Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS
Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS
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DOI：
10.1378/chest.114.6.1653
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发表时间：
1998-12-01
期刊：
影响因子：
9.6
通讯作者：
Christman, BW
中科院分区：
文献类型：
--
作者：
Carpenter, CT;Price, PV;Christman, BW
背景：氧化应激是ARDS和急性肺损伤（ALI）患者组织损伤的一种机制。异前列腺素，前列腺素类化合物主要通过脂质过氧化非酶促形成，是体内氧化应激的精确标记物。血浆8-异前列腺素F-2 α（8-iso-PGF（2 α））代谢产物水平与ARDS患者预后相关目的：检测呼出气冷凝液中8-iso-PGF（2 α）水平，作为ARDS/ALI患者或有ARDS/ALI风险患者肺氧化应激的非侵入性定量指标。研究方法：通过将Tygon管浸没在冰浴中与呼吸机回路的呼气支路成一直线，从22名患有或有患ARDS/ALI风险的患者中收集呼吸冷凝液。10名无肺部疾病的患者在接受小手术时插管，作为对照组。在30至60分钟的时间内收集1至3公吨的冷凝物，然后立即冷冻并储存在-70 ° C下直至分析。将8-iso-PGF（2 α）纯化并衍生化，然后通过稳定同位素稀释结合气相色谱/质谱法进行定量。ALI/ARDS患者呼出气8-iso-PGF（2 α）的平均水平为87 ± 28 pg/mL，显著高于正常组的平均水平7 ± 4 pg/mL。22例急性呼吸窘迫综合征（ARDS）/急性肺损伤（ALI）患者中，12例血清8-iso-PGF（2 α）水平高于正常对照组平均值2个标准差以上。呼出异前列腺素的测量是一种新的、非侵入性的方法来量化这类患者的氧化应激。
Background: Oxidant stress is a purported mechanism of tissue damage in patients with ARDS and acute lung injury (ALI). Isoprostanes, prostanoid compounds primarily formed nonenzymatically via lipid peroxidation, are precise markers of in vivo oxidant stress. Plasma levels of metabolites of 8-iso-prostaglandin-F-2 alpha (8-iso-PGF(2 alpha)) correlate with outcome in patients with ARDS.Objective: To examine exhaled breath condensate levels of 8-iso-PGF(2 alpha) as a noninvasive quantification of pulmonary oxidant stress in patients with, or at risk for, ARDS/ALI.,Methods: Breath condensate was collected from 22 patients with, or at risk for, ARDS/ALI by placing Tygon tubing submerged in an ice bath in line with the expiratory limb of the ventilator circuit. Ten patients without lung disease, who were intubated while undergoing minor surgical procedures, served as control subjects. Between 1 and 3 mt of condensate was collected over a 30- to 60-min period, then immediately frozen and stored at -70 degrees C until analysis, The 8-iso-PGF(2 alpha) was purified and derivatized, then quantified by stable isotope dilution in conjunction with gas chromatography/mass spectrometry.Results: The mean level of exhaled 8-iso-PGF(2 alpha) in the patients with ALI/ARDS, 87 +/- 28 pg/mL, nas significantly higher than die mean in the normal group, 7 +/- 4 pg/mL (p = 0.007), The 8-iso-PGF(2 alpha) levels were gr eater than two standard deviations above the mean of the normal group in 12 of 22 patients with or at risk for ARDS/ALI.Conclusions: These results provide further evidence that lipid peroxidation does occur in patients with ARDS/ALI. The measurement of exhaled isoprostanes pl oxides a novel, noninvasive method to quantify oxidant stress in such patients.