Hydrogen cyanide concentrations in the breath of adult cystic fibrosis patients with and without Pseudomonas aeruginosa infection
Hydrogen cyanide concentrations in the breath of adult cystic fibrosis patients with and without Pseudomonas aeruginosa infection
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DOI：
10.1088/1752-7155/7/2/026010
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发表时间：
2013-06-01
影响因子：
3.8
通讯作者：
Lenney, Warren
中科院分区：
文献类型：
--
作者：
Gilchrist, Francis J.;Bright-Thomas, Rowland J.;Lenney, Warren
在铜绿假单胞菌（PA）培养物的顶部空间以及囊性纤维化（CF）和PA感染儿童的呼吸中检测到浓度升高的氰化氢（HCN）。使用口腔呼出气HCN作为成人PA感染的标志物更难以评估，因为一些没有PA感染的人在口腔中产生HCN。通过鼻子呼出的气体的分析，从而避免了在口腔中产生的挥发性化合物，将证明慢性感染PA的成年CF患者中HCN浓度升高。使用选择性离子流质谱（SIFT-MS），口和鼻呼出气的20名成人CF患者，10例慢性PA感染和10例无PA感染，分析了HCN。还测量丙酮和乙醇作为对照。SIFT-MS允许对单次呼吸呼气进行直接采样和分析，避免了将样品收集到袋中或收集到捕集器上的需要，这可能会损害样品。两组患者的口呼出气和慢性PA感染患者的鼻呼出气中均检测到HCN。两组之间鼻呼出HCN中位数（IQR）的差异具有统计学显著性（11（0.8-18）ppbv vs 0（0-3.2）ppbv，p = 0.03）。鼻子呼出气和嘴巴呼出气中丙酮和乙醇的浓度与先前的研究一致。鼻呼出气中的HCN是CF成人中PA慢性气道感染的生物标志物。其作为早期PA感染的非侵入性诊断测试的应用值得进一步研究。
Elevated concentrations of hydrogen cyanide (HCN) have been detected in the headspace of Pseudomonas aeruginosa (PA) cultures and in the breath of children with cystic fibrosis (CF) and PA infection. The use of mouth-exhaled breath HCN as a marker of PA infection in adults is more difficult to assess as some without PA infection generate HCN in their mouths. The analysis of breath exhaled via the nose, thereby avoiding volatile compounds produced in the mouth, will demonstrate elevated concentrations of HCN in adult CF patients chronically infected with PA. Using selected ion flow mass spectrometry (SIFT-MS), the mouth and the nose-exhaled breaths of 20 adult CF patients; 10 with chronic PA infection and 10 free from PA infection, were analysed for HCN. Acetone and ethanol were also measured as controls. SIFT-MS allows direct sampling and analysis of single breath exhalations, obviating the need to collect samples into bags or onto traps, which can compromise samples. HCN was detected in the mouth-exhaled breath of patients in both groups and in the nose-exhaled breath of patients with chronic PA infection. The difference in median (IQR) nose-exhaled HCN between the groups is statistically significant (11 (0.8-18) ppbv versus 0 (0-3.2) ppbv, p = 0.03). The concentrations of acetone and ethanol in nose-exhaled and mouth-exhaled breath are in keeping with previous studies. HCN in nose-exhaled breath is a biomarker of chronic airway infection with PA in adults with CF. Its application as a non-invasive diagnostic test for early PA infection warrants further investigation.