Pediatric Pulmonology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Am J Physiol Lung Cell Mol Physiol. 2013 Apr 1;304(7):L504-9. doi: 10.1152/ajplung.00344.2012. Epub 2013 Jan 25.
Measurement of exhaled breath condensate (EBC) biomarkers offers a noninvasive means to assess airway disease, but the ability of EBC biomarkers to track longitudinal changes in disease severity remains unproven. EBC was collected from pediatric patients with cystic fibrosis (CF) during regular clinic visits over 1 yr. EBC biomarkers urea, adenosine (Ado), and phenylalanine (Phe) were measured by mass spectrometry, and biomarker ratios were used to control for variable dilution of airway secretions. EBC biomarker ratios were assessed relative to lung function in longitudinal, multivariate models and compared with sputum inflammatory markers and quality of life assessment (CFQ-R). EBC was successfully analyzed from 51 subjects during 184 visits (3.6 ± 0.9 visits per subject). EBC Ado/urea ratio was reproducible in duplicate samples (r = 0.62, P < 0.01, n = 20) and correlated with sputum neutrophil elastase (β = 2.5, P < 0.05). EBC Ado/urea correlated with the percentage predicted of forced expiratory volume in 1 s in longitudinal, multivariate models (β = -2.9, P < 0.01); EBC Ado/Phe performed similarly (β = -2.1, P < 0.05). In contrast, IL-8 and elastase measured in spontaneously expectorated sputum (n = 57 samples from 25 subjects) and the CFQ-R respiratory scale (n = 90 tests from 47 subjects) were not significantly correlated with lung function. EBC was readily collected in a clinic setting from a wide range of subjects. EBC Ado tracked longitudinal changes in lung function in CF, with results similar to or better than established measures.
呼出气冷凝液 (EBC) 标志物的测量提供了一种非侵入性的方法来评估气道疾病，但 EBC 标志物跟踪疾病严重程度的纵向变化的能力尚未得到证实。在 1 年的定期就诊期间，从囊性纤维化 (CF) 儿科患者中收集 EBC。通过质谱法测量 EBC 生物标志物尿素、腺苷 (Ado) 和苯丙氨酸 (Phe)，并使用生物标志物比值来控制气道分泌物的可变稀释。在纵向多变量模型中，EBC 生物标志物比值相对于肺功能进行评估，并与痰炎症标志物和生活质量评估 (CFQ-R) 进行比较。在 184 次就诊中，成功分析了 51 例患者的 EBC (每位患者 3.6 ± 0.9 次就诊)。EBC Ado/urea 比值在重复样本中具有可重复性 (r = 0.62，P < 0.01，n = 20)，并与痰中性粒细胞弹性蛋白酶相关 (β = 2.5，P < 0.05)。EBC Ado/urea 在纵向多变量模型中与用力呼气量的百分比预测值相关 (β = -2.9，P < 0.01)；EBC Ado/Phe 表现类似 (β = -2.1，P < 0.05)。相比之下，在自发性咳出的痰中测量的 IL-8 和弹性蛋白酶 (n = 25 例患者的 57 个样本) 和 CFQ-R 呼吸量表 (n = 47 例患者的 90 个测试) 与肺功能均无显著相关性。EBC 可在诊所环境中从广泛的患者中轻松采集。EBC Ado 可跟踪 CF 中肺功能的纵向变化，结果与已建立的指标相似或更好。
