Vyklicka Katerina, Gregor Petr, Lipovy Bretislav, Raska Filip, Kukucka Petr, Kohoutek Jiri, Pribylova Petra, Čupr Pavel, Borilova Linhartova Petra
RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.
Department of Burns Medicine, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
PLoS One. 2024 Aug 1;19(8):e0308163. doi: 10.1371/journal.pone.0308163. eCollection 2024.
Specific toxic compounds, such as polycyclic aromatic hydrocarbons (PAHs) and their metabolites, may affect the inhalation injury (INHI) grade, patients' status, and prognosis for recovery. This pilot prospective study aimed to: i) evaluate the suitability of bronchoalveolar lavage (BAL) for determination of PAHs in the LRT and of urine for determination of hydroxylated metabolites (OH-PAHs) in patients with INHI, ii) describe the dynamic changes in the levels of these toxic compounds, and iii) correlate these findings with clinical variables of the patients with INHI.
The BAL and urine samples from 10 patients with INHI were obtained on Days 1, 3, 5, 7, and 14 of hospitalization, if possible, and PAHs (BAL) and OH-PAHs (urine) were analyzed using chromatographic methods (GC-MS and HPLC).
Concentrations of analyzed PAHs were in most cases and time points below the limit of quantification in BAL samples. Nine OH-PAHs were detected in the urine samples; however, their concentrations sharply decreased within the first three days of the hospitalization. On Day 14, the total amount of OH-PAHs in urine was higher in surviving patients with High-grade INHI (≥3) than in those with Low-grade INHI (<3, p = 0.032). Finally, a significant correlation between certain OH-PAHs and clinical variables (AST/ALT, TBSA, ABSI) from Day 1 of the hospitalization was observed (p<0.05).
BAL samples are not suitable for the analysis of PAHs. However, the OH-PAHs levels in urine can be measured reliably and were correlated with several clinical variables. Moreover, High-grade INHI was associated with higher total concentrations of OH-PAHs in urine.
特定的有毒化合物，如多环芳烃（PAHs）及其代谢产物，可能会影响吸入性损伤（INHI）的分级、患者状况及恢复预后。这项前瞻性试点研究旨在：i）评估支气管肺泡灌洗（BAL）用于测定下呼吸道中PAHs以及尿液用于测定INHI患者中羟基化代谢产物（OH-PAHs）的适用性，ii）描述这些有毒化合物水平的动态变化，iii）将这些发现与INHI患者的临床变量相关联。
如有可能，在10例INHI患者住院的第1、3、5、7和14天采集BAL和尿液样本，并使用色谱方法（气相色谱-质谱联用仪和高效液相色谱法）分析PAHs（BAL）和OH-PAHs（尿液）。
在大多数情况和时间点，BAL样本中分析的PAHs浓度低于定量限。在尿液样本中检测到9种OH-PAHs；然而，它们的浓度在住院的头三天内急剧下降。在第14天，重度INHI（≥3级）存活患者尿液中OH-PAHs的总量高于轻度INHI（<3级，p = 0.032）患者。最后，观察到从住院第1天起某些OH-PAHs与临床变量（谷草转氨酶/谷丙转氨酶、烧伤总面积、美国烧伤学会损伤严重度评分）之间存在显著相关性（p<0.05）。
BAL样本不适合用于分析PAHs。然而，尿液中的OH-PAHs水平可以可靠地测量，并且与几个临床变量相关。此外，重度INHI与尿液中OH-PAHs的总浓度较高有关。
