TY - JOUR
T1 - Higher urine desmosine levels are associated with mortality in patients with acute lung injury
AU - National Heart, Lung, Blood Institute Acute Respiratory Distress Syndrome Clinical Trials Network
AU - McClintock, Dana E.
AU - Starcher, Barry
AU - Eisner, Mark D.
AU - Taylor Thompson, B.
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 E.
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 - Daniel, Brian
AU - Abraham, Edward
AU - Piedalue, Fran
AU - Jagusch, Rebecca
AU - Miller, Paul
AU - McIntyre, Robert
N1 - Publisher Copyright:
Copyright © 2006 the American Physiological Society
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 how 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 entilator groups from day 0 to day 3, but the average rise was higher in the 12-ml/kg predicted body weight group ompared 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 biolog-ical 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 how 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 entilator groups from day 0 to day 3, but the average rise was higher in the 12-ml/kg predicted body weight group ompared 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 biolog-ical markers that may have prognostic and pathogenetic significance in acute lung injury.
KW - Acute respiratory distress syndrome
KW - Extracellular matrix
KW - Stretch injury
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U2 - 10.1152/ajplung.00457.2005
DO - 10.1152/ajplung.00457.2005
M3 - Article
C2 - 16698854
AN - SCOPUS:33749319934
SN - 1040-0605
SP - L566-L571
JO - American Journal of Physiology - Lung Cellular and Molecular Physiology
JF - American Journal of Physiology - Lung Cellular and Molecular Physiology
ER -