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Ghelli F, Panizzolo M, Garzaro G, Squillacioti G, Bellisario V, Colombi N, Bergamaschi E, Guseva Canu I, Bono R. Inflammatory Biomarkers in Exhaled Breath Condensate: A Systematic Review. Int J Mol Sci 2022; 23:ijms23179820. [PMID: 36077213 PMCID: PMC9456215 DOI: 10.3390/ijms23179820] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 01/08/2023] Open
Abstract
Inflammation is a comprehensive set of physiological processes that an organism undertakes in response to a wide variety of foreign stimuli, such as viruses, bacteria, and inorganic particles. A key role is played by cytokines, protein-based chemical mediators produced by a broad range of cells, including the immune cells recruited in the inflammation site. The aim of this systematic review is to compare baseline values of pro/anti-inflammatory biomarkers measured in Exhaled Breath Condensate (EBC) in healthy, non-smoking adults to provide a summary of the concentrations reported in the literature. We focused on: interleukin (IL)-1β, IL-4, IL-6, IL-8, IL-10, tumour necrosis factor-alpha (TNF-α), and C reactive protein (CRP). Eligible articles were identified in PubMed, Embase, and Cochrane CENTRAL. Due to the wide differences in methodologies employed in the included articles concerning EBC sampling, storage, and analyses, research protocols were assessed specifically to test their adherence to the ATS/ERS Task Force guidelines on EBC. The development of reference intervals for these biomarkers can result in their introduction and use in both research and clinical settings, not only for monitoring purposes but also, in the perspective of future longitudinal studies, as predictive parameters for the onset and development of chronic diseases with inflammatory aetiology.
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Affiliation(s)
- Federica Ghelli
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Marco Panizzolo
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Giacomo Garzaro
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Giulia Squillacioti
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Valeria Bellisario
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Nicoletta Colombi
- Federated Library of Medicine “F. Rossi”, University of Turin, 10126 Turin, Italy
| | - Enrico Bergamaschi
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Correspondence:
| | - Irina Guseva Canu
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Lausanne, Switzerland
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
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Felix SN, Agondi RC, Aun MV, Olivo CR, de Almeida FM, Amorim TS, Cezario JC, Giavina-Bianchi P, Tiberio IDFLC, de Martins MDA, Romanholo BMS. Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial. Sci Rep 2021; 11:18267. [PMID: 34521963 PMCID: PMC8440547 DOI: 10.1038/s41598-021-97846-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/10/2021] [Indexed: 02/08/2023] Open
Abstract
This study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 min applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 before and after bronchodilator and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in both groups. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.
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Affiliation(s)
- Soraia Nogueira Felix
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Sao Paulo, SP, Brazil.
| | - Rosana Câmara Agondi
- Serviço de Imunologia Clínica e Alergia, HCFMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Marcelo Vivolo Aun
- Serviço de Imunologia Clínica e Alergia, HCFMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Clarice Rosa Olivo
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Sao Paulo, SP, Brazil
- Universidade Cidade de Sao Paulo (UNICID), Sao Paulo, SP, Brazil
- Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Francine Maria de Almeida
- Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - Pedro Giavina-Bianchi
- Serviço de Imunologia Clínica e Alergia, HCFMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | | | - Milton de Arruda de Martins
- Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Beatriz Mangueira Saraiva Romanholo
- Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Sao Paulo, SP, Brazil.
- Universidade Cidade de Sao Paulo (UNICID), Sao Paulo, SP, Brazil.
- Laboratório de Terapêutica Experimental (LIM-20), Faculdade de Medicina da USP (FMUSP), Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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Połomska J, Bar K, Sozańska B. Exhaled Breath Condensate-A Non-Invasive Approach for Diagnostic Methods in Asthma. J Clin Med 2021; 10:jcm10122697. [PMID: 34207327 PMCID: PMC8235112 DOI: 10.3390/jcm10122697] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/04/2021] [Accepted: 06/15/2021] [Indexed: 01/08/2023] Open
Abstract
The pathophysiology of asthma has been intensively studied, but its underlying mechanisms such as airway inflammation, control of airway tone, and bronchial reactivity are still not completely explained. There is an urgent need to implement novel, non-invasive diagnostic tools that can help to investigate local airway inflammation and connect the molecular pathways with the broad spectrum of clinical manifestations of asthma. The new biomarkers of different asthma endotypes could be used to confirm diagnosis, predict asthma exacerbations, or evaluate treatment response. In this paper, we briefly describe the characteristics of exhaled breath condensate (EBC) that is considered to be an interesting source of biomarkers of lung disorders. We look at the composition of EBC, some aspects of the collection procedure, the proposed biomarkers for asthma, and its clinical implications. We also indicate the limitations of the method and potential strategies to standardize the procedure of EBC collection and analytical methods.
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Nelson J, Chalbot MCG, Pavicevic Z, Kavouras IG. Characterization of exhaled breath condensate (EBC) non-exchangeable hydrogen functional types and lung function of wildland firefighters. J Breath Res 2020; 14:046010. [PMID: 32969351 DOI: 10.1088/1752-7163/abb761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Inhalation of smoke is shown to be associated with adverse respiratory outcomes in firefighters. Due to invasiveness of procedures to obtain airways lining fluid, the immediate responses of the target organ (i.e. lung) are secondarily assessed through biomarkers in blood and urine. The objective of this study was to identify changes in metabolic profile of exhaled breath condensate (EBC) and lung function of firefighters exposed to wildfires smoke. A total of 29 subjects were studied over 16 events; 14 of these subjects provided cross-shift EBC samples. The predominant types of non-exchangeable hydrogen in EBC were saturated oxygenated hydrogen, aliphatic alkyl and allylic. Non-exchangeable allylic and oxygenated hydrogen concentrations decreased in post-exposure EBC samples. Longer exposures were correlated with increased abundance of oxidized carbon in ketones, acids and esters. Post-exposure lung function declines (forced expiratory volume in 1 s (FEV1): 0.08 l, forced vital capacity (FVC): 0.07 l, FEV1/FVC: 0.03 l, peak expiratory flow (PEF): 0.39 l s-1) indicated airways inflammation. They were related to exposure intensity (FEV1 and FVC) and exposure duration (PEF). This study showed that EBC characterization of non-exchangeable hydrogen types by NMR may provide insights on EBC molecular compositions in response to smoke inhalation and facilitate targeted analysis to identify specific biomarkers.
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Affiliation(s)
- Jordan Nelson
- Department of Environmental Health Sciences, Ryals School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35219, United States of America
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dos Santos DO, de Souza HCD, Baddini-Martinez JA, Ramos EMC, Gastaldi AC. Effects of exercise on secretion transport, inflammation, and quality of life in patients with noncystic fibrosis bronchiectasis: Protocol for a randomized controlled trial. Medicine (Baltimore) 2018; 97:e9768. [PMID: 29443739 PMCID: PMC5839837 DOI: 10.1097/md.0000000000009768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Bronchiectasis is characterized by pathological and irreversible bronchial dilatation caused by the inefficient mucus and microorganism clearance and progression of inflammatory processes. The most frequent characteristic is the increase in bronchial mucus production resulting in slower transport and damage to the mucociliary transport. AIMS To evaluate the effects of exercise on mucus transport, inflammation, and resistance of the respiratory and autonomic nervous systems and subsequent effects on quality of life in patients with bronchiectasis who are enrolled in a pulmonary rehabilitation program. METHODS Sixty subjects of both sexes between 18 and 60 years (30 volunteers with clinically stable bronchiectasis and 30 healthy volunteers) will be included. Participants with chronic obstructive pulmonary disease, decompensated cardiovascular or metabolic diseases, neuromuscular and musculoskeletal diseases, and active smokers will be excluded. Volunteers will be randomly allocated to the pulmonary rehabilitation or control groups. The primary outcomes will be nasal transport time as evaluated by nasal saccharin transport time, analysis of nasal lavage, enzyme immunoassay of exhaled expiration, and analysis of the mucus properties. The secondary outcomes will include pulmonary function tests, impulse oscillometry, heart rate variability analysis, and quality of life questionnaires. DISCUSSION In addition to the benefits for patients already described in the literature, the additional benefit of mucus removal may contribute to optimizing treatments and better control of the disease. CONCLUSION This protocol could provide new information about the unclear mechanisms regarding exercise to aid in the removal of secretions.
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Affiliation(s)
| | | | | | - Ercy Mara Cipulo Ramos
- Department of Physiotherapy, São Paulo State University, Presidente Prudente, São Paulo, Brazil
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Peel AM, Crossman-Barnes CJ, Tang J, Fowler SJ, Davies GA, Wilson AM, Loke YK. Biomarkers in adult asthma: a systematic review of 8-isoprostane in exhaled breath condensate. J Breath Res 2017; 11:016011. [PMID: 28102831 DOI: 10.1088/1752-7163/aa5a8a] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES We aimed to assess the evidence for the use of 8-isoprostane in exhaled breath condensate (EBC) as a biomarker in adult asthma. DESIGN A systematic review and meta-analysis of EBC 8-isoprostane. METHODS We searched a number of online databases (including PubMed, Embase and Scopus) in January 2016. We included studies of adult non-smokers with EBC collection and asthma diagnosis conducted according to recognised guidelines. We aimed to pool data using random effects meta-analysis and assess heterogeneity using I 2. RESULTS We included twenty studies, the findings from which were inconsistent. Seven studies (n = 329) reported 8-isoprostane levels in asthma to be significantly higher than that of control groups, whilst six studies (n = 403) did not. Only four studies were appropriate for inclusion in a random effects meta-analysis of mean difference. This found a statistically significant between-groups difference of 22 pg ml-1. Confidence in the result is limited by the small number of studies and by substantial statistical heterogeneity (I 2 = 94). CONCLUSION The clinical value of EBC 8-isoprostane as a quantitative assessment of oxidative stress in asthma remains unclear due to variability in results and methodological heterogeneity. It is essential to develop a robust and standardised methodology if the use of EBC 8-isoprostane in asthma is to be properly evaluated.
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Affiliation(s)
- Adam M Peel
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, United Kingdom
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Beale DJ, Jones OAH, Karpe AV, Dayalan S, Oh DY, Kouremenos KA, Ahmed W, Palombo EA. A Review of Analytical Techniques and Their Application in Disease Diagnosis in Breathomics and Salivaomics Research. Int J Mol Sci 2016; 18:E24. [PMID: 28025547 PMCID: PMC5297659 DOI: 10.3390/ijms18010024] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/12/2016] [Accepted: 12/16/2016] [Indexed: 12/14/2022] Open
Abstract
The application of metabolomics to biological samples has been a key focus in systems biology research, which is aimed at the development of rapid diagnostic methods and the creation of personalized medicine. More recently, there has been a strong focus towards this approach applied to non-invasively acquired samples, such as saliva and exhaled breath. The analysis of these biological samples, in conjunction with other sample types and traditional diagnostic tests, has resulted in faster and more reliable characterization of a range of health disorders and diseases. As the sampling process involved in collecting exhaled breath and saliva is non-intrusive as well as comparatively low-cost and uses a series of widely accepted methods, it provides researchers with easy access to the metabolites secreted by the human body. Owing to its accuracy and rapid nature, metabolomic analysis of saliva and breath (known as salivaomics and breathomics, respectively) is a rapidly growing field and has shown potential to be effective in detecting and diagnosing the early stages of numerous diseases and infections in preclinical studies. This review discusses the various collection and analyses methods currently applied in two of the least used non-invasive sample types in metabolomics, specifically their application in salivaomics and breathomics research. Some of the salient research completed in this field to date is also assessed and discussed in order to provide a basis to advocate their use and possible future scientific directions.
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Affiliation(s)
- David J Beale
- Commonwealth Scientific & Industrial Research Organization (CSIRO), Land & Water, P.O. Box 2583, Brisbane, QLD 4001, Australia.
| | - Oliver A H Jones
- Australian Centre for Research on Separation Science, School of Science, RMIT University, P.O. Box 2547, Melbourne, VIC 3001, Australia.
| | - Avinash V Karpe
- Commonwealth Scientific & Industrial Research Organization (CSIRO), Land & Water, P.O. Box 2583, Brisbane, QLD 4001, Australia.
- Department of Chemistry and Biotechnology, Swinburne University of Technology, P.O. Box 218, Hawthorn, VIC 3122, Australia.
| | - Saravanan Dayalan
- Metabolomics Australia, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, 30 Flemington Road, Parkville, VIC 3010, Australia.
| | - Ding Yuan Oh
- WHO Collaborating Centre for Reference and Research on Influenza (VIDRL), Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, VIC 3000, Australia.
- School of Applied and Biomedical Sciences, Federation University, Churchill, VIC 3350, Australia.
| | - Konstantinos A Kouremenos
- Metabolomics Australia, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, 30 Flemington Road, Parkville, VIC 3010, Australia.
| | - Warish Ahmed
- Commonwealth Scientific & Industrial Research Organization (CSIRO), Land & Water, P.O. Box 2583, Brisbane, QLD 4001, Australia.
| | - Enzo A Palombo
- Department of Chemistry and Biotechnology, Swinburne University of Technology, P.O. Box 218, Hawthorn, VIC 3122, Australia.
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Exhaled Breath Condensate pH in Lung Cancer, the Impact of Clinical Factors. Lung 2015; 193:957-63. [PMID: 26260979 DOI: 10.1007/s00408-015-9778-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/04/2015] [Indexed: 01/17/2023]
Abstract
PURPOSE Lung cancer may be associated with airway acidification due to enhanced airway inflammation and oxidative stress. Exhaled breath condensate (EBC) pH is a non-invasive indicator of airway acidity; however, it is still unclear how EBC pH changes in lung cancer. The aim of the study was to investigate EBC pH in lung cancer together with clinical variables. METHODS Thirty-five patients with lung cancer and 37 control subjects (21 patients with stable COPD and 16 non-COPD smokers) were enrolled. EBC was collected for pH, which was determined with the argon-purging method, compared among the groups and correlated with clinical variables of patients with lung cancer. RESULTS No difference was found in EBC pH between patients with lung cancer and control subjects. However, endobronchial tumour localisation, squamous-cell carcinoma subtype and gastro-oesophageal reflux were associated with low EBC pH values. No relationship was observed between EBC pH and the presence of COPD, lung function variables or smoking history. CONCLUSIONS Although, EBC pH is unchanged in lung cancer, lower EBC pH values are associated with distinct phenotypes. Our findings could facilitate further research on airway acidity in lung cancer.
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Nussbaumer-Ochsner Y, Stolk J, Ferraz da Silva LF, van Schadewijk A, de Jeu RC, Prins FA, Mauad T, Rabe KF, Hiemstra PS. Association of Lung Inflammatory Cells with Small Airways Function and Exhaled Breath Markers in Smokers - Is There a Specific Role for Mast Cells? PLoS One 2015; 10:e0129426. [PMID: 26069967 PMCID: PMC4466526 DOI: 10.1371/journal.pone.0129426] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 05/10/2015] [Indexed: 12/31/2022] Open
Abstract
Background Smoking is associated with a mixed inflammatory infiltrate in the airways. We evaluated whether airway inflammation in smokers is related to lung function parameters and inflammatory markers in exhaled breath. Methods Thirty-seven smokers undergoing lung resection for primary lung cancer were assessed pre-operatively by lung function testing including single-breath-nitrogen washout test (sb-N2-test), measurement of fractional exhaled nitric oxide (FeNO) and pH/8-isoprostane in exhaled breath condensate (EBC). Lung tissue sections containing cancer-free large (LA) and small airways (SA) were stained for inflammatory cells. Mucosal (MCT) respectively connective tissue mast cells (MCTC) and interleukin-17A (IL-17A) expression by mast cells was analysed using a double-staining protocol. Results The median number of neutrophils, macrophages and mast cells infiltrating the lamina propria and adventitia of SA was higher than in LA. Both MCTC and MCT were higher in the lamina propria of SA compared to LA (MCTC: 49 vs. 27.4 cells/mm2; MCT: 162.5 vs. 35.4 cells/mm2; P<0.005 for both instances). IL-17A expression was predominantly detected in MCTC of LA. Significant correlations were found for the slope of phase III % pred. of the sb-N2-test (rs= -0.39), for the FEV1% pred. (rs= 0.37) and for FEV1/FVC ratio (rs=0.38) with MCT in SA (P<0.05 for all instances). 8-isoprostane concentration correlated with the mast cells in the SA (rs=0.44), there was no correlation for pH or FeNO with cellular distribution in SA. Conclusions Neutrophils, macrophages and mast cells are more prominent in the SA indicating that these cells are involved in the development of small airway dysfunction in smokers. Among these cell types, the best correlation was found for mast cells with lung function parameters and inflammatory markers in exhaled breath. Furthermore, the observed predominant expression of IL-17A in mast cells warrants further investigation to elucidate their role in smoking-induced lung injury, despite the lack of correlation with lung function and exhaled breath parameters.
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Affiliation(s)
- Yvonne Nussbaumer-Ochsner
- Department of Pulmonology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
- * E-mail:
| | - Jan Stolk
- Department of Pulmonology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | | | | | - Ronald C. de Jeu
- Department of Pulmonology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Frans A. Prins
- Department of Pathology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Thais Mauad
- Department of Pathology, Sao Paulo University Medical School, Sao Paulo, Brazil
| | - Klaus F. Rabe
- Department of Pulmonology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
- Center for Pneumology and Thoracic Surgery, Grosshansdorf Hospital, Grosshansdorf, Germany
| | - Pieter S. Hiemstra
- Department of Pulmonology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
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Exhaled Breath Condensate: Technical and Diagnostic Aspects. ScientificWorldJournal 2015; 2015:435160. [PMID: 26106641 PMCID: PMC4461795 DOI: 10.1155/2015/435160] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/21/2015] [Indexed: 01/18/2023] Open
Abstract
Purpose. The aim of this study was to evaluate the 30-year progress of research on exhaled breath condensate in a disease-based approach. Methods. We searched PubMed/Medline, ScienceDirect, and Google Scholar using the following keywords: exhaled breath condensate (EBC), biomarkers, pH, asthma, gastroesophageal reflux (GERD), smoking, COPD, lung cancer, NSCLC, mechanical ventilation, cystic fibrosis, pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnea (OSA), and drugs. Results. We found 12600 related articles in total in Google Scholar, 1807 in ScienceDirect, and 1081 in PubMed/Medline, published from 1980 to October 2014. 228 original investigation and review articles were eligible. Conclusions. There is rapidly increasing number of innovative articles, covering all the areas of modern respiratory medicine and expanding EBC potential clinical applications to other fields of internal medicine. However, the majority of published papers represent the results of small-scale studies and thus current knowledge must be further evaluated in large cohorts. In regard to the potential clinical use of EBC-analysis, several limitations must be pointed out, including poor reproducibility of biomarkers and absence of large surveys towards determination of reference-normal values. In conclusion, contemporary EBC-analysis is an intriguing achievement, but still in early stage when it comes to its application in clinical practice.
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Liu KF, Li CX, Dai L, Liu J, Wang LY, Lei JD, Guo LQ. Design, synthesis and in vivo antitumor efficacy of novel eight-arm-polyethylene glycol–pterostilbene prodrugs. RSC Adv 2015. [DOI: 10.1039/c5ra06253e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Illustration of 8arm-PEG–pterostilbene. In contrast to linear PEG, the 8arm-PEG significantly increased drug-binding capacity.
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Affiliation(s)
- Ke-feng Liu
- Beijing Key Laboratory of Lignocellulosic Chemistry
- Beijing Forestry University
- Beijing 100083
- P. R. China
| | - Chun-xiao Li
- Beijing Key Laboratory of Lignocellulosic Chemistry
- Beijing Forestry University
- Beijing 100083
- P. R. China
| | - Lin Dai
- Beijing Key Laboratory of Lignocellulosic Chemistry
- Beijing Forestry University
- Beijing 100083
- P. R. China
| | - Jing Liu
- Beijing Key Laboratory of Lignocellulosic Chemistry
- Beijing Forestry University
- Beijing 100083
- P. R. China
| | - Lu-ying Wang
- Beijing Key Laboratory of Lignocellulosic Chemistry
- Beijing Forestry University
- Beijing 100083
- P. R. China
| | - Jian-du Lei
- Beijing Key Laboratory of Lignocellulosic Chemistry
- Beijing Forestry University
- Beijing 100083
- P. R. China
| | - Li-qun Guo
- Yunnan Pharmaceutical Industrial Co., Ltd
- Kunming 650106
- P. R. China
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Lozo Vukovac E, Lozo M, Mise K, Gudelj I, Puljiz Ž, Jurcev-Savicevic A, Bradaric A, Kokeza J, Mise J. Bronchoalveolar pH and inflammatory biomarkers in newly diagnosed IPF and GERD patients: a case-control study. Med Sci Monit 2014; 20:255-61. [PMID: 24535066 PMCID: PMC3930643 DOI: 10.12659/msm.889800] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Several studies have suggested that idiopathic pulmonary fibrosis (IPF) may be related to repeated aspiration of gastric contents over long periods of time. We aimed to investigate differences between pH measured directly in the lung, and biomarkers of acute inflammation in patients with newly diagnosed IPF and in patients with newly diagnosed GERD. Material/Methods All subjects (N=61) underwent collection of medical history, physical examination, pulmonary function testing, bronchoscopy, endoscopy, arterial blood gas analyses, and biochemical testing. Results Previously diagnosed GERD was found in 56.7%, typical symptoms of reflux in 80%, and Helicobacter pylori in gastric biopsy specimens in 76.6% of the cases. pH in peripheral branches of bronchi in the cases was 5.32±0.44 and was 6.27±0.31 (p<0.001) in the control group. The average values of LDH, ALP, and CRP in bronchoalveolar aspirate and in serum, as well as TNF-α in bronchoalveolar aspirate, were significantly higher in IPF patients. Conclusions The more acidic environment in the bronchoalveolar aspirate of the IPF subjects could contribute to the development or progression of IPF, possibly via changes in local metabolism or by damaging local cells and tissue. However, further studies with larger numbers of patients are required to clarify the role of gastric fluid aspiration in IPF pathogenesis. Our preliminary work has identified inflammatory biomarkers LDH, ALP, and TNF-α as potentially important in the pathologic processes in IPF. Further research is needed to determine their importance in clinical intervention and patient care.
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Affiliation(s)
- Emilija Lozo Vukovac
- Department of Pulmonary Diseases and School of Medicine, Split University Hospital, University of Split, Split, Croatia
| | - Mislav Lozo
- Department of Cardiology, Split University Hospital, Split, Croatia
| | - Kornelija Mise
- Department of Pulmonary Diseases and School of Medicine, Split University Hospital, University of Split, Split, Croatia
| | - Ivan Gudelj
- Department of Pulmonary Diseases and School of Medicine, Split University Hospital, University of Split, Split, Croatia
| | - Željko Puljiz
- Department of Gastroenterology, Split University Hospital, Split, Croatia
| | - Anamarija Jurcev-Savicevic
- Depatrment of Epidemiology, Teaching Public Health Institute of Split and Dalmatia County and School of Medicine, University of Split, Split, Croatia
| | - Anteo Bradaric
- Department of Cardiology, Split University Hospital, Split, Croatia
| | - Josipa Kokeza
- Department of Pulmonary Diseases and School of Medicine, Split University Hospital, University of Split, Split, Croatia
| | - Josko Mise
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Lima TMD, Kazama CM, Koczulla AR, Hiemstra PS, Macchione M, Fernandes ALG, Santos UDP, Bueno-Garcia ML, Zanetta DM, André CDSD, Saldiva PHN, Nakagawa NK. pH in exhaled breath condensate and nasal lavage as a biomarker of air pollution-related inflammation in street traffic-controllers and office-workers. Clinics (Sao Paulo) 2013; 68:1488-94. [PMID: 24473505 PMCID: PMC3840367 DOI: 10.6061/clinics/2013(12)03] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/14/2013] [Accepted: 06/08/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To utilize low-cost and simple methods to assess airway and lung inflammation biomarkers related to air pollution. METHODS A total of 87 male, non-smoking, healthy subjects working as street traffic-controllers or office-workers were examined to determine carbon monoxide in exhaled breath and to measure the pH in nasal lavage fluid and exhaled breath condensate. Air pollution exposure was measured by particulate matter concentration, and data were obtained from fixed monitoring stations (8-h work intervals per day, during the 5 consecutive days prior to the study). RESULTS Exhaled carbon monoxide was two-fold greater in traffic-controllers than in office-workers. The mean pH values were 8.12 in exhaled breath condensate and 7.99 in nasal lavage fluid in office-workers; these values were lower in traffic-controllers (7.80 and 7.30, respectively). Both groups presented similar cytokines concentrations in both substrates, however, IL-1β and IL-8 were elevated in nasal lavage fluid compared with exhaled breath condensate. The particulate matter concentration was greater at the workplace of traffic-controllers compared with that of office-workers. CONCLUSION The pH values of nasal lavage fluid and exhaled breath condensate are important, robust, easy to measure and reproducible biomarkers that can be used to monitor occupational exposure to air pollution. Additionally, traffic-controllers are at an increased risk of airway and lung inflammation during their occupational activities compared with office-workers.
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Affiliation(s)
| | - Cristiane Mayumi Kazama
- Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | | | - Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mariangela Macchione
- Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Ana Luisa Godoy Fernandes
- Department of Pneumology, School of Medicine, Universidade Federal de São Paulo, São PauloSP, Brazil
| | - Ubiratan de Paula Santos
- Pneumology Division, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Maria Lucia Bueno-Garcia
- Department of Internal Medicine, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
| | - Dirce Maria Zanetta
- Department of Epidemiology, Public Health Faculty, Universidade de São Paulo, São PauloSP, Brazil
| | | | | | - Naomi Kondo Nakagawa
- Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São PauloSP, Brazil
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The degradation of airway tight junction protein under acidic conditions is probably mediated by transient receptor potential vanilloid 1 receptor. Biosci Rep 2013; 33:BSR20130087. [PMID: 24073800 PMCID: PMC3814059 DOI: 10.1042/bsr20130087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Acidic airway microenvironment is one of the representative pathophysiological features of chronic inflammatory respiratory diseases. Epithelial barrier function is maintained by TJs (tight junctions), which act as the first physical barrier against the inhaled substances and pathogens of airway. As previous studies described, acid stress caused impaired epithelial barriers and led the hyperpermeability of epithelium. However, the specific mechanism is still unclear. We have showed previously the existence of TRPV (transient receptor potential vanilloid) 1 channel in airway epithelium, as well as its activation by acidic stress in 16HBE cells. In this study, we explored the acidic stress on airway barrier function and TJ proteins in vitro with 16HBE cell lines. Airway epithelial barrier function was determined by measuring by TER (trans-epithelial electrical resistance). TJ-related protein [claudin-1, claudin-3, claudin-4, claudin-5, claudin-7 and ZO-1 (zonula occluden 1)] expression was examined by western blotting of insoluble fractions of cell extraction. The localization of TJ proteins were visualized by immunofluorescent staining. Interestingly, stimulation by pH 6.0 for 8 h slightly increased the epithelial resistance in 16HBE cells insignificantly. However, higher concentration of hydrochloric acid (lower than pH 5.0) did reduce the airway epithelial TER of 16HBE cells. The decline of epithelial barrier function induced by acidic stress exhibited a TRPV1-[Ca2+]i-dependent pathway. Of the TJ proteins, claudin-3 and claudin-4 seemed to be sensitive to acidic stress. The degradation of claudin-3 and claudin-4 induced by acidic stress could be attenuated by the specific TRPV1 blocker or intracellular Ca2+ chelator BAPTA/AM [1,2-bis-(o-aminophenoxy)ethane-N,N,N',N'-tetra-acetic acid tetrakis(acetoxymethyl ester)].
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15
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Polyethylene glycol-drug ester conjugates for prolonged retention of small inhaled drugs in the lung. J Control Release 2013; 171:234-40. [DOI: 10.1016/j.jconrel.2013.07.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/03/2013] [Accepted: 07/22/2013] [Indexed: 01/21/2023]
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16
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Ma J, Strub P, Lavori PW, Buist AS, Camargo CA, Nadeau KC, Wilson SR, Xiao L. DASH for asthma: a pilot study of the DASH diet in not-well-controlled adult asthma. Contemp Clin Trials 2013; 35:55-67. [PMID: 23648395 PMCID: PMC4217513 DOI: 10.1016/j.cct.2013.04.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 04/24/2013] [Accepted: 04/26/2013] [Indexed: 01/03/2023]
Abstract
This pilot study aims to provide effect size confidence intervals, clinical trial and intervention feasibility data, and procedural materials for a full-scale randomized controlled trial that will determine the efficacy of Dietary Approaches to Stop Hypertension (DASH) as adjunct therapy to standard care for adults with uncontrolled asthma. The DASH diet encompasses foods (e.g., fresh fruit, vegetables, and nuts) and antioxidant nutrients (e.g., vitamins A, C, E, and zinc) with potential benefits for persons with asthma, but it is unknown whether the whole diet is beneficial. Participants (n = 90) will be randomized to receive usual care alone or combined with a DASH intervention consisting of 8 group and 3 individual sessions during the first 3 months, followed by at least monthly phone consultations for another 3 months. Follow-up assessments will occur at 3 and 6 months. The primary outcome measure is the 7-item Juniper Asthma Control Questionnaire, a validated composite measure of daytime and nocturnal symptoms, activity limitations, rescue medication use, and percentage predicted forced expiratory volume in 1 second. We will explore changes in inflammatory markers important to asthma pathophysiology (e.g., fractional exhaled nitric oxide) and their potential to mediate the intervention effect on disease control. We will also conduct pre-specified subgroup analyses by genotype (e.g., polymorphisms on the glutathione S transferase gene) and phenotype (e.g., atopy, obesity). By evaluating a dietary pattern approach to improving asthma control, this study could advance the evidence base for refining clinical guidelines and public health recommendations regarding the role of dietary modifications in asthma management.
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Affiliation(s)
- Jun Ma
- Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
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17
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Mickleborough TD, Vaughn CL, Shei RJ, Davis EM, Wilhite DP. Marine lipid fraction PCSO-524 (lyprinol/omega XL) of the New Zealand green lipped mussel attenuates hyperpnea-induced bronchoconstriction in asthma. Respir Med 2013; 107:1152-63. [PMID: 23660397 DOI: 10.1016/j.rmed.2013.04.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 04/09/2013] [Accepted: 04/10/2013] [Indexed: 02/06/2023]
Abstract
PURPOSE Evaluate the effect of the marine lipid fraction of the New Zealand green-lipped mussel (Perna canaliculus) PCSO-524 (Lyprinol/Omega XL), rich in omega-3 fatty acids, on airway inflammation and the bronchoconstrictor response to eucapnic voluntary hyperpnea (EVH) in asthmatics. METHODS Twenty asthmatic subjects, with documented HIB, participated in a placebo controlled double-blind randomized crossover trial. Subjects entered the study on their usual diet and were then placed on 3 weeks of PCSO-524 or placebo supplementation, followed by a 2 week washout period, before crossing over to the alternative diet. Pre- and post-eucapnic voluntary hyperpnea (EVH) pulmonary function, fraction of exhaled nitric oxide (FENO), asthma symptom scores, medication use, exhaled breath condensate (EBC) pH, cysteinyl leukotrienes (cyst-LT), 8-isoprostane and urinary 9α, 11β-prostaglandin (PG)F2 and Clara (CC16) protein concentrations were assessed at the beginning of the trial and at the end of each treatment period. RESULTS The PCSO-524 diet significantly reduced (p < 0.05) the maximum fall in post-EVH FEV1 (-8.4 ± 3.2%) compared to usual (-19.3 ± 5.4%) and placebo diet (-22.5 ± 13.7%). Pre- and post- EVH EBC cyst-LT and 8-isoprostane, and urinary 9α, 11β-PGF2 and CC16 concentrations were significantly reduced (p < 0.05) on the PCSO-524 diet compared to the usual and placebo diet. EBC pH and asthma symptom scores were significantly improved (p < 0.05) and rescue medication use significantly reduced (p < 0.05) on the PCSO-524 diet compared to the usual and placebo diet. CONCLUSION PCSO-524 (Lyprinol)/Omega XL) may have beneficial effects in HIB and asthma by serving as a pro-resolving agonist and/or inflammatory antagonist.
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Affiliation(s)
- Timothy D Mickleborough
- School of Public Health-Bloomington, Department of Kinesiology, Human Performance and Exercise Biochemistry Laboratory, 1025 E. 7th St. SPH 112, Bloomington, IN 47404, USA.
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18
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Eszes N, Bikov A, Lázár Z, Bohács A, Müller V, Stenczer B, Rigó J, Losonczy G, Horváth I, Tamási L. Changes in exhaled breath condensate pH in healthy and asthmatic pregnant women. Acta Obstet Gynecol Scand 2013; 92:591-7. [PMID: 23369006 DOI: 10.1111/aogs.12094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 01/11/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Asthma is a common chronic disease complicating pregnancy with a risk for perinatal complications. Control of airway inflammation in the asthmatic pregnancy improves pregnancy outcomes. Our aim was to evaluate pH of exhaled breath condensate (EBC), a non-invasive method for the assessment of asthmatic airway inflammation, in healthy and asthmatic pregnancies. DESIGN Cross-sectional study. SETTING Hungarian university clinics. POPULATION Seventeen healthy pregnant women, 21 asthmatic pregnant women, 23 healthy non-pregnant women and 22 asthmatic non-pregnant women. METHODS EBC samples were collected using a portable condenser, EBC pH was measured after argon deaeration. MAIN OUTCOME MEASURE EBC pH. RESULTS EBC pH (mean ± SD) of healthy non-pregnant and asthmatic non-pregnant women was similar (7.75 ± 0.27 vs. 7.54 ± 0.57; p = 0.118), probably indicating an optimal control of airway inflammation in asthmatic women. On the other hand, EBC pH was higher in healthy pregnant women compared with healthy non-pregnant women (8.02 ± 0.43 vs. 7.75 ± 0.27; p = 0.017). Higher EBC pH accompanying healthy pregnancy was absent in asthmatic pregnant patients whose EBC pH was lower (7.65 ± 0.38) than that of healthy pregnant women (p = 0.006), and it was similar to that in asthmatic and healthy non-pregnant women (p = 0.470 and p = 0.300, respectively). The EBC pH in asthmatic pregnant women correlated positively with birthweight (r = 0.49, p = 0.047) and negatively with forced vital capacity (r = 0.45, p = 0.039). EBC pH was not related to blood pH. CONCLUSIONS EBC pH is higher in healthy pregnant women but not in asthmatic pregnant women compared with data from healthy non-pregnant women, indicating that oxidative inflammatory processes induced by asthma may compromise the regulatory mechanisms causing alkaline pH in the airways during pregnancy.
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Affiliation(s)
- Noémi Eszes
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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19
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Schivo M, Seichter F, Aksenov AA, Pasamontes A, Peirano DJ, Mizaikoff B, Kenyon NJ, Davis CE. A mobile instrumentation platform to distinguish airway disorders. J Breath Res 2013; 7:017113. [PMID: 23446184 PMCID: PMC3633523 DOI: 10.1088/1752-7155/7/1/017113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are distinct but clinically overlapping airway disorders which often create diagnostic and therapeutic dilemmas. Current strategies to discriminate these diseases are limited by insensitivity and poor performance due to biologic variability. We tested the hypothesis that a gas chromatograph/differential mobility spectrometer (GC/DMS) sensor could distinguish between clinically well-defined groups with airway disorders based on the volatile organic compounds (VOCs) obtained from exhaled breath. After comparing VOC profiles obtained from 13 asthma, 5 COPD and 13 healthy control subjects, we found that VOC profiles distinguished asthma from healthy controls and also a subgroup of asthmatics taking the drug omalizumab from healthy controls. The VOC profiles could not distinguish between COPD and any of the other groups. Our results show a potential application of the GC/DMS for non-invasive and bedside diagnostics of asthma and asthma therapy monitoring. Future studies will focus on larger sample sizes and patient cohorts.
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Affiliation(s)
- Michael Schivo
- Division of Pulmonary, Critical Care, and Sleep Medicine, Center for Comparative Respiratory Biology and Medicine, University of California, Davis, CA 95616, USA
| | - Felicia Seichter
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Germany
| | - Alexander A. Aksenov
- Department of Mechanical and Aerospace Engineering, University of California, Davis, CA 95616, USA
| | - Alberto Pasamontes
- Department of Mechanical and Aerospace Engineering, University of California, Davis, CA 95616, USA
| | - Daniel J. Peirano
- Department of Mechanical and Aerospace Engineering, University of California, Davis, CA 95616, USA
| | - Boris Mizaikoff
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Germany
| | - Nicholas J. Kenyon
- Division of Pulmonary, Critical Care, and Sleep Medicine, Center for Comparative Respiratory Biology and Medicine, University of California, Davis, CA 95616, USA
| | - Cristina E. Davis
- Department of Mechanical and Aerospace Engineering, University of California, Davis, CA 95616, USA
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20
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Induced Sputum, Exhaled Nitric Oxide, and Particles in Exhaled Air in Assessing Airways Inflammation in Occupational Exposures. Clin Chest Med 2012; 33:771-82. [DOI: 10.1016/j.ccm.2012.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Nunez-Naveira L, Marinas-Pardo LA, Amor-Carro O, Montero-Martinez C. Determination of ELISA reproducibility to detect protein markers in exhaled breath condensate. J Breath Res 2012; 6:046003. [DOI: 10.1088/1752-7155/6/4/046003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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22
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Bikov A, Galffy G, Tamasi L, Lazar Z, Losonczy G, Horvath I. Exhaled breath condensate pH is influenced by respiratory droplet dilution. J Breath Res 2012; 6:046002. [PMID: 22990071 DOI: 10.1088/1752-7155/6/4/046002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Several studies support that airway acid stress plays a role in the pathophysiology of asthma. Exhaled breath condensate pH (EBC pH) was suggested as a surrogate marker of airway acidification. The dilution of airway lining fluid (ALF) acids and bases by alveolar water may influence condensate pH, but it has not been studied yet. The aim of our study was to investigate the relationship between EBC pH and ALF dilution in EBC samples obtained from asthmatic and healthy subjects. EBC was collected from 55 asthmatic and 57 healthy subjects for pH and conductivity measurements. Fractional exhaled nitric oxide (FE(NO)) and lung function tests were also performed in asthmatic patients. EBC pH was determined after 10 min of argon deareation and the dilution was estimated by the measurement of conductivity in vacuum-treated samples. There was no difference either in EBC pH or dilution between the two groups. However, a significant relationship was found between EBC pH and dilution in both groups (p < 0.05, r = -0.35 and r = -0.29, asthmatic and healthy groups, respectively). Our results suggest important methodological aspect indicating that EBC pH is affected by respiratory droplet dilution, and this effect should be taken into consideration when interpreting EBC pH data.
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Affiliation(s)
- Andras Bikov
- Department of Pulmonology, Semmelweis University, Dios arok 1/C, Budapest, H-1125, Hungary
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23
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Antus B, Barta I, Csiszer E, Kelemen K. Exhaled breath condensate pH in patients with cystic fibrosis. Inflamm Res 2012; 61:1141-7. [PMID: 22706320 DOI: 10.1007/s00011-012-0508-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 05/29/2012] [Accepted: 05/30/2012] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE AND DESIGN Exhaled breath condensate (EBC) pH has been proposed as a useful, non-invasive marker of airway inflammation in pulmonary diseases. In this study we tested whether cystic fibrosis (CF) is associated with acidification of EBC, when pH is assessed by the CO(2) gas standardization method. METHODS EBC was collected using two different devices (EcoScreen and R-Tube) in 46 stable CF patients during routine clinical visits and in 28 healthy controls. RESULTS Mean EBC pH in CF patients and in healthy controls was similar (EcoScreen: CF patients: 6.38 ± 0.03 versus controls: 6.39 ± 0.03, p = 0.699; R-tube: CF patients: 5.94 ± 0.04 versus controls: 6.02 ± 0.03, p = 0.159). Inflammatory cell counts in spontaneously expectorated sputum obtained in a subset of patients (n = 20) showed no correlation with pH values. EBC samples collected with the R-tube were more acidic than those collected with the EcoScreen device (p < 0.001). CONCLUSIONS Our data suggest that EBC pH does not discriminate between healthy controls and those with CF disease indicating that the clinical applicability of EBC pH measurements for assessing airway inflammation in CF is limited.
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Affiliation(s)
- Balazs Antus
- Department of Pathophysiology, National Koranyi Institute of TB and Pulmonology, Piheno ut 1, Budapest 1121, Hungary.
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24
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Yu H, Li Q, Zhou X, Kolosov VP, Perelman JM. Transient receptor potential vanilloid 1 receptors mediate acid-induced mucin secretion via Ca2+ influx in human airway epithelial cells. J Biochem Mol Toxicol 2012; 26:179-86. [PMID: 22566028 DOI: 10.1002/jbt.20413] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 08/09/2011] [Accepted: 08/20/2011] [Indexed: 12/20/2022]
Abstract
Mucin hypersecretion is a key pathological feature of inflammatory respiratory diseases. Previous studies have reported that acids (gastroesophageal reflux or environmental exposure) induce many respiratory symptoms and are implicated in the pathophysiology of obstructive airway diseases. To understand these mechanisms, we measured acid-induced mucin secretion in human bronchial epithelial cells. In the present study, acid induced inward currents of transient receptor potential vanilloid (TRPV)1 and mucin 5AC (MUC5AC) secretion dose dependently, which were inhibited by TRPV1 antagonist capsazepine in a concentration-dependent manner. TRPV1 agonist capsaicin mediated a concentration-dependent increase in TRPV1 inward currents and MUC5AC secretion. Furthermore, capsaicin enhanced acid-induced TRPV1 inward currents and MUC5AC secretion. Acid-induced Ca(2+) influx was prevented by capsazepine dose dependently and enhanced by capsaicin. Pretreatment only with capsaicin also increased the Ca(2+) concentration in a concentration-dependent manner. These data suggest that pharmacological inhibition of calcium-permeable TRPV1 receptors could be used to prevent acid-induced mucin secretion, thereby providing a potential mechanism to reduce their toxicity.
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Affiliation(s)
- Hongmei Yu
- Division of Respiratory Medicine, Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, People's Republic of China
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25
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Comparison of two devices and two breathing patterns for exhaled breath condensate sampling. PLoS One 2011; 6:e27467. [PMID: 22087323 PMCID: PMC3210176 DOI: 10.1371/journal.pone.0027467] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 10/17/2011] [Indexed: 11/28/2022] Open
Abstract
Introduction Analysis of exhaled breath condensate (EBC) is a noninvasive method to access the epithelial lining fluid of the lungs. Due to standardization problems the method has not entered clinical practice. The aim of the study was to assess the comparability for two commercially available devices in healthy controls. In addition, we assessed different breathing patterns in healthy controls with protein markers to analyze the source of the EBC. Methods EBC was collected from ten subjects using the RTube and ECoScreen Turbo in a randomized crossover design, twice with every device - once in tidal breathing and once in hyperventilation. EBC conductivity, pH, surfactant protein A, Clara cell secretory protein and total protein were assessed. Bland-Altman plots were constructed to display the influence of different devices or breathing patterns and the intra-class correlation coefficient (ICC) was calculated. The volatile organic compound profile was measured using the electronic nose Cyranose 320. For the analysis of these data, the linear discriminant analysis, the Mahalanobis distances and the cross-validation values (CVV) were calculated. Results Neither the device nor the breathing pattern significantly altered EBC pH or conductivity. ICCs ranged from 0.61 to 0.92 demonstrating moderate to very good agreement. Protein measurements were greatly influenced by breathing pattern, the device used, and the way in which the results were reported. The electronic nose could distinguish between different breathing patterns and devices, resulting in Mahalanobis distances greater than 2 and CVVs ranging from 64% to 87%. Conclusion EBC pH and (to a lesser extent) EBC conductivity are stable parameters that are not influenced by either the device or the breathing patterns. Protein measurements remain uncertain due to problems of standardization. We conclude that the influence of the breathing maneuver translates into the necessity to keep the volume of ventilated air constant in further studies.
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Koczulla AR, Noeske S, Herr C, Koepke J, Jörres RA, Nell C, Schmid S, Vogelmeier C, Bals R. Alpha-1 antitrypsin is elevated in exhaled breath condensate and serum in exacerbated COPD patients. Respir Med 2011; 106:120-6. [PMID: 21872457 DOI: 10.1016/j.rmed.2011.06.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 06/27/2011] [Accepted: 06/27/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Exacerbations of chronic obstructive pulmonary disease (COPD) significantly contribute to COPD-related morbidity. Diagnosis of COPD exacerbations may be improved by analyzing biomarkers such as alpha-1 antitrypsin (AAT). AAT is an acute-phase protein and inhibitor of neutrophil elastase. Deficiency of AAT may result in early-onset respiratory symptoms. Measurement of exhaled breath condensate (EBC) is a noninvasive method to investigate biomarkers present in the epithelial lining fluid, such as AAT. OBJECTIVE To investigate whether AAT can be detected and quantified in EBC and to compare AAT levels in the EBC of healthy controls, patients with COPD, and during exacerbations of COPD. METHODS EBC from 10 healthy controls, 17 subjects with COPD, and 18 subjects with exacerbations of COPD was collected with the RTube™ device. AAT from EBC and serum were quantified by ELISA. RESULTS AAT in EBC was detectable in every individual. Patients with exacerbations of COPD had significantly increased AAT values (mean, 514.33 pg/mL, [SD 279.41 ]) compared with healthy controls (mean, 251.32 pg/mL, [SD 44.71]) and stable COPD patients (mean, 242.01 pg/mL [SD 65.74]) (P=0.0003; P=0.00003). EBC AAT showed only a correlation trend with serum AAT (r=0.3, P=0.054). CONCLUSIONS AAT in EBC was detectable and quantifiable. AAT measured in EBC was significantly increased during exacerbations of COPD and can potentially be used as a biomarker in exacerbations.
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Affiliation(s)
- A Rembert Koczulla
- Department of Internal Medicine, Division for Pulmonary Diseases, Philipps-Universität Marburg, Hospital of the University of Marburg, Baldingerstrasse 1, 35043 Marburg, Germany.
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27
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Exhaled breath condensate pH in patients with lung cancer. Lung Cancer 2011; 75:178-80. [PMID: 21831475 DOI: 10.1016/j.lungcan.2011.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 06/28/2011] [Accepted: 07/11/2011] [Indexed: 11/22/2022]
Abstract
Assessment of exhaled breath condensate (EBC) pH is a promising method for investigating and monitoring airway pathology in a number of lung diseases. In this cross-sectional study we tested whether development of lung cancer is associated with acidification of EBC. EBC was collected in 43 smoking patients with lung cancer (squamous cell carcinoma: 17 patients, adenocarcinoma: 16 patients, and small cell lung cancer: 10 patients) before receiving any anticancer treatment and in 20 healthy smokers without any clinical and radiological evidence of pulmonary tumor. EBC pH was measured by CO(2) gas standardization, the most reliable and accurate method at present. EBC pH in patients with pulmonary tumor (6.68±0.02) and in controls (6.63±0.05) was similar (p>0.05). Results were affected neither by the histological subtype nor the stage of the tumors. Our data suggest that assessment of EBC pH is of limited value for the diagnosis and/or screening of lung cancer.
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Prieto L, Orosa B, Barato D, Marin J. The effect of different periods of argon deaeration on exhaled breath condensate pH. J Asthma 2011; 48:319-23. [PMID: 21385108 DOI: 10.3109/02770903.2011.560321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Exhaled breath condensate (EBC) pH has been considered as a biomarker of airway inflammation in asthma. However, little information is available on the duration of argon deaeration required to achieve a stable pH in EBC samples. OBJECTIVE To identify differences in EBC pH after argon deaeration for 2, 4, and 8 min. METHODS EBC pH was determined in EBC samples from 48 subjects with allergic rhinitis (11 asthmatics) and 14 healthy volunteers without deaeration and after argon deaeration for 2, 4, and 8 min. RESULTS The mean (95% CI) pH values obtained from samples analyzed after 4 min [7.66 (7.52-7.80)] and 8 min [7.70 (7.55-7.85)] of argon deaeration were significantly less acidic (p < .001) than those identified after 2 min of deaeration [7.53 (7.40-7.66)]; differences between pH values at 4 and 8 min were not significant. Furthermore, changes in EBC pH of nondeaerated samples after 4 and 8 min of deaeration were significantly greater than those after 2 min, the mean difference being 0.11 (95% CI, 0.02-0.20, p < .05) and 0.13 (95% CI, 0.04-0.22, p < .01), respectively; differences between changes at 4 and 8 min were not significant. CONCLUSIONS Stabilization of EBC pH is achieved after argon deaeration for 4 min. Therefore, this deaeration period may be recommended instead of the 7-8 min used in several studies.
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Affiliation(s)
- Luis Prieto
- Departamento de Medicina, Facultad de Medicina y Odontologia, Universidad de Valencia, Valencia, Spain.
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Isoprostanes-biomarkers of lipid peroxidation: their utility in evaluating oxidative stress and analysis. Int J Mol Sci 2010; 11:4631-59. [PMID: 21151461 PMCID: PMC3000105 DOI: 10.3390/ijms11114631] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 10/29/2010] [Accepted: 11/16/2010] [Indexed: 11/17/2022] Open
Abstract
Isoprostanes (IsoPs) are key biomarkers for investigating the role of free radical generation in the pathogenesis of human disorders. To solve IsoPs-related problems with regard to isoprostanes, analytical tools are required. This paper reviews the problems and trends in this field focusing on the methodology for assaying biomarkers in exhaled breath condensate (EBC) samples. A large amount of work has been done in the qualitative and quantitative analysis of IsoPs, but a standardized method has yet to emerge. The methodologies described differ, either in the sample preparation steps or in the detection techniques, or both. Requiring a number of chromatographic steps, the relevant extraction and purification procedures are often critical and time-consuming, and they lead to a substantial loss of target compounds. Recent data show that EBC is a promising non-invasive tool for the evaluation of different diseases. Two main analytical approaches have been adopted for IsoPs measurement: immunological methods and mass spectrometry. The methodologies for the extraction, purification and analysis of IsoPs in EBC samples are presented.
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Tecklenburg-Lund S, Mickleborough TD, Turner LA, Fly AD, Stager JM, Montgomery GS. Randomized controlled trial of fish oil and montelukast and their combination on airway inflammation and hyperpnea-induced bronchoconstriction. PLoS One 2010; 5:e13487. [PMID: 20976161 PMCID: PMC2956690 DOI: 10.1371/journal.pone.0013487] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 08/12/2010] [Indexed: 01/07/2023] Open
Abstract
Background Both fish oil and montelukast have been shown to reduce the severity of exercise-induced bronchoconstriction (EIB). The purpose of this study was to compare the effects of fish oil and montelukast, alone and in combination, on airway inflammation and bronchoconstriction induced by eucapnic voluntary hyperpnea (EVH) in asthmatics. Methods In this model of EIB, twenty asthmatic subjects with documented hyperpnea-induced bronchoconstriction (HIB) entered a randomized double-blind trial. All subjects entered on their usual diet (pre-treatment, n = 20) and then were randomly assigned to receive either one active 10 mg montelukast tablet and 10 placebo fish oil capsules (n = 10) or one placebo montelukast tablet and 10 active fish oil capsules totaling 3.2 g EPA and 2.0 g DHA (n = 10) taken daily for 3-wk. Thereafter, all subjects (combination treatment; n = 20) underwent another 3-wk treatment period consisting of a 10 mg active montelukast tablet or 10 active fish oil capsules taken daily. Results While HIB was significantly inhibited (p<0.05) by montelukast, fish oil and combination treatment compared to pre-treatment, there was no significant difference (p>0.017) between treatment groups; percent fall in forced expiratory volume in 1-sec was −18.4±2.1%, −9.3±2.8%, −11.6±2.8% and −10.8±1.7% on usual diet (pre-treatment), fish oil, montelukast and combination treatment respectively. All three treatments were associated with a significant reduction (p<0.05) in FENO, exhaled breathe condensate pH and cysteinyl-leukotrienes, while the fish oil and combination treatment significantly reduced (p<0.05) urinary 9α, 11β-prostaglandin F2 after EVH compared to the usual diet; however, there was no significant difference (p>0.017) in these biomarkers between treatments. Conclusion While fish oil and montelukast are both effective in attenuating airway inflammation and HIB, combining fish oil with montelukast did not confer a greater protective effect than either intervention alone. Fish oil supplementation should be considered as an alternative treatment for EIB. Trial Registration ClinicalTrials.gov NCT00676468
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Affiliation(s)
- Sandra Tecklenburg-Lund
- Human Performance and Exercise Biochemistry Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana, United States of America
- Health and Human Performance, Nebraska Wesleyan University, Lincoln, Nebraska, United States of America
| | - Timothy D. Mickleborough
- Human Performance and Exercise Biochemistry Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana, United States of America
- * E-mail:
| | - Louise A. Turner
- Human Performance and Exercise Biochemistry Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana, United States of America
| | - Alyce D. Fly
- Department of Applied Health Science, Indiana University, Bloomington, Indiana, United States of America
| | - Joel M. Stager
- Human Performance and Exercise Biochemistry Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana, United States of America
| | - Gregory S. Montgomery
- Indiana University School of Medicine, Indiana University, Indianapolis, Indiana, United States of America
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Antus B, Barta I, Kullmann T, Lazar Z, Valyon M, Horvath I, Csiszer E. Assessment of exhaled breath condensate pH in exacerbations of asthma and chronic obstructive pulmonary disease: A longitudinal study. Am J Respir Crit Care Med 2010; 182:1492-7. [PMID: 20656939 DOI: 10.1164/rccm.201003-0451oc] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Exhaled breath condensate pH has been proposed as a noninvasive marker of airway inflammation. However, due to standardization difficulties in pH measurement techniques, different pH readings were obtained in previous studies. OBJECTIVES In this longitudinal study we assessed condensate pH in patients with an exacerbation of asthma or chronic obstructive airway disease using the very precise carbon dioxide standardization method that negates the effect of this gas on condensate acidity. METHODS Condensate pH, fractional exhaled nitric oxide, lung function, and blood gases were measured in 20 nonsmoking patients with asthma and 21 smoking and 17 ex-smoking patients with chronic obstructive airway disease first at hospital admission due to an acute exacerbation of the disease and again at discharge after treatment. Condensate pH was also assessed in 18 smoking and 18 nonsmoking healthy control subjects. MEASUREMENTS AND MAIN RESULTS In patients with asthma, condensate pH was significantly decreased at the time of exacerbation compared with nonsmoking control subjects and increased with treatment. In patients with chronic obstructive airway disease, condensate pH remained unchanged during exacerbation, both in smokers and ex-smokers. Nevertheless, condensates collected from smokers were more acidic than those of ex-smokers. A similar difference was observed between smoker and nonsmoker healthy control subjects. No correlations were found between condensate pH and fractional exhaled nitric oxide or lung function variables measured either at admission or discharge. CONCLUSIONS Our data suggest that exacerbation of asthma, but not chronic obstructive airway disease, is associated with acidification of breath condensate.
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Affiliation(s)
- Balazs Antus
- Department of Pathophysiology, National Koranyi Institute of TB and Pulmonology, Budapest, Hungary.
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MISE K, CAPKUN V, JURCEV-SAVICEVIC A, SUNDOV Z, BRADARIC A, MLADINOV S. The influence of gastroesophageal reflux in the lung: A case-control study. Respirology 2010; 15:837-42. [DOI: 10.1111/j.1440-1843.2010.01777.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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