title: Systematic review and meta-analysis of nasal potential difference in hypoxia-induced lung injury.
abstract: Nasal potential difference (NPD), a well-established in vivo clinical test for cystic fibrosis, reflects transepithelial cation and anion transport in the respiratory epithelium. To analyze whether NPD can be applied to diagnose hypoxic lung injury, we searched PubMed, EMBASE, Scopus, Web of Science, Ovid MEDLINE, and Google Scholar, and analyzed data retrieved from eleven unbiased studies for high altitude pulmonary edema (HAPE) and respiratory distress syndrome (RDS) using the software RevMan and R. There was a significant reduction in overall basal (WMD -5.27 mV, 95% CI: -6.03 to -4.52, P < 0.00001, I(2) = 42%), amiloride-sensitive (ENaC) (-2.87 mV, 95% CI: -4.02 to -1.72, P < 0.00001, I(2) = 51%), and -resistant fractions (-3.91 mV, 95% CI: -7.64 to -0.18, P = 0.04, I(2) = 95%) in lung injury patients. Further analysis of HAPE and RDS separately corroborated these observations. Moreover, SpO2 correlated with ENaC-associated NPD positively in patients only, but apparently related to CFTR-contributed NPD level inversely. These correlations were confirmed by the opposite associations between NPD values and altitude, which had a negative regression with SpO2 level. Basal NPD was significantly associated with amiloride-resistant but not ENaC fraction. Our analyses demonstrate that acute lung injury associated with systemic hypoxia is characterized by dysfunctional NPD.
authors.affiliation: Institute of Lung and Molecular Therapy, Xinxiang Medical University, Xinxiang Henan 453003, China.|School of Public Health, Xinxiang Medical University, Xinxiang Henan, 453003, China.
authors.forename: Zhenlei
authors.initials: Z
authors.lastname: Su
authors.affiliation: School of Nursing, Xinxiang Medical University, Xinxiang Henan 453003, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Institute of Lung and Molecular Therapy, Xinxiang Medical University, Xinxiang Henan 453003, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Cellular and Molecular Biology, University of Texas Health Science Center at Tyler, Tyler, Texas, 75708, USA.
authors.forename: Runzhen
authors.initials: R
authors.lastname: Zhao
authors.affiliation: Department of Cellular and Molecular Biology, University of Texas Health Science Center at Tyler, Tyler, Texas, 75708, USA.|Texas Lung Injury Institute, University of Texas Health Science Center at Tyler, Tyler, Texas, 75708, USA.
authors.forename: Hong-Long
authors.initials: HL
authors.lastname: Ji
mesh_terms: D055371:Acute Lung Injury / Q000175:diagnosis*; D000328:Adult; D000532:Altitude Sickness / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000175:diagnosis*; D012984:Software