New bronchoscopic microsample probe to measure the biochemical constituents in epithelial lining fluid of patients with acute respiratory distress syndrome

Ishizaka, Akitoshi; Watanabe, Masahiro; Yamashita, Tetsuji; Ogawa, Yu; Koh, Hidefumi; Hasegawa, Naoki; Nakamura, Hidetoshi; Asano, Koichiro; Yamaguchi, Kazuhiro; Kotani, Masahiro; Kotani, Toru; Morisaki, Hiroshi; Takeda, Junzo; Kobayashi, Koichi; Ogawa, Satoshi

doi:10.1097/00003246-200104000-00043

Cited by 89 publications

(99 citation statements)

References 9 publications

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“…The BMS probe, recently developed in conjunction with Olympus (Tokyo, Japan), consists of a 1.7-mmdiameter polyethylene outer sheath and an inner fiber rod probe 1.2 mm in diameter and 30 mm in length attached to a stainless steel guide wire 100 cm in length. The BMS procedure has been described in detail previously (16). Briefly, the probe was inserted into the channel and gently advanced.…”

Section: Methodsmentioning

confidence: 99%

Elevation of KL-6, a lung epithelial cell marker, in plasma and epithelial lining fluid in acute respiratory distress syndrome

Ishizaka¹,

Matsuda²,

Albertine³

et al. 2004

American Journal of Physiology-Lung Cellular and Molecular Phys

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Elevation of KL-6, a lung epithelial cell marker, in plasma and epithelial lining fluid in acute respiratory distress syndrome. Am J Physiol Lung Cell Mol Physiol 286: L1088 -L1094, 2004. First published September 5, 2003 10.1152 10. /ajplung. 00420.2002 is a pulmonary epithelial mucin more prominently expressed on the surface membrane of alveolar type II cells when these cells are proliferating, stimulated, and/or injured. We hypothesized that high levels of KL-6 in epithelial lining fluid and plasma would reflect the severity of lung injury in patients with acute lung injury (ALI). Epithelial lining fluid was obtained at onset (day 0) and day 1 of acute respiratory distress syndrome (ARDS)/ALI by bronchoscopic microsampling procedure in 35 patients. On day 0, KL-6 and albumin concentrations in epithelial lining fluid were significantly higher than in normal controls (P Ͻ 0.001), and the concentrations of KL-6 in epithelial lining fluid (P Ͻ 0.002) and in plasma (P Ͻ 0.0001) were higher in nonsurvivors than in survivors of ALI/ARDS. These observations were corroborated by the immunohistochemical localization of KL-6 protein expression in the lungs of nonsurvivors with ALI and KL-6 secretion from cultured human alveolar type II cells stimulated by proinflammatory cytokines. Because injury to distal lung epithelial cells, including alveolar type II cells, is important in the pathogenesis of ALI, the elevation of KL-6 concentrations in plasma and epithelial lining fluid could be valuable indicators for poor prognosis in clinical ALI. alveolar type II cell; pulmonary edema; microsampling

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Section: Methodsmentioning

confidence: 99%

Elevation of KL-6, a lung epithelial cell marker, in plasma and epithelial lining fluid in acute respiratory distress syndrome

Ishizaka¹,

Matsuda²,

Albertine³

et al. 2004

American Journal of Physiology-Lung Cellular and Molecular Phys

Self Cite

160

149

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“…of bronchial ELF at either a subsegmental or subsubsegmental bronchus [3]. This is in contrast to bronchoalveolar lavage (BAL), which samples two sites of infection, i.e., fluid lining the small airways distal to the point of the wedge of the tip of the bronchoscope (alveolar ELF) and alveolar macrophage (AM).…”

Section: Bronchoscopic Microsampling (Bms) Is a New Technique For Repmentioning

confidence: 99%

“…Bronchial ELF sampling was performed with the BMS probe under bronchoscopy [3,6]. In vitro studies showed that more than 90% recovery could be obtained after 1 mg/l of telithromycin or 2-20 ml of human serum was absorbed to the BMS probe.…”

Section: Bms Under Bronchoscopymentioning

confidence: 99%

“…Since the bronchial ELF sampled by BMS probe was diluted with 2 ml of saline, the concentration of antibiotics in bronchial ELF (ABX br-ELF ) was determined as follows: ABX br-ELF = ABX BMS x (2 + V br-ELF ) / V br-ELF , where ABX BMS was the measured concentration of antibiotic in the saline-diluted sample, and V br-ELF was the volume of bronchial ELF recovered by the BMS probe [3,6].…”

Section: Measurement Of Telithromycin Concentrations In Plasma and Inmentioning

confidence: 99%

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Pharmacokinetics of telithromycin using bronchoscopic microsampling after single and multiple oral doses

Kikuchi

Yamazaki

Kikuchi

et al. 2007

Pulmonary Pharmacology & Therapeutics

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Objectives: Bronchoscopic microsampling (BMS) is a new technique for repeated sampling of bronchial epithelial lining fluid (ELF) to obtain the pharmacokinetic profile of drugs. We analyzed the time versus concentration profiles of telithromycin in bronchial ELF obtained by BMS and compared these finding to those in plasma and alveolar ELF obtained by bronchoalveolar lavage (BAL).Methods: Bronchial ELF samples were obtained from five healthy subjects using BMS probe at 0, 2, 3, 4, 6, 10 and 24 h after single or multiple oral doses of 600 mg of telithromycin. Alveolar ELF was also obtained by BAL 3 h after single or multiple oral doses of 600 mg of telithromycin. Results:The areas under the concentration-time curve from 0 to 24 h (AUC0-24) of telithromycin in plasma and bronchial ELF were 2.86 ± 0.60 and 19.5 ± 10.4 mg·h/l after single treatment and 3.60 ± 0.49 and 42.2 ± 22.7 mg·h/l after multiple treatments, respectively. Single and multiple oral doses of telithromycin produced significantly (p<0.05) higher AUC0-24 in bronchial ELF compared to those in plasma. While concentrations in bronchial ELF obtained by BMS were significantly lower than those in alveolar ELF obtained by BAL, they tended to be higher than those in plasma after multiple administration. The telithromycin concentrations obtained by BMS method were very consistent in bronchial ELF at different bronchi at one time point and at the same bronchus at different time points.Conclusions: Using the BMS technique, we could describe the pharmacokinetics of telithromycin in bronchial ELF. Furthermore, BMS was reasonably validated and reconfirmed to be a feasible and reliable method for measuring antimicrobial concentrations in bronchial ELF.-2 -

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“…Ishizuka et al have reported that bronchial microsampling (BMS) is a safe and useful technique to monitor pulmonary events, enabling the sequential analyses of biochemical and immunological markers in alveolar epithelial lining fluid (ELF), thereby helping to evaluate their pathophysiological significance at several time points during the progression of ARDS (12). Moreover, an advantage of BMS is its uncomplicated performance, without the use of saline, as opposed to bronchoalveolar lavage (13).…”

Section: Introductionmentioning

confidence: 99%

Effects of sivelestat on bronchial inflammatory responses after esophagectomy

Yamaguchi

Sugasawa²,

Takeuchi³

et al. 2011

Int J Mol Med

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Abstract. Post-operative pulmonary complications such as systemic inflammatory response syndrome (SIRS), acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are strongly associated with morbidity and mortality after esophagectomy. Post-operative administration of sivelestat sodium hydrate (sivelestat), a selective inhibitor of neutrophil elastase (NE), has been shown to improve the post-operative clinical course after esophagectomy. This study aimed to evaluate the effect of prophylactic administration of sivelestat on bronchial inflammatory responses. We randomized 24 patients into two groups. One group received 0.2 mg/kg/h sivelestat from the induction of anesthesia to post-operative day 1 (sivelestat group) and the other group received the same amount of physiological saline (control group). Bronchial alveolar epithelial lining fluid (ELF) samples were obtained from both groups at the induction of anesthesia and at the end of surgery. The serum and ELF levels of interleukin (IL)-6 and IL-8 were measured by enzyme-linked immunosorbent assay, and NE activity was spectrophotometrically determined using the same samples. Although IL-6 levels in the ELF significantly increased at the end of surgery compared with the pre-operative levels in both groups, the IL-8 levels and NE activity did not significantly increase at the end of the surgery compared to the corresponding pre-operative values in the sivelestat group. Moreover, IL-8 levels and NE activity in the ELF were significantly reduced at the end of surgery in the sivelestat group compared with corresponding values in the control group. The durations of ALI and ARDS were apparently shorter in the sivelestat group and the duration of SIRS was significantly shorter in the sivelestat group compared to the control group. We demonstrated that prophylactic use of sivelestat mitigated bronchial inflammation by suppressing NE activity and IL-8 levels in the ELF and shortened the duration of SIRS after transthoracic esophagectomy.

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New bronchoscopic microsample probe to measure the biochemical constituents in epithelial lining fluid of patients with acute respiratory distress syndrome

Abstract: These results suggest that BMS is safe and useful to monitor pulmonary biochemical events in ARDS.

Cited by 89 publications

References 9 publications

Elevation of KL-6, a lung epithelial cell marker, in plasma and epithelial lining fluid in acute respiratory distress syndrome

Elevation of KL-6, a lung epithelial cell marker, in plasma and epithelial lining fluid in acute respiratory distress syndrome

Pharmacokinetics of telithromycin using bronchoscopic microsampling after single and multiple oral doses

Effects of sivelestat on bronchial inflammatory responses after esophagectomy

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