Lung RejectionPatterns and significance of exhaled-breath biomarkers in lung transplant recipients with acute allograft rejection
Section snippets
Materials and methods
This study was conducted during a 10-month period (March to December 1999) among ambulatory lung transplant recipients who attended routine follow-up visits at the Johns Hopkins Medical Institutions Lung Transplantation Program (Baltimore, MD). Patients gave verbal consent to breath sampling (no patients refused). Data from patients who underwent single fiberoptic bronchoscopy (see below) within 7 days of their exhaled-breath sample are presented in this study. For patients who underwent
Results
We obtained 152 breath samples from 44 consecutive patients during the study period. Of these, 21 patients (5 double lung and 16 single lung transplants) met criteria for inclusion in this analysis (histology available from fiberoptic bronchoscopy within 7 days of breath sampling). Table I presents the demographics and key clinical descriptors of the 21 study subjects.
Subjects were grouped into those with histologic evidence of AR (n = 6) and those without AR (n = 15), and their exhaled gas
Discussion
This study reports information on a novel test for AR of lung allografts in humans. We hypothesized that exhaled-breath biomarkers would evidence measurable changes during AR and this was demonstrated for COS. In our study, most patients without AR had undetectable or low exhaled COS levels, whereas only 1 subject with AR had an undetectable level of exhaled COS. If these findings are confirmed in future studies, patients with undetectable COS levels and stable pulmonary function may be
Acknowledgements
This work was supported by NIH Grant P01-HL56091. The authors wish to thank Helena Studer, MD, for her editorial assistance.
References (29)
Acute pulmonary allograft rejectionmechanisms, diagnosis and management
Clin Chest Med
(1997)- et al.
Diagnostic yield of bronchoscopies after isolated lung transplantation
Chest
(1996) - et al.
Obliterative bronchiolitis after lung and heart-lung transplantation. An analysis of risk factors and management
J Thorac Cardiovasc Surg
(1995) - et al.
The Registry of the International Society for Heart and Lung Transplantationsixteenth official report—1999
J Heart Lung Transplant
(1999) - et al.
Development of obliterative bronchiolitis after allogeneic rat lung transplantationimplication of acute rejection and the time point of treatment
J Heart Lung Transplant
(1999) Prophylaxis post-transplant
Clin Chest Med
(1997)- et al.
Breath ethanea specific indicator of free-radical-mediated lipid peroxidation following reperfusion of the ischemic liver
Free Radic Biol Med
(1992) - et al.
Visceral lipid peroxidation occurs at reperfusion after supraceliac aortic cross clamping
J Vasc Surg
(1994) - et al.
Ethanea marker of lipid peroxidation during cardiopulmonary bypass in humans
Free Radic Biol Med
(1999) - et al.
Clinical application of breath biomarkers of oxidative stress status
Free Radic Biol Med
(1999)
Oxidative metabolism of carbon disulfide by isolated rat hepatocytes and microsomes
Biochem Pharmacol
Studies of carbonyl sulfide toxicitymetabolism by carbonic anhydrase
Toxicol Appl Pharmacol
Inhibition of inducible nitric oxide synthase ameliorates rat lung allograft rejection
J Thorac Cardiovasc Surg
Histologic prognostic indicators for the lung allografts of heart-lung transplants
J Heart Transplant
Cited by (123)
H<inf>2</inf>S and polysulfide metabolism: Conventional and unconventional pathways
2018, Biochemical PharmacologyQuantification of propionaldehyde in breath of patients after lung transplantation
2015, Free Radical Biology and MedicineCitation Excerpt :The event of primary graft failure after lung transplantation and the development of bronchiolitis obliterative syndrome are well known to be associated with I/R injury and oxidative stress [27,38]. Studer et al. observed increased amounts of breath carbonyl sulfide in lung transplant patients with acute rejection and suggested a different pathway of carbonyl sulfide generation compared to markers of LPO [39]. Differences in breath ethane were not found, possibly attributable to the presence of chronic oxidative stress in even stable lung transplant recipients making the absolute change in pro-oxidant biomarkers undetectable [39,40].
Smelling the Disease: Diagnostic Potential of Breath Analysis
2023, Molecular Diagnosis and TherapyCarbonyl Sulfide
2023, Encyclopedia of Toxicology, Fourth Edition: Volume 1-9