Urinary desmosine as a biomarker in acute lung injury

Abstract

Acute lung injury (ALI) is a complex disorder associated with an acute inflammatory response thought to contribute to tissue injury. Desmosine, a cross-linking amino acid present in elastin, is released during matrix degradation and cleared by the kidney. Results from animal models and human disease studies have suggested that ALI is associated with the release of desmosine, resulting in increased urinary desmosine. A radioimmunoassay was used to monitor urinary desmosine levels over 10 days in ten patients with ALI. The concentration of desmosine was measured with and without acid hydrolysis. Baseline urinary desmosine was increased in two of ten patients. The concentration of desmosine at baseline did not appear to be related to age, gender, neutrophil elastase (NE)/alpha(1)-antiprotease complex concentration or P(a)O(2)/F(i)O(2) ratio. No meaningful changes in desmosine levels were noted after removal from mechanical ventilation. Baseline desmosine concentrations did not appear to correlate with the risk of death. The limited sensitivity, predictive correlations and dynamic modulation would suggest that urine desmosine has a limited role as a biomarker for ALI. Hydrolysis of urine samples appears necessary for optimal measurement of urine desmosine.

Inhalation of LPS induces inflammatory airway responses mimicking characteristics of chronic obstructive pulmonary disease

“…However, in the present study, no such increase could be detected, possibly reflecting a limited and ⁄ or short-lasting proteolytic effect induced by single LPS inhalation. Our findings support recent data showing that urinary desmosine may be of limited value in detecting an acute inflammatory lung reaction (Fill et al, 2006).…”

Stability of interleukin 8 and neutrophil elastase in bronchoalveolar lavage fluid following long-term storage

“…Desmosines in urine exhibit appreciable recovery after storage and repeated freeze-thaw cycles at − 70°C [9], as do lipocalins [10]. Urinary markers of styrene exposure have also been shown to maintain stability for up to 4 days at 4°C [11].…”

“…Urinary markers of styrene exposure have also been shown to maintain stability for up to 4 days at 4°C [11]. Similarly, markers in cerebrospinal fluid [12], pleural fluid [13] and sera [5,9,14] are also suitable for safe storage at−80°C, while the reverse seems true of those in cervical mucous, where snap-freezing can cause significant degradation [15]. Inflammatory cytokines in serum such as TNF-α and IFN-γ have been shown to remain stable for up to 20 days in both refrigerated and frozen conditions [16].…”

Progress in the methodological strategies for the detection in real samples of desmosine and isodesmosine, two biological markers of elastin degradation

“…Given that different desmosine concentrations were detected for different groups of patients, the authors concluded that substantial increases in urinary desmosine excretion may favor a diagnosis of ARDS. Based on their results Fill et al [68] have suggested that acute lung injury (ALI) is associated with an increase of urinary desmosine excretion. Desmosine levels from ten ALI patients were monitored (with and without acid hydrolysis) over 10 days using a RIA.…”