled corticosteroids may reduce oxidative stress and improve airway function.
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Affiliation(s)
- Ling Liu
- Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada.
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46
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Somoza N, Torà M. [Biological safety in the storage and transport of biological specimens from patients with respiratory diseases used in research settings]. Arch Bronconeumol 2009; 45:187-95. [PMID: 19327879 DOI: 10.1016/j.arbres.2009.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Accepted: 02/05/2009] [Indexed: 02/04/2023]
Abstract
Major advances in genomics and proteomics have prompted the creation of biological specimen collections and biobanks for use in biomedical research. These specimen collections and the wealth of data they generate will allow longitudinal studies to be conducted and subproducts such as DNA or RNA to be obtained. They may even be used in future studies. To ensure specimen integrity, from the outset it is necessary to define procedures for sampling, transport and storage, the subproducts to be obtained, and the end purpose, as well as to address biosafety issues and arrange for suitable equipment monitoring. Strict control of these conditions will confer added value on the specimens, as quality and traceability would be assured. This article aims to provide a general overview of the recommendations concerning biological safety, transport, and storage of biological specimens for biomedical research into respiratory diseases in accordance with current legislation.
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Affiliation(s)
- Nuria Somoza
- Servicios Científico-Técnicos, IMIM-Hospital del Mar, Universitat Autònoma de Barcelona (UDIMAS-UAB), Barcelona, España
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Sepponen A, Lehtimäki L, Huhtala H, Kaila M, Kankaanranta H, Moilanen E. Alveolar and bronchial nitric oxide output in healthy children. Pediatr Pulmonol 2008; 43:1242-8. [PMID: 19009623 DOI: 10.1002/ppul.20953] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Exhaled nitric oxide (NO) concentration is a marker of pulmonary inflammation. It is usually measured at a single exhalation flow rate. However, measuring exhaled NO at multiple flow rates allows assessment of the flow-independent NO parameters: alveolar NO concentration, bronchial NO flux, bronchial wall NO concentration, and bronchial diffusing capacity of NO. Our aim was to determine the flow-independent NO parameters in healthy schoolchildren and to compare two different mathematical approaches. Exhaled NO was measured at four flow rates (10, 50, 100, and 200 ml/sec) in 253 schoolchildren (7-13 years old). Flow-independent NO parameters were calculated with linear method (flows >or=50 ml/sec) and non-linear method (all flows). Sixty-six children (32 boys and 34 girls) with normal spirometry and no history or present symptoms of asthma, allergy, atopy or other diseases were included in the analysis. Median bronchial NO flux was 0.4 nl/sec (mean +/- SD: 0.5 +/- 0.3 nl/sec) and median alveolar NO concentration was 1.9 ppb (2.0 +/- 0.8 ppb) with the linear method. Bronchial NO flux correlated positively with height (r = 0.423; P < 0.001), FEV(1) (r = 0.358; P = 0.003), and FVC (r = 0.359; P = 0.003). With the non-linear method, median bronchial wall NO concentration was 49.6 ppb (68.0 +/- 53.3 ppb) and bronchial diffusing capacity of NO was 10.0 pl/sec/ppb (11.8 +/- 7.5 pl/sec/ppb). The non-linear method gave lower alveolar NO concentration (1.4 [1.5 +/- 0.7] ppb, P < 0.001) and higher bronchial NO flux (0.5 [0.6 +/- 0.3] nl/sec, P < 0.001) than the linear method, but the results were highly correlated between the two methods (r = 0.854 and r = 0.971, P < 0.001). In conclusion, the multiple flow rate method is feasible in children but different mathematical methods give slightly different results. Reference values in healthy children are of value when applying bronchial and alveolar NO parameters in the diagnostics and follow-up of inflammatory lung diseases.
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Affiliation(s)
- Anna Sepponen
- The Immunopharmacology Research Group, Medical School, University of Tampere, Tampere, Finland
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Pelclová D, Fenclová Z, Kacer P, Kuzma M, Navrátil T, Lebedová J. Increased 8-isoprostane, a marker of oxidative stress in exhaled breath condensate in subjects with asbestos exposure. INDUSTRIAL HEALTH 2008; 46:484-489. [PMID: 18840939 DOI: 10.2486/indhealth.46.484] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Asbestosis and pleural plaques exhibit unpredictable but progressive development, and there are no markers routinely available to measure their prognosis. Asbestos exposure induces the generation of reactive oxygen species, and 8-isoprostane is involved in experimental asbestos-related lung toxicity. This oxidative stress marker was measured in exhaled breath condensate (EBC) in 92 former asbestos workers with mean age 68.8+/-1.7 yr and mean duration of asbestos exposure 24.1+/-2.0 yr. The control group had 46 subjects with mean age 65.2+/-3.3 yr. The mean level of 8-isoprostane, analyzed by liquid chromatography-electrospray ionization-mass spectrometry, was higher in asbestos-exposed subjects (69.5+/-6.6 pg/ml, p=0.0001) compared with the control group, where the concentration was 47.0+/-7.8 pg/ml. The results presented support the hypothesis that oxidative stress due to asbestos is the main cause of increased 8-isoprostane in EBC. Measurement of 8-isoprostane in EBC is a promising non-invasive means for assessing the activity of asbestos-induced diseases.
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Affiliation(s)
- Daniela Pelclová
- 1st Medical Faculty, Department of Occupational Medicine, Charles University of Prague, Prague, Czech Republic
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49
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Grob NM, Aytekin M, Dweik RA. Biomarkers in exhaled breath condensate: a review of collection, processing and analysis. J Breath Res 2008; 2:037004. [PMID: 21386165 DOI: 10.1088/1752-7155/2/3/037004] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Exhaled breath condensate (EBC) is a potential rich source for countless biomarkers that can provide valuable information about respiratory as well as systemic diseases. EBC has been studied in a variety of diseases including allergic rhinitis, asthma, chronic obstructive lung disease, cystic fibrosis, lung cancer, and obstructive sleep apnea syndrome. Although numerous biomarkers have been discovered and studied in EBC, the methods of collection and biomarker detection have not been fully standardized. While leaving standardization methods up to individual labs for the present time is optimal for the continued discovery of new biomarkers in EBC, this decreases the reproducibility and generalizability of the findings. In this review we will discuss specific biomarkers studied in specific diseases as well as some of the related technical issues including collection, processing and analysis.
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Affiliation(s)
- N M Grob
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA. Pathobiology/Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Case Western Reserve University, School of Medicine, Cleveland, OH, USA
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50
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Puckett JL, George SC. Partitioned exhaled nitric oxide to non-invasively assess asthma. Respir Physiol Neurobiol 2008; 163:166-77. [PMID: 18718562 DOI: 10.1016/j.resp.2008.07.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Revised: 07/17/2008] [Accepted: 07/23/2008] [Indexed: 01/02/2023]
Abstract
Asthma is a chronic inflammatory disease of the lungs, characterized by airway hyperresponsiveness. Chronic repetitive bouts of acute inflammation lead to airway wall remodeling and possibly the sequelae of fixed airflow obstruction. Nitric oxide (NO) is a reactive molecule synthesized by NO synthases (NOS). NOS are expressed by cells within the airway wall and functionally, two NOS isoforms exist: constitutive and inducible. In asthma, the inducible isoform is over expressed, leading to increased production of NO, which diffuses into the airway lumen, where it can be detected in the exhaled breath. The exhaled NO signal can be partitioned into airway and alveolar components by measuring exhaled NO at multiple flows and applying mathematical models of pulmonary NO dynamics. The airway NO flux and alveolar NO concentration can be elevated in adults and children with asthma and have been correlated with markers of airway inflammation and airflow obstruction in cross-sectional studies. Longitudinal studies which specifically address the clinical potential of partitioning exhaled NO for diagnosis, managing therapy, and predicting exacerbation are needed.
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Affiliation(s)
- James L Puckett
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA 92697, United States
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