Cepelak Ivana, Dodig Slavica
Department of Medical Biochemistry and Hematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia.
Clin Chem Lab Med. 2007;45(8):945-52. doi: 10.1515/CCLM.2007.326.
Analysis of exhaled breath composition in lung disease patients can indirectly point to biochemical changes that occur in the fluid lining airway surfaces. The parameters of redox and acid-base changes, and of inflammatory changes relevant in the pathogenesis of most pulmonary diseases are currently most widely determined in exhaled breath condensate. The collection of exhaled breath condensate is a safe, non-invasive, easy and simple diagnostic procedure that is suitable for longitudinal studies and applicable in patients of all age groups, irrespective of the disease severity. In spite of many scientific studies involving lung disease patients, methodology for exhaled breath condensate collection and analysis has not yet been realized for daily utilization. Additional studies of the exact origin of condensate constituents and standardization of the overall analytical process, including collection, storage, analysis and result interpretation, are needed. Irrespective of these limitations, further investigation of this sample type is fully justified by the fact that classical specimens used in the management of pulmonary disease are either obtained by invasive procedures (e.g., induced sputum, biopsy, bronchoalveolar lavage) or cannot provide appropriate information (e.g., urine, serum). Analysis of exhaled breath condensate in the future might contribute significantly to our understanding of the physiological and pathophysiological processes in lungs, to early detection, diagnosis and follow up of disease progression, and to evaluation of therapeutic response.
对肺病患者呼出气体成分的分析可以间接指出气道表面液体中发生的生化变化。目前,呼出气体冷凝物中最广泛测定的是氧化还原和酸碱变化参数,以及与大多数肺部疾病发病机制相关的炎症变化参数。呼出气体冷凝物的收集是一种安全、无创、简便的诊断程序,适用于纵向研究,适用于所有年龄组的患者,无论疾病严重程度如何。尽管有许多涉及肺病患者的科学研究,但呼出气体冷凝物的收集和分析方法尚未实现日常应用。需要对冷凝物成分的确切来源以及整个分析过程(包括收集、储存、分析和结果解释)进行标准化的进一步研究。尽管有这些局限性,但鉴于用于肺病管理的经典标本要么通过侵入性程序(如诱导痰、活检、支气管肺泡灌洗)获得,要么无法提供适当信息(如尿液、血清),对这种样本类型的进一步研究是完全合理的。未来对呼出气体冷凝物的分析可能会极大地有助于我们理解肺部的生理和病理生理过程,有助于疾病进展的早期检测、诊断和随访,以及评估治疗反应。