tailieunhanh - Volatile biomarkers of pulmonary tuberculosis in the breath

The current global epidemic of pulmonary tuberculosis has highlighted the need for new screening tests that are rapid and accurate. The social burden of pulmonary tuberculosis has increased because many patients are also infected with human immunodeficiency virus (HIV), and the rates of multidrug-resistant tuberculosis are However, screening technology has not changed greatly during the past several decades. Many highburden countries depend upon sputum smears and chest radiographs, supplemented by cultures when resources permit. This approach is highly specific for active pulmonary tuberculosis, but its value in primary screening is limited by low sensitivity and high cost. We tested the hypothesis that volatile organic compounds (VOCs) in the breath might provide new biomarkers of active pulmonary. | Tuberculosis 2007 87 44-52 Tuberculosis http journals tube Volatile biomarkers of pulmonary tuberculosis in the breath Michael Phillipsa b Renee N. Cataneoa Rany Condosc Gerald A. Ring Ericksond Joel Greenberga Vincent La Bombardie Muhammad I. Munawara Olaf Tietjef aMenssana Research Inc. Fort Lee NJ 07024 USÁ bDepartment of Medicine New York Medical College Valhalla NY USÁ cDivision of Pulmonary and Critical Care Medicine Bellevue Chest Service NYU School of Medicine New York NY USÁ dInfometrix Inc Woodinville WÁ USÁ eSaint Vincent s Medical Center New York NY USÁ fSystÁim GmbH Pfingstweidstr. 31a CH 8005 Zurich Switzerland Received 14 December 2005 received in revised form 8 March 2006 accepted 10 March 2006 KEYWORDS Volatile organic compounds Breath Pulmonary tubercu- losis Diagnosis Summary Pulmonary tuberculosis may alter volatile organic compounds VOCs in breath because Mycobacteria and oxidative stress resulting from Mycobacterial infection both generate distinctive VOCs. The objective of this study was to determine if breath VOCs contain biomarkers of active pulmonary tuberculosis. Head space VOCs from cultured Mycobacterium tuberculosis were captured on sorbent traps and assayed by gas chromatography mass spectroscopy GC MS . One hundred and thirty different VOCs were consistently detected. The most abundant were naphthalene 1-methyl- 3-heptanone methylcyclododecane heptane 2 2 4 6 6-pentamethyl- benzene 1-methyl-4- 1-methylethyl - and cyclohexane 1 4-dimethyl-. Breath VOCs were assayed by GC MS in 42 patients hospitalized for suspicion of pulmonary tuberculosis and in 59 healthy controls. Sputum cultures were positive for Mycobacteria in 23 42 and negative in19 42 patients. Breath markers of oxidative stress were increased in all hospitalized patients p . Pattern recognition analysis and fuzzy logic analysis of breath VOCs independently distinguished healthy controls from hospitalized patients with 100 sensitivity and 100 .