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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Greguš M, Foret F, Kubáň P. Single-breath analysis using a novel simple sampler and capillary electrophoresis with contactless conductometric detection. Electrophoresis 2015; 36:526-33. [PMID: 25377628 DOI: 10.1002/elps.201400456] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 10/29/2014] [Accepted: 10/29/2014] [Indexed: 11/11/2022]
Abstract
The analysis of ionic content of exhaled breath condensate (EBC) from one single breath by CE with C(4) D is demonstrated for the first time. A miniature sampler made from a 2-mL syringe and an aluminum cooling cylinder for collection of EBC was developed. Various parameters of the sampler that influence its collection efficiency, repeatability, and effect of respiratory patterns were studied in detail. Efficient procedures for the cleanup of the miniature sampler were also developed and resulted in significant improvement of sampling repeatability. Analysis of EBC was performed by CE-C(4) D in a 60 mM MES/l-histidine BGE with 30 μM CTAB and 2 mM 18-crown-6 at pH 6 and excellent repeatability of migration times (RSD < 1.3% (n = 7)) and peak areas (RSD < 7% (n = 7)) of 12 inorganic anions, cations, and organic acids was obtained. It has been shown that the breathing pattern has a significant impact on the concentration of the analytes in the collected EBC. As the ventilatory pattern can be easily controlled during single exhalation, the developed collection system and method provides a highly reproducible and fast way of collecting EBC with applicability in point-of-care diagnostics.
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Affiliation(s)
- Michal Greguš
- Bioanalytical Instrumentation, CEITEC, Masaryk University, Brno, Czech Republic; Department of Chemistry, Masaryk University, Brno, Czech Republic
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Cumeras R, Cheung WHK, Gulland F, Goley D, Davis CE. Chemical analysis of whale breath volatiles: a case study for non-invasive field health diagnostics of marine mammals. Metabolites 2014; 4:790-806. [PMID: 25222833 PMCID: PMC4192693 DOI: 10.3390/metabo4030790] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 08/16/2014] [Accepted: 08/20/2014] [Indexed: 12/20/2022] Open
Abstract
We explored the feasibility of collecting exhaled breath from a moribund gray whale (Eschrichtius robustus) for potential non-invasive health monitoring of marine mammals. Biogenic volatile organic compound (VOC) profiling is a relatively new field of research, in which the chemical composition of breath is used to non-invasively assess the health and physiological processes on-going within an animal or human. In this study, two telescopic sampling poles were designed and tested with the primary aim of collecting whale breath exhalations (WBEs). Once the WBEs were successfully collected, they were immediately transferred onto a stable matrix sorbent through a custom manifold system. A total of two large volume WBEs were successfully captured and pre-concentrated onto two Tenax®-TA traps (one exhalation per trap). The samples were then returned to the laboratory where they were analyzed using solid phase micro extraction (SPME) and gas chromatography/mass spectrometry (GC/MS). A total of 70 chemicals were identified (58 positively identified) in the whale breath samples. These chemicals were also matched against a database of VOCs found in humans, and 44% of chemicals found in the whale breath are also released by healthy humans. The exhaled gray whale breath showed a rich diversity of chemicals, indicating the analysis of whale breath exhalations is a promising new field of research.
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Affiliation(s)
- Raquel Cumeras
- Department of Mechanical and Aerospace Engineering, University of California, Davis, One Shields Avenue 95616, CA, USA.
| | - William H K Cheung
- Department of Mechanical and Aerospace Engineering, University of California, Davis, One Shields Avenue 95616, CA, USA.
| | - Frances Gulland
- The Marine Mammal Center, 2000 Bunker Road, Fort Cronkhite, Sausalito 94965-2619, CA, USA.
| | - Dawn Goley
- Marine Mammal Education and Research Program, Marine Mammal Stranding Network, Humboldt State University, 1 Harpst Street, Arcata 95521, CA, USA.
| | - Cristina E Davis
- Department of Mechanical and Aerospace Engineering, University of California, Davis, One Shields Avenue 95616, CA, USA.
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Kubáň P, Foret F. Exhaled breath condensate: Determination of non-volatile compounds and their potential for clinical diagnosis and monitoring. A review. Anal Chim Acta 2013; 805:1-18. [DOI: 10.1016/j.aca.2013.07.049] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 07/16/2013] [Accepted: 07/20/2013] [Indexed: 12/31/2022]
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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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Goldoni M, Corradi M, Mozzoni P, Folesani G, Alinovi R, Pinelli S, Andreoli R, Pigini D, Tillo R, Filetti A, Garavelli C, Mutti A. Concentration of exhaled breath condensate biomarkers after fractionated collection based on exhaled CO2 signal. J Breath Res 2013; 7:017101. [PMID: 23445573 DOI: 10.1088/1752-7155/7/1/017101] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A standard procedure for exhaled breath condensate (EBC) collection is still lacking. The aim of this study was to compare the concentration of several biomarkers in whole (W-EBC) and fractionated EBC (A-EBC), the latter collected starting from CO2 ≥ 50% increase during exhalation. Forty-five healthy non-smokers or asymptomatic light smokers were enrolled. Total protein concentrations in W-EBC and A-EBC were overlapping (median: 0.7 mg l(-1) in both cases), whereas mitochondrial DNA was higher in A-EBC (0.021 versus 0.011 ng ml(-1)), indicating a concentration rather than a dilution of lining fluid droplets in the last portion of exhaled air. H2O2 (0.13 versus 0.08 µM), 8-isoprostane (4.9 versus 4.4 pg ml(-1)), malondialdehyde (MDA) (4.2 versus 3.2 nM) and 4-hydroxy-2-nonhenal (HNE) (0.78 versus 0.66 nM) were all higher in W-EBC, suggesting a contribution from the upper airways to oxidative stress biomarkers in apparently healthy subjects. NH4(+) was also higher in W-EBC (median: 590 versus 370 µM), with an estimated increase over alveolar and bronchial air by a factor 1.5. pH was marginally, but significantly higher in W-EBC (8.05 versus 8.01). In conclusion, the fractionation of exhaled air may be promising in clinical and occupational medicine.
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Affiliation(s)
- Matteo Goldoni
- Laboratory of Industrial Toxicology, Department of Clinical and Experimental Medicine, University of Parma, via Gramsci 14, Parma, Italy
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Hunt KE, Moore MJ, Rolland RM, Kellar NM, Hall AJ, Kershaw J, Raverty SA, Davis CE, Yeates LC, Fauquier DA, Rowles TK, Kraus SD. Overcoming the challenges of studying conservation physiology in large whales: a review of available methods. Conserv Physiol 2013; 1:cot006. [PMID: 27293590 PMCID: PMC4806609 DOI: 10.1093/conphys/cot006] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/22/2013] [Accepted: 03/27/2013] [Indexed: 05/15/2023]
Abstract
Large whales are subjected to a variety of conservation pressures that could be better monitored and managed if physiological information could be gathered readily from free-swimming whales. However, traditional approaches to studying physiology have been impractical for large whales, because there is no routine method for capture of the largest species and there is presently no practical method of obtaining blood samples from free-swimming whales. We review the currently available techniques for gathering physiological information on large whales using a variety of non-lethal and minimally invasive (or non-invasive) sample matrices. We focus on methods that should produce information relevant to conservation physiology, e.g. measures relevant to stress physiology, reproductive status, nutritional status, immune response, health, and disease. The following four types of samples are discussed: faecal samples, respiratory samples ('blow'), skin/blubber samples, and photographs. Faecal samples have historically been used for diet analysis but increasingly are also used for hormonal analyses, as well as for assessment of exposure to toxins, pollutants, and parasites. Blow samples contain many hormones as well as respiratory microbes, a diverse array of metabolites, and a variety of immune-related substances. Biopsy dart samples are widely used for genetic, contaminant, and fatty-acid analyses and are now being used for endocrine studies along with proteomic and transcriptomic approaches. Photographic analyses have benefited from recently developed quantitative techniques allowing assessment of skin condition, ectoparasite load, and nutritional status, along with wounds and scars from ship strikes and fishing gear entanglement. Field application of these techniques has the potential to improve our understanding of the physiology of large whales greatly, better enabling assessment of the relative impacts of many anthropogenic and ecological pressures.
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Affiliation(s)
- Kathleen E. Hunt
- John H. Prescott Marine Laboratory, Research Department, New England Aquarium, Boston, MA 02110, USA
- Corresponding author: New England Aquarium, Central Wharf, Boston, MA 02110, USA. Tel: +1 617 226 2175.
| | - Michael J. Moore
- Biology Department, Woods Hole Oceanographic Insitution, Woods Hole, MA 02543, USA
| | - Rosalind M. Rolland
- John H. Prescott Marine Laboratory, Research Department, New England Aquarium, Boston, MA 02110, USA
| | - Nicholas M. Kellar
- Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, La Jolla, CA 92037, USA
| | - Ailsa J. Hall
- Sea Mammal Research Unit, Scottish Oceans Institute, St Andrews KY16 8LB, UK
| | - Joanna Kershaw
- Sea Mammal Research Unit, Scottish Oceans Institute, St Andrews KY16 8LB, UK
| | | | - Cristina E. Davis
- Mechanical and Aerospace Engineering, University of California, Davis, CA 95616, USA
| | | | - Deborah A. Fauquier
- Marine Mammal Health and Stranding Response Program, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, Silver Spring, MD 20910, USA
| | - Teresa K. Rowles
- Marine Mammal Health and Stranding Response Program, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, Silver Spring, MD 20910, USA
| | - Scott D. Kraus
- John H. Prescott Marine Laboratory, Research Department, New England Aquarium, Boston, MA 02110, USA
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Abstract
The collection and analysis of exhaled breath condensate (EBC) may be useful for the management of patients with chronic respiratory disease at all ages. It is a promising technique due to its apparent simplicity and non-invasiveness. EBC does not disturb an ongoing respiratory inflammation. However, the methodology remains controversial, as it is not yet standardized. The current diversity of the methods used to collect and preserve EBC, the analytical pitfalls and the high degree of within-subject variability are the main issues that hamper further development into a clinical useful technique. In order to facilitate the process of standardization, a simplified schematic approach is proposed. An update of available data identified open issues on EBC methodology. These issues were then classified into three separate conditions related to their influence before, during or after the condensation process: (1) pre-condenser conditions related to subject and/or environment; (2) condenser conditions related to condenser equipment; and (3) post-condenser conditions related to preservation and/or analysis. This simplified methodological approach highlights the potential influence of the many techniques used before, during and after condensation of exhaled breath. It may also serve as a methodological checklist for a more systematical approach of EBC research and development.
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Affiliation(s)
- Philippe Rosias
- Department of Paediatrics, Orbis Medical Center, Sittard, The Netherlands.
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Carter SR, Davis CS, Kovacs EJ. Exhaled breath condensate collection in the mechanically ventilated patient. Respir Med 2012; 106:601-13. [PMID: 22398157 DOI: 10.1016/j.rmed.2012.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 02/07/2012] [Accepted: 02/10/2012] [Indexed: 10/28/2022]
Abstract
Collection of exhaled breath condensate (EBC) is a non-invasive means of sampling the airway-lining fluid of the lungs. EBC contains numerous measurable mediators, whose analysis could change the management of patients with certain pulmonary diseases. While initially popularized in investigations involving spontaneously breathing patients, an increasing number of studies have been performed using EBC in association with mechanical ventilation. Collection of EBC in mechanically ventilated patients follows basic principles of condensation, but is influenced by multiple factors. Effective collection requires selection of a collection device, adequate minute ventilation, low cooling temperatures, and sampling times of greater than 10 min. Condensate can be contaminated by saliva, which needs to be filtered. Dilution of samples occurs secondary to distilled water in vapors and humidification in the ventilator circuit. Dilution factors may need to be employed when investigating non-volatile biomarkers. Storage and analysis should occur promptly at -70 °C to -80 °C to prevent rapid degradation of samples. The purpose of this review is to examine and describe methodologies and problems of EBC collection in mechanically ventilated patients. A straightforward and safe framework has been established to investigate disease processes in this population, yet technical aspects of EBC collection still exist that prevent clinical practicality of this technology. These include a lack of standardization of procedure and analysis of biomarkers, and of normal reference ranges for mediators in healthy individuals. Once these procedural aspects have been addressed, EBC could serve as a non-invasive alternative to invasive evaluation of lungs in mechanically ventilated patients.
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Affiliation(s)
- Stewart R Carter
- Department of Surgery, Loyola University Medical Center, Stritch School of Medicine, Building 110, Room 4232, 2160 South First Avenue, Maywood, IL 60153, USA
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