Pavel Dřevínek

Quantification of methyl thiocyanate in the headspace of Pseudomonas aeruginosa cultures and in the breath of cystic fibrosis patients by selected ion flow tube mass spectrometry

Infection by Pseudomonas aeruginosa (PA) is a major cause of morbidity and mortality in patients with cystic fibrosis (CF). Breath analysis could potentially be a useful diagnostic of such infection, and analyses of volatile organic compounds (VOCs) emitted from PA cultures are an important part of the search for volatile breath markers of PA lung infection. Our pilot experiments using solid-phase microextraction, SPME and gas chromatography/mass spectrometric (GC/MS) analyses of volatile compounds produced by PA strains indicated a clear presence of methyl thiocyanate. This provided a motivation to develop a method for real-time online quantification of this compound by selected ion flow tube mass spectrometry, SIFT-MS. The kinetics of reactions of H(3)O(+), NO(+) and O(2)(+•) with methyl thiocyanate at 300 K were characterized and the characteristic product ions determined (proton transfer for H(3)O(+), rate constant 4.6 × 10(-9) cm(3) s(-1); association for NO(+), 1.7 × 10(-9) cm(3) s(-1) and nondissociative charge transfer for O(2)(+•) 4.3 × 10(-9) cm(3) s(-1)). The kinetics library was extended by a new entry for methyl thiocyanate accounting for overlaps with isotopologues of hydrated hydronium ions. Solubility of methyl thiocyanate in water (Henrys law constant) was determined using standard reference solutions and the linearity and limits of detection of both SIFT-MS and SPME-GC/MS methods were characterized. Thirty-six strains of PA with distinct genotype were cultivated under identical conditions and 28 of them (all also producing HCN) were found to release methyl thiocyanate in headspace concentrations greater than 6 parts per billion by volume (ppbv). SIFT-MS was also used to analyze the breath of 28 children with CF and the concentrations of methyl thiocyanate were found to be in the range 2-21 ppbv (median 7 ppbv).

Direct PCR Detection of Burkholderia cepacia Complex and Identification of Its Genomovars by Using Sputum as Source of DNA

ABSTRACT We developed a nested PCR assay that detects the recA gene of the Burkholderia cepacia complex in sputum. The product of the first PCR round is also used to identify the genomovar of the pathogen. The protocol achieves high sensitivity and specificity with simple interpretation of genomovar status.

Breath concentration of acetic acid vapour is elevated in patients with cystic fibrosis.

A study has been carried out of the volatile organic compounds present in the exhaled breath of 58 cystic fibrosis (CF) patients. An important observation is that the acetic acid vapour concentration measured by selected ion flow tube mass spectrometry (SIFT-MS) is significantly elevated in the exhaled breath of CF patients, independent of the Pseudomonas aeruginosa (PA) infection status (PA-infected median 170 ppbv; PA-negative median 182 ppbv), compared to that of healthy controls (median 48 ppbv). The cause for this may be decreased pH of the mucus lining the CF airways. Thus, we speculate that non-invasive measurement of breath acetic acid concentration could serve as an indicator of the acidity of the CF airways mucosa.

NEUROD polymorphism Ala45Thr is associated with Type 1 diabetes mellitus in Czech children

Association of the NEUROD Ala45Thr polymorphism with Type 1 diabetes mellitus (DM) has been found in some but not all populations. We performed a study on the association of two NEUROD exon 2 polymorphisms, the Ala45Thr and the Pro197His, with childhood-onset Type 1 DM in the Czech population. We compared 285 children with Type 1 DM diagnosed under the age of 15 years with 289 non-diabetic control children. The genotypes were determined using novel real-time allele-specific PCR assays in the TaqMan format, and data were analysed using logistic regression. The numbers of subjects with codon 45 genotypes Ala/Ala, Ala/Thr, Thr/Thr were 95, 145, 45 among cases and 117, 130, 42 among controls. Thr45 phenotypic positivity was associated with a significant risk of Type 1 DM (OR=2.01, CI 95% 1.25-3.24) in a multivariate logistic regression model involving also the insulin gene -23HphI genotype and the presence of Type 1 DM-associated HLA-DQB1*0302-DQA1*03 (DQ8) and DQB1*0201-DQA1*05 (DQ2) molecules. No association was observed for the Pro197His mutation which was carried by 5.3% cases and 5.9% controls. Our results confirm that the NEUROD Ala45Thr polymorphism is associated with childhood-onset Type 1 DM.

Do linear logistic model analyses of volatile biomarkers in exhaled breath of cystic fibrosis patients reliably indicate Pseudomonas aeruginosa infection

Non-invasive breath analysis has been used to search for volatile biomarkers of lungs and airways infection by Pseudomonas aeruginosa, PA, in cystic fibrosis patients. The exhaled breath of 20 PA-infected patients and 38 PA-negative patients was analysed using selected ion flow tube mass spectrometry, SIFT-MS. Special attention was given to the positive identification and accurate quantification of 16 volatile compounds (VOCs) as assured by the detailed consideration of their analytical ion chemistry occurring in the SIFT-MS reactor. However, the diagnostic sensitivity and specificity of the concentrations of any of the 16 compounds taken individually were found to be low. But when a linear combination of the concentrations of all 16 VOCs was used to construct an optimised receiver operating characteristics (ROC) curve using a linear logistic model, the diagnostic separation of PA-infected patients relative to the PA-negative patients was apparently good in terms of the derived sensitivity (89%), specificity (86%), and the area under the ROC curve is 0.91. Four compounds were revealed by the linear logistic model as significant, viz. malondialdehyde, isoprene, phenol and acetoin. The implications of these results to PA detection in the airways are assessed. Whilst such a metabolomics approach to optimise the ROC curve is widely used in breath analysis, it can lead to misleading indications. Therefore, we conclude that the results of the linear logistic model analyses are of limited immediate clinical value. The identified compounds should rather be considered as a stimulus for further independent studies involving larger patient cohorts.

Pilot newborn screening project for cystic fibrosis in the Czech Republic: defining role of the delay in its symptomatic diagnosis and influence of ultrasound-based prenatal diagnosis on the incidence of the disease.

The objective need for cystic fibrosis (CF) newborn screening (NBS) in the Czech Republic has recently been substantiated by a significant delay of its symptomatic diagnosis. This trend most likely resulted from the process of decentralisation of health care which led to the deterioration of care for patients who need specialised approaches. Applied newborn screening model (IRT/DNA/IRT) was efficacious enough to detect CF cases with median age at diagnosis of 37 days. The incidence of CF (1 in 6946 live births) ascertained in this project was lower than that established previously by epidemiological studies (1 in 2700-1 in 3300). However, adjustment for broadly applied ultrasound-based prenatal diagnosis (PND) in the 2nd trimester of pregnancy, that was performed within the period of the project (1/2/2005-2/11/2006), rendered an incidence estimate of 1 in 4023. This value is closer to that observed in other CF NBS programmes and reflects influence of PND on the incidence of CF.

Evaluation of anti-PAIIL lectin hen yolk antibody as an agent inhibiting Pseudomonasaeruginosa adherence to epithelial cells

Hen yolk antibody (IgY) against Pseudomonasaeruginosa (PA) virulence factor, lectin PAIIL, was prepared from two hens. As judged from ELISA, both animals produced equally reactive anti-PAIIL antibodies. The IgY prophylaxis against adhesion of PA on epithelium cell lines derived from normal or cystic fibrosis (CF) human lungs was examined. Both anti-PAIIL antibodies comparably prevented PA adherence on epithelial cells. In accordance with clinical data, cells from CF patient showed higher susceptibility to PA binding compared to cells of a healthy subject. In additional experiments, a luminescent PA strain (PA-lux) was used in the PA adhesion assay instead of an originally used regular PA strain (ST 1763). The employment of PA-lux in the assay is advantageous since the bacteria do not need to be fluorescently labeled for their quantification. The application of both non-luminescent PA (ST 1763) and newly tested PA-lux strains provides consistent results as far as the anti-PAIIL IgY protection against of PA adherence is concerned. Furthermore, in lung epithelium adherence assay we examined also other PA strains for their sensitivity to anti-PAIIL antibody. The adherence of all PA strains tested was reduced by anti-PAIIL antibody when compared with un-affected controls. This finding suggests a wide applicability of anti-PAIIL antibody in prophylaxis of PA lung infections.Graphical abstract