Measurements of desmosine and isodesmosine by mass spectrometry in COPD.
OBJECTIVE
Application of mass spectrometry (MS) for direct measurements of desmosine (D) and isodesmosine (I) in urine, plasma, and sputum as markers of elastin degradation in patients with alpha(1)-antitrypsin deficiency (AATD) and non-AATD-related COPD.


BACKGROUND
In COPD patients, the lungs undergo elastin injury, which can be monitored by measurements of D and I in body fluids as specific markers of elastin degradation using the specificity and sensitivity of MS.


METHODS
Acid hydrolysis of blood plasma, 24-h urine and sputum measurements, followed by chromatographic separation for mass spectrometric analysis.


RESULTS
Each patient group had levels of plasma D and I that were statistically significantly higher than those of control subjects. AATD patients had higher levels than COPD patients with normal alpha(1)-antitrypsin (AAT) levels. Twenty-four-hour urine measurements demonstrated no significant difference in total levels of D and I among control subjects and patients but showed a free (unbound) concentration of D and I in urine, which was statistically significantly higher in patients with COPD with and without AAT. The D and I levels in the sputum of patients with AATD exceeded the levels in COPD patients with normal AAT levels.


CONCLUSIONS
MS allows a sensitive and specific analysis of D and I in body fluids. The quantification of D and I in sputum, along with increases of D and I in plasma and an elevated free component of D and I in urine provide indexes that characterize patients with COPD and can be followed in relation to the course of the disease and/or therapy.
Ma
Shuren
S
St. Luke's-Roosevelt Hospital, Department of Medicine, 1000 Tenth Avenue, Mara Center, New York, NY 10019, USA.
Lin
Yong Y
YY
Turino
Gerard M
GM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003895:Desmosine / Q000032:analysis*; D004549:Elastin / Q000032:analysis; D005260:Female; D006801:Humans; D007524:Isodesmosine / Q000032:analysis*; D008297:Male; D013058:Mass Spectrometry; D016555:Matched-Pair Analysis; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000145:classification / Q000652:urine; D012680:Sensitivity and Specificity; D013183:Sputum / Q000737:chemistry; D019896:alpha 1-Antitrypsin Deficiency / Q000378:metabolism
D003895:Desmosine; D004549:Elastin; D007524:Isodesmosine