Active hydrogen inhalation (H(H2O)m) has powerful antioxidant and antiapoptotic effects. In recent years, it has been used in a number of experimental and clinical studies.Aim. To study the safety and effectiveness of inhalation of the “active form of hydrogen” (AFV;(H(H2O)m)) in the rehabilitation program of coronavirus disease 2019 (COVID-19) survivors during the recovery period.Material and methods. This randomized controlled parallel prospective study included 60 COVID-19 survivors with post-COVID-19 syndrome (ICD-10: U09.9) during the recovery period, with clinical manifestations of chronic fatigue syndrome (CFS), who received standard therapy in accordance with the management protocol of patients with CFS (ICD-10: G93.3): physiotherapy and medication therapy with drugs containing magnesium, B vitamins and L-carnitine. The patients were divided into 2 groups. The experimental group (n=30) included patients who received hydrogen inhalation for 90 minutes every day during 10 days (SUISONIA hydrogen inhalation device, Japan). The control group (n=30) consisted of patients who received standard therapy. In both groups, patients were comparable in sex and mean age: in the experimental group — 53 (22; 70) years, in the control group — 51 (25; 70) years. Biological markers of systemic inflammation, oxygen transport, lactate metabolism, intrapulmonary shunting, 6-minute walk test, and vascular endothelial function were determined in all patients on the 1st and 10th days of follow-up.Results. In the experimental group, a decrease in following parameters was revealed: stiffness index (SI), from 8,8±1,8 to 6,8±1,5 (p<0,0001); ALT, from 24,0±12,7 to 20,22±10,61 U/L (p<0,001); venous blood lactate, from 2,5±0,8 to 1,5±1,0 mmol/L (p<0,001); capillary blood lactate, from 2,9±0,8 to 2,0±0,8 mmol/L (p<0,0001); estimated pulmonary shunt fraction (Qs/Qt, Berggren equation, 1942) from 8,98±5,7 to 5,34±3,2 (p<0,01); white blood cells, from 6,64±1,57 to 5,92±1,32 109/L. In addition, we revealed an increase in the refractive index (RI) from 46,67±13,26% to 63,32±13,44% (p<0,0001), minimum blood oxygen saturation (SpO2) from 92,25±2,9 to 94,25±1, 56% (p<0,05), direct bilirubin from 2,99±1,41 to 3,39±1,34 pmol/L (p<0,01), partial oxygen tension (PvO2) from 26,9±5,0 to 34,8±5,6 mm Hg (p<0,0001), venous oxygen saturation (SvO2) from 51,8±020,6 to 61,1±018,1% (p<0,05), partial capillary oxygen tension (PcO2) from 48,7±15,4 to 63,8±21,2 mm Hg (p<0,01), capillary oxygen saturation (ScO2) from 82,2±4,2 to 86,2±4,8% (p<0,01), distance in 6 minute walk test from 429±45,0 to 569±60 m.Conclusion. Inhalation therapy with H(H2O)m in the rehabilitation program of COVID-19 survivors during the recovery period is a safe and highly effective method. Manifestations of silent hypoxemia and endothelial dysfunction decreased, while exercise tolerance increased. As for laboratory tests, a decrease in the white blood cell count, estimated pulmonary shunt fraction and lactate content parameters was revealed.
Investigation of exhaled breath condensate (EBC) is a noninvasive diagnostic method in respiratory diseases. The objective of this study was to compare EBC protein spectrum in healthy volunteers and in patients with chronic obstructive pulmonary disease (COPD), pneumonia and lung cancer (NSCLC), as well as to assess a role of proteomic analysis of EBC for diagnosis and differential diagnosis of these diseases. Methods. We examined 18 patients with COPD, 13 patients with community-acquired pneumonia, 26 patients with lung cancer and 24 healthy non-smoking volunteers. EBC was collected using ECoScreen system (VIASYS Healthcare, Germany) and a standardized method. EBC-samples were lyophilized, hydrolyzed and analyzed by HPLC and tandem mass spectrometry. To identify proteins, we used Mascot (Matrix Science, UK) and IPI-human (version 3.82) databases provided by the European Bioinformatics Institute. Results. Proteomic analysis of EBC identified more than 300 different proteins; most of them were types I and II cytoskeletal keratins. Cytokeratin 5, 6, and 14 concentrations in EBC of NSCLC patients were significantly higher than that in healthy volunteers. Dermcidin, immunoglobulin alpha, kininogen, cytoplasmic actin, serum albumin, and Zn-alpha2-glycoprotein were identified in EBC of healthy volunteers and patients with COPD and pneumonia. High concentration of peroxiredoxin in EBC of COPD patients could be due to severe oxidative stress. High levels of acute-phase and hypoxia proteins (annexins A1 and A2, HSP90B, cystatins M and B, collagen and histones fragments) were detected in EBC of pneumonia patients. Also, β- и α-subunit of hemoglobin, nuclear ubiquitin casein (NUCKS), POTEE, high mobility group protein (HMG-I/HMG-Y) and lactoferrin were identified in EBC of NSCLC patients. Conclusion. We found that EBC in healthy nonsmokers and in patients with COPD, pneumonia and NSCLC had characteristic protein spectrum. Most of the identified proteins could be used for diagnosis of these diseases.
Comparative proteomic analysis of exhaled breath condensate in patients with lung carcinoma using high resolution mass-spectrometry SummaryAnalysis of exhaled breath condensate (EBC) is a promising non-invasive method to diagnose respiratory diseases. Most researchers emphasize the importance of proteomic analysis of EBC for early diagnosis of certain respiratory diseases including lung cancer. This study was aimed at identification of potential biomarkers of neoplastic disorders in EBC of patients with lung cancer using high-performance liquid chromatography and high resolution mass-spectrometry. The study involved 26 patients with lung carcinoma (21 males, 5 females, mean age 57 ± 12 years) and 23 healthy non-smokers (19 males, 4 females, mean age 30 ± 7 years). EBC samples were collected using a disposable portable condenser R-Tube. The most of proteins identified (65 %) belonged to keratin family including type 1 (1; 2; 5 and 6А) and type 2 (9; 10; 14; 16 and 17) cytoskeletal keratins and transport proteins (albumin, lipocalin-1). Keratin family proteins (5, 6 and 14) prevailed in lung cancer patients compared to controls (p < 0.05). Other 6 proteins were also detected predominantly in lung cancer patients including β-subunit and α-subunit of haemoglobin, nuclear ubiquitous casein (NUCKS), high-mobility group proteins (HMG-I/HMG-Y), and lactoferrin. Most of these proteins could be used as a diagnostic panel to detect lung cancer. Further investigations are needed to estimate diagnostic values of these biomarkers and their role in pathogenesis of lung cancer.
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