RESUMO
Background: Diagnosing chronic pulmonary aspergillosis is a major challenge in clinical practice. The development and validation of a novel, sensitive and specific assay for diagnosing chronic pulmonary aspergillosis is urgently needed. Methods: From April 2018 to June 2019, 53 patients with chronic pulmonary aspergillosis (CPA), 32 patients with community-acquired pneumonia (CAP) and 48 healthy controls were recruited from the First Affiliated Hospital of Guangzhou Medical University. Clinical characteristics and samples were collected at enrollment. All exhaled breath samples were analyzed offline using thermal desorption single-photon ionization time-of-flight mass spectrometry; to analyze the metabolic pathways of the characteristic volatile organic compounds, serum samples were subjected to ultrahigh-performance liquid chromatography. Results: We identified characteristic volatile organic compounds in patients with chronic pulmonary aspergillosis, which mainly consisted of phenol, neopentyl alcohol, toluene, limonene and ethylbenzene. These compounds were assessed using a logistic regression model. The sensitivity and specificity were 95.8 and 96.9% for discriminating patients in the CPA group from those in the CAP group and 95.8 and 97.9% for discriminating patients in the CPA group from healthy controls, respectively. The concentration of limonene (m/z 136) correlated significantly positively with anti-Aspergillus fumigatus IgG antibody titers (r = 0.420, P < 0.01). After antifungal treatment, serum IgG and the concentration of limonene (m/z 136) decreased in the subgroup of patients with chronic pulmonary aspergillosis. Conclusions: We identified VOCs that can be used as biomarkers for differential diagnosis and therapeutic response prediction in patients with chronic pulmonary aspergillosis.
RESUMO
OBJECTIVE: To investigate the expressions of transforming growth factor beta 1(TGF-ß1) /smad, connective tissue growth factor (CTGF), collagen I and collagen III in ankylosing spondylitis (AS). METHODS: Thirty patients with AS were included in the study. All the patients were performed with computed tomography-guided needle biopsy in sacroiiliac joint. Sera TGF-ß1 and CTGF were determined by enzyme-linked immunosorbent assay (ELISA). Immunohistologic studies were performed with the alkaline phosphatase-anti-alkaline phosphatase technique to assess the expressions of TGF-ß1, p-smad3, smad7, CTGF, collagen I and collagen III in sacroiiliac joint tissue samples. RESULTS: In the AS patients, neither serum TGF-ß1 level nor serum CTGF level was found significantly different from that of the controls [(6.7±2.1)mg/L vs.(5.4±5.8)mg/L, P<0.05, (0.83±0.46)µg/L vs.(1.07±0.79 )µg/L, P<0.05]. In contrast to the healthy controls, TGF-ß1 and CTGF were found upexpressed in cytoplasm of inflammatory cells in pannus and bone marrow in sacroiliac tissue samples of patients with AS [(104.5±66.2) /HP vs. (24.4±9.3) /HP, (57.94±42.40) /HP vs. (2.67±2.52) /HP]. Meantime, p-smad3 was found expressed in the nuclear, while smad7 was detected to be downexpressed. Additionally, collagen I and collagen III were found upexpressed in bone, cartilage and ligament tissue. CONCLUSION: TGF-ß1, CTGF, collagen I and collagen III were upexpressed in sarcoiliac joints of AS patients. TGF-ß1/CTGF may play an important role in articular cartilage fibrosis and ossification of AS by smad signal pathyway.
