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Thwaites RS, Jarvis HC, Singh N, Jha A, Pritchard A, Fan H, Tunstall T, Nanan J, Nadel S, Kon OM, Openshaw PJ, Hansel TT. Absorption of Nasal and Bronchial Fluids: Precision Sampling of the Human Respiratory Mucosa and Laboratory Processing of Samples. J Vis Exp 2018. [PMID: 29443104 PMCID: PMC5908664 DOI: 10.3791/56413] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The methods of nasal absorption (NA) and bronchial absorption (BA) use synthetic absorptive matrices (SAM) to absorb the mucosal lining fluid (MLF) of the human respiratory tract. NA is a non-invasive technique which absorbs fluid from the inferior turbinate, and causes minimal discomfort. NA has yielded reproducible results with the ability to frequently repeat sampling of the upper airway. By comparison, alternative methods of sampling the respiratory mucosa, such as nasopharyngeal aspiration (NPA) and conventional swabbing, are more invasive and may result in greater data variability. Other methods have limitations, for instance, biopsies and bronchial procedures are invasive, sputum contains many dead and dying cells and requires liquefaction, exhaled breath condensate (EBC) contains water and saliva, and lavage samples are dilute and variable. BA can be performed through the working channel of a bronchoscope in clinic. Sampling is well tolerated and can be conducted at multiple sites in the airway. BA results in MLF samples being less dilute than bronchoalveolar lavage (BAL) samples. This article demonstrates the techniques of NA and BA, as well as the laboratory processing of the resulting samples, which can be tailored to the desired downstream biomarker being measured. These absorption techniques are useful alternatives to the conventional sampling techniques used in clinical respiratory research.
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Affiliation(s)
- Ryan S Thwaites
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Hannah C Jarvis
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Nehmat Singh
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Akhilesh Jha
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | | | - Hailing Fan
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Tanushree Tunstall
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Joan Nanan
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Simon Nadel
- St Mary's Hospital, Imperial College Healthcare Trust
| | - Onn Min Kon
- St Mary's Hospital, Imperial College Healthcare Trust
| | - Peter J Openshaw
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital
| | - Trevor T Hansel
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital;
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Wang H, Gu X, Weng Y, Xu T, Fu Z, Peng W, Yu W. Quantitative analysis of pathogens in the lower respiratory tract of patients with chronic obstructive pulmonary disease. BMC Pulm Med 2015; 15:94. [PMID: 26286268 PMCID: PMC4543462 DOI: 10.1186/s12890-015-0094-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 08/05/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Bacterial infection of the lower respiratory tract is believed to play a major role in the pathogenesis of chronic obstructive pulmonary disease (COPD) and acute exacerbations of COPD (AECOPD). This study investigates the potential relationship between AECOPD and the load of six common bacterial pathogens in the lower respiratory tract using real-time quantitative PCR (RT-qPCR) in COPD patients. METHODS Protected specimen brush (PSB) and bronchoalveolar lavage fluid (BALF) samples from the lower respiratory tract of 66 COPD patients and 33 healthy subjects were collected by bronchoscopy. The load of Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonos aeruginosa, Haemophilus influenzeae, and Moraxella catarrhalis were detected by RT-qPCR. RESULTS High Klebsiella pneumoniae, Pseudomonos aeruginosa, Haemophilus influenzeae and Moraxella catarrhalis burden were detected by RT-qPCR in both PSB and BALF samples obtained from stable COPD and AECOPD patients compared with healthy subjects. The load of the above four pathogenic strains in PSB and BALF samples obtained from AECOPD patients were significantly higher compared with stable COPD patients. Finally, positive correlations between bacterial loads and inflammatory mediators such as neutrophil count and cytokine levels of IL-1β, IL-6 and IL-8, as well as negative correlations between bacterial loads and the forced expiratory volume in one second (FEV1) % predicted, forced vital capacity (FVC) % predicted, and FEV1/FVC ratio, were detected. CONCLUSIONS These findings suggest that increased bacterial loads mediated inflammatory response in the lower respiratory tract and were associated with AECOPD. In addition, these results provide guidance for antibiotic therapy of AECOPD patients.
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Affiliation(s)
- Huaying Wang
- Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China
| | - Xiao Gu
- Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China
| | - Yuesong Weng
- Clinical Laboratory, First Hospital, 58 Liuting Road, Ningbo City, Zhejiang Province, 315010, P. R. China
| | - Tao Xu
- Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China
| | - Zhongming Fu
- Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China
| | - Weidong Peng
- Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China
| | - Wanjun Yu
- Department of Respiratory Diseases, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, 251 East Baizhang Road, Ningbo City, Zhejiang Province, 315040, P. R. China.
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Kamiyama I, Kohno M, Kamiya K, Nakamura H, Sawafuji M, Kobayashi K, Watanabe M. A new technique of bronchial microsampling and proteomic analysis of epithelial lining fluid in a rat model of acute lung injury. Mol Immunol 2014; 59:217-25. [DOI: 10.1016/j.molimm.2014.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 02/09/2014] [Accepted: 02/25/2014] [Indexed: 12/15/2022]
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Franciosi L, Govorukhina N, Fusetti F, Poolman B, Lodewijk ME, Timens W, Postma D, ten Hacken N, Bischoff R. Proteomic analysis of human epithelial lining fluid by microfluidics-based nanoLC-MS/MS: A feasibility study. Electrophoresis 2013; 34:2683-94. [DOI: 10.1002/elps.201300020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/28/2013] [Accepted: 04/02/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Lorenza Franciosi
- Department of Pharmacy, Analytical Biochemistry; University of Groningen and Netherlands Proteomics Center; Groningen; The Netherlands
| | - Natalia Govorukhina
- Department of Pharmacy, Analytical Biochemistry; University of Groningen and Netherlands Proteomics Center; Groningen; The Netherlands
| | - Fabrizia Fusetti
- Department of Biochemistry; University of Groningen and Netherlands Proteomics Center; Groningen; The Netherlands
| | - Bert Poolman
- Department of Biochemistry; University of Groningen and Netherlands Proteomics Center; Groningen; The Netherlands
| | - Monique E. Lodewijk
- Department of Pathology; University Medical Center Groningen, University of Groningen; Groningen; The Netherlands
| | - Wim Timens
- Department of Pathology; University Medical Center Groningen, University of Groningen; Groningen; The Netherlands
| | - Dirkje Postma
- Department of Pulmonary Diseases; University Medical Center Groningen; University of Groningen; Groningen; The Netherlands
| | - Nick ten Hacken
- Department of Pulmonary Diseases; University Medical Center Groningen; University of Groningen; Groningen; The Netherlands
| | - Rainer Bischoff
- Department of Pharmacy, Analytical Biochemistry; University of Groningen and Netherlands Proteomics Center; Groningen; The Netherlands
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Komatsu Y, Yamamoto H, Tsushima K, Furuya S, Yoshikawa S, Yasuo M, Kubo K, Yamazaki Y, Hasegawa J, Eguchi T, Kondo R, Yoshida K, Koizumi T. Increased Interleukin-8 in Epithelial Lining Fluid of Collapsed Lungs During One-Lung Ventilation for Thoracotomy. Inflammation 2012; 35:1844-50. [DOI: 10.1007/s10753-012-9505-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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KAMIYA KAZUNORI, WATANABE MASAZUMI, KOHNO MITSUTOMO, IZUMI YOTARO, HORINOUCHI HIROHISA, KAWAMURA MASAFUMI, SHIMADA NAOKI, NOMORI HIROAKI. KL-6 and CEA levels in epithelial lining fluid microsamples predict response to gefitinib in patients with advanced non-small cell lung cancer. Respirology 2011; 16:976-82. [DOI: 10.1111/j.1440-1843.2011.02009.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
Pharmacokinetic studies require information regarding drug concentration at numerous time points during the process of absorption, distribution, metabolism and excretion. In order to obtain reproducible and good-quality data, the sampling method is as important as the bioanalytical method. A further difficulty in performing pharmacokinetic studies is related to the limited amount of sample that can be collected in some cases. Since analytical methods should interfere as little as possible with the investigated organism, microsampling techniques are a natural choice for pharmacokinetic studies. Accordingly, microdevices and microsampling approaches have been used increasingly in recent years for a wide variety of analytical applications, including analysis of drugs in biological samples. Such techniques not only reduce the amount of reagents needed for analysis, but are also faster and less disrupting. This review provides a brief overview of contemporary microsampling techniques: collection of small sample aliquots, ultrafiltration, microdialysis, solid-phase microextraction, biosensors and microfluidics. It is concluded that recent developments in microsampling and microdevices promise to streamline pharmacokinetic studies and bring bedside monitoring of therapeutic drugs into clinical practice.
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Ushiki A, Yamazaki Y, Koyama S, Tsushima K, Yamamoto H, Hanaoka M, Kubo K. Bronchoscopic microsampling for bacterial colony counting in relevant lesions in patients with pulmonary Mycobacterium avium complex infection. Intern Med 2011; 50:1287-92. [PMID: 21673463 DOI: 10.2169/internalmedicine.50.5034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The incidence of pulmonary Mycobacterium avium complex (MAC) infections with nodular/bronchiectasis lesions is increasing. However, factors determining deterioration are unknown. In the present study, we investigated quantitative MAC cultures obtained through bronchoscopic microsampling (BMS) from patients with pulmonary MAC infection and analyzed the relationship between MAC culture and the short-term natural history. We also assessed chest computed tomography (CT) findings for the deteriorating factors. DESIGN For this prospective study, MAC was collected from peripheral lung lesions by BMS through endobronchial ultrasonography. MAC colonies were counted on Middlebrook 7H11 agar. We compared the number of MAC colonies with laboratory data and chest CT findings. PATIENTS We studied 26 patients with pulmonary MAC infection. RESULTS The patients were divided into 2 groups: 11 patients in the non-deteriorated group and 15 patients in the deteriorated group. The number of MAC colonies was significantly correlated with deterioration of MAC infection (p < 0.001). In the non-deteriorated group, chest CT scans showed nodular/bronchiectasis lesions in 8 patients (73%) and consolidated lesions in 3 patients (27%). In the deteriorated group, chest CT scans showed nodular/bronchiectasis lesions in 1 patient (7%), consolidated lesions in 6 patients (40%), and cavitary lesions in 8 patients (53%). CONCLUSION The number of MAC colonies in relevant lesions investigated by BMS was significantly larger in the deteriorated group than in the non-deteriorated group. Cavitary and consolidated lesions observed from chest CT scans are thought to indicate a high risk of progression of pulmonary MAC infection.
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Affiliation(s)
- Atsuhito Ushiki
- The First Department of Internal Medicine, Shinshu University School of Medicine, Japan
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Kahn N, Kuner R, Eberhardt R, Meister M, Muley T, Winteroll S, Schnabel PA, Ishizaka A, Herth FJF, Poustka A, Sültmann H, Hoffmann H. Gene expression analysis of endobronchial epithelial lining fluid in the evaluation of indeterminate pulmonary nodules. J Thorac Cardiovasc Surg 2009; 138:474-9. [PMID: 19619798 DOI: 10.1016/j.jtcvs.2009.04.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 03/12/2009] [Accepted: 04/23/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Making a definitive preoperative diagnosis in patients with indeterminate pulmonary nodules is still a challenge. Gene expression profiling may be a useful adjunctive diagnostic utility in this regard. We investigated the feasibility of bronchoscopic microsampling to collect endobronchial epithelial lining fluid to obtain RNA as a starting point for gene expression profiling. METHODS In 15 patients, epithelial lining fluid was collected in triplicate from subsegmental bronchi close to the pulmonary nodules and from contralateral lungs. Diagnosis was confirmed by transbronchial biopsy or surgery (non-small cell lung cancer, n = 11; benign or other lesions, n = 4). Total RNA was isolated from the samples and evaluated concerning quantity and quality. The complementary DNA was generated and analyzed by quantitative real-time polymerase chain reaction for potential lung cancer associated genes like matrix metalloprotinase (MMP9). RESULTS Total RNA of adequate amount (>0.8 microg) and sufficient quality was obtained in 13 (86%) of the 15 patients. In patients with lung cancer, normalized MMP9 gene expression levels in endobronchial lining fluid samples collected close to the lesions were in median 12 times higher than levels in the matching contralateral samples. MMP9 expression levels were particularly high in endobronchial lining fluid samples collected from patients with squamous cell carcinoma but not elevated in the case of benign lesions. CONCLUSIONS Our results show that quantitative gene expression analysis of endobronchial lining fluid collected by bronchoscopic microsampling is both feasible and reliable and may therefore be a useful additional diagnostic method in patients with indeterminate pulmonary nodules.
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Affiliation(s)
- Nicolas Kahn
- Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg, Germany
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Current World Literature. Curr Opin Pulm Med 2008; 14:266-73. [DOI: 10.1097/mcp.0b013e3282ff8c19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kipnis E, Guery B, Wiener-Kronish J. Promises and Limitations of the Bronchoscopic Microsampling Probe. Chest 2007; 132:1414. [DOI: 10.1378/chest.07-0519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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