Patterns and significance of exhaled-breath biomarkers in lung transplant recipients with acute allograft rejection

Citation
Sm. Studer et al., Patterns and significance of exhaled-breath biomarkers in lung transplant recipients with acute allograft rejection, J HEART LUN, 20(11), 2001, pp. 1158-1166
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF HEART AND LUNG TRANSPLANTATION
ISSN journal
1053-2498 → ACNP
Volume
20
Issue
11
Year of publication
2001
Pages
1158 - 1166
Database
ISI
SICI code
1053-2498(200111)20:11<1158:PASOEB>2.0.ZU;2-E
Abstract
Background: Obliterative bronchiolitis (OB) remains one of the leading caus es of death in lung transplant recipients after 2 years, and acute rejectio n (AR) of lung allograft is a major risk factor for OB. Treatment of AR may reduce the incidence of OB, although diagnosis of AR often requires bronch oscopic lung biopsy. In this study, we evaluated the utility of exhaled-bre ath biomarkers for tile non-invasive diagnosis of AR. Methods: We obtained breath samples from 44 consecutive lung transplant rec ipients who attended ambulatory follow-up visits for the Johns Hopkins Lung Transplant Program. Bronchoscopy within 7 days of their breath samples sho wed histopathology in 21of these patients, and we included them in our anal ysis. We measured hydrocarbon markers of pro-oxidant events (ethane and 1-p entane), isoprene, acetone, and sulfur-containing compounds (hydrogen sulfi de and carbonyl sulfide) in exhaled breath and compared their levels to the lung histopathology, graded as stable (non-rejection) or AR. None of the s tudy subjects were diagnosed with OB or infection at the time of the clinic al bronchoscopy. Results: We found no significant difference in exhaled levels of hydrocarbo ns, acetone, or hydrogen sulfide between the stable and AR groups. However, we did find significant increase in exhaled carbonyl sulfide (COS) levels in AR subjects compared with stable subjects. We also observed a trend in 7 of 8 patients who had serial sets of breath and histopathology data that s upported a role for COS as a breath biomarker of AR. Conclusions: This study demonstrated elevations in exhaled COS levels in su bjects with AR compared with stable subjects, suggesting a diagnostic role for this non-invasive Z biomarker. Further exploration of breath analysis i n lung transplant recipients is warranted to complement fiberoptic bronchos copy and obviate the need for this procedure in some patients.