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Tai J, Shin JM, Park J, Han M, Kim TH. Oxidative Stress and Antioxidants in Chronic Rhinosinusitis with Nasal Polyps. Antioxidants (Basel) 2023; 12:antiox12010195. [PMID: 36671057 PMCID: PMC9854928 DOI: 10.3390/antiox12010195] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Oxidative stress results from an imbalance between the production of reactive oxygen species and the body's antioxidant defense system. It plays an important role in the regulation of the immune response and can be a pathogenic factor in various diseases. Chronic rhinosinusitis (CRS) is a complex and heterogeneous disease with various phenotypes and endotypes. Recently, an increasing number of studies have proposed that oxidative stress (caused by both environmental and intrinsic stimuli) plays an important role in the pathogenesis and persistence of CRS. This has attracted the attention of several researchers. The relationship between the presence of reactive oxygen species composed of free radicals and nasal polyp pathology is a key topic receiving attention. This article reviews the role of oxidative stress in respiratory diseases, particularly CRS, and introduces potential therapeutic antioxidants that may offer targeted treatment for CRS.
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Affiliation(s)
- Junhu Tai
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Jae-Min Shin
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Jaehyung Park
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Munsoo Han
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Mucosal Immunology Institute, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Tae Hoon Kim
- Department of Otorhinolaryngology—Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Mucosal Immunology Institute, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Correspondence: ; Tel.: +82-02-920-5486
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Xepapadaki P, Adachi Y, Pozo Beltrán CF, El-Sayed ZA, Gómez RM, Hossny E, Filipovic I, Le Souef P, Morais-Almeida M, Miligkos M, Nieto A, Phipatanakul W, Pitrez PM, Wang JY, Wong GW, Papadopoulos NG. Utility of biomarkers in the diagnosis and monitoring of asthmatic children. World Allergy Organ J 2022; 16:100727. [PMID: 36601259 PMCID: PMC9791923 DOI: 10.1016/j.waojou.2022.100727] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
Asthma imposes a heavy morbidity burden during childhood; it affects over 10% of children in Europe and North America and it is estimated to exceed 400 million people worldwide by the year 2025. In clinical practice, diagnosis of asthma in children is mostly based on clinical criteria; nevertheless, assessment of both physiological and pathological processes through biomarkers, support asthma diagnosis, aid monitoring, and further lead to better treatment outcomes and reduced morbidity. Recently, identification and validation of biomarkers in pediatric asthma has emerged as a top priority across leading experts, researchers, and clinicians. Moreover, the implementation of non-invasive biomarkers for the assessment and monitoring of paediatric patients with asthma, has been prioritized; however, only a proportion of them are currently included in the clinical practise. Although, the use of non-invasive biomarkers is highly supported in recent asthma guidelines for documenting diagnosis and supporting monitoring of asthmatic patients, data on the Pediatric population are limited. In the present report, the Pediatric Asthma Committee of the World Allergy Organization (WAO), aims to summarize and discuss available data for the implementation of non-invasive biomarkers in the diagnosis and monitoring in children with asthma. Information on the most studied biomarkers, including spirometry, oscillometry, markers of allergic sensitization, fractional exhaled nitric oxide, and the most recent exhaled breath markers and "omic" approaches, will be reviewed. Practical limitations and considerations based on both experts' opinion and critical review of the literature, on the utility of all "well-known" and newly introduced non-invasive biomarkers will be presented. A critical commentary on biomarkers' use in diagnosing and monitoring asthma during the COVID-19 pandemic, cost and availability of biomarkers in different settings and in developing countries, the differences on the biomarkers use between Primary Practitioners, Pediatricians, and Specialists and their role on the longitudinal aspect of asthma is provided.
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Affiliation(s)
- Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
- Corresponding author.
| | - Yuichi Adachi
- Department of Pediatrics, Faculty of Medicine, University of Toyam, Japan
| | | | - Zeinab A. El-Sayed
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | | | - Elham Hossny
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Ivana Filipovic
- University Hospital Center Dr Dragiša Mišović Hospital Pediatric Department, Serbia
| | - Peter Le Souef
- Faculty of Health and Medical Sciences, Dept of Respiratory Medicine, Child and Adolescent Health Service, University of Western Australia, Perth, Australia
| | | | - Michael Miligkos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - Antonio Nieto
- Pediatric Pulmonology & Allergy Unit Children's. Health Research Institute. Hospital La Fe, 46026, Valencia, Spain
| | - Wanda Phipatanakul
- Pediatric Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Paulo M. Pitrez
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Jiu-Yao Wang
- Center for Allergy and Clinical Immunology Research, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Gary W.K. Wong
- Department of Paediatrics, The Chinese University of Hong Kong, China
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Santri IN, Irham LM, Djalilah GN, Perwitasari DA, Wardani Y, Phiri YVA, Adikusuma W. Identification of Hub Genes and Potential Biomarkers for Childhood Asthma by Utilizing an Established Bioinformatic Analysis Approach. Biomedicines 2022; 10:biomedicines10092311. [PMID: 36140412 PMCID: PMC9496621 DOI: 10.3390/biomedicines10092311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Childhood asthma represents a heterogeneous disease resulting from the interaction between genetic factors and environmental exposures. Currently, finding reliable biomarkers is necessary for the clinical management of childhood asthma. However, only a few biomarkers are being used in clinical practice in the pediatric population. In the long run, new biomarkers for asthma in children are required and would help direct therapy approaches. This study aims to identify potential childhood asthma biomarkers using a genetic-driven biomarkers approach. Herein, childhood asthma-associated Single Nucleotide Polymorphisms (SNPs) were utilized from the GWAS database to drive and facilitate the biomarker of childhood asthma. We uncovered 466 childhood asthma-associated loci by extending to proximal SNPs based on r2 > 0.8 in Asian populations and utilizing HaploReg version 4.1 to determine 393 childhood asthma risk genes. Next, the functional roles of these genes were subsequently investigated using Gene Ontology (GO) term enrichment analysis, a Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, and a protein−protein interaction (PPI) network. MCODE and CytoHubba are two Cytoscape plugins utilized to find biomarker genes from functional networks created using childhood asthma risk genes. Intriguingly, 10 hub genes (IL6, IL4, IL2, IL13, PTPRC, IL5, IL33, TBX21, IL2RA, and STAT6) were successfully identified and may have been identified to play a potential role in the pathogenesis of childhood asthma. Among 10 hub genes, we strongly suggest IL6 and IL4 as prospective childhood asthma biomarkers since both of these biomarkers achieved a high systemic score in Cytohubba’s MCC algorithm. In summary, this study offers a valuable genetic-driven biomarker approach to facilitate the potential biomarkers for asthma in children.
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Affiliation(s)
| | | | | | | | - Yuniar Wardani
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta 55164, Indonesia
| | - Yohane Vincent Abero Phiri
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Institute for Health Research and Communication (IHRC), Lilongwe P.O. Box 1958, Malawi
| | - Wirawan Adikusuma
- Departement of Pharmacy, University of Muhammadiyah Mataram, Mataram 83127, Indonesia
- Correspondence: (W.A.)
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Tereshchenko SY, Malinchik MA, Smolnikova MV. Inflammatory markers in exhaled breath condensate in bronchial asthma. Medicinskij sovet 2021. [DOI: 10.21518/2079-701x-2021-16-212-223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Chronic respiratory diseases are among the most common non- infection diseases. In particular, it is bronchial asthma (BA), characterized by bronchial hyperreactivity and varying degrees of airway obstruction that is the cause of morbidity and mortality. The methods available for the information about the presence of inflammation in the airways, such as bronchoscopy and bronchial biopsy to be obtained have currently been invasive and difficult in everyday clinical practice, especially for children and seriously ill patients. In this regard, recently there has been an increase in the development of non-invasive methods for diagnosing the respiratory system, being comfortable and painless for trial subjects, especially children, also providing the inflammatory process control in the lungs, the severity assessment and monitoring the treatment process. The exhaled breath condensate (EBC) is of great attention, which is a source of various biomolecules, including nitric oxide (NO), leukotrienes, 8-isoprostane, prostaglandins, etc., being locally or systemically associated with disease processes in the body. Of particular interest is the presence of cytokines in EBC, namely the specific proteins produced by various cells of the body that play a key role in inflammatory processes in AD and provide cell communication (cytokine network). Thereby, it becomes possible for the severity and control level of childhood bronchial asthma using only the EBC analysis to be assessed. In addition, the non-invasiveness of this method allows it to be reused for monitoring lung diseases of even the smallest patients, including infants. Thus, the field of metabolite analysis in EBC has been developing and, in the near future, the given method is likely to be the most common for diagnosing the respiratory system diseases in both children and adults.
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Affiliation(s)
- S. Yu. Tereshchenko
- Scientific Research Institute of Medical Problems of the North, Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences
| | - M. A. Malinchik
- Scientific Research Institute of Medical Problems of the North, Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences
| | - M. V. Smolnikova
- Scientific Research Institute of Medical Problems of the North, Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences
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Krejner-Bienias A, Grzela K, Zagórska W, Chojnowska M, Grzela T. Exhaled breath condensates from healthy children induce cell death of in vitro cultured cells by activation of apoptosis. Postepy Dermatol Alergol 2021; 38:85-90. [PMID: 34408572 DOI: 10.5114/ada.2019.87087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 07/15/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Exhaled breath condensate (EBC) is a liquefied air, containing a mixture of non-volatile compounds, reflecting pathophysiological status of the bronchopulmonary system. Therefore, EBC analysis may be useful in diagnostics and monitoring of various respiratory diseases. In previous studies it was found that EBC from asthmatic children contained several regulators of angiogenesis. In vitro experiments with EBCs from children with asthma revealed their weak influence on proliferation of various cells. Surprisingly, EBCs from healthy children led to apoptosis of all tested cells. Aim To assess the expression of selected apoptosis-related proteins in human and murine cells exposed to EBC from healthy children. Material and methods EBCs from healthy children were added to cultures of murine endothelial cells (C166) or human lung fibroblasts (HLF) to induce their apoptosis. For proteome analysis the apoptosis pathway-specific protein microarrays were used. Results The homogenates from EBC-treated C166 cells contained low amounts of Hsp27, which correlated with their fast death. Contrary to C166, the lysates from EBC-treated fibroblasts displayed increased amounts of Hsp27, which correlated with delayed HLF response to the induction of apoptosis. Except for increased caspase-3 in EBC-treated HLF, none of the other apoptosis regulators revealed any significant changes in that analysis. Conclusions The screening of apoptosis pathways with microarray technology allowed identification of two molecules, Hsp27 and caspase-3, involved in cellular response to EBC. However, the factor responsible for induction of the cytotoxic effect of EBC from healthy children still remains unknown.
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Abstract
Biomarkers may be diagnostic of asthma, they may predict or reflect response to therapy or they may identify patients at risk of asthma exacerbation. A biomarker is most often measured in biologic fluids that are sampled using relatively non-invasive sampling techniques such as blood, sputum, urine or exhaled breath. Biomarkers should be stable, readily quantifiable and their measurement should be reproducible and not confounded by other host factors, or the presence of comorbidities. However, asthma comprises multiple molecular endotypes and single, sensitive, specific, biomarkers reflecting these endotypes may not exist. Combining biomarkers may improve their predictive capability in asthma. The most well-established endotypes are those described as Type2 and non-Type2 asthma. Clinical trials established the fraction of exhaled nitric oxide (FeNO) and blood eosinophil counts as key biomarkers of response to corticosteroid or targeted anti-inflammatory therapy in Type2 asthma. However, these biomarkers may have limited value in the management of asthma in real-life settings or routine clinical practise. Biomarkers for Type2 asthma are not well described or validated and more research is needed. Breathomics has provided evidence to propose a number of exhaled volatile organic compounds (VOCs) as surrogate biomarkers for airway inflammatory phenotypes, disease activity and adherence to therapy. Analysis of urinary eicosanoids has identified eicosanoids related to Type2 and non-Type2 inflammation. Future clinical trials will be important in determining how exhaled VOCs or urinary eicosanoid profiles can be used to direct precision treatments. Their future clinical use will also depend on developing simplified instrumentation for biomarker analysis at the point-of-care.
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Affiliation(s)
- Janis Shute
- School of Pharmacy and Biomedical Sciences, Institute of Biomedical and Biomolecular Sciences, University of Portsmouth, Portsmouth, UK -
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Elenius V, Chawes B, Malmberg PL, Adamiec A, Ruszczyński M, Feleszko W, Jartti T. Lung function testing and inflammation markers for wheezing preschool children: A systematic review for the EAACI Clinical Practice Recommendations on Diagnostics of Preschool Wheeze. Pediatr Allergy Immunol 2021; 32:501-513. [PMID: 33222297 DOI: 10.1111/pai.13418] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/06/2020] [Accepted: 11/13/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Preschool wheeze is highly prevalent; 30%-50% of children have wheezed at least once before age six. Wheezing is not a disorder; it is a symptom of obstruction in the airways, and it is essential to identify the correct diagnosis behind this symptom. An increasing number of studies provide evidence for novel diagnostic tools for monitoring and predicting asthma in the pediatric population. Several techniques are available to measure airway obstruction and airway inflammation, including spirometry, impulse oscillometry, whole-body plethysmography, bronchial hyperresponsiveness test, multiple breath washout test, measurements of exhaled NO, and analyses of various other biomarkers. METHODS We systematically reviewed all the existing techniques available for measuring lung function and airway inflammation in preschool children to assess their potential and clinical value in the routine diagnostics and monitoring of airway obstruction. RESULTS If applicable, measuring FEV1 using spirometry is considered useful. For those unable to perform spirometry, whole-body plethysmography and IOS may be useful. Bronchial reversibility to beta2-agonist and hyperresponsiveness test with running exercise challenge may improve the sensitivity of these tests. CONCLUSIONS The difficulty of measuring lung function and the lack of large randomized controlled trials makes it difficult to establish guidelines for monitoring asthma in preschool children.
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Affiliation(s)
- Varpu Elenius
- Department of Pediatrics, Turku University Hospital and Turku University, Turku, Finland
| | - Bo Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Pekka L Malmberg
- The Skin and Allergy Hospital, University of Helsinki, Helsinki, Finland
| | - Aleksander Adamiec
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.,Department of Pediatric Pneumology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Marek Ruszczyński
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Feleszko
- Department of Pediatric Pneumology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Tuomas Jartti
- Department of Pediatrics, University of Oulu and Oulu University Hospital, Oulu, Finland
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Breiteneder H, Peng Y, Agache I, Diamant Z, Eiwegger T, Fokkens WJ, Traidl‐Hoffmann C, Nadeau K, O'Hehir RE, O'Mahony L, Pfaar O, Torres MJ, Wang D, Zhang L, Akdis CA. Biomarkers for diagnosis and prediction of therapy responses in allergic diseases and asthma. Allergy 2020; 75:3039-3068. [PMID: 32893900 PMCID: PMC7756301 DOI: 10.1111/all.14582] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 02/06/2023]
Abstract
Modern health care requires a proactive and individualized response to diseases, combining precision diagnosis and personalized treatment. Accordingly, the approach to patients with allergic diseases encompasses novel developments in the area of personalized medicine, disease phenotyping and endotyping, and the development and application of reliable biomarkers. A detailed clinical history and physical examination followed by the detection of IgE immunoreactivity against specific allergens still represents the state of the art. However, nowadays, further emphasis focuses on the optimization of diagnostic and therapeutic standards and a large number of studies have been investigating the biomarkers of allergic diseases, including asthma, atopic dermatitis, allergic rhinitis, food allergy, urticaria and anaphylaxis. Various biomarkers have been developed by omics technologies, some of which lead to a better classification of distinct phenotypes or endotypes. The introduction of biologicals to clinical practice increases the need for biomarkers for patient selection, prediction of outcomes and monitoring, to allow for an adequate choice of the duration of these costly and long‐lasting therapies. Escalating healthcare costs together with questions about the efficacy of the current management of allergic diseases require further development of a biomarker‐driven approach. Here, we review biomarkers in diagnosis and treatment of asthma, atopic dermatitis, allergic rhinitis, viral infections, chronic rhinosinusitis, food allergy, drug hypersensitivity and allergen immunotherapy with a special emphasis on specific IgE, the microbiome and the epithelial barrier. In addition, EAACI guidelines on biologicals are discussed within the perspective of biomarkers.
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Affiliation(s)
- Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research Medical University of Vienna Vienna Austria
| | - Ya‐Qi Peng
- Swiss Institute of Allergy and Asthma Research (SIAF) University Zurich Davos Switzerland
- CK CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
- Otorhinolaryngology Hospital The First Affiliated Hospital Sun Yat‐Sen University Guangzhou China
| | - Ioana Agache
- Department of Allergy and Clinical Immunology Faculty of Medicine Transylvania University of Brasov Brasov Romania
| | - Zuzana Diamant
- Department of Respiratory Medicine & Allergology Institute for Clinical Science Skane University Hospital Lund University Lund Sweden
- Department of Respiratory Medicine First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
- Department of Clinical Pharmacy & Pharmacology University of GroningenUniversity Medical Center Groningen Groningen Netherlands
| | - Thomas Eiwegger
- Translational Medicine Program, Research Institute Hospital for Sick Children Toronto ON Canada
- Department of Immunology University of Toronto Toronto ON Canada
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program The Hospital for Sick Children Departments of Paediatrics and Immunology University of Toronto Toronto ON Canada
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology Amsterdam University Medical Centres Amsterdam The Netherlands
| | - Claudia Traidl‐Hoffmann
- CK CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- ZIEL ‐ Institute for Food & Health Technical University of Munich Freising‐Weihenstephan Germany
| | - Kari Nadeau
- Sean N. Parker Center for Allergy & Asthma Research Stanford University Stanford CA USA
| | - Robyn E. O'Hehir
- Department of Allergy, immunology and Respiratory Medicine Central Clinical School Monash University Melbourne Vic. Australia
- Allergy, Asthma and Clinical Immunology Service Alfred Health Melbourne Vic. Australia
| | - Liam O'Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland National University of Ireland Cork Ireland
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital MarburgPhilipps‐Universität Marburg Marburg Germany
| | - Maria J. Torres
- Allergy Unit Regional University Hospital of Malaga‐IBIMA‐UMA‐ARADyAL Malaga Spain
| | - De‐Yun Wang
- Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery and Department of Allergy Beijing TongRen Hospital Beijing China
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University Zurich Davos Switzerland
- CK CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
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Quimbar ME, Davis SQ, Al-Farra ST, Hayes A, Jovic V, Masuda M, Lippert AR. Chemiluminescent Measurement of Hydrogen Peroxide in the Exhaled Breath Condensate of Healthy and Asthmatic Adults. Anal Chem 2020; 92:14594-14600. [PMID: 33064450 DOI: 10.1021/acs.analchem.0c02929] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Reactive oxygen species are centrally involved in the pathophysiology of airway diseases such as asthma and chronic obstructive pulmonary disease. This study reports the development of a chemiluminescence assay and a device for measuring hydrogen peroxide in the exhaled breath condensate of asthma patients and healthy participants. A stand-alone photon detection device was constructed for use with an optimized chemiluminescence assay. Calibrations using a catalase control to scavenge residual hydrogen peroxide in calibrant solutions provided analytically sensitive and specific measurements. We evaluated exhaled breath condensate hydrogen peroxide in 60 patients (ages 20-83; 30 healthy patients and 30 asthma patients) recruited from the John Peter Smith Hospital Network. The exhaled breath condensate hydrogen peroxide concentrations trended toward higher values in asthma patients compared to healthy participants (mean 142.5 vs 115.5 nM; p = 0.32). Asthma patients who had not used an albuterol rescue inhaler in the past week were compared to those who had and showed a trend toward higher hydrogen peroxide levels (mean 172.8 vs 115.9 nM; p = 0.25), and these patients also trended toward higher hydrogen peroxide than healthy participants (mean 172.8 vs 115.5 nM; p = 0.14). This pilot study demonstrates the ability of the newly developed assay and device to measure exhaled breath condensate hydrogen peroxide in asthma patients and healthy participants. The trends observed in this study are in agreement with previous literature and warrant further investigation of using this system to measure exhaled breath condensate hydrogen peroxide for monitoring oxidative stress in asthma.
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Affiliation(s)
| | - Steven Q Davis
- John Peter Smith Hospital Network, Fort Worth, Texas 76104, United States
| | - Sherif T Al-Farra
- John Peter Smith Hospital Network, Fort Worth, Texas 76104, United States
| | - Amanda Hayes
- John Peter Smith Hospital Network, Fort Worth, Texas 76104, United States
| | - Valentina Jovic
- John Peter Smith Hospital Network, Fort Worth, Texas 76104, United States
| | - Maximillian Masuda
- John Peter Smith Hospital Network, Fort Worth, Texas 76104, United States
| | - Alexander R Lippert
- BioLum Sciences LLC, Dallas, Texas 75206, United States.,Department of Chemistry and Center for Drug Discovery, Design, and Delivery (CD4), Southern Methodist University, Dallas, Texas 75275-0314, United States
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10
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Ferraro VA, Zanconato S, Baraldi E, Carraro S. Nitric Oxide and Biological Mediators in Pediatric Chronic Rhinosinusitis and Asthma. J Clin Med 2019; 8:jcm8111783. [PMID: 31731479 PMCID: PMC6912805 DOI: 10.3390/jcm8111783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In the context of the so-called unified airway theory, chronic rhinosinusitis (CRS) and asthma may coexist. The inflammation underlying these conditions can be studied through the aid of biomarkers. Main body: We described the main biological mediators that have been studied in pediatric CRS and asthma, and, according to the available literature, we reported their potential role in the diagnosis and management of these conditions. As for CRS, we discussed the studies that investigated nasal nitric oxide (nNO), pendrin, and periostin. As for asthma, we discussed the role of fractional exhaled nitric oxide (feNO), the role of periostin, and that of biological mediators measured in exhaled breath condensate (EBC) and exhaled air (volatile organic compounds, VOCs). CONCLUSION Among non-invasive biomarkers, nNO seems the most informative in CRS and feNO in asthma. Other biological mediators seem promising, but further studies are needed before they can be applied in clinical practice.
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Nejman-Gryz P, Górska K, Krenke K, Peradzyńska J, Paplińska-Goryca M, Kulus M, Krenke R. Periostin concentration in exhaled breath condensate in children with mild asthma. J Asthma 2019; 58:60-68. [PMID: 31496317 DOI: 10.1080/02770903.2019.1659312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Periostin is considered to be a marker of eosinophilic inflammation in patients with asthma. However, there are no literature data on exhaled breath condensate (EBC) periostin level in pediatric patients with asthma. The aim of this study was to analyze EBC periostin concentration in children with mild asthma and to evaluate the potential usefulness of EBC periostin level as a biomarker for the disease. METHODS EBC and serum periostin concentrations were measured by enzyme-linked immunosorbent assay in 23 children with asthma and 23 healthy controls. RESULTS EBC periostin concentration was 250- to 780-fold lower than that found in serum. No significant differences between serum nor EBC periostin concentration in asthmatics and the control group were showed. The comparison between children with Th2 and non-Th2 type of asthma did not show significant differences in periostin concentration, both in serum and EBC. Serum periostin concentration inversely correlated with BMI and age not only in asthma patients but also in controls. CONCLUSIONS In children with mild asthma, periostin may be measured not only in serum but also in EBC. The low periostin level in patients with mild asthma and lack of difference between asthmatic subjects and controls indicate that EBC periostin may not be useful as an asthma biomarker in this group.
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Affiliation(s)
- Patrycja Nejman-Gryz
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Górska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Krenke
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Peradzyńska
- Department of Epidemiology and Biostatistics, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Paplińska-Goryca
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Marek Kulus
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Rafał Krenke
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
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Krejner-Bienias A, Grzela K, Zagórska W, Chojnowska M, Świrska M, Grzela T. Influence of exhaled breath condensates from children with asthma on endothelial cells cultured in vitro. Do we really know everything about our breath condensate? Postepy Dermatol Alergol 2020; 37:368-74. [PMID: 33603596 DOI: 10.5114/ada.2019.86181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/27/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction Asthma-associated remodelling involves subepithelial fibrosis and increased vascularization of the bronchial wall. The latter may be associated with excessive production of several angiogenesis regulators which may be found in exhaled breath condensates (EBCs) collected from children with asthma. Aim To assess the influence of EBC samples of asthmatic children and healthy controls on in vitro cultures of normal human lung microvascular endothelial cells (HLMVEC) and murine endothelial cell line (C-166). Moreover, the proteomic profile of cytokines in EBC samples was analysed. Material and methods Breath condensates collected from children with mild asthma (n = 10) and from healthy controls (n = 10) were used for experiments. Colorimetric tetrazolium salt reduction assay was used to evaluate the effect of EBCs on HLMVEC and C-166 cell lines. Furthermore, influence of EBCs on C-166 cell line was assessed using Annexin V-binding assay. The cytokine screening of EBC samples was performed using a proteome microarray system. Results The EBCs from patients with asthma revealed a weak inhibitory influence on human and murine endothelial cells. Surprisingly, EBCs from healthy children led to cell death, mainly by the induction of apoptosis. There were no statistically significant differences in the cytokine profile between EBC samples from children with asthma and healthy controls. Conclusions Our preliminary report shows for the first time that the incubation of EBCs from healthy controls induced apoptosis in endothelial cells. The detailed mechanism responsible for this action remains unknown and requires further research.
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Lee YJ, Fujisawa T, Kim CK. Biomarkers for Recurrent Wheezing and Asthma in Preschool Children. Allergy Asthma Immunol Res 2019; 11:16-28. [PMID: 30479074 PMCID: PMC6267183 DOI: 10.4168/aair.2019.11.1.16] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/08/2018] [Accepted: 09/10/2018] [Indexed: 01/21/2023]
Abstract
Wheezing is one of the characteristic symptoms of asthma, but all preschool children with wheezing are not diagnosed with asthma. Preschool children are not cooperative enough to participate in spirometry and invasive tests. Thus, there is no conventional method to diagnose asthma in preschool children. We reviewed studies on non-invasive biomarkers for assessing asthma in preschool children. Specimens that can be easily obtained by non-invasive methods are blood, exhaled breath and urine. Eosinophils, eosinophil cationic protein and eosinophil-derived neurotoxin (EDN) in blood are helpful in evaluating eosinophilic inflammation of the airways. Exhaled breath contains nitric oxide, volatile organic compounds, various cytokines and mediators as analytical components. Fraction of exhaled nitric oxide has been used to assess the degree of eosinophil inflammation and has been standardized in school-age children and adults, but not yet in preschool children. Exhaled breath condensate (EBC) pH and various cytokines/mediators that are detected in EBC seem to be promising biomarkers for assessing asthma, but need more standardization and validation. There are several biomarkers useful for assessing asthma, but none are ideal. Some biomarkers need standardized methods of obtaining samples from uncooperative preschool children for clinical use and require sufficient validation. Recently, another activated eosinophil marker, serum EDN, has shown promising results as a biomarker for recurrent wheezing and asthma in preschool children.
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Affiliation(s)
- Yong Ju Lee
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | | | - Chang Keun Kim
- Asthma and Allergy Center, Inje University Sanggye Paik Hospital, Seoul, Korea.,SKIMS-BIO Co., Ltd. Seoul, Korea.
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Bannier MAGE, Rosias PPR, Jöbsis Q, Dompeling E. Exhaled Breath Condensate in Childhood Asthma: A Review and Current Perspective. Front Pediatr 2019; 7:150. [PMID: 31106182 PMCID: PMC6494934 DOI: 10.3389/fped.2019.00150] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 04/01/2019] [Indexed: 11/23/2022] Open
Abstract
Exhaled breath condensate (EBC) was introduced more than two decades ago as a novel, non-invasive tool to assess airway inflammation. This review summarizes the latest literature on the various markers in EBC to predict asthma in children. Despite many recommendations and two comprehensive Task Force reports, there is still large heterogeneity in published data. The biggest issue remains a lack of standardization regarding EBC collection, preservation, processing, and analysis. As a result, published studies show mixed or conflicting results, questioning the reproducibility of findings. A joint, multicenter research study is urgently needed to address the necessary methodological standardization.
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Affiliation(s)
- Michiel A G E Bannier
- Department of Pediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Quirijn Jöbsis
- Department of Pediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, Netherlands
| | - Edward Dompeling
- Department of Pediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, Netherlands
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Sahiner UM, Birben E, Erzurum S, Sackesen C, Kalayci Ö. Oxidative stress in asthma: Part of the puzzle. Pediatr Allergy Immunol 2018; 29:789-800. [PMID: 30069955 DOI: 10.1111/pai.12965] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/08/2018] [Accepted: 07/23/2018] [Indexed: 01/17/2023]
Abstract
An imbalance between the production of reactive oxygen species and the capacity of antioxidant defense mechanisms favoring oxidants is called oxidative stress and is implicated in asthmatic inflammation and severity. Major reactive oxygen species that are formed endogenously include hydrogen peroxide, superoxide anion, hydroxyl radical, and hypohalite radical; and the major antioxidants that fight against the endogenous and environmental oxidants are superoxide dismutase, catalase, and glutathione. Despite the well-known presence of oxidative stress in asthma, studies that target oxidative burden using a variety of nutritional, pharmacological, and environmental approaches have generally been disappointing. In this review, we summarize the current knowledge on oxidative stress and antioxidant imbalance in asthma. In addition, we focus on possible biomarkers of oxidative stress in asthma and on current and future treatment strategies using the modulation of oxidative stress to treat asthma patients.
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Affiliation(s)
- Umit M Sahiner
- Department of Pediatric Allergy and Asthma, Hacettepe University School of Medicine, Ankara, Turkey
| | - Esra Birben
- Department of Pediatric Allergy and Asthma, Hacettepe University School of Medicine, Ankara, Turkey
| | - Serpil Erzurum
- Department of Pathobiology, Cleveland Clinic, Lerner Research Institute, and the Respiratory Institute, Cleveland, Ohio
| | - Cansin Sackesen
- Department of Pediatric Allergy, Koc University School of Medicine, Istanbul, Turkey
| | - Ömer Kalayci
- Department of Pediatric Allergy and Asthma, Hacettepe University School of Medicine, Ankara, Turkey
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Ferraro V, Carraro S, Bozzetto S, Zanconato S, Baraldi E. Exhaled biomarkers in childhood asthma: old and new approaches. Asthma Res Pract 2018; 4:9. [PMID: 30094051 PMCID: PMC6081883 DOI: 10.1186/s40733-018-0045-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/30/2018] [Indexed: 12/21/2022] Open
Abstract
Background Asthma is a chronic condition usually characterized by underlying inflammation. The study of asthmatic inflammation is of the utmost importance for both diagnostic and monitoring purposes. The gold standard for investigating airway inflammation is bronchoscopy, with bronchoalveolar lavage and bronchial biopsy, but the invasiveness of such procedures limits their use in children. For this reason, in the last decades there has been a growing interest for the development of noninvasive methods. Main body In the present review, we describe the most important non-invasive methods for the study of airway inflammation in children, focusing on the measure of the fractional exhaled nitric oxide (feNO), on the measure of the exhaled breath temperature (EBT) and on the analysis of both exhaled breath condensate (EBC) and exhaled air (Volatile Organic Compounds, VOCs), using targeted and untargeted approaches. We summarize what is currently known on the topic of exhaled biomarkers in childhood asthma, with a special emphasis on emerging approaches, underlining the role of exhaled biomarkers in the diagnosis, management and treatment of asthma, and their potential for the development of personalized treatments. Conclusion Among non-invasive methods to study asthma, exhaled breath analysis remains one of the most interesting approaches, feNO and “-omic” sciences seem promising for the purpose of characterizing biomarkers of this disease.
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Affiliation(s)
- Valentina Ferraro
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Silvia Carraro
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Sara Bozzetto
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Stefania Zanconato
- Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Eugenio Baraldi
- Women's and Children's Health Department, University of Padova, Padova, Italy
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Mulholland A, Ainsworth A, Pillarisetti N. Tools in Asthma Evaluation and Management: When and How to Use Them? Indian J Pediatr 2018; 85:651-657. [PMID: 29139062 DOI: 10.1007/s12098-017-2462-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 08/24/2017] [Indexed: 01/08/2023]
Abstract
The goals of asthma management are accurate diagnosis, prompt initiation of treatment and monitoring of disease progression to limit potential morbidity and mortality. While the diagnosis and management is largely based on history taking and clinical examination, there are an increasing number of tools available that could be used to aid diagnosis, define phenotypes, monitor progress and assess response to treatment. Tools such as the Asthma Predictive Index could help in making predictions about the possibility of asthma in childhood based on certain clinical parameters in pre-schoolers. Lung function measurements such as peak expiratory flow, spirometry, bronchodilator responsiveness, and bronchial provocation tests help establish airway obstruction and variability over time. Tools such as asthma questionnaires, lung function measurements and markers of airway inflammation could be used in combination with clinical assessments to assess ongoing asthma control. Recent advances in digital technology, which open up new frontiers in asthma management, need to be evaluated and embraced if proven to be of value. This review summarises the role of currently available tools in asthma diagnosis and management. While many of the tools are readily available in resource rich settings, it becomes more challenging when working in resource poor settings. A rational approach to the use of these tools is recommended.
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Affiliation(s)
- Anna Mulholland
- Pediatric Respiratory Medicine, Starship Children's Hospital, Park Road, Grafton, Auckland, 1023, New Zealand
| | - Alana Ainsworth
- Pediatric Respiratory Medicine, Starship Children's Hospital, Park Road, Grafton, Auckland, 1023, New Zealand
| | - Naveen Pillarisetti
- Pediatric Respiratory Medicine, Starship Children's Hospital, Park Road, Grafton, Auckland, 1023, New Zealand. .,Department of Pediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand.
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Liu A, Liang J, Shi R, Zhao Z, Tian Y. Ultrasensitive sensor based on nano-Cu/polyaniline/nickel foam for monitoring H
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in exhaled breath. J Breath Res 2018; 12:036001. [DOI: 10.1088/1752-7163/aaa672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Chérot-Kornobis N, Hulo S, Giovannelli J, de Broucker V, Matran R, Amouyel P, Sobaszek A, Dauchet L, Edmé JL. Exhaled breath NOx levels in a middle-aged adults population-based study: reference values and association with the smoking status. Respir Med 2018; 137:134-140. [PMID: 29605196 DOI: 10.1016/j.rmed.2018.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Biomarkers in exhaled breath condensate (EBC) are potentially sensitive indicators of early biochemical changes in airways following exposure to pneumotoxic substances, particularly in susceptible subjects. NOx are the stable end products of the nitrite-nitrate-NO oxidative stress pathway and can be used to monitor airway inflammatory diseases, especially in asthma. Nevertheless, population-based surveys are needed to better interpret EBC NOx levels in clinical studies. The aim of this study was to establish reference values of EBC NOx in a large group of middle-aged, healthy adults of a sample of the general population with particular focus on the smoking status. METHODS The EBC NOx levels were analysed from 2872 subjects among the ELISABET population-based cross sectional study including a representative sample of men and women aged from 40 to 66 years olds conducted in northern France, which included comprehensive questionnaires by interview and spirometry data. Healthy participants were defined as participants with no self-reported respiratory disease. RESULTS For the healthy subjects (n = 1251), the median NOx concentration (IQR) was equal to 7.2 μM (3.12) and concentrations of NOx in EBC did not differ significantly according to smoking status. The upper fifth percentile (95%) (ULN) of NOx concentrations among healthy subjects was equal to 13.6 μM, ranging from 12.7 μM (smokers) to 14.4 μM (ex smokers). Among subjects with EBC NOx values higher than the ULN and compared with subjects that had EBC NOx values lower than the ULN, we found a significant higher proportion of subjects with current asthma (10.5% vs 6.5%) or with chronic bronchitis symptoms (7.6% vs 3.3%). CONCLUSION This population-based study has provided the distribution and the upper limit reference value of a nitrosative stress biomarker (NOx) in EBC of middle aged, healthy adults. EBC NOx levels were not associated with smoking status.
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Affiliation(s)
- Nathalie Chérot-Kornobis
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service Médecine du Travail du Personnel Hospitalier et de Pathologies Professionnelles et Environnementales, F-59000 Lille, France.
| | - Sébastien Hulo
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service explorations fonctionnelles Respiratoires, F-59000 Lille, France.
| | - Jonathan Giovannelli
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Facteurs de Risque et déterminant moléculaires des maladies liées au vieillissement, F-59000 Lille, France; CHU Lille, Service épidémiologie, économie de la santé et prévention, F-59000 Lille, France.
| | - Virginie de Broucker
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service explorations fonctionnelles Respiratoires, F-59000 Lille, France.
| | - Régis Matran
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service explorations fonctionnelles Respiratoires, F-59000 Lille, France.
| | - Philippe Amouyel
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Facteurs de Risque et déterminant moléculaires des maladies liées au vieillissement, F-59000 Lille, France; CHU Lille, Service épidémiologie, économie de la santé et prévention, F-59000 Lille, France.
| | - Annie Sobaszek
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service Médecine du Travail du Personnel Hospitalier et de Pathologies Professionnelles et Environnementales, F-59000 Lille, France.
| | - Luc Dauchet
- Univ. Lille, Institut Pasteur de Lille, INSERM U1167 - RID-AGE Facteurs de Risque et déterminant moléculaires des maladies liées au vieillissement, F-59000 Lille, France; CHU Lille, Service épidémiologie, économie de la santé et prévention, F-59000 Lille, France.
| | - Jean-Louis Edmé
- Univ. Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on Human Health), F-59000 Lille, France; CHU Lille, Service explorations fonctionnelles Respiratoires, F-59000 Lille, France.
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Abstract
Asthma is the most common chronic respiratory disease in children characterized by airways inflammation, bronchial hyperresponsiveness, recurrent reversible airways obstruction, and respiratory symptoms. The diagnosis of the disease is based on clinical history, airways obstruction at spirometry, and bronchial reversibility. Asthma treatment is aimed to disease control, through the use of controller treatment and monitoring lung function. However, lung function and symptoms not always reflect the underlying airways inflammation and response to the therapy. Objective parameters of asthma inflammation could be important for the clinician in the management of patients with asthma. In the last years, some studies were focused on biomarkers to identify phenotype, inflammation, and pathobiological pathways to help the clinician in the diagnosis and in personalizing the management. Accordingly, clinically feasible tests are represented by the collection of exhaled breath condensate (EBC) and measurement of exhaled nitric oxide (FeNO). Other-methods such as the evaluation of volatile organic compound (VOCs), that reflect airways inflammation and treatment efficacy, are currently used for research purposes For some of these methods, The lack of standardization in pre-collection, collection, post-collection of samples, and interpretation of the results may a problem in clinical practice. Improved these limitations, several biomarkers will be useful to distinguish patients with a different disease condition to personalize the treatment.
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Affiliation(s)
- Laura Tenero
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Marco Zaffanello
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Michele Piazza
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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Cumpstey AF, Hennis PJ, Gilbert-Kawai ET, Fernandez BO, Poudevigne M, Cobb A, Meale P, Mitchell K, Moyses H, Pöhnl H, Mythen MG, Grocott MPW, Feelisch M, Martin DS. Effects of dietary nitrate on respiratory physiology at high altitude - Results from the Xtreme Alps study. Nitric Oxide 2017; 71:57-68. [PMID: 29042272 PMCID: PMC5687938 DOI: 10.1016/j.niox.2017.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/10/2017] [Accepted: 10/13/2017] [Indexed: 11/30/2022]
Abstract
Nitric oxide (NO) production plays a central role in conferring tolerance to hypoxia. Tibetan highlanders, successful high-altitude dwellers for millennia, have higher circulating nitrate and exhaled NO (ENO) levels than native lowlanders. Since nitrate itself can reduce the oxygen cost of exercise in normoxia it may confer additional benefits at high altitude. Xtreme Alps was a double-blinded randomised placebo-controlled trial to investigate how dietary nitrate supplementation affects physiological responses to hypoxia in 28 healthy adult volunteers resident at 4559 m for 1 week; 14 receiving a beetroot-based high-nitrate supplement and 14 receiving a low-nitrate 'placebo' of matching appearance/taste. ENO, vital signs and acute mountain sickness (AMS) severity were recorded at sea level (SL) and daily at altitude. Moreover, standard spirometric values were recorded, and saliva and exhaled breath condensate (EBC) collected. There was no significant difference in resting cardiorespiratory variables, peripheral oxygen saturation or AMS score with nitrate supplementation at SL or altitude. Median ENO levels increased from 1.5/3.0 mPa at SL, to 3.5/7.4 mPa after 5 days at altitude (D5) in the low and high-nitrate groups, respectively (p = 0.02). EBC nitrite also rose significantly with dietary nitrate (p = 0.004), 1.7-5.1 μM at SL and 1.6-6.3 μM at D5, and this rise appeared to be associated with increased levels of ENO. However, no significant changes occurred to levels of EBC nitrate or nitrosation products (RXNO). Median salivary nitrite/nitrate concentrations increased from 56.5/786 μM to 333/5,194 μM with nitrate supplementation at SL, and changed to 85.6/641 μM and 341/4,553 μM on D5. Salivary RXNO rose markedly with treatment at SL from 0.55 μM to 5.70 μM. At D5 placebo salivary RXNO had increased to 1.90 μM whilst treatment RXNO decreased to 3.26 μM. There was no association with changes in any observation variables or AMS score. In conclusion, dietary nitrate supplementation is well tolerated at altitude and significantly increases pulmonary NO availability and both salivary and EBC NO metabolite concentrations. Surprisingly, this is not associated with changes in hemodynamics, oxygen saturation or AMS development.
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Affiliation(s)
- Andrew F Cumpstey
- Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Tremona Road, Southampton, SO16 6YD UK; Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
| | - Philip J Hennis
- UCL Centre for Altitude, Space and Extreme Environment (CASE) Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport Exercise & Health, 170 Tottenham Court Road, London, W1T 7HA, UK
| | - Edward T Gilbert-Kawai
- UCL Centre for Altitude, Space and Extreme Environment (CASE) Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport Exercise & Health, 170 Tottenham Court Road, London, W1T 7HA, UK
| | - Bernadette O Fernandez
- Clinical & Experimental Sciences, Faculty of Medicine, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK; Warwick Medical School, Division of Metabolic and Vascular Health, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK
| | - Matthieu Poudevigne
- Clinical & Experimental Sciences, Faculty of Medicine, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK
| | - Alexandra Cobb
- UCL Centre for Altitude, Space and Extreme Environment (CASE) Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport Exercise & Health, 170 Tottenham Court Road, London, W1T 7HA, UK
| | - Paula Meale
- UCL Centre for Altitude, Space and Extreme Environment (CASE) Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport Exercise & Health, 170 Tottenham Court Road, London, W1T 7HA, UK
| | - Kay Mitchell
- Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Tremona Road, Southampton, SO16 6YD UK; Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
| | - Helen Moyses
- Clinical & Experimental Sciences, Faculty of Medicine, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK
| | - Helmut Pöhnl
- AURAPA, Paul-Heidelbauer-Straße 26, 74321 Bietigheim-Bissingen, Germany
| | - Monty G Mythen
- UCL Centre for Altitude, Space and Extreme Environment (CASE) Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport Exercise & Health, 170 Tottenham Court Road, London, W1T 7HA, UK
| | - Michael P W Grocott
- Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Tremona Road, Southampton, SO16 6YD UK; Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
| | - Martin Feelisch
- Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Tremona Road, Southampton, SO16 6YD UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, University of Southampton, Tremona Road, Southampton, SO16 6YD UK; Clinical & Experimental Sciences, Faculty of Medicine, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK; Warwick Medical School, Division of Metabolic and Vascular Health, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK.
| | - Daniel S Martin
- UCL Centre for Altitude, Space and Extreme Environment (CASE) Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport Exercise & Health, 170 Tottenham Court Road, London, W1T 7HA, UK.
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Abstract
Lipid mediators (LM) of inflammation are a class of compounds derived from ω-3 and ω-6 fatty acids that play a wide role in modulating inflammatory responses. Some LM possess pro-inflammatory properties, while others possess proresolving characteristics, and the class switch from pro-inflammatory to proresolving is crucial for tissue homeostasis. In this article, we review the major classes of LM, focusing on their biosynthesis and signaling pathways, and their role in systemic and, especially, oral health and disease. We discuss the detection of these LM in various body fluids, focusing on diagnostic and therapeutic applications. We also present data showing gender-related differences in salivary LM levels in healthy controls, leading to a hypothesis on the etiology of inflammatory diseases, particularly Sjögren's syndrome. We conclude by enumerating open areas of research where further investigation of LM is likely to result in therapeutic and diagnostic advances.
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Affiliation(s)
- Salah Sommakia
- School of Dentistry, The University of Utah, Salt Lake City, UT, USA
| | - Olga J. Baker
- School of Dentistry, The University of Utah, Salt Lake City, UT, USA
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23
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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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Chi CH, Liao JP, Zhao YN, Li XY, Wang GF. Effect of Inhaled Budesonide on Interleukin-4 and Interleukin-6 in Exhaled Breath Condensate of Asthmatic Patients. Chin Med J (Engl) 2017; 129:819-23. [PMID: 26996478 PMCID: PMC4819303 DOI: 10.4103/0366-6999.178962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Studies of interleukin (IL)-4 and IL-6 in the exhaled breath condensate (EBC) of asthmatic patients are limited. This study was to determine the effect of inhaled corticosteroid (ICS) treatment on IL-4 and IL-6 in the EBC of asthmatic patients. Methods: In a prospective, open-label study, budesonide 200 μg twice daily by dry powder inhaler was administered to 23 adult patients with uncontrolled asthma (mean age 42.7 years) for 12 weeks. Changes in asthma scores, lung function parameters (forced expiratory volume in 1 s [FEV1], peak expiratory flow [PEF], forced expiratory flow at 50% of forced vital capacity [FEF50], forced expiratory flow at 75% of forced vital capacity, maximum mid-expiratory flow rate) and the concentrations of IL-4 and IL-6 in EBC were measured. Results: Both asthma scores and lung function parameters were significantly improved by ICS treatment. The mean IL-4 concentration in the EBC was decreased gradually, from 1.92 ± 0.56 pmol/L before treatment to 1.60 ± 0.36 pmol/L after 8 weeks of treatment (P < 0.05) and 1.54 ± 0.81 pmol/L after 12 weeks of treatment (P < 0.01). However, the IL-6 concentration was not significantly decreased. The change in the IL-4 concentration was correlated with improvements in mean FEV1, PEF and FEF50 values (correlation coefficients −0.468, −0.478, and −0.426, respectively). Conclusions: The concentration of IL-4 in the EBC of asthmatic patients decreased gradually with ICS treatment. Measurement of IL-4 in EBC could be useful to monitor airway inflammation in asthmatics.
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Affiliation(s)
| | | | | | | | - Guang-Fa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China
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Wandalsen GF, Solé D, Bacharier LB. Identification of infants and preschool children at risk for asthma: predictive scores and biomarkers. Curr Opin Allergy Clin Immunol 2016; 16:120-6. [PMID: 26807784 DOI: 10.1097/ACI.0000000000000240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW Predictive asthma scores and biomarkers are important tools that help many physicians in the identification of infants and preschool children at high risk for asthma. Our objective was to review recent data regarding this subject. RECENT FINDINGS Recently, two new predictive asthma scores were developed with some innovative features, such as the definition of scales of asthma risk. In a systematic review, 12 asthma-predictive models were identified with heterogeneous performance. Prospective studies have shown that elevated fractional concentration of nitric oxide (FeNO) is a strong risk factor for latter asthma among early wheezers, and a predictive asthma score with FeNO values has been proposed. Plasma cytokines and exhaled volatile organic compounds were also identified as potential asthma predictors. SUMMARY Predictive scores are simple, practical, and inexpensive tools to identify children at high risk for asthma at school age. Whereas some scores are better at identifying asthmatic children, others are better at excluding the diagnosis of asthma. Although promising, clear evidence for FeNO as a robust asthma predictor in comparison to clinical scores is still lacking. Specific IgE and eosinophil counts remain the most consistent biomarkers for the identification of children at risk for asthma, and further studies are necessary to clarify the role of other biomarkers.
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Aldakheel FM, Thomas PS, Bourke JE, Matheson MC, Dharmage SC, Lowe AJ. Relationships between adult asthma and oxidative stress markers and pH in exhaled breath condensate: a systematic review. Allergy 2016; 71:741-57. [PMID: 26896172 DOI: 10.1111/all.12865] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 01/02/2023]
Abstract
Oxidative stress has a recognized role in the pathophysiology of asthma. Recently, interest has increased in the assessment of pH and airway oxidative stress markers. Collection of exhaled breath condensate (EBC) and quantification of biomarkers in breath samples can potentially indicate lung disease activity and help in the study of airway inflammation, and asthma severity. Levels of oxidative stress markers in the EBC have been systematically evaluated in children with asthma; however, there is no such systematic review conducted for adult asthma. A systematic review of oxidative stress markers measured in EBC of adult asthma was conducted, and studies were identified by searching MEDLINE and SCOPUS databases. Sixteen papers met the inclusion criteria. Concentrations of exhaled hydrogen ions, nitric oxide products, hydrogen peroxide and 8-isoprostanes were generally elevated and related to lower lung function tests in adults with asthma compared to healthy subjects. Assessment of EBC markers may be a noninvasive approach to evaluate airway inflammation, exacerbations, and disease severity of asthma, and to monitor the effectiveness of anti-inflammatory treatment regimens. Longitudinal studies, using standardized analytical techniques for EBC collection, are required to establish reference values for the interpretation of EBC markers in the context of asthma.
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Affiliation(s)
- F. M. Aldakheel
- Allergy and Lung Health Unit; The University of Melbourne; Melbourne Australia
- Department of Clinical Laboratory Sciences; College of Applied Medical Sciences; King Saud University; Riyadh Saudi Arabia
| | - P. S. Thomas
- Department of Respiratory Medicine and Prince of Wales Hospital Clinical School; University of New South Wales; Sydney Australia
| | - J. E. Bourke
- Biomedicine Discovery Institute; Department of Pharmacology; Monash University; Clayton Australia
| | - M. C. Matheson
- Allergy and Lung Health Unit; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
| | - S. C. Dharmage
- Allergy and Lung Health Unit; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
| | - A. J. Lowe
- Allergy and Lung Health Unit; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
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Bikov A, Hull JH, Kunos L. Exhaled breath analysis, a simple tool to study the pathophysiology of obstructive sleep apnoea. Sleep Med Rev 2016; 27:1-8. [DOI: 10.1016/j.smrv.2015.07.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/30/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
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van Mastrigt E, de Jongste JC, Pijnenburg MW. The analysis of volatile organic compounds in exhaled breath and biomarkers in exhaled breath condensate in children - clinical tools or scientific toys? Clin Exp Allergy 2016; 45:1170-88. [PMID: 25394891 DOI: 10.1111/cea.12454] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Current monitoring strategies for respiratory diseases are mainly based on clinical features, lung function and imaging. As airway inflammation is the hallmark of many respiratory diseases in childhood, noninvasive methods to assess the presence and severity of airway inflammation might be helpful in both diagnosing and monitoring paediatric respiratory diseases. At present, the measurement of fractional exhaled nitric oxide is the only noninvasive method available to assess eosinophilic airway inflammation in clinical practice. We aimed to evaluate whether the analysis of volatile organic compounds (VOCs) in exhaled breath (EB) and biomarkers in exhaled breath condensate (EBC) is helpful in diagnosing and monitoring respiratory diseases in children. An extensive literature search was conducted in Medline, Embase and PubMed on the analysis and applications of VOCs in EB and EBC in children. We retrieved 1165 papers, of which nine contained original data on VOCs in EB and 84 on biomarkers in EBC. These were included in this review. We give an overview of the clinical applications in childhood and summarize the methodological issues. Several VOCs in EB and biomarkers in EBC have the potential to distinguish patients from healthy controls and to monitor treatment responses. Lack of standardization of collection methods and analysis techniques hampers the introduction in clinical practice. The measurement of metabolomic profiles may have important advantages over detecting single markers. There is a lack of longitudinal studies and external validation to reveal whether EB and EBC analysis have added value in the diagnostic process and follow-up of children with respiratory diseases. In conclusion, the use of VOCs in EB and biomarkers in EBC as markers of inflammatory airway diseases in children is still a research tool and not validated for clinical use.
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Affiliation(s)
- E van Mastrigt
- Department of Paediatric Respiratory Medicine, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - J C de Jongste
- Department of Paediatric Respiratory Medicine, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - M W Pijnenburg
- Department of Paediatric Respiratory Medicine, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
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Moeller A, Carlsen KH, Sly PD, Baraldi E, Piacentini G, Pavord I, Lex C, Saglani S. Monitoring asthma in childhood: lung function, bronchial responsiveness and inflammation. Eur Respir Rev 2016; 24:204-15. [PMID: 26028633 DOI: 10.1183/16000617.00003914] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
This review focuses on the methods available for measuring reversible airways obstruction, bronchial hyperresponsiveness (BHR) and inflammation as hallmarks of asthma, and their role in monitoring children with asthma. Persistent bronchial obstruction may occur in asymptomatic children and is considered a risk factor for severe asthma episodes and is associated with poor asthma outcome. Annual measurement of forced expiratory volume in 1 s using office based spirometry is considered useful. Other lung function measurements including the assessment of BHR may be reserved for children with possible exercise limitations, poor symptom perception and those not responding to their current treatment or with atypical asthma symptoms, and performed on a higher specialty level. To date, for most methods of measuring lung function there are no proper randomised controlled or large longitudinal studies available to establish their role in asthma management in children. Noninvasive biomarkers for monitoring inflammation in children are available, for example the measurement of exhaled nitric oxide fraction, and the assessment of induced sputum cytology or inflammatory mediators in the exhaled breath condensate. However, their role and usefulness in routine clinical practice to monitor and guide therapy remains unclear, and therefore, their use should be reserved for selected cases.
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Affiliation(s)
- Alexander Moeller
- Division of Respiratory Medicine, University Children's Hospital Zurich, Zurich, Switzerland
| | - Kai-Hakon Carlsen
- Dept of Paediatrics, Women and Children's Division, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Peter D Sly
- Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia
| | - Eugenio Baraldi
- Women's and Children's Health Department, Unit of Respiratory Medicine and Allergy, University of Padova, Padova, Italy
| | - Giorgio Piacentini
- Paediatric Section, Dept of Life and Reproduction Sciences, University of Verona, Verona, Italy
| | - Ian Pavord
- Dept of Respiratory Medicine, University of Oxford, NDM Research Building, Oxford, UK
| | - Christiane Lex
- Dept of Paediatric Cardiology and Intensive Care Medicine, Division of Paediatric Respiratory Medicine, University Hospital Goettingen, Goettingen, Germany
| | - Sejal Saglani
- Leukocyte Biology and Respiratory Paediatrics, National Heart and Lung Institute, Imperial College London, London, UK
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Bannier MAGE, van de Kant KDG, Jöbsis Q, Dompeling E. Biomarkers to predict asthma in wheezing preschool children. Clin Exp Allergy 2016; 45:1040-50. [PMID: 25409553 DOI: 10.1111/cea.12460] [Citation(s) in RCA: 17] [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: 01/10/2023]
Abstract
Wheezing in preschool children is a very common symptom. An adequate prediction of asthma in these children is difficult and cannot be reliably assessed with conventional clinical tools. The study of potential predictive biomarkers in various media, ranging from invasive sampling (e.g. bronchoscopy) to non-invasive sampling (lung function testing and exhaled breath analysis), was comprehensively reviewed. The evolution in biomarker discovery has resulted in an 'omics' approach, in which hundreds of biomarkers in the field of genomics, proteomics, metabolomics, and 'breath-omics' can be simultaneously studied. First, results on gene expression and exhaled breath profiles in predicting an early asthma diagnosis are promising. However, many hurdles need to be overcome before clinical implementation is possible. To reliably predict asthma in a wheezing child, probably a holistic approach is needed, combining clinical information with blood sampling, lung function tests, and potentially exhaled breath analysis. The further development of predictive, non-invasive biomarkers may eventually improve an early asthma diagnosis in wheezing preschool children and assist clinicians in early treatment decision-making.
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Affiliation(s)
- M A G E Bannier
- Department of Paediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - K D G van de Kant
- Department of Paediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Q Jöbsis
- Department of Paediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - E Dompeling
- Department of Paediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands
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31
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Lin J, Yin K, Su N, Huang M, Qiu C, Liu C, Cai S, Hao C. Chinese expert consensus on clinical use of non-invasive airway inflammation assessment in bronchial asthma. J Thorac Dis 2015; 7:2061-78. [PMID: 26716047 DOI: 10.3978/j.issn.2072-1439.2015.11.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Jiangtao Lin
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Kaisheng Yin
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Nan Su
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Mao Huang
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Chen Qiu
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Chuntao Liu
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Shaoxi Cai
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Chuangli Hao
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
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Lin J, Yin K, Su N, Huang M, Qiu C, Liu C, Cai S, Hao C. Chinese expert consensus on clinical use of non-invasive airway inflammation assessment in bronchial asthma. Ann Transl Med 2015; 3:302. [PMID: 26697462 DOI: 10.3978/j.issn.2305-5839.2015.11.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Jiangtao Lin
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Kaisheng Yin
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Nan Su
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Mao Huang
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Chen Qiu
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Chuntao Liu
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Shaoxi Cai
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
| | - Chuangli Hao
- 1 China-Japan Friendship Hospital, Beijing 100029, China ; 2 The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China ; 3 Shenzhen People's Hospital, Shenzhen 518020, China ; 4 West China Hospital, Sichuan University, Chengdu 610041, China ; 5 Nanfang Hospital, Southern Medical University, Guangzhou 510515, China ; 6 Soochow University Affiliated Children's Hospital, Suzhou 215003, China
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Moschino L, Zanconato S, Bozzetto S, Baraldi E, Carraro S. Childhood asthma biomarkers: present knowledge and future steps. Paediatr Respir Rev 2015; 16:205-12. [PMID: 26100359 DOI: 10.1016/j.prrv.2015.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 11/28/2022]
Abstract
Asthma represents the most common chronic respiratory disease of childhood. Its current standard diagnosis relies on patient history of symptoms and confirmed expiratory airflow limitation. Nevertheless, the spectrum of asthma in clinical presentation is broad, and both symptoms and lung function may not always reflect the underlying airway inflammation, which can be determined by different pathogenetic mechanisms. For these reasons, the identification of objective biomarkers of asthma, which may guide diagnosis, phenotyping, management and treatment is of great clinical utility and might have a role in the development of personalized therapy. The availability of non-invasive methods to study and monitor disease inflammation is of relevance especially in childhood asthma. In this sense, a promising role might be played by the measurement of exhaled biomarkers, such as exhaled nitric oxide (FE(NO)) and molecules in exhaled breath condensate (EBC). Furthermore, recent studies have shown encouraging results with the application of the novel metabolomic approach to the study of exhaled biomarkers. In this paper the existing knowledge in the field of asthma biomarkers, with a special focus on exhaled biomarkers, will be highlighted.
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Affiliation(s)
- Laura Moschino
- Department of Women's and Children's Health, University of Padova, Padova Italy
| | - Stefania Zanconato
- Department of Women's and Children's Health, University of Padova, Padova Italy
| | - Sara Bozzetto
- Department of Women's and Children's Health, University of Padova, Padova Italy
| | - Eugenio Baraldi
- Department of Women's and Children's Health, University of Padova, Padova Italy
| | - Silvia Carraro
- Department of Women's and Children's Health, University of Padova, Padova Italy.
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van Vliet D, Alonso A, Rijkers G, Heynens J, Rosias P, Muris J, Jöbsis Q, Dompeling E. Prediction of asthma exacerbations in children by innovative exhaled inflammatory markers: results of a longitudinal study. PLoS One 2015; 10:e0119434. [PMID: 25799487 PMCID: PMC4370663 DOI: 10.1371/journal.pone.0119434] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/13/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In asthma management guidelines the primary goal of treatment is asthma control. To date, asthma control, guided by symptoms and lung function, is not optimal in many children and adults. Direct monitoring of airway inflammation in exhaled breath may improve asthma control and reduce the number of exacerbations. AIM 1) To study the use of fractional exhaled nitric oxide (FeNO) and inflammatory markers in exhaled breath condensate (EBC), in the prediction of asthma exacerbations in a pediatric population. 2) To study the predictive power of these exhaled inflammatory markers combined with clinical parameters. METHODS 96 asthmatic children were included in this one-year prospective observational study, with clinical visits every 2 months. Between visits, daily symptom scores and lung function were recorded using a home monitor. During clinical visits, asthma control and FeNO were assessed. Furthermore, lung function measurements were performed and EBC was collected. Statistical analysis was performed using a test dataset and validation dataset for 1) conditionally specified models, receiver operating characteristic-curves (ROC-curves); 2) k-nearest neighbors algorithm. RESULTS Three conditionally specified predictive models were constructed. Model 1 included inflammatory markers in EBC alone, model 2 included FeNO plus clinical characteristics and the ACQ score, and model 3 included all the predictors used in model 1 and 2. The area under the ROC-curves was estimated as 47%, 54% and 59% for models 1, 2 and 3 respectively. The k-nearest neighbors predictive algorithm, using the information of all the variables in model 3, produced correct predictions for 52% of the exacerbations in the validation dataset. CONCLUSION The predictive power of FeNO and inflammatory markers in EBC for prediction of an asthma exacerbation was low, even when combined with clinical characteristics and symptoms. Qualitative improvement of the chemical analysis of EBC may lead to a better non-invasive prediction of asthma exacerbations.
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Affiliation(s)
- Dillys van Vliet
- Department of Pediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+),Maastricht, The Netherlands
| | - Ariel Alonso
- Department of Methodology and Statistics, CAPHRI, MUMC+, Maastricht, The Netherlands
| | - Ger Rijkers
- Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Jan Heynens
- Department of Pediatrics, Orbis Medical Center, Sittard, The Netherlands
| | - Philippe Rosias
- Department of Pediatrics, Orbis Medical Center, Sittard, The Netherlands
| | - Jean Muris
- Department of Family Medicine, CAPHRI, MUMC, Maastricht, The Netherlands
| | - Quirijn Jöbsis
- Department of Pediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+),Maastricht, The Netherlands
| | - Edward Dompeling
- Department of Pediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+),Maastricht, The Netherlands
- * E-mail:
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Abstract
Personalized medicine for children with asthma aims to provide a tailored management of asthma, which leads to faster and better asthma control, has less adverse events and may be cost saving. Several patient characteristics, lung function parameters and biomarkers have been shown useful in predicting treatment response or predicting successful reduction of asthma medication. As treatment response to the main asthma therapies is partly genetically determined, pharmacogenetics may open the way for personalized medicine in children with asthma. However, the number of genes identified for the various asthma drug response phenotypes remains small and randomized controlled trials are lacking. Biomarkers in exhaled breath or breath condensate remain promising but did not find their way from bench to bedside yet, except for the fraction of exhaled nitric oxide. E-health will most likely find its way to clinical practice and most interventions are at least non-inferior to usual care. More studies are needed on which interventions will benefit most individual children.
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Affiliation(s)
- Mariëlle W Pijnenburg
- Department of Paediatrics/ Paediatric Respiratory Medicine, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.
| | - Stanley Szefler
- The Breathing Institute / Pulmonary Medicine, Department of Pediatrics, Children's Hospital Colorado; University of Colorado Denver School of Medicine, Aurora (CO), USA.
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Barreto M, Zambardi R, Villa MP. Exhaled nitric oxide and other exhaled biomarkers in bronchial challenge with exercise in asthmatic children: current knowledge. Paediatr Respir Rev 2015; 16:68-74. [PMID: 24368252 DOI: 10.1016/j.prrv.2013.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 04/23/2013] [Accepted: 11/15/2013] [Indexed: 12/31/2022]
Abstract
The fractional concentration of exhaled nitric oxide (FENO), a known marker of atopic-eosinophilic inflammation, may be used as a surrogate to assess exercise-induced bronchoconstriction (EIB) in asthmatic children. The predictive value of baseline FENO for EIB appears to be influenced by several factors, including age, atopy, current therapy with corticosteroids and measurement technique. Nonetheless, FENO cut-off values appear to be able to rule out EIB. FENO levels decrease during EIB, apparently through neural mechanisms rather than by decreased airway-epithelial surface. Partition of FENO into proximal and peripheral contributions of the respiratory tract may improve our understanding on NO exchange during exercise and help to screen subjects prone to EIB. Other biomarkers of inflammation and oxidative stress contained in exhaled gases and exhaled breath condensate (EBC) may shed light on the pathophysiology of EIB. Exhaled breath temperature is a promising real-time measurement whose routine use for assessing EIB warrants further investigation.
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Affiliation(s)
- Mario Barreto
- Pediatric Unit, Sant'Andrea Hospital, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
| | - Rosanna Zambardi
- Pediatric Unit, Sant'Andrea Hospital, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Maria Pia Villa
- Pediatric Unit, Sant'Andrea Hospital, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Krenke K, Peradzyńska J, Lange J, Banaszkiewicz A, Łazowska-Przeorek I, Grzela K, Radzikowski A, Kulus M. Inflammatory cytokines in exhaled breath condensate in children with inflammatory bowel diseases. Pediatr Pulmonol 2014; 49:1190-5. [PMID: 24339443 DOI: 10.1002/ppul.22953] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 10/14/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although inflammatory bowel diseases (IBD) affect mainly the gastrointestinal tract, the extra-intestinal manifestations are not uncommon. Different diagnostic methods have been applied to assess pulmonary involvement in patients with IBD, but majority of these methods show significant limitations in children. The aim of our study was to evaluate the usefulness of exhaled breath condensate (EBC) measurements of pro-inflammatory cytokines in children with IBD. MATERIAL AND METHODS Twenty-two children with Crohn's disease (CD) (mean age 13.8 ± 3.3 years), 25 with ulcerative colitis (UC) (mean age 14.1 ± 3.3 years) and 37 healthy volunteers (mean age 13.9 ± 3.6 years) were studied. IBD activity was assessed using appropriate scoring systems. None of the patients had signs or symptoms of pulmonary disease. Exhaled breath condensate was collected and EBC concentration of interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin 8 (IL-8) was measured. RESULTS The concentrations of all the assessed cytokines were significantly higher in the study group as compared to controls. A negative correlation between IL-1β and CD activity index was found. There were no significant relationships between TNF-α, IL-6, or IL-8 level and CD activity index as well as between IL-1β, TNF-α, IL-6, IL-8 and UC activity index. No significant correlation between the concentration of IL-1β, TNF-α, IL-6, IL-8, and IBD duration or treatment duration was found. CONCLUSIONS Elevated concentration of pro-inflammatory cytokines in EBC in children with IBD may suggest the presence of asymptomatic inflammation in the lower airways.
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Affiliation(s)
- K Krenke
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
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Huang Y, Lemberg DA, Day AS, Dixon B, Leach S, Bujanover Y, Jaffe A, Thomas PS. Markers of inflammation in the breath in paediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2014; 59:505-10. [PMID: 24897166 DOI: 10.1097/MPG.0000000000000450] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Breath analysis and exhaled breath condensate (EBC) collection are simple and noninvasive processes whereby inflammatory mediators and other biomarkers can be assessed in diseases that affect the lung. It was hypothesised that markers of epithelial dysfunction and secretion, such as a low pH, 8-isoprostane, and release of epithelial factors such as trefoil factor 2 (TFF2) and mucin, would be elevated in the breath of those with inflammatory bowel disease (IBD). The aim was to compare the levels of these biomarkers in EBC and the fraction of expired nitric oxide (FENO) in children with Crohn disease (CD), in those with asthma, and in normal individuals in a pilot study. METHODS EBC was collected from patients in the 3 groups mentioned above in a cross-sectional design. pH, 8-isoprostane, TFF2, and mucin levels were measured in the EBC. Spirometry was performed in asthmatic patients and patients with IBD, whereas FENO and skin prick tests were performed in patients with IBD. RESULTS Breath samples including EBC were collected from 80 patients (30 CD, 30 asthma, 20 controls). Compared with controls, EBC pH was lower in children with IBD (P < 0.0001) or asthma (P = 0.0041). 8-Isoprostane levels differed between the 3 groups (P < 0.05). EBC TFF2 was mainly less than the limit of detection, whereas mucin levels did not differ significantly between the 3 groups. FENO was measurable in children with IBD, but did not correlate with disease activity or serum markers of inflammation. CONCLUSIONS A lower EBC pH may reflect inflammatory events either in the lung or systemically. 8-Isoprostane, FENO, and mucin were detected for the first time in the EBC of children with IBD. Further studies are required to assess the value of these assessments.
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De Prins S, Marcucci F, Sensi L, Van de Mieroop E, Nelen V, Nawrot TS, Schoeters G, Koppen G. Exhaled nitric oxide and nasal tryptase are associated with wheeze, rhinitis and nasal allergy in primary school children. Biomarkers 2014; 19:481-7. [PMID: 25019424 DOI: 10.3109/1354750x.2014.937362] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Rhinitis and asthma are the most common respiratory diseases in children. We assessed whether airway inflammation markers were associated with nasal allergies and self-reported symptoms of wheeze and rhinitis in 130 children 6-12 year old in an epidemiological context. Independent of sex and age, the fraction of exhaled nitric oxide (FeNO) and nasal mast cell (MC) activation (tryptase ≥ 5 ng/mL) were positively associated with wheeze, rhinitis and with nasal allergy. Nasal eosinophil cationic protein (ECP) and exhaled breath condensate (EBC) markers (pH, 8-isoprostane, interleukin-1β) were not associated with symptoms or with nasal allergy. In conclusion, FeNO and nasal tryptase reflect allergic inflammation in the respiratory system.
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Affiliation(s)
- Sofie De Prins
- Environmental Risk and Health Unit, VITO (Flemish Institute for Technological Research) , Boeretang , Belgium
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Abstract
Traditionally, symptoms are important patient-oriented outcomes in asthma treatment, and assessment of symptoms is an essential component of assessing asthma control. However, variable airways obstruction, airways hyperresponsiveness and chronic inflammation are key components of the asthma syndrome, and correlations among these hallmarks and symptoms are weak or even absent. Therefore, it might be questioned if symptom-based therapy is effective for treating asthma in (all) children. To date, there is no firm indication that monitoring asthma based on repetitive lung function measurement or markers of airway inflammation is superior to monitoring based on symptoms only. In the majority of patients, symptom-based asthma management may well be sufficient, and in preschool children, symptoms are presently the only feasible outcome. Nevertheless, there is some evidence that selected groups might benefit from an approach that takes into account individual phenotypic characteristics. In patients with poor perception, those with a discordant phenotype and those with persistent severe asthma, considering lung function, airways hyperresponsiveness and inflammatory markers in treatment decisions might improve outcomes.
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Affiliation(s)
- Marianne Nuijsink
- Department of Paediatrics, Juliana Children's Hospital, The Hague, The Netherlands,
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