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      Profiling the Proteome of Exhaled Breath Condensate in Healthy Smokers and COPD Patients by LC-MS/MS

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          Abstract

          Three pools of exhaled breath condensate (EBC) from non-smokers plus healthy smokers (NS + HS, n = 45); chronic obstructive pulmonary disease (COPD) without emphysema (COPD, n = 15) and subjects with pulmonary emphysema associated with α 1-antitrypsin deficiency (AATD, n = 23) were used for an exploratory proteomic study aimed at generating fingerprints of these groups that can be used in future pathophysiological and perhaps even clinical research. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was the platform applied for this hypothesis-free investigation. Analysis of pooled specimens resulted in the production of a “fingerprint” made of 44 proteins for NS/HS; 17 for COPD and 15 for the group of AATD subjects. Several inflammatory cytokines (IL-1α, IL-1β, IL-2; IL-12, α and β subunits, IL-15, interferon α and γ, tumor necrosis factor α); Type I and II cytokeratins; two SP-A isoforms; Calgranulin A and B and α1-antitrypsin were detected and validated through the use of surface enhanced laser-desorption ionization mass spectrometry (SELDI-MS) and/or by Western blot (WB) analysis. These results are the prelude of quantitative studies aimed at identifying which of these proteins hold promise as identifiers of differences that could distinguish healthy subjects from patients.

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          Most cited references42

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          Measuring agreement in method comparison studies.

          Agreement between two methods of clinical measurement can be quantified using the differences between observations made using the two methods on the same subjects. The 95% limits of agreement, estimated by mean difference +/- 1.96 standard deviation of the differences, provide an interval within which 95% of differences between measurements by the two methods are expected to lie. We describe how graphical methods can be used to investigate the assumptions of the method and we also give confidence intervals. We extend the basic approach to data where there is a relationship between difference and magnitude, both with a simple logarithmic transformation approach and a new, more general, regression approach. We discuss the importance of the repeatability of each method separately and compare an estimate of this to the limits of agreement. We extend the limits of agreement approach to data with repeated measurements, proposing new estimates for equal numbers of replicates by each method on each subject, for unequal numbers of replicates, and for replicated data collected in pairs, where the underlying value of the quantity being measured is changing. Finally, we describe a nonparametric approach to comparing methods.
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            Indices of airway inflammation in induced sputum: reproducibility and validity of cell and fluid-phase measurements.

            Methods to examine sputum for indices of airway inflammation are evolving. We have examined the repeatability and the validity of an improved method to measure sputum cells and fluid-phase eosinophil cationic protein (ECP), major basic protein (MBP), eosinophil-derived neurotoxin (EDN), albumin, fibrinogen, tryptase, and interleukin-5 (IL-5). Sputum was induced with hypertonic saline twice within 6 d in 10 healthy subjects, 19 stable asthmatics, and 10 smokers with nonobstructive bronchitis. The method included the processing of freshly expectorated sputum separated from saliva, treatment with a fixed proportion of dithiothreitol 0.1% followed by Dulbecco's phosphate-buffered saline, making cytospins, and collecting the supernatant. The reproducibility of measurements, calculated by the intraclass correlation coefficient, was high for all indices measured with the exception of total cell counts and proportion of lymphocytes. Asthmatics, in comparison with healthy subjects and smokers with bronchitis, had a higher proportion of sputum eosinophils (median percent 5.2 versus 0.5 and 0.3), metachromatic cells (0.3 versus 0.07 and 0.08), ECP (1,040 micrograms/L versus 288 and 352), MBP (1,176 micrograms/L versus 304 and 160), and EDN (1,512 micrograms/L versus 448 and 272). Asthmatics differed from healthy subjects, but not from smokers with bronchitis, in the proportion of neutrophils (46.9% versus 24.1%), albumin (704 versus 288 micrograms/mL), and fibrinogen (2,080 versus 440 ng/mL). Smokers with bronchitis showed a trend for a higher neutrophil count and levels of albumin and fibrinogen than healthy subjects. The proportion of sputum eosinophils correlated positively with ECP, MBP, EDN, albumin and fibrinogen levels, and metachromatic cell counts correlated with tryptase. In asthmatics, IL-5 correlated with eosinophil counts. There was a significant negative correlation between sputum indices and expiratory flows and methacholine PC20. Thus, the methods of measuring cell and fluid phase markers in induced sputum used in this study are reproducible and valid. They can therefore be used to reliably measure these indices of airway inflammation.
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              Breath analysis: potential for clinical diagnosis and exposure assessment.

              Breath tests are among the least invasive methods available for clinical diagnosis, disease state monitoring, and environmental exposure assessment. In recent years, interest in breath analysis for clinical purposes has increased. This review is intended to describe the potential applications of breath tests, including clinical diagnosis of diseases and monitoring of environmental pollutant exposure, with emphasis on oxidative stress, lung diseases, metabolic disorder, gastroenteric diseases, and some other applications. The application of breath tests in assessment of exposure to volatile organic compounds is also addressed. Finally, both the advantages and limitations of breath analysis are summarized and discussed.
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                Author and article information

                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                Molecular Diversity Preservation International (MDPI)
                1422-0067
                2012
                29 October 2012
                : 13
                : 11
                : 13894-13910
                Affiliations
                [1 ]Department of Biology and Biotechnology, University of Pavia, Via Taramelli 3/B, 27100 Pavia, Italy; E-Mail: fummar07@ 123456unipv.it
                [2 ]Lab Analysis Inc., Casanova Lonati, 27041 Pavia, Italy; E-Mail: f.ferrari@ 123456labanalysis.it
                [3 ]Department of Molecular Medicine, Division of Pneumology, University of Pavia & IRCCS Policlinico San Matteo, Via Taramelli 5, 27100 Pavia, Italy; E-Mails: m.luisetti@ 123456smatteo.pv.it (M.L.); daniela.capuano83@ 123456gmail.com (D.C.); icerveri@ 123456smatteo.pv.it (I.C.)
                [4 ]Department of Pulmonology, Leiden University Medical Center, 2333 Leiden, The Netherlands; E-Mails: J.Stolk@ 123456lumc.nl (J.S.); p.s.hiemstra@ 123456lumc.nl (P.S.H.); laurafregonese@ 123456gmail.com (L.F.)
                [5 ]Department of Molecular Medicine, Division of Biochemistry, University of Pavia, Via Taramelli 3/B, 27100, Pavia, Italy; E-Mail: simona.viglio@ 123456unipv.it
                [6 ]Centro Grandi Strumenti, University of Pavia, Via Bassi 6, 27100 Pavia, Italy; E-Mail: federica.corana@ 123456unipv.it
                [7 ]Biometric Unit, IRCCS San Matteo Hospital Foundation, 27100 Pavia, Italy; E-Mail: ctinelli@ 123456smatteo.pv.it
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: piadarol@ 123456unipv.it ; Tel.: +39-0382-987264; Fax: + 39-0382-423108.
                Article
                ijms-13-13894
                10.3390/ijms131113894
                3509556
                23203040
                445fb22e-11d9-4b42-b129-f39fc3e14366
                © 2012 by the authors; licensee Molecular Diversity Preservation International, Basel, Switzerland.

                This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0).

                History
                : 29 August 2012
                : 16 October 2012
                : 18 October 2012
                Categories
                Article

                Molecular biology
                ebc,lc-ms/ms,proteomics,copd
                Molecular biology
                ebc, lc-ms/ms, proteomics, copd

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