Novel Method for Noninvasive Sampling of the Distal Airspace in Acute Respiratory Distress Syndrome

McNeil, J. Brennan; Shaver, Ciara M.; Kerchberger, V.E.; Russell, Derek W.; Grove, Brandon S.; Warren, Melissa; Wickersham, Nancy; Ware, Lorraine B.; Bastarache, Julie A.

doi:10.1164/rccm.201707-1474oc

Cited by 36 publications

(48 citation statements)

References 31 publications

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“…In the present study, we provided evidence that PCTR1 effec- (Brodie et al, 2019;Thompson et al, 2017). Therefore, the removal of excess alveolar and interstitial edema fluid is crucial to the recovery and survival of ARDS patients (McNeil et al, 2018;Thompson et al, 2017). Our research clearly showed that PCTR1 ameliorated interstitial edema, hemorrhage, alveolar collapse, inflammatory cell infiltration, and inflammatory factors, and recovered the normal blood-Air barrier and the lamellar bodies.…”

Section: Discussionsupporting

confidence: 60%

PCTR1 improves pulmonary edema fluid clearance through activating the sodium channel and lymphatic drainage in lipopolysaccharide‐induced ARDS

Zhang

Han

Cao

et al. 2020

Journal Cellular Physiology

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Acute respiratory distress syndrome (ARDS) is a lethal clinical syndrome characterized by damage of the epithelial barriers and accumulation of pulmonary edema fluid. Protectin conjugates in tissue regeneration 1 (PCTR1), an endogenously produced lipid mediator, are believed to exert anti‐inflammatory and pro‐resolution effects. PCTR1 (1 µg/kg) was injected at 8 hr after lipopolysaccharide (LPS; 14 mg/kg) administration, and the rate of pulmonary fluid clearance was measured in live rats at 1 hr after PCTR1 treatment. The primary type II alveolar epithelial cells were cultured with PCTR1 (10 nmol/ml) and LPS (1 μg/ml) for 8 hr. PCTR1 effectively improved pulmonary fluid clearance and ameliorated morphological damage and reduced inflammation of lung tissue, as well as improved the survival rate in the LPS‐induced acute lung injury (ALI) model. Moreover, PCTR1 markedly increased sodium channel expression as well as Na, K‐ATPase expression and activity in vivo and in vitro. In addition, PCTR1i also upregulated the expression of LYVE‐1 in vivo. Besides that, BOC‐2, HK7, and LY294002 blocked the promoted effect of PCTR1 on pulmonary fluid clearance. Taken together, PCTR1 upregulates sodium channels' expression via activating the ALX/cAMP/P‐Akt/Nedd4‐2 pathway and increases Na, K‐ATPase expression and activity to promote alveolar fluid clearance. Moreover, PCTR1 also promotes the expression of LYVE‐1 to recover the lymphatic drainage resulting in the increase of lung interstitial fluid clearance. In summary, these results highlight a novel systematic mechanism for PCTR1 in pulmonary edema fluid clearance after ALI/ARDS, suggesting its potential role in a therapeutic approach for ALI/ARDS.

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Section: Discussionsupporting

confidence: 60%

PCTR1 improves pulmonary edema fluid clearance through activating the sodium channel and lymphatic drainage in lipopolysaccharide‐induced ARDS

Zhang

Han

Cao

et al. 2020

Journal Cellular Physiology

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“…While simple, e-Nose has poor chemical selectivity, deviceto-device repeatability, and stability, as well as high susceptibility to background or interference VOCs 18,19 . Very recently, a new technology was developed to collect and analyze the breath from mechanically ventilated patients using an in-line heat-moisture exchanger installed on a ventilator 33 . While potentially useful in ARDS diagnosis, this technology is focused on proteomic analysis of the breath condensates and requires long analysis time.…”

Section: Introductionmentioning

confidence: 99%

Rapid breath analysis for acute respiratory distress syndrome diagnostics using a portable 2-dimensional gas chromatography device

Zhou

Sharma

Zhu

et al. 2019

Preprint

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Acute respiratory distress syndrome (ARDS) is the most severe form of acute lung injury, responsible for high mortality and long-term morbidity. As a dynamic syndrome with multiple etiologies its timely diagnosis is difficult as is tracking the course of the syndrome. Therefore, there is a significant need for early, rapid detection and diagnosis as well as clinical trajectory monitoring of ARDS. Here we report our work on using human breath to differentiate ARDS and non-ARDS causes of respiratory failure. A fully automated portable 2-dimensional gas chromatography device with high peak capacity, high sensitivity, and rapid analysis capability was designed and made in-house for on-site analysis of patients' breath. A total of 85 breath samples from 48 ARDS patients and controls were collected. Ninety-seven elution peaks were separated and detected in 13 minutes. An algorithm based on machine learning, principal component analysis (PCA), and linear discriminant analysis (LDA) was developed. As compared to the adjudications done by physicians based on the Berlin criteria, our device and algorithm achieved an overall accuracy of 87.1% with 94.1% positive predictive value and 82.4% negative predictive value. The high overall accuracy and high positive predicative value suggest that the breath analysis method can accurately diagnose ARDS. The ability to continuously and non-invasively monitor exhaled breath for early diagnosis, disease trajectory tracking, and outcome prediction monitoring of ARDS may have a significant impact on changing practice and improving patient outcomes.

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“…In addition, individualized microbiological sampling could help diagnosis of ARDS. A new method was recently described, based on fluid collected from heat-moisture exchanger filters attached to mechanical ventilators of ARDS patients [10]. It was found that this fluid accurately represented fluid in the distal airspace.…”

Section: Biomarkers and Microbiological Samplingmentioning

confidence: 99%

Focus on ventilation and ARD: recent insights

2019

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Novel Method for Noninvasive Sampling of the Distal Airspace in Acute Respiratory Distress Syndrome

Abstract: These data suggest that HMEF is a novel, noninvasive method to accurately sample the distal airspace in patients with ARDS.

Cited by 36 publications

References 31 publications

PCTR1 improves pulmonary edema fluid clearance through activating the sodium channel and lymphatic drainage in lipopolysaccharide‐induced ARDS

PCTR1 improves pulmonary edema fluid clearance through activating the sodium channel and lymphatic drainage in lipopolysaccharide‐induced ARDS

Rapid breath analysis for acute respiratory distress syndrome diagnostics using a portable 2-dimensional gas chromatography device

Focus on ventilation and ARD: recent insights

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