1
|
Cao Y, Chen X, Shu L, Shi L, Wu M, Wang X, Deng K, Wei J, Yan J, Feng G. Analysis of the correlation between BMI and respiratory tract microbiota in acute exacerbation of COPD. Front Cell Infect Microbiol 2023; 13:1161203. [PMID: 37180432 PMCID: PMC10166817 DOI: 10.3389/fcimb.2023.1161203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/07/2023] [Indexed: 05/16/2023] Open
Abstract
Objective To investigate the distribution differences in the respiratory tract microbiota of AECOPD patients in different BMI groups and explore its guiding value for treatment. Methods Sputum samples of thirty-eight AECOPD patients were collected. The patients were divided into low, normal and high BMI group. The sputum microbiota was sequenced by 16S rRNA detection technology, and the distribution of sputum microbiota was compared. Rarefaction curve, α-diversity, principal coordinate analysis (PCoA) and measurement of sputum microbiota abundance in each group were performed and analyzed by bioinformatics methods. Results 1. The rarefaction curve in each BMI group reached a plateau. No significant differences were observed in the OTU total number or α-diversity index of microbiota in each group. PCoA showed significant differences in the distance matrix of sputum microbiota between the three groups, which was calculated by the Binary Jaccard and the Bray Curtis algorithm. 2. At the phylum level, most of the microbiota were Proteobacteria, Bacteroidetes Firmicutes, Actinobacteria, and Fusobacteria. At the genus level, most were Streptococcus, Prevotella, Haemophilus, Neisseria and Bacteroides. 3. At the phylum level, the abundance of Proteobacteria in the low group was significantly higher than that in normal and high BMI groups, the abundances of Firmicutes in the low and normal groups were significantly lower than that in high BMI groups. At the genus level, the abundance of Haemophilus in the low group was significantly higher than that in high BMI group, and the abundances of Streptococcus in the low and normal BMI groups were significantly lower than that in the high BMI group. Conclusions 1. The sputum microbiota of AECOPD patients in different BMI groups covered almost all microbiota, and BMI had no significant association with total number of respiratory tract microbiota or α-diversity in AECOPD patients. However, there was a significant difference in the PCoA between different BMI groups. 2. The microbiota structure of AECOPD patients differed in different BMI groups. Gram-negative bacteria (G-) in the respiratory tract of patients predominated in the low BMI group, while gram-positive bacteria (G+) predominated in the high BMI group.
Collapse
Affiliation(s)
- Yang Cao
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaolin Chen
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Shu
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Shi
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mingjing Wu
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xueli Wang
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Kaili Deng
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jing Wei
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiaxin Yan
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ganzhu Feng
- Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
2
|
Ma J, Du M, Wang C, Xie X, Wang H, Li T, Chen S, Zhang L, Mao S, Zhou X, Wu M. Rapid and Sensitive Detection of Mycobacterium tuberculosis by an Enhanced Nanobiosensor. ACS Sens 2021; 6:3367-3376. [PMID: 34470206 DOI: 10.1021/acssensors.1c01227] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tuberculosis (TB) mostly spreads from person to person through Mycobacterium tuberculosis (MTB). However, the majority of conventional detection methods for MTB cannot satisfy the requirements for actual TB detection. As one of the most promising powerful platforms, a silicon nanowire field-effect transistor (SiNW-FET) biosensor shows good prospect in TB detection. In this study, an enhanced SiNW-FET biosensor was developed for the rapid and sensitive detection of MTB. The surface functional parameters of the biosensor were explored and optimized. The SiNW-FET biosensor has good sensitivity with a detection limit of 0.01 fg/mL toward protein. The current change value shows a linear upward trend with the increase in protein concentration in the range of 1 fg/mL to 100 μg/mL. One whole test cycle can be accomplished within only 30 s. More importantly, a good distinction was realized in the sputum without pretreatment between normal people and TB patients, which greatly shortened the TB detection time (only 2-5 min, considering the dilution of sputum). Compared with other methods, the SiNW-FET biosensor can detect MTB with a remarkably broad dynamic linear range in a shorter time.
Collapse
Affiliation(s)
- Jinbiao Ma
- School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, PR China
- Tianjin Key Lab of Indoor Air Environmental Quality Control, Tianjin 300072, PR China
| | - Manman Du
- School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, PR China
- Tianjin Key Lab of Indoor Air Environmental Quality Control, Tianjin 300072, PR China
| | - Can Wang
- School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, PR China
- Tianjin Key Lab of Indoor Air Environmental Quality Control, Tianjin 300072, PR China
| | - Xinwu Xie
- Institute of Medical Support Technology, Academy of Military Science, Tianjin 300161, PR China
- National Bio-Protection Engineering Center, Tianjin 300161, PR China
| | - Hao Wang
- Institute of Medical Support Technology, Academy of Military Science, Tianjin 300161, PR China
- School of Electronic Information and Automation, Tianjin University of Science and Technology, Tianjin 300222, PR China
| | - Tie Li
- Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, PR China
- State Key Laboratories of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, PR China
| | - Shixing Chen
- Science and Technology on Micro-system Laboratory, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, PR China
- State Key Laboratories of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, PR China
| | - Lixia Zhang
- Tianjin Haihe Hospital, Tianjin 300350, PR China
| | - Shun Mao
- College of Environmental Science and Engineering, Tongji University, Shanghai 200092, PR China
| | - Xiaohong Zhou
- State Key Joint Laboratory of ESPC, School of Environment, Tsinghua University, Beijing 100084, PR China
| | - Min Wu
- Tianjin Haihe Hospital, Tianjin 300350, PR China
| |
Collapse
|
3
|
Peláez EC, Estevez MC, Mongui A, Menéndez MC, Toro C, Herrera-Sandoval OL, Robledo J, García MJ, Portillo PD, Lechuga LM. Detection and Quantification of HspX Antigen in Sputum Samples Using Plasmonic Biosensing: Toward a Real Point-of-Care (POC) for Tuberculosis Diagnosis. ACS Infect Dis 2020; 6:1110-1120. [PMID: 32233503 DOI: 10.1021/acsinfecdis.9b00502] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Advancements that occurred during the last years in the diagnosis of Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis infection, have prompted increased survival rates of patients. However, limitations related to the inefficiency of an early detection still remain; some techniques and laboratory methods do not have enough specificity and most instruments are expensive and require handling by trained staff. In order to contribute to a prompt and effective diagnosis of tuberculosis, we report the development of a portable, user-friendly, and low-cost biosensor device for its early detection. By using a label-free surface plasmon resonance (SPR) biosensor, we have established a direct immunoassay for the direct detection and quantification of the heat shock protein X (HspX) of Mtb, a well-established biomarker of this pathogen, directly in pretreated sputum samples. The method relies on highly specific monoclonal antibodies that are previously immobilized on the plasmonic sensor surface. This technology allows for the direct detection of the biomarker without amplification steps, showing a limit of detection (LOD) of 0.63 ng mL-1 and a limit of quantification (LOQ) of 2.12 ng mL-1. The direct analysis in pretreated sputum shows significant differences in the HspX concentration in patients with tuberculosis (with concentration levels in the order of 116-175 ng mL-1) compared with non-tuberculosis infected patients (values below the LOQ of the assay).
Collapse
Affiliation(s)
- Enelia Cristina Peláez
- Nanobiosensors and Bioanalytical Applications Group (NanoB2A), Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and BIST, Campus UAB, 08193 Barcelona, Spain
- Centro de Investigación y Desarrollo Tecnológico de la Industria Electro Electrónica y TIC (CIDEI), Calle 45a BIS # 19-09 Floor 2, Bogotá, DC, Colombia
- Corporación CorpoGen, Departamento Biotecnología Molecular, Carrera 4 # 20-41, Bogotá, DC, Colombia
- Research Cluster on Converging Sciences and Technology (NBIC), Universidad Central, Calle 21 #4-40, Bogotá, DC, Colombia
| | - Maria Carmen Estevez
- Nanobiosensors and Bioanalytical Applications Group (NanoB2A), Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and BIST, Campus UAB, 08193 Barcelona, Spain
| | - Alvaro Mongui
- Corporación CorpoGen, Departamento Biotecnología Molecular, Carrera 4 # 20-41, Bogotá, DC, Colombia
| | - M-Carmen Menéndez
- Departamento de Medicina Preventiva, Salud Pública y Microbiología, Facultad de Medicina, Universidad Autónoma de Madrid, St Arzobispo Morcillo s/n, 28029 Madrid, Spain
| | - Carlos Toro
- Department of Microbiology, La Paz University Hospital, IdiPaz, St/Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Oscar L. Herrera-Sandoval
- Centro de Investigación y Desarrollo Tecnológico de la Industria Electro Electrónica y TIC (CIDEI), Calle 45a BIS # 19-09 Floor 2, Bogotá, DC, Colombia
- Research Cluster on Converging Sciences and Technology (NBIC), Universidad Central, Calle 21 #4-40, Bogotá, DC, Colombia
| | - Jaime Robledo
- Corporación para Investigaciones Biológicas (CIB), Laboratorio de Micobacterias, Carrera 72A 78B-141, 050034 Medellín, Colombia
| | - Maria J. García
- Departamento de Medicina Preventiva, Salud Pública y Microbiología, Facultad de Medicina, Universidad Autónoma de Madrid, St Arzobispo Morcillo s/n, 28029 Madrid, Spain
| | - Patricia Del Portillo
- Corporación CorpoGen, Departamento Biotecnología Molecular, Carrera 4 # 20-41, Bogotá, DC, Colombia
| | - Laura M. Lechuga
- Nanobiosensors and Bioanalytical Applications Group (NanoB2A), Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and BIST, Campus UAB, 08193 Barcelona, Spain
| |
Collapse
|
4
|
Kononova N, Sikkeland LIB, Mahmood F, Vistnes M, Kongerud J, Einvik G, Søyseth V. Annual decline in forced expiratory volume and airway inflammatory cells and mediators in a general population-based sample. BMC Pulm Med 2019; 19:90. [PMID: 31072364 PMCID: PMC6509765 DOI: 10.1186/s12890-018-0765-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 12/12/2018] [Indexed: 12/03/2022] Open
Abstract
Background Few studies have examined the relationships between sputum inflammatory markers and subsequent annual decline in forced expiratory volume in 1 s (dFEV1). This study investigated whether indices of airway inflammation are predictors of dFEV1 in a general population-based sample. Methods The study, conducted from 2003 to 2005, included 120 healthy Norwegian subjects aged 40 to 70 years old. At baseline, the participants completed a self-administered respiratory questionnaire and underwent a clinical examination that included spirometry, venous blood sampling, and induced sputum examination. From 2015 to 2016, 62 (52%) participants agreed to a follow-up examination that did not include induced sputum examination. Those with a FEV1/forced vital capacity (FVC) ratio < 0.70 underwent a bronchial reversibility test. The levels of cytokines, pro-inflammatory M1 macrophage phenotypes were measured in induced sputum using bead-based multiplex analysis. The associations between cytokine levels and dFEV1 were then analysed. Results The mean dFEV1 was 32.9 ml/year (standard deviation 26.3). We found no associations between dFEV1 and the baseline indices of sputum inflammation. Seven participants had irreversible airflow limitation at follow-up. They had lower FEV1 and gas diffusion at baseline compared with the remaining subjects. Moreover, two of these individuals had a positive reversibility test and sputum eosinophilia at baseline. Conclusions In this cohort of presumably healthy subjects, we found no associations between sputum inflammatory cells or mediators and dFEV1 during 10 years of follow-up. Electronic supplementary material The online version of this article (10.1186/s12890-018-0765-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Natalia Kononova
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Liv Ingunn Bjoner Sikkeland
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Faiza Mahmood
- Unit of Medical Biochemistry, Division of Diagnostics and Technology, Akershus University Hospital, Lørenskog, Norway
| | - Maria Vistnes
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway.,Institute for Experimental Medical Research, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Johny Kongerud
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Gunnar Einvik
- Department of Pulmonology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Vidar Søyseth
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Pulmonology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| |
Collapse
|
5
|
Pedersen F, Holz O, Kanniess F, Zielen S, Schulze J, Gillissen A, von Berg A, Berdel D, Beier J, Beeh K, Schnoor M, Magnussen H. Longitudinal measurement of airway inflammation over one year in children and adults with intermittent asthma. BMC Res Notes 2014; 7:925. [PMID: 25515668 PMCID: PMC4301900 DOI: 10.1186/1756-0500-7-925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 11/21/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Asthma is an inflammatory disease of the airways, but in clinical practice inflammation is rarely monitored. The aim of this study was to assess the level of airway inflammation in steroid naïve adult and pediatric patients with intermittent asthma over one year. METHODS 54 children and 50 adults with intermittent asthma (GINA step 1) were included. On up to 6 visits lung function, airway hyperresponsiveness to methacholine (PC20FEV1), sputum eosinophils and exhaled nitric oxide (FeNO) were assessed. RESULTS 36 pediatric and 34 adult patients were able to produce at least three adequate sputum samples over the study period and were included into the analysis.In 8 children (22%) the percentage of sputum eosinophils was always below 2.5%. A higher level of eosinophils (>2.5%) was found on at least one visit in 16 (44%) and always >2.5% in 12 children (33%). In the adult group the respective numbers were 14 patients (41%) with always low (<2.5%), 17 (50%) with at least once over 2.5% and three patients (9%) were always above the threshold of 2.5% sputum eosinophils. CONCLUSION These results demonstrate that a substantial number of children and adults with intermittent asthma under ß-agonist treatment only, have variable or persistently high levels of eosinophilic airway inflammation. Long-term studies are needed to observe the progression of asthma severity in such patient populations.
Collapse
Affiliation(s)
- Frauke Pedersen
- />LungClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research, Wöhrendamm 80, 22927 Großhansdorf, Germany
- />Pulmonary Research Institute at LungClinic Grosshansdorf, Wöhrendamm 80, 22927 Großhansdorf, Germany
| | - Olaf Holz
- />Fraunhofer ITEM, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Feodor-Lynen-Str. 15, 30625 Hannover, Germany
| | - Frank Kanniess
- />Pulmonary Research Institute at LungClinic Grosshansdorf, Wöhrendamm 80, 22927 Großhansdorf, Germany
- />Practice for Allergy and Family Medicine, Raiffeisenpassage 15, 23858 Reinfeld, Germany
| | - Stefan Zielen
- />University Hospital Frankfurt, Center for children and adolescents, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Johannes Schulze
- />University Hospital Frankfurt, Center for children and adolescents, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Adrian Gillissen
- />Robert Koch Klinik, Pneumologie Zentrum, Nikolai-Rumjanzew-Str. 100, 04207 Leipzig, Germany
- />Department of Pulmonary Medicine, Hospital Kassel, Mönchebergstr. 41-43, 34125 Kassel, Germany
| | - Andrea von Berg
- />Marienhospital Wesel, Klinik für Kinder und Jugendmedizin, Pastor-Janssen-Str. 8-38, 46483 Wesel, Germany
| | - Dietrich Berdel
- />Marienhospital Wesel, Klinik für Kinder und Jugendmedizin, Pastor-Janssen-Str. 8-38, 46483 Wesel, Germany
| | - Jutta Beier
- />insaf - Respiratory Research Institute GmbH, Biebricher Allee 34, 65187 Wiesbaden, Germany
| | - Kai Beeh
- />insaf - Respiratory Research Institute GmbH, Biebricher Allee 34, 65187 Wiesbaden, Germany
| | - Maike Schnoor
- />Department of Social Medicine, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, house 50, 23552 Lübeck, Germany
| | - Helgo Magnussen
- />Pulmonary Research Institute at LungClinic Grosshansdorf, Wöhrendamm 80, 22927 Großhansdorf, Germany
| |
Collapse
|
6
|
Syslová K, Böhmová A, Demirbağ E, Šimková K, Kuzma M, Pelclová D, Sedlák V, Čáp P, Martásek P, Kačer P. Immunomagnetic molecular probe with UHPLC-MS/MS: a promising way for reliable bronchial asthma diagnostics based on quantification of cysteinyl leukotrienes. J Pharm Biomed Anal 2013; 81-82:108-17. [PMID: 23644905 DOI: 10.1016/j.jpba.2013.03.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 03/26/2013] [Accepted: 03/28/2013] [Indexed: 11/26/2022]
Abstract
A sensitive and precise method for simultaneous quantification of cysteinyl leukotrienes (=cys LTs) - leukotriene C4 (=LTC4), leukotriene D4 (=LTD4) and leukotriene E4 (=LTE4) - essential biomarkers of bronchial asthma present in exhaled breath condensate (=EBC) was developed. An immunomagnetic molecular probe was prepared by anchoring cysteinyl leukotrienes antibody on the surface of functionalized monodispersed magnetic particles and used to selectively isolate cys LTs from biological matrices - EBC, plasma and urine. Immobilization and the immunoaffinity capture procedures were optimized to maximize the amount of separated cys LTs, which were detected "off-beads" after acidic elution by UHPLC-ESI-MS/MS operated in a multiple reaction monitoring mode. The developed method was characterized with high precision ≤13.6% (intra-day precision determined as RSD) and ≤14.5% (inter-day precision determined as RSD), acceptable accuracy ≤18.5% (determined as RE), and high recovery of immunoseparation (≥93.1%) in aforementioned biological matrices. The applicability of the method was demonstrated on EBC, plasma and urine clinical samples of patients with various subtypes of bronchial asthma (occupational, steroid-resistant, moderate with and without corticosteroids therapy) and healthy subjects where reasonable differences in cys LTs concentration levels were found. Combining extremely selective immunomagnetic separation with highly sensitive and precise detection step, the developed method was used to aid diagnosis, predict the most effective therapy, and monitor the response to treatment. The detection of elevated inflammatory mediators (cys LTs) in EBC of subjects with relatively asymptomatic asthma and normal pulmonary function tests could offer a novel way for monitoring the lung inflammation and perhaps initiating treatment in an earlier stage.
Collapse
Affiliation(s)
- Kamila Syslová
- Institute of Chemical Technology, Technicka 5, 166 28 Prague 6, Czech Republic
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Marin A, Garcia-Aymerich J, Sauleda J, Belda J, Millares L, García-Núñez M, Serra I, Benet M, Agustí A, Antó JM, Monsó E. Effect of bronchial colonisation on airway and systemic inflammation in stable COPD. COPD 2013; 9:121-30. [PMID: 22458940 DOI: 10.3109/15412555.2011.636407] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The recovery of potentially pathogenic microorganisms (PPMs) from bronchial secretions is associated with a local inflammatory response in COPD patients. The objective of this study was to determine the relationships between bronchial colonisation and both bronchial and systemic inflammation in stable COPD. In COPD patients recruited on first admission for an exacerbation, bacterial sputum cultures, interleukin (IL)-1β, IL-6 and IL-8 levels, and blood C-reactive protein (CRP) were measured in stable condition. Bronchial colonisation was found in 39 of the 133 (29%) patients and was significantly related to higher sputum IL-1β (median [percentile 25-75]; 462 [121-993] vs. 154 [41-477] pg/ml, p = 0.002), IL-6 (147 [71-424] vs. 109 [50-197] pg/ml, p = 0.047) and IL-8 values (15 [9-19] vs. 8 [3-15] (×10³) pg/ml, p = 0.002). Patients with positive cultures also showed significantly elevated levels of serum CRP (6.5 [2.5-8.5] vs. 3.5 [1.7-5.4] mg/l, p = 0.016). Bronchial colonisation by Haemophilus influenzae was associated with higher levels of IL-1β and IL-8 and clinically significant worse scores on the activity and impact domains of the St. George's Respiratory Questionnaire. In conclusion, bronchial colonisation is associated with bronchial inflammation and high blood CRP levels in stable COPD patients, being Haemophilus influenzae related to a more severe inflammatory response and impairment in health-related quality of life.
Collapse
Affiliation(s)
- Alicia Marin
- Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Pedersen F, Marwitz S, Seehase S, Kirsten AM, Zabel P, Vollmer E, Rabe KF, Magnussen H, Watz H, Goldmann T. HOPE-preservation of paraffin-embedded sputum samples--a new way of bioprofiling in COPD. Respir Med 2013; 107:587-95. [PMID: 23312618 DOI: 10.1016/j.rmed.2012.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 12/03/2012] [Accepted: 12/09/2012] [Indexed: 11/26/2022]
Abstract
Induced sputum is a non-invasive sampling technique for the analysis of airway inflammation in various lung diseases and comprises valuable potential for the identification of biomarkers and therapeutic targets by molecular methods. In the context of biobanking with preservation of induced sputum samples for subsequent analyses we applied the HEPES-glutamic acid buffer-mediated organic solvent protection effect (HOPE)-technique for preparation of induced sputum samples. Induced sputum samples of 20 patients with moderate to severe chronic obstructive pulmonary disease (COPD) and 12 healthy controls were collected. Cell pellets of induced sputum samples were preserved with HOPE and subsequently embedded in paraffin. Immunostaining of paraffin-block sections for interleukin-8, interleukin-17, myeloperoxidase, matrixmetalloproteinase-9, CD68, and CD8 revealed distinct signals without antigen retrieval. Moreover, RNA was extracted and successfully used for transcription microarray analysis. Sputum samples preserved by the HOPE-technique display a tool to address scientific approaches in pulmonary research, which can enable the identification of new biomarkers and therapeutic targets in respiratory diseases.
Collapse
Affiliation(s)
- Frauke Pedersen
- Pulmonary Research Institute at Hospital Grosshansdorf, Center for Pneumology and Thoracic Surgery, Grosshansdorf, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Capillary electrophoresis – A new tool for ionic analysis of exhaled breath condensate. J Chromatogr A 2012; 1267:239-45. [DOI: 10.1016/j.chroma.2012.06.085] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 06/19/2012] [Accepted: 06/25/2012] [Indexed: 12/18/2022]
|
10
|
Marin A, Garcia-Aymerich J, Sauleda J, Belda J, Millares L, García-Núñez M, Serra I, Benet M, Agustí A, Antó JM, Monsó E, on behalf of the PAC-COPD Study Gro. Effect of Bronchial Colonisation on Airway and Systemic Inflammation in Stable COPD. COPD 2012. [DOI: 10.3109/15412555.2012.636407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
11
|
Syslová K, Kačer P, Vilhanová B, Kuzma M, Lipovová P, Fenclová Z, Lebedová J, Pelclová D. Determination of cysteinyl leukotrienes in exhaled breath condensate: method combining immunoseparation with LC-ESI-MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879:2220-8. [PMID: 21724475 DOI: 10.1016/j.jchromb.2011.06.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 05/29/2011] [Accepted: 06/06/2011] [Indexed: 11/13/2022]
Abstract
A rapid and precise method for the identification and quantification of cysteinyl leukotrienes (leukotriene C(4), leukotriene D(4) and leukotriene E(4)), essential markers of bronchial asthma, in exhaled breath condensate was developed. The protocol consists of immunoaffinity separation and a detection step, liquid chromatography combined with electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS). In particular, 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 with a high precision (≤ 7.7%, determined as RSD), an acceptable accuracy (90.4-93.7%, determined as recovery), a low limit of detection (≤ 2 pg/ml EBC) and a low limit of quantification (≤ 10 pg/ml EBC). It was compared to other simple, clinically appropriate combinations of pre-treatment methods (solid phase extraction and lyophilization) with LC/MS. Finally, the method (a combination of immunoaffinity separation with LC-MS) was successfully tested in a clinical study where a significant difference was found in the concentration levels of cysteinyl leukotrienes between patients with occupational bronchial asthma and healthy subjects.
Collapse
Affiliation(s)
- Kamila Syslová
- Institute of Chemical Technology, Technická 5, 166 28 Prague 6, Czech Republic
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Botturi K, Langelot M, Lair D, Pipet A, Pain M, Chesne J, Hassoun D, Lacoeuille Y, Cavaillès A, Magnan A. Preventing asthma exacerbations: what are the targets? Pharmacol Ther 2011; 131:114-29. [PMID: 21440000 DOI: 10.1016/j.pharmthera.2011.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Accepted: 03/07/2011] [Indexed: 12/22/2022]
Abstract
Exacerbations of asthma are the main cause of asthma morbidity. They induce acute respiratory failure, and sometimes death. Two immunological signals acting in synergy are necessary for inducing asthma exacerbations. The first, triggered by allergens and/or unknown agents leads to the chronic Th2 inflammation characteristic of asthma. The second, caused by either viral infection, allergens, pollutants or a combination of these, results in an acute Th1 and Th2 inflammation precipitating symptoms. In both, innate and adaptive immunities are involved, providing a series of potential targets for therapy. Molecules associated to the first, chronic inflammation constitute targets for preventing therapies, when these related to the second, acute signal provide the rationale for curative treatments. Toll like receptors and bronchial epithelial cell-derived cytokines, engaged upstream of inflammation constitute interesting candidates for future treatments. The great heterogeneity of asthma has to be taken into account when considering targets for therapy to identify clusters of responders and nonresponders, and an integrative system biology approach will be necessary to go further.
Collapse
|
13
|
MacRedmond R, Singhera G, Attridge S, Bahzad M, Fava C, Lai Y, Hallstrand TS, Dorscheid DR. Conjugated linoleic acid improves airway hyper-reactivity in overweight mild asthmatics. Clin Exp Allergy 2010; 40:1071-8. [PMID: 20642580 DOI: 10.1111/j.1365-2222.2010.03531.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Conjugated linoleic acids (CLA) are naturally occurring fatty acids that have multiple biological properties including the regulation of metabolic, proliferative and immune processes. OBJECTIVE The aim of this study was to investigate the efficacy and safety of CLA as a dietary supplement in mild asthma. METHODS This was a prospective, randomized, double-blind, placebo-controlled study. Twenty-eight adult subjects (aged 19-40 years) with mild asthma (FEV(1)>70% predicted) were randomized to CLA 4.5 g/day or placebo for 12 weeks in addition to usual treatment. On average, subjects were overweight with a mean body mass index (BMI) of 27.9 kg/m(2). RESULTS Subjects in the CLA group had a significant improvement in airway hyperresponsiveness (AHR) at week 12 compared with week 0 [PC(20) 6.6 (2.1) mg/mL vs. 2.2 (0.7) mg/mL; P<0.05]. The CLA group had a significant reduction in weight and BMI compared with placebo and this was associated with a reduction in leptin/adiponectin ratio. There were no differences in systemic cytokine levels, induced sputum cell counts, quality-of-life scores or adverse events. CONCLUSIONS CLA treatment as an adjunct to usual care in overweight mild asthmatics was well tolerated and was associated with improvements in AHR and BMI.
Collapse
Affiliation(s)
- R MacRedmond
- Providence Healthcare Heart+Lung Institute, St Paul's Hospital, University of British Columbia, Vancouver, Canada.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Lourenço O, Mafalda Fonseca A, Taborda-Barata L. T cells in sputum of asthmatic patients are activated independently of disease severity or control. Allergol Immunopathol (Madr) 2009; 37:285-92. [PMID: 19850398 DOI: 10.1016/j.aller.2009.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 05/06/2009] [Accepted: 05/08/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND T cells play an important role in bronchial asthma. Although airway CD4+ T cells have been extensively studied previously, there are hardly any studies relating CD8+ T cell activation and disease symptoms. OBJECTIVES The aim of this study was to analyse the association between T cell activation in induced sputum T cells and asthma severity and control; and to evaluate T cell subpopulations in the same subgroups. METHODS Fifty allergic asthmatic patients were recruited and lung function testing was performed. Airway cells were obtained by sputum induction via inhalation of hypertonic saline solution. CD3, CD4, CD8, CD28, CD25 and CD69 were studied by flow cytometry in whole induced sputum and peripheral blood cells. RESULTS Total induced sputum T cells and CD8+ T cells had a higher relative percentage of the activation markers CD25 and CD69 in comparison with peripheral blood. In sputum, the relative percentage of CD25 was higher in CD4+ T cells when compared to CD8+ T cells and the reverse was true regarding CD69. However, neither disease severity nor control were associated with the relative percentage of CD25 or CD69 expression on T cells in sputum. CONCLUSIONS Both CD4+ and CD8+ T cells are activated in the lungs and peripheral blood of asthmatic patients. However, with the possible exception of CD69+ CD8+ T lymphocytes in the sputum, there is no association between T cell activation phenotype in the target organ and disease severity or control.
Collapse
|
15
|
Terada K, Muro S, Ohara T, Kudo M, Ogawa E, Hoshino Y, Hirai T, Niimi A, Chin K, Mishima M. Abnormal swallowing reflex and COPD exacerbations. Chest 2009; 137:326-32. [PMID: 19783670 DOI: 10.1378/chest.09-0482] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND It is unclear whether an abnormal swallowing reflex affects COPD exacerbations. This study investigated the prevalence of abnormal swallowing reflexes and its relationship with COPD exacerbation prospectively. We also clarified its association with gastroesophageal reflux disease (GERD) and airway bacterial colonization. METHODS Swallowing reflex and serum C-reactive protein (CRP) levels were examined in subjects with stable COPD and in control subjects. Concurrently, GERD symptoms were assessed using a self-reported questionnaire, and sputum bacterial cultures were investigated in the same subjects. Exacerbations were counted prospectively during the following 12 months. RESULTS The study group comprised 67 subjects with COPD and 19 controls. The prevalence of abnormal swallowing reflex was significantly higher in subjects with COPD (22/67) than controls (1/19; P = .02). Among subjects with COPD, the serum CRP level, GERD symptoms, isolation of sputum bacteria, and the frequency of exacerbations were significantly increased in those with abnormal swallowing reflexes compared with controls (2.72 vs 1.04 mg/L, P = .04, for serum CRP level; 6.75 vs 4.10 points, P = .04, for GERD symptoms; 5/11 vs 3/22, P = .04, for the isolation of sputum bacteria; and 2.82 vs 1.56/y, P = .007, for the annual frequency of exacerbations). Multivariable analysis confirmed that abnormal swallowing reflex was significantly associated with frequent exacerbations (>or= 3/y; P = 0.01). CONCLUSIONS Abnormal swallowing reflexes frequently occurred in subjects with COPD and predisposed them to exacerbations. Abnormal swallowing reflexes in COPD might be affected by the comorbidity of GERD, and cause bacterial colonization.
Collapse
Affiliation(s)
- Kunihiko Terada
- Department of Respiratory Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Boorsma M, Lutter R, van de Pol MA, Out TA, Jansen HM, Jonkers RE. Repeatability of Inflammatory Parameters in Induced Sputum of COPD Patients. COPD 2009; 4:321-9. [DOI: 10.1080/15412550701597720] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
17
|
Sawyer K, Samet JM, Ghio AJ, Pleil JD, Madden MC. Responses measured in the exhaled breath of human volunteers acutely exposed to ozone and diesel exhaust. J Breath Res 2008; 2:037019. [DOI: 10.1088/1752-7155/2/3/037019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
18
|
Mamessier E, Nieves A, Lorec AM, Dupuy P, Pinot D, Pinet C, Vervloet D, Magnan A. T-cell activation during exacerbations: a longitudinal study in refractory asthma. Allergy 2008; 63:1202-10. [PMID: 18699937 DOI: 10.1111/j.1398-9995.2008.01687.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Asthma exacerbations represent the main source of costs and morbidity in asthma care, and drugs specifically designed to prevent exacerbations are needed. A prerequisite is to dispose of a precise knowledge of inflammatory events leading to exacerbations. OBJECTIVE To study T-cell activation during exacerbations from severe refractory asthmatics. METHODS Proportions of blood T-cell interleukin (IL)-13, interferon-gamma, IL-4, IL-5, IL-10 production and of CD4+CD25+(high)CD62L+CD45RO+ [T regulatory (Treg)] cells were determined by flow cytometry. Blood cytokine mRNA was studied by reverse transcription-polymerase chain reaction and the respective protein levels were determined by cytokine beads array. Depletion of Treg cells was performed to study their activation. T-cell cytokines were detected in parallel in induced sputum. RESULTS At baseline, T helper 2 (Th2) cells were increased in asthmatics, whereas T helper 1 (Th1) and Treg T cells were decreased. T helper 2 cells increased before exacerbations, followed by Th1 cells, in blood and induced sputum, albeit Treg cells decreased in parallel with IL-10-producing T cells. Concordant results were found at the mRNA level. The suppressive activity of Treg cells was impaired during exacerbations compared to baseline. CONCLUSIONS New insights are given into pathophysiology of asthma exacerbations: Although at baseline T-cell activation is Th2-biased, a mixed Th1/Th2 activation occurs during exacerbations. The Treg cell deficiency found at baseline in SRA increases during exacerbations.
Collapse
Affiliation(s)
- E Mamessier
- Université de Méditerranée, EA 3287, IFR125, France
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Celio S, Troxler H, Durka SS, Chládek J, Wildhaber JH, Sennhauser FH, Heizmann CW, Moeller A. Free 3-nitrotyrosine in exhaled breath condensates of children fails as a marker for oxidative stress in stable cystic fibrosis and asthma. Nitric Oxide 2006; 15:226-32. [PMID: 16931075 DOI: 10.1016/j.niox.2006.06.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2005] [Revised: 04/26/2006] [Accepted: 06/21/2006] [Indexed: 10/24/2022]
Abstract
3-Nitrotyrosine (3-NT) is considered as a marker of oxidative stress, which occurs during inflammation. Since 3-NT levels in exhaled breath condensate (EBC) are very low, we applied a specific and sensitive gas chromatography-negative ion chemical ionization-mass spectrometry (GC-NICI-MS) method and high performance liquid chromatography (HPLC) with electrochemical detection for the analysis of free 3-NT in EBC. A total of 42 children (aged 5-17 years) were enrolled in this study, including children with asthma (n=12), cystic fibrosis (n=12), and healthy controls (n=18). Additionally, 14 healthy non-smoking adults (aged 18-59 years) were included. An EcoScreen system was used for the collection of EBC samples. Free 3-NT levels in EBC ranged from 0.54-6.8 nM. Median (interquartile range) concentrations (nM) were similar in all groups: 1.46 (0.97-2.49) in healthy adults, 2.51 (1.22-3.51) in healthy children, 1.46 (0.88-2.02) in children with asthma, and 1.97 (1.37-2.35) in CF children, respectively (p=0.24, Kruskall-Walis test). No difference was found between the children with airway disease and age-matched healthy controls. In healthy subjects, there was no effect of age on 3-NT concentrations. HPLC analyses provided similar concentration ranges for EBC 3-NT when compared with GC-NICI-MS. Our study has clearly demonstrated that free 3-NT in EBC fails as a marker for oxidative stress in children with stable CF and asthma.
Collapse
Affiliation(s)
- Silva Celio
- Division of Respiratory Medicine, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Hartl D, Starosta V, Maier K, Beck-Speier I, Rebhan C, Becker BF, Latzin P, Fischer R, Ratjen F, Huber RM, Rietschel E, Krauss-Etschmann S, Griese M. Inhaled glutathione decreases PGE2 and increases lymphocytes in cystic fibrosis lungs. Free Radic Biol Med 2005; 39:463-72. [PMID: 16043018 DOI: 10.1016/j.freeradbiomed.2005.03.032] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2004] [Revised: 03/23/2005] [Accepted: 03/29/2005] [Indexed: 10/25/2022]
Abstract
Reduced glutathione (GSH), a major antioxidant and modulator of cell proliferation, is decreased in the bronchoalveolar lavage fluid (BALF) of cystic fibrosis (CF) patients. We previously have shown that GSH inhalation in CF patients significantly increased GSH levels in BALF and improved lung function (M. Griese et al., 2004, Am. J. Respir. Crit. Care Med.169, 822-828). GSH depletion in vitro enhances susceptibility to oxidative stress, increases inflammatory cytokine release, and impairs T cell responses. We therefore hypothesized that an increase in GSH in BALF reduces oxidative stress, decreases inflammation, and modulates T cell responses in lungs of CF patients. BALF from 17 CF patients (median FEV1 67% (43-105%) of predicted) was assessed before and after GSH inhalation for total protein, markers of oxidative stress (8-isoprostane, myeloperoxidase, and ascorbic and uric acid), pattern of protein oxidation, prostaglandin E2 (PGE2), and proinflammatory cytokines. BALF cells were differentiated using cytospin slides, and lymphocytes were further analyzed by flow cytometry. Inhalation of GSH decreased BALF levels of PGE2 and increased CD4+ and CD8+ lymphocytes in BALF significantly but had no effect on markers of oxidative stress. BALF lymphocytes correlated positively with lung function, whereas levels of PGE2 showed an inverse correlation. The patients with the greatest improvement in lung function after GSH treatment also had the largest decline in PGE2 levels. We conclude that GSH inhalation in CF patients increases lymphocytes and suppresses PGE2 in the bronchoalveolar space. Thus, GSH primarily affected the pulmonary immune response rather than the oxidative status in CF patients. The effect of GSH inhalation on PGE2 levels and lymphocytes in CF warrants further investigation.
Collapse
Affiliation(s)
- D Hartl
- Department of Pediatrics, Ludwig Maximilians University, Munich, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Parnham MJ, Culić O, Eraković V, Munić V, Popović-Grle S, Barisić K, Bosnar M, Brajsa K, Cepelak I, Cuzić S, Glojnarić I, Manojlović Z, Novak-Mircetić R, Oresković K, Pavicić-Beljak V, Radosević S, Sucić M. Modulation of neutrophil and inflammation markers in chronic obstructive pulmonary disease by short-term azithromycin treatment. Eur J Pharmacol 2005; 517:132-43. [PMID: 15964564 DOI: 10.1016/j.ejphar.2005.05.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2004] [Revised: 05/18/2005] [Accepted: 05/24/2005] [Indexed: 10/25/2022]
Abstract
The anti-inflammatory potential of azithromycin in chronic obstructive pulmonary disease (COPD) patients was explored following a standard oral dosing regimen. Patients with moderate and severe COPD were treated with azithromycin (500 mg, n=16) or placebo (n=8) once daily for 3 days in a randomized, double blind design, to compare effects on inflammation markers with those seen in a previous study in healthy volunteers. A battery of tests was made on serum, blood neutrophils and sputum on days 1 (baseline), 3, 4, 11, 18 and 32. In comparison to placebo, azithromycin resulted in an early transient increase in serum nitrites plus nitrates (day 3), associated with a tendency towards an increase in the blood neutrophil oxidative burst to phorbol myristic acetate. Subsequently, prolonged decreases in blood leukocyte and platelet counts, serum acute phase protein (including C reactive protein) and soluble E-selectin and blood neutrophil lactoferrin concentrations and a transient decrease in serum interleukin-8 were observed. Blood neutrophil glutathione peroxidase activity showed a prolonged increase after azithromycin treatment. The biphasic facilitatory-then-inhibitory response to azithromycin seen in healthy volunteers is not so clearly detectable in COPD patients, only potential anti-inflammatory effects. Treatment for longer periods may give therapeutic anti-inflammatory benefit in these patients.
Collapse
Affiliation(s)
- Michael J Parnham
- PLIVA Research Institute Ltd, Prilaz baruna Filipovića 29, HR-10 000 Zagreb, Croatia.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Antoniou KM, Alexandrakis M, Tzanakis N, Tsiligianni I, Tzortzaki EG, Siafakas NM, Bouros DE. Induced sputum versus bronchoalveolar lavage fluid in the evaluation of patients with idiopathic pulmonary fibrosis. Respiration 2005; 72:32-8. [PMID: 15753632 DOI: 10.1159/000083398] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2003] [Accepted: 08/19/2004] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Induced sputum (IS) has been proposed as a useful noninvasive method for the assessment of airway diseases. Bronchoalveolar lavage fluid (BALF), an important tool for evaluating interstitial lung diseases, has limited utility due to its invasiveness and the difficulties of performing it in severely ill patients, while it is impractical for follow-up evaluation. OBJECTIVES The aim of this study was to investigate the differences and the possible correlation of cell differential and lymphocyte subpopulations between BALF and IS samples in patients with idiopathic pulmonary fibrosis (IPF). METHODS We studied prospectively 20 patients (18 male, 2 female) of median age 67 years (range 40-75) with IPF and 10 normal subjects (5 female, 5 male) of median age 59 years (range 36-70). IS was performed with hypertonic saline solution using an ultrasonic nebulizer (Ultraneb 2000). BALF was performed by a conventional procedure using fiberoptic bronchoscopy within 3 days from IS. May-Grunewald-Giemsa-stained preps were differentially counted and T-lymphocyte subsets were analyzed by a flow-activated cell sorter. RESULTS The percentage of macrophages was significantly lower in IS than in BALF (p < 0.0001), while the neutrophils were lower in BALF (p < 0.0001). A significant correlation was found between BALF and IS eosinophil counts (r = 0.54, p = 0.01) and CD4+/CD8+ ratio (r = 0.74, p < 0.0001). CONCLUSION Our data suggest that different information is obtained by IS and BALF and thus, the two methods are complementary in IPF.
Collapse
Affiliation(s)
- Katerina M Antoniou
- Interstitial Lung Disease Unit, Department of Pneumonology, Medical School University of Crete and University Hospital, Heraklion, Greece
| | | | | | | | | | | | | |
Collapse
|
23
|
Beier J, Beeh KM, Kornmann O, Buhl R. Induced sputum methodology: Validity and reproducibility of total glutathione measurement in supernatant of healthy and asthmatic individuals. ACTA ACUST UNITED AC 2004; 144:38-44. [PMID: 15252406 DOI: 10.1016/j.lab.2004.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Glutathione (GSH), a major antioxidant, has repeatedly been linked to the pathogenesis of pulmonary disease. The measurement of GSH in induced sputum (IS) offers a noninvasive tool for the study and monitoring of oxidative stress in airway diseases. In this study we assessed the validity and reproducibility of GSH quantification in IS from healthy subjects and individuals with mild asthma. We spectrophotometrically quantified total GSH in the IS of 31 healthy nonsmoking volunteers and 12 individuals with mild asthma. IS was processed with varying concentrations of dithiothreitol (DTT) in an effort to evaluate the effect of DTT on GSH measurements. We performed spiking experiments with defined concentrations of GSH and quantified the percentage of recovery and also analyzed the effect of induction time on GSH levels through sequential sampling of sputum portions (15, 30, and 45 minutes' induction). Finally we tested the reproducibility of GSH measurements at 2 separate time points (0 and 72 hours) and expressed it as an intraclass correlation coefficient (R(i)) with a coefficient of reliability (CR). Processing with DTT increased GSH values in IS (P <.05 for each DTT concentration > 0.001%). Recovery of GSH after spiking was complete, with a mean recovery of 102% +/- 4.8%. Increasing duration of induction led to an increase in sputum GSH (15 minutes, 10.2 +/- 2.3 micromol/L; 30 minutes, 18.4 +/- 3.5 micromol/L; 45 minutes, 26.1 +/- 4 micromol/L; P <.05 for all comparisons). Reproducibility of sputum GSH both in healthy subjects and asthmatic individuals was good (R(i) =.78, P <.001; and R(i) =.51, P =.003, respectively). With the use of standardized protocols for duration of induction and sample processing, sputum GSH measurement in healthy subjects and asthmatic individuals is valid and reproducible.
Collapse
Affiliation(s)
- Jutta Beier
- Pulmonary Department, Division of Internal Medicine, University Hospital Mainz, Mainz, Germany.
| | | | | | | |
Collapse
|
24
|
Lönnkvist K, Anderson M, Hedlin G, Svartengren M. Exhaled NO and eosinophil markers in blood, nasal lavage and sputum in children with asthma after withdrawal of budesonide. Pediatr Allergy Immunol 2004; 15:351-8. [PMID: 15305945 DOI: 10.1111/j.1399-3038.2004.00165.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is a need for controlled trials among children with asthma to evaluate and compare different markers of inflammation. OBJECTIVE Our goal was to investigate the effect of withdrawal of inhaled budesonide on repeated measurements of exhaled NO (ENO), peripheral blood eosinophils (PBE), sputum/NAL/serum-eosinophil cationic protein (ECP), bronchial hyperresponsiveness (BHR) and forced expiratory volume in 1 s (FEV(1)) in children with allergic asthma. METHODS Eighteen asthmatic children were randomly allocated to continue or discontinue use of inhaled budesonide. They were followed up, at six visits for 4 months with regular blood, serum, sputum, and NAL samples. Sixteen age-matched healthy children served as controls. RESULTS ENO, PBE, and S-ECP increased significantly in the withdrawal group (p < 0.05) but not in the continuous treatment group. No trend could be observed during the study for markers in sputum or in NAL in either group. CONCLUSION The present data provide evidence for the clinical usefulness of measuring ENO, PBE, and S-ECP and when combined they could help to avoid over- and undertreatment with corticosteroids in the growing child.
Collapse
Affiliation(s)
- Karin Lönnkvist
- Astrid Lindgren Children's Hospital, Karolinska Hospital, Stockholm, Sweden.
| | | | | | | |
Collapse
|
25
|
Mamessier E, Boniface S, Dupuy P, Reynaud-Gaubert M, Vervloet D, Magnan A. Study of cytokine gene expression in small cell samples: use in induced sputum. J Immunol Methods 2003; 280:37-47. [PMID: 12972186 DOI: 10.1016/s0022-1759(03)00230-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sputum examination is being increasingly used as a non-invasive method for the study of airway inflammation. However, the technical applications of sputum are still limited because of the small number of cells recovered. In attempt to extend applications of sputum examinations, we developed and standardised, the reverse transcriptase-polymerase chain reaction (RT-PCR), a sensitive and specific technique of detection of mRNA, in induced sputum samples. Total RNA were extracted from samples containing as few as 50 to 80,000 cells, using a phenol-chloroform extraction method. RT-PCR was successfully tested on beta-actin, interferon-gamma (IFN-gamma), interleukin-4 (IL-4) and tumour necrosis factor-beta (TGF-beta) genes. This protocol provides a simple technique to extract total RNA from a few number of induced sputum cells. It permits the semi-quantitatively study of cytokine gene expression in airways with simple means.
Collapse
Affiliation(s)
- E Mamessier
- UPRES EA 3287, Univ-Mediterranée, Pathologie respiratoire liée à l'environnement, Hôpital Ste Marguerite, Service de Pneumo-allergologie, 270 Bd de Ste Marguerite, 13009 Marseilles, France
| | | | | | | | | | | |
Collapse
|
26
|
Abstract
During the last decade, the method of sputum induction (SI) has offered the opportunity to study inflammation in patients with chronic obstructive pulmonary disease (COPD). This paper reviews methodological aspects of SI and summarizes its uses in the research of inflammation in COPD, including sputum cellularity and soluble markers. SI is a relatively safe, reliable, and reproducible technique, used to investigate different aspects of airway inflammation. Although various methods of induction and processing have been proved safe and highly reproducible, a generally accepted method is needed. Sputum analysis has given evidence for increased numbers of macrophages and neutrophils in COPD patients compared to normal subjects. In some studies, increased numbers of eosinophils have been also reported. Changes in various mediators have been found in sputum supernatant of COPD patients (IL-8, LTB-4 and TNF-a). The clinical usefulness of the method in the follow-up of the disease has not been explored extensively. A number of observations in patients with different clinical characteristics could be proven useful in identifying patterns of inflammation associated with different prognosis. Finally, SI could also guide treatment; such as, sputum eosinophilia in COPD could predict response to inhaled corticosteroids.
Collapse
Affiliation(s)
- M Tsoumakidou
- Department of Thoracic Medicine, Medical School, University of Crete, P. O. Box 1352, Heraklion, Crete 71110, Greece
| | | | | |
Collapse
|
27
|
Domagała-Kulawik J, Maskey-Warzechowska M, Kraszewska I, Chazan R. The cellular composition and macrophage phenotype in induced sputum in smokers and ex-smokers with COPD. Chest 2003; 123:1054-9. [PMID: 12684293 DOI: 10.1378/chest.123.4.1054] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVES The relationship between smoking and COPD has been well-documented. We investigated the impact of cigarette smoking on airway inflammation in COPD patients. DESIGN Changes in cell profiles in induced sputum (IS) samples from smokers with COPD and patients who ceased smoking were compared. SETTING Department of pneumonology in a university hospital. PATIENTS IS samples were collected from 17 smokers and 17 ex-smokers with COPD. INTERVENTIONS We examined IS samples for differential cell counts and macrophage phenotypes determined by immunocytochemistry with monoclonal antibodies anti-CD11b, anti-CD14, anti-CD54, and anti-CD71. MEASUREMENTS AND RESULTS The median IS volume was greater and the total cell count was higher in smokers than in ex-smokers. The difference, however, was not significant. We did not find any significant differences in the proportions of cells and in the phenotypes of macrophages between the two groups, with the proportion of eosinophils being slightly higher in the group of smokers. We found, however, a significant positive correlation between the decrease in pulmonary function parameters and the number of pack-years smoked, an inverse correlation of pulmonary function test results with the number of lymphocytes in IS, and a correlation between some changes in the expression of macrophage surface markers and smoking history. There was no correlation between the time from smoking cessation and any cellular component found in IS samples. CONCLUSIONS The analysis of IS samples in patients with COPD revealed no significant differences in cell count and macrophage phenotypes between active smokers and ex-smokers.
Collapse
|
28
|
Beeh KM, Beier J, Kornmann O, Mander A, Buhl R. Long-term repeatability of induced sputum cells and inflammatory markers in stable, moderately severe COPD. Chest 2003; 123:778-83. [PMID: 12628878 DOI: 10.1378/chest.123.3.778] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVES Neutrophilic inflammation is a major feature of COPD. Induced sputum is increasingly used to monitor inflammatory airway diseases. Although short-term repeatability of selected sputum markers has been extensively studied in several populations, data on the long-term repeatability of induced sputum markers in stable COPD are scant. DESIGN Sputum supernatant of 12 patients with stable COPD was analyzed on three separate occasions with 4-weekly intervals. Sputum cells and inflammatory markers interleukin (IL)-8 and soluble intercellular adhesion molecule (sICAM)-1 were measured in supernatant using enzyme-linked immunosorbent assay. Repeatability of sputum markers was expressed by intraclass correlation coefficients (Ri). MEASUREMENTS AND RESULTS Sputum induction was safe in all patients. None of the sputum parameters analyzed changed significantly throughout the study. The repeatability for cell differential counts in stable COPD was as follows: total cells, Ri = 0.07; neutrophils, Ri = 0.66; macrophages, Ri = 0.47; eosinophils, Ri = 0.49; and lymphocytes, Ri = 0.58. The repeatability of soluble markers was as follows: IL-8, Ri = 0.50; and sICAM, Ri = 0.58. Sputum neutrophils were negatively correlated with lung function on each separate occasion, whereas soluble markers were not correlated with sputum cells (p > 0.16, all correlations) or lung function (p > 0.24, all correlations). CONCLUSIONS Clinically stable, moderate COPD is associated with equally stable sputum inflammatory markers. Repeatability of induced-sputum markers of neutrophilic inflammation in stable COPD is satisfactory, even over extended periods of time. These data support the usefulness of serial monitoring of induced-sputum inflammatory markers in COPD.
Collapse
Affiliation(s)
- Kai M Beeh
- Pulmonary Department, Internal Medicine, University Hospital, Mainz, Germany.
| | | | | | | | | |
Collapse
|
29
|
Leckie MJ, Jenkins GR, Khan J, Smith SJ, Walker C, Barnes PJ, Hansel TT. Sputum T lymphocytes in asthma, COPD and healthy subjects have the phenotype of activated intraepithelial T cells (CD69+ CD103+). Thorax 2003; 58:23-9. [PMID: 12511714 PMCID: PMC1746466 DOI: 10.1136/thorax.58.1.23] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND T cells of intraepithelial phenotype have previously been detected in bronchoalveolar lavage (BAL) fluid in a range of lung diseases; these cells express the adhesion molecule alpha(E)beta(7) integrin, CD103, the ligand for epithelial cell E-cadherin. In subjects with asthma CD4+ lymphocytes are the predominant T cell subtype found in bronchial biopsy specimens and in BAL fluid, whereas CD8+ lymphocytes have been shown to predominate in subjects with chronic obstructive pulmonary disease (COPD). The aim of this study was to analyse the expression of CD103, activation markers (CD25 and CD69), and chemokine receptors (CXCR3, CCR5 and CCR3) on CD4+ and CD8+ lymphocytes from sputum and peripheral blood of subjects with asthma, COPD, and healthy controls. METHODS T cell surface markers were assessed by immunofluorescence labelling and flow cytometry of gated lymphocytes among CD45+ leucocytes in sputum cell suspensions. RESULTS Sputum lymphocytes expressed higher levels of CD103 and CD69 than blood lymphocytes in all subject groups, with CD103 expressed at higher levels on CD8+ than on CD4+ cells. There were no detectable differences in numbers of CD4+ and CD8+ T cells between subjects with asthma, COPD and controls. The percentage of sputum lymphocytes expressing CXCR3 was lower in subjects with asthma or COPD than in healthy controls; CCR3 was not detectable on sputum or blood lymphocytes. CONCLUSIONS Sputum T lymphocytes are predominantly of activated intraepithelial phenotype (CD103+ CD69+), and normal numbers of CD4+ and CD8+ T cell populations are found in the sputum of patients with asthma and COPD.
Collapse
Affiliation(s)
- M J Leckie
- National Heart and Lung Institute (NHLI) Clinical Studies Unit, Imperial College, London, UK
| | | | | | | | | | | | | |
Collapse
|
30
|
Sampson AP, Pizzichini E, Bisgaard H. Effects of cysteinyl leukotrienes and leukotriene receptor antagonists on markers of inflammation. J Allergy Clin Immunol 2003; 111:S49-59; discussion S59-61. [PMID: 12532086 DOI: 10.1067/mai.2003.24] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The understanding that asthma pathophysiology includes an inflammatory component has spurred the more aggressive use of anti-inflammatory therapies and created a need for effective tools to measure inflammation. Biomarkers of airway inflammation proposed are obtained by methods that are direct but highly invasive (bronchial biopsy, bronchoalveolar lavage), moderately direct, and less invasive (indirect sputum, exhaled air, breath condensate) or indirect and least invasive (blood, urine). Several studies described in this review have implicated the cysteinyl leukotrienes (CysLTs) as inflammatory mediators in a wide range of diseases, implying that their biological activities reach far beyond acute bronchoconstriction, the activity traditionally ascribed to them. The validity of examining sputum for "biomarkers" has improved the understanding of asthma pathophysiology, optimization of asthma treatment and management, and investigation of the relation between CysLTs and airway inflammation in asthma. Nitric oxide is also a surrogate marker of asthma and reflects airway inflammation. The anti-inflammatory effects of the leukotriene receptor antagonists and the markers of their activity continue to grow.
Collapse
Affiliation(s)
- Anthony P Sampson
- Respiratory Cell Division at Southampton General Hospital, Southampton, UK
| | | | | |
Collapse
|
31
|
Pignatti P, Delmastro M, Perfetti L, Bossi A, Balestrino A, Di Stefano A, Pisati P, Balbi B, Moscato G. Is dithiothreitol affecting cells and soluble mediators during sputum processing? A modified methodology to process sputum. J Allergy Clin Immunol 2002; 110:667-8. [PMID: 12373281 DOI: 10.1067/mai.2002.128279] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
32
|
|
33
|
Montuschi P, Barnes PJ. Analysis of exhaled breath condensate for monitoring airway inflammation. Trends Pharmacol Sci 2002; 23:232-7. [PMID: 12008001 DOI: 10.1016/s0165-6147(02)02020-5] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Several inflammatory mediators have been identified in the exhaled breath condensate (EBC) that is formed by breathing through a cooling system. Analysis of EBC is a noninvasive method that allows repeat measurements of lung inflammation and is potentially useful for monitoring drug therapy. Characterization of the profiles of exhaled markers could help to discriminate between different inflammatory lung diseases; thus, EBC might be a novel, noninvasive approach to monitoring lung diseases. However, several methodological issues, such as standardization of sample collection and validation of analytical techniques, need to be addressed before this method can be applied clinically. Controlled studies are needed to establish the utility of EBC markers for guiding pharmacological treatment in inflammatory lung diseases.
Collapse
Affiliation(s)
- Paolo Montuschi
- Dept of Pharmacology, School of Medicine, Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | | |
Collapse
|
34
|
|