Abstract
Desmosine is a stable breakdown product of elastin that can be reliably measured in urine samples. We tested the hypothesis that higher baseline urine desmosine would be associated with higher mortality in 579 of 861 patients included in the recent Acute Respiratory Distress Syndrome Network trial of lower tidal volume ventilation (1). We also correlated urine desmosine levels with indexes of disease severity. Finally, we assessed whether urine desmosine was lower in patients who received lower tidal volumes. Desmosine was measured by radioimmunoassay in urine samples from days 0, 1, and 3 of the study. The data were expressed as a ratio of urine desmosine to urine creatinine to control for renal dilution. The results show that higher baseline (day 0) urine desmosine-to-creatinine concentration was associated with a higher risk of death on adjusted analysis (odds ratio 1.36, 95% confidence interval 1.02-1.82, P = 0.03). Urine desmosine increased in both ventilator groups from day 0 to day 3, but the average rise was higher in the 12-ml/kg predicted body weight group compared with the 6-ml/kg predicted body weight group (P = 0.053, repeated-measures model). In conclusion, patients with acute lung injury ventilated with lower tidal volumes have lower urine desmosine levels, a finding that may reflect reduced extracellular matrix breakdown. These results illustrate the value of evaluating urinary biological markers that may have prognostic and pathogenetic significance in acute lung injury.
| Original language | English (US) |
|---|---|
| Journal | American Journal of Physiology - Lung Cellular and Molecular Physiology |
| Volume | 291 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2006 |
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Keywords
- Acute respiratory distress syndrome
- Extracellular matrix
- Stretch injury
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cell Biology
- Physiology
Cite this
Higher urine desmosine levels are associated with mortality in patients with acute lung injury. / McClintock, Dana E.; Starcher, Barry; Eisner, Mark D.; Thompson, B. Taylor; Hayden, Doug L.; Church, Gwynne D.; Matthay, Michael A.; Wiedemann, Herbert P.; Arroliga, Alejandro C.; Fisher, Charles J.; Komara, John J.; Periz-Trepichio, Patricia; Parsons, Polly E.; Welsh, Carolyn; Fulkerson, William J.; MacIntyre, Neil; Mallatratt, Lee; Sebastian, Mark; Davies, John; Van Dyne, Elizabeth; Govert, Joseph; Sevransky, Jonathan; Murray, Stacey; Brower, Roy G; Thompson, David; Fessler, Henry Eric; Morris, Alan H.; Clemmer, Terry; Davis, Robin; Orme, James; Weaver, Lindell; Grissom, Colin; Thomas, Frank; Gleich, Martin; Lawton, Charles; D'Hulst, Janice; Peerless, Joel R.; Smith, Carolyn; Kallet, Richard; Luce, John M.; Gottlieb, Jonathan; Park, Pauline; Girod, Aimee; Yannarell, Lisa; Matthay, Michael A.; Eisner, Mark D.; Daniel, Brian; Abraham, Edward; Piedalue, Fran; Jagusch, Rebecca; Miller, Paul; McIntyre, Robert; Greene, Kelley E.; Silverman, Henry J.; Shanholtz, Carl; Corral, Wanda; Toews, Galen B.; Arnoldi, Deborah; Bartlett, Robert H.; Dechert, Ron; Watts, Charles; Lanken, Paul N.; Anderson, Harry; Finkel, Barbara; Hanson, C. William; Barton, Richard; Mone, Mary; Hudson, Leonard D.; Carter, Greg; Cooper, Claudette Lee; Hiemstra, Annemieke; Maier, Ronald V.; Steinberg, Kenneth P.; Hill, Tracy; Thaut, Phil; Wheeler, Arthur P.; Bernard, Gordon; Christman, Brian; Bozeman, Susan; Collins, Linda; Swope, Teresa; Ware, Lorraine B.; Schoenfeld, David A.; Thompson, B. Taylor; Ancukiewicz, Marek; Hayden, Douglas; Molay, Francine; Ringwood, Nancy; Wenzlow, Gail; Kazeroonin, Ali S.; Gail, Dorothy B.; Harabin, Andrea; Lew, Pamela; Waclawiw, Myron; Bernard, Gordon R.; Spragg, Roger G.; Boyett, James; Kelley, Jason; Leeper, Kenneth; Secundy, Marion Gray; Slutsky, Arthur; Garcia, Joe G N; Emerson, Scott S.; Pingleton, Susan K.; Shasby, Michael D.; Sibbald, William J.
In: American Journal of Physiology - Lung Cellular and Molecular Physiology, Vol. 291, No. 4, 2006.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Higher urine desmosine levels are associated with mortality in patients with acute lung injury
AU - McClintock, Dana E.
AU - Starcher, Barry
AU - Eisner, Mark D.
AU - Thompson, B. Taylor
AU - Hayden, Doug L.
AU - Church, Gwynne D.
AU - Matthay, Michael A.
AU - Wiedemann, Herbert P.
AU - Arroliga, Alejandro C.
AU - Fisher, Charles J.
AU - Komara, John J.
AU - Periz-Trepichio, Patricia
AU - Parsons, Polly E.
AU - Welsh, Carolyn
AU - Fulkerson, William J.
AU - MacIntyre, Neil
AU - Mallatratt, Lee
AU - Sebastian, Mark
AU - Davies, John
AU - Van Dyne, Elizabeth
AU - Govert, Joseph
AU - Sevransky, Jonathan
AU - Murray, Stacey
AU - Brower, Roy G
AU - Thompson, David
AU - Fessler, Henry Eric
AU - Morris, Alan H.
AU - Clemmer, Terry
AU - Davis, Robin
AU - Orme, James
AU - Weaver, Lindell
AU - Grissom, Colin
AU - Thomas, Frank
AU - Gleich, Martin
AU - Lawton, Charles
AU - D'Hulst, Janice
AU - Peerless, Joel R.
AU - Smith, Carolyn
AU - Kallet, Richard
AU - Luce, John M.
AU - Gottlieb, Jonathan
AU - Park, Pauline
AU - Girod, Aimee
AU - Yannarell, Lisa
AU - Matthay, Michael A.
AU - Eisner, Mark D.
AU - Daniel, Brian
AU - Abraham, Edward
AU - Piedalue, Fran
AU - Jagusch, Rebecca
AU - Miller, Paul
AU - McIntyre, Robert
AU - Greene, Kelley E.
AU - Silverman, Henry J.
AU - Shanholtz, Carl
AU - Corral, Wanda
AU - Toews, Galen B.
AU - Arnoldi, Deborah
AU - Bartlett, Robert H.
AU - Dechert, Ron
AU - Watts, Charles
AU - Lanken, Paul N.
AU - Anderson, Harry
AU - Finkel, Barbara
AU - Hanson, C. William
AU - Barton, Richard
AU - Mone, Mary
AU - Hudson, Leonard D.
AU - Carter, Greg
AU - Cooper, Claudette Lee
AU - Hiemstra, Annemieke
AU - Maier, Ronald V.
AU - Steinberg, Kenneth P.
AU - Hill, Tracy
AU - Thaut, Phil
AU - Wheeler, Arthur P.
AU - Bernard, Gordon
AU - Christman, Brian
AU - Bozeman, Susan
AU - Collins, Linda
AU - Swope, Teresa
AU - Ware, Lorraine B.
AU - Schoenfeld, David A.
AU - Thompson, B. Taylor
AU - Ancukiewicz, Marek
AU - Hayden, Douglas
AU - Molay, Francine
AU - Ringwood, Nancy
AU - Wenzlow, Gail
AU - Kazeroonin, Ali S.
AU - Gail, Dorothy B.
AU - Harabin, Andrea
AU - Lew, Pamela
AU - Waclawiw, Myron
AU - Bernard, Gordon R.
AU - Spragg, Roger G.
AU - Boyett, James
AU - Kelley, Jason
AU - Leeper, Kenneth
AU - Secundy, Marion Gray
AU - Slutsky, Arthur
AU - Garcia, Joe G N
AU - Emerson, Scott S.
AU - Pingleton, Susan K.
AU - Shasby, Michael D.
AU - Sibbald, William J.
PY - 2006
Y1 - 2006
N2 - Desmosine is a stable breakdown product of elastin that can be reliably measured in urine samples. We tested the hypothesis that higher baseline urine desmosine would be associated with higher mortality in 579 of 861 patients included in the recent Acute Respiratory Distress Syndrome Network trial of lower tidal volume ventilation (1). We also correlated urine desmosine levels with indexes of disease severity. Finally, we assessed whether urine desmosine was lower in patients who received lower tidal volumes. Desmosine was measured by radioimmunoassay in urine samples from days 0, 1, and 3 of the study. The data were expressed as a ratio of urine desmosine to urine creatinine to control for renal dilution. The results show that higher baseline (day 0) urine desmosine-to-creatinine concentration was associated with a higher risk of death on adjusted analysis (odds ratio 1.36, 95% confidence interval 1.02-1.82, P = 0.03). Urine desmosine increased in both ventilator groups from day 0 to day 3, but the average rise was higher in the 12-ml/kg predicted body weight group compared with the 6-ml/kg predicted body weight group (P = 0.053, repeated-measures model). In conclusion, patients with acute lung injury ventilated with lower tidal volumes have lower urine desmosine levels, a finding that may reflect reduced extracellular matrix breakdown. These results illustrate the value of evaluating urinary biological markers that may have prognostic and pathogenetic significance in acute lung injury.
AB - Desmosine is a stable breakdown product of elastin that can be reliably measured in urine samples. We tested the hypothesis that higher baseline urine desmosine would be associated with higher mortality in 579 of 861 patients included in the recent Acute Respiratory Distress Syndrome Network trial of lower tidal volume ventilation (1). We also correlated urine desmosine levels with indexes of disease severity. Finally, we assessed whether urine desmosine was lower in patients who received lower tidal volumes. Desmosine was measured by radioimmunoassay in urine samples from days 0, 1, and 3 of the study. The data were expressed as a ratio of urine desmosine to urine creatinine to control for renal dilution. The results show that higher baseline (day 0) urine desmosine-to-creatinine concentration was associated with a higher risk of death on adjusted analysis (odds ratio 1.36, 95% confidence interval 1.02-1.82, P = 0.03). Urine desmosine increased in both ventilator groups from day 0 to day 3, but the average rise was higher in the 12-ml/kg predicted body weight group compared with the 6-ml/kg predicted body weight group (P = 0.053, repeated-measures model). In conclusion, patients with acute lung injury ventilated with lower tidal volumes have lower urine desmosine levels, a finding that may reflect reduced extracellular matrix breakdown. These results illustrate the value of evaluating urinary biological markers that may have prognostic and pathogenetic significance in acute lung injury.
KW - Acute respiratory distress syndrome
KW - Extracellular matrix
KW - Stretch injury
UR - http://www.scopus.com/inward/record.url?scp=33749319934&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33749319934&partnerID=8YFLogxK
U2 - 10.1152/ajplung.00457.2005
DO - 10.1152/ajplung.00457.2005
M3 - Article
C2 - 16698854
AN - SCOPUS:33749319934
VL - 291
JO - American Journal of Physiology
JF - American Journal of Physiology
SN - 0363-6135
IS - 4
ER -