词条 | Exhaled breath condensate |
释义 |
OverviewExhaled breath condensate reflects not only the composition of the airway lining fluid and alveoli. EBC may also mix with salivary and gastric droplets. In addition, volatile gases arising from the alveoli, lower and upper airway wall as well as oral cavity dissolve into the exhaled water vapour and influence its pH.[3] The primary constituents of EBC include:
As EBC reflects the composition of the airway lining fluid, it contains most molecules found in the airway, but these are probably diluted by water vapour. Thus, these can range from simple ions, e.g. H+ measured as pH,[4][5] hydrogen peroxide,[6] proteins, cytokines, eicosanoids,[7][8] and macromolecules such as mucin, phospholipids and DNA.[9][10] Dilution is an issue that is a problem with all methods of sampling the airway and lungs including sputum collection and bronchoalveolar lavage. Suggestions to allow for dilution include using a denominator such as protein, urea or conductivity,[11] but no single method is universally accepted at present. Increasing evidence indicates that in disease states EBC contains molecules reflective of that disease or greater concentrations of particular markers. For example, patients with gastroesophageal reflux disease patients have been demonstrated to have pepsin (usually localised to the stomach) in their EBC.[12] Patients with COPD and asthma have been demonstrated to have increased levels of reactive oxygen species[13] and histamine after bronchial challenge (Ratnawatti 2008). The content of exhaled breath condensate, however, is also strongly affected by physiological factors, such as diet,[14] physical exercise[15][16][17] and even pregnancy may affect mediator concentrations.[18] Collection devicesThe chemical properties of the collection device will influence the device and its characteristics. Some devices can contaminate the sample, or react with oxidative markers particularly if containing metals Examples of devices include:
Potential applicationsEBC has potential uses in combination with exhaled breath analysis. There is significant interest in exhaled nitric oxide analysis in conjunction with EBC analysis but in addition, the analysis of the breath has many applications. Well known examples include and estimation of the breath alcohol level, but others included non-invasive measurements to estimate blood glucose, and well as using it for diagnosing other systemic and local lung diseases, such as lung cancer. Footnotes1. ^Liu, J., Conrad, D. H., Chow, S., Tran, V. H., Yates, D. H., & Thomas, P. S. (2007) Collection devices influence the constituents of exhaled breath condensate. Eur Respir J, 30(4), 807-808. {{DEFAULTSORT:Exhaled Breath Condensate}}2. ^Sidorenko, G. I., E. I. Zborovskii, et al. (1980). "[Surface-active properties of the exhaled air condensate (a new method of studying lung function)]." Ter Arkh 52(3): 65-8 3. ^Bikov A, Lazar Z, Schandl K, Antus BM, Losonczy G, Horvath I. Exercise changes volatiles in exhaled breath assessed by an electronic nose. ACTA PHYSIOLOGICA HUNGARICA 98:(3) pp. 321-328. (2011) 4. ^Vaughan J, Ngamtrakulpanit L, Pajewski TN, Turner R, Nguyen TA, Smith A, Urban P, Hom S, Gaston B, Hunt J. Exhaled breath condensate pH is a robust and reproducible assay of airway acidity. Eur Respir J. 2003 Dec;22(6):889-94. 5. ^Bikov A, Antus B, Losonczy G, Horváth I. Exhaled breath condensate pH (Chapter 13). In: Horvath I, J C de Jongste (editors). Exhaled biomarkers: Clinical handbook for the respiratory professional. 249 p.Plymouth: European Respiratory Society Journals Ltd., 2010. pp. 173-182. (European Respiratory Society Monograph; 49.)({{ISBN|978-1-849840-05-7}}) 6. ^Gajdocsi R, Bikov A, Antus B, Horvath I, Barnes PJ, Kharitonov SA. Assessment of reproducibility of exhaled hydrogen peroxide concentration and the effect of breathing pattern in healthy subjects. JOURNAL OF AEROSOL MEDICINE AND PULMONARY DRUG DELIVERY 24:(6) pp. 271-275. (2011) 7. ^Montuschi P Analysis of exhaled breath condensate in respiratory medicine: methodological aspects and potential clinical applications. Ther Adv Respir Dis. 2007 Oct;1(1):5-23 8. ^Bikov A, Gajdocsy R, Huszar E, Szili B, Lazar Z, Antus B, Losonczy G, Horvath I. Exercise increases exhaled breath condensate cysteinyl leukotriene concentration in asthmatic patients. JOURNAL OF ASTHMA 47:(9) pp. 1057-1062. (2010) 9. ^Jackson AS, Sandrini A, Campbell C, Chow S, Thomas PS, Yates DH. Comparison of Biomarkers in Exhaled Breath Condensate and Bronchoalveolar Lavage. Am. J. Respir. Crit. Care Med. 2007; 175(3): 222 - 227 10. ^Carpagnano GE, Foschino-Barbaro MP, Spanevello A, Resta O, Carpagnano F, Mulé G, Pinto R, Tommasi S, Paradiso A. 3p microsatellite signature in exhaled breath condensate and tumor tissue of patients with lung cancer. Am J Respir Crit Care Med. 1 February 2008;177(3):337-41 11. ^Lazar Z, Cervenak L, Orosz M, Galffy G, Komlosi ZI, Bikov A, Losonczy G, Horvath I. Adenosine Triphosphate Concentration of Exhaled Breath Condensate in Asthma. CHEST 138:(3) pp. 536-542. (2010) 12. ^Krishnan, A., Chow, S., Thomas, P., Malouf, M., Glanville, A., & Yates, D. (2007). Exhaled breath condensate pepsin: a new noninvasive marker of GERD after lung transplantation. J Heart Lung Transplant, 26((2 Suppl. 1)) 13. ^Massimo, C., Alberto, P., Romano, C., Rossella, A., Matteo, G., Maria, V. V., et al. (2003). Nitrate in exhaled breath condensate of patients with different airway diseases. {{doi|10.1016/S1089-8603(02)00128-3}}. Nitric Oxide, 8(1), 26-30. 14. ^Bikov A, Pako J, Montvai D, Kovacs D, Koller Z, Losonczy G, Horvath I. Exhaled breath condensate pH decreases following oral glucose tolerance test. JOURNAL OF BREATH RESEARCH 9:(4) p. 047112. (2015) 15. ^Bikov A, Lazar Z, Schandl K, Antus BM, Losonczy G, Horvath I. Exercise changes volatiles in exhaled breath assessed by an electronic nose. ACTA PHYSIOLOGICA HUNGARICA 98:(3) pp. 321-328. (2011) 16. ^Bikov A, Gajdocsy R, Huszar E, Szili B, Lazar Z, Antus B, Losonczy G, Horvath I. Exercise increases exhaled breath condensate cysteinyl leukotriene concentration in asthmatic patients. JOURNAL OF ASTHMA 47:(9) pp. 1057-1062. (2010) 17. ^Bikov A, Galffy G, Tamasi L, Bartusek D, Antus B, Losonczy Gy, Horvath I. Exhaled breath condensate pH decreases during exercise-induced bronchoconstriction. RESPIROLOGY 19:(4) pp. 563-569. (2014) 18. ^Eszes N, Bikov A, Lazar Z, Bohacs A, Muller V, Stenczer B, Rigo J Jr, Losonczy G, Horvath I, Tamasi L. Changes in exhaled breath condensate pH in healthy and asthmatic pregnant women. ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 92:(5) pp. 591-597. (2013) 1 : Breath tests |
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