ABSTRACT
BACKGROUND: There is no clinically available marker for early detection or monitoring of chronic rejection in the form of bronchiolitis obliterans syndrome (BOS), the main long-term complication after lung transplantation. Sampling and analysis of particles in exhaled air is a valid, noninvasive method for monitoring surfactant protein A (SP-A) and albumin in the distal airways. METHODS: We asked whether differences in composition of exhaled particles can be detected when comparing stable lung transplant recipients (LTRs) (n = 26) with LTRs who develop BOS (n = 7). A comparison between LTRs and a matching group of healthy controls (n = 33) was also conducted. Using a system developed in-house, particles were collected from exhaled air by the principal of inertial impaction before chemical analysis by immunoassays. RESULTS: Surfactant protein A in exhaled particles and the SP-A/albumin ratio were lower (P = 0.002 and P = 0.0001 respectively) in the BOS group compared to the BOS-free group. LTRs exhaled higher amount of particles (P < 0.0001) and had lower albumin content (P < 0.0001) than healthy controls. CONCLUSIONS: We conclude that low levels of SP-A in exhaled particles are associated with increased risk of BOS in LTRs. The possibility that this noninvasive method can be used to predict BOS onset deserves further study with prospective and longitudinal approaches.
ABSTRACT
The study aims to observe whether subjects with a primary affective disease and manic attacks show modifications of serum concentration of creatine-kinase conferring it the role of a biologic marker. Serum concentration of creatine-kinase was determined for 122 men with mono- and bipolar affective disease during the different stages as well as for schizophrenic men with different clinical forms excepting the affective form. The control group included 60 men. Data indicated that enzyme concentration can constitute a biological marker for a primary affective disease also showing the differences between the different stages of the disease (mania, hypomania, depression and the symptom-free intervals).