Increased urinary l-histidine in patients with asthma-COPD overlap: A pilot study

Jee Youn Oh, Young Seok Lee, Kyung-Hoon Min, Gyu Young Hur, Sung Yong Lee, Kyung Ho Kang, Chin Kook Rhee, Seoung Ju Park, Adnan Khan, Jinhyuk Na, Youngja H. Park, Jae Jeong Shim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: Asthma-COPD overlap (ACO) is heterogeneous in nature and requires a unified diagnostic approach. We investigated the urinary levels of l-histidine, a precursor of histamine related to inflammatory responses, as a new candidate biomarker for diagnosing this condition. Patients and methods: We performed a prospective multicenter cohort study with retrospective analysis of 107 patients, who were divided into three groups: asthma, COPD, and ACO, according to the Spanish guidelines algorithm. Urinary l-histidine levels were measured using liquid chromatography-mass spectrometry. High-resolution metabolomic analysis, coupled with liquid chromatography-mass spectrometry and followed by multivariate statistical analysis, was performed on urine samples to discriminate between the metabolic profiles of the groups. Results: Urinary l-histidine levels were significantly higher in patients with ACO than in those with asthma or COPD, but the subgroups of ACO, classified according to disease origin, did not differ significantly. High urinary l-histidine level was a significant factor for the diagnosis of ACO even after adjusting for age, sex, and smoking amount. Among patients with airflow obstruction, the urinary l-histidine levels were elevated in patients with a documented history of asthma before the age of 40 years or bronchodilator responsiveness ≥400 mL; bronchodilator responsiveness ≥200 mL of forced expiratory volume in 1 second and exceeding baseline values by 12% on two or more visits; blood eosinophil count ≥300 cells⋅mm-3; and frequent exacerbations (P < 0.05). Conclusion: Urinary l-histidine could be a potential biomarker for ACO, regardless of the diversity of diagnostic definitions used.

Original languageEnglish
Pages (from-to)1809-1818
Number of pages10
JournalInternational Journal of COPD
Volume13
DOIs
Publication statusPublished - 2018 Jun 5

Fingerprint

Histidine
Chronic Obstructive Pulmonary Disease
Asthma
Bronchodilator Agents
Liquid Chromatography
Mass Spectrometry
Biomarkers
Metabolomics
Metabolome
Forced Expiratory Volume
Eosinophils
Histamine
Multicenter Studies
Cohort Studies
Multivariate Analysis
Smoking
Urine
Guidelines

Keywords

  • ACO
  • Asthma
  • COPD
  • Inhaled corticosteroid
  • Metabolomics
  • Urinary l-histidine

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Increased urinary l-histidine in patients with asthma-COPD overlap : A pilot study. / Oh, Jee Youn; Lee, Young Seok; Min, Kyung-Hoon; Hur, Gyu Young; Lee, Sung Yong; Kang, Kyung Ho; Rhee, Chin Kook; Park, Seoung Ju; Khan, Adnan; Na, Jinhyuk; Park, Youngja H.; Shim, Jae Jeong.

In: International Journal of COPD, Vol. 13, 05.06.2018, p. 1809-1818.

Research output: Contribution to journalArticle

Oh, Jee Youn ; Lee, Young Seok ; Min, Kyung-Hoon ; Hur, Gyu Young ; Lee, Sung Yong ; Kang, Kyung Ho ; Rhee, Chin Kook ; Park, Seoung Ju ; Khan, Adnan ; Na, Jinhyuk ; Park, Youngja H. ; Shim, Jae Jeong. / Increased urinary l-histidine in patients with asthma-COPD overlap : A pilot study. In: International Journal of COPD. 2018 ; Vol. 13. pp. 1809-1818.
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abstract = "Purpose: Asthma-COPD overlap (ACO) is heterogeneous in nature and requires a unified diagnostic approach. We investigated the urinary levels of l-histidine, a precursor of histamine related to inflammatory responses, as a new candidate biomarker for diagnosing this condition. Patients and methods: We performed a prospective multicenter cohort study with retrospective analysis of 107 patients, who were divided into three groups: asthma, COPD, and ACO, according to the Spanish guidelines algorithm. Urinary l-histidine levels were measured using liquid chromatography-mass spectrometry. High-resolution metabolomic analysis, coupled with liquid chromatography-mass spectrometry and followed by multivariate statistical analysis, was performed on urine samples to discriminate between the metabolic profiles of the groups. Results: Urinary l-histidine levels were significantly higher in patients with ACO than in those with asthma or COPD, but the subgroups of ACO, classified according to disease origin, did not differ significantly. High urinary l-histidine level was a significant factor for the diagnosis of ACO even after adjusting for age, sex, and smoking amount. Among patients with airflow obstruction, the urinary l-histidine levels were elevated in patients with a documented history of asthma before the age of 40 years or bronchodilator responsiveness ≥400 mL; bronchodilator responsiveness ≥200 mL of forced expiratory volume in 1 second and exceeding baseline values by 12{\%} on two or more visits; blood eosinophil count ≥300 cells⋅mm-3; and frequent exacerbations (P < 0.05). Conclusion: Urinary l-histidine could be a potential biomarker for ACO, regardless of the diversity of diagnostic definitions used.",
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T1 - Increased urinary l-histidine in patients with asthma-COPD overlap

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AU - Oh, Jee Youn

AU - Lee, Young Seok

AU - Min, Kyung-Hoon

AU - Hur, Gyu Young

AU - Lee, Sung Yong

AU - Kang, Kyung Ho

AU - Rhee, Chin Kook

AU - Park, Seoung Ju

AU - Khan, Adnan

AU - Na, Jinhyuk

AU - Park, Youngja H.

AU - Shim, Jae Jeong

PY - 2018/6/5

Y1 - 2018/6/5

N2 - Purpose: Asthma-COPD overlap (ACO) is heterogeneous in nature and requires a unified diagnostic approach. We investigated the urinary levels of l-histidine, a precursor of histamine related to inflammatory responses, as a new candidate biomarker for diagnosing this condition. Patients and methods: We performed a prospective multicenter cohort study with retrospective analysis of 107 patients, who were divided into three groups: asthma, COPD, and ACO, according to the Spanish guidelines algorithm. Urinary l-histidine levels were measured using liquid chromatography-mass spectrometry. High-resolution metabolomic analysis, coupled with liquid chromatography-mass spectrometry and followed by multivariate statistical analysis, was performed on urine samples to discriminate between the metabolic profiles of the groups. Results: Urinary l-histidine levels were significantly higher in patients with ACO than in those with asthma or COPD, but the subgroups of ACO, classified according to disease origin, did not differ significantly. High urinary l-histidine level was a significant factor for the diagnosis of ACO even after adjusting for age, sex, and smoking amount. Among patients with airflow obstruction, the urinary l-histidine levels were elevated in patients with a documented history of asthma before the age of 40 years or bronchodilator responsiveness ≥400 mL; bronchodilator responsiveness ≥200 mL of forced expiratory volume in 1 second and exceeding baseline values by 12% on two or more visits; blood eosinophil count ≥300 cells⋅mm-3; and frequent exacerbations (P < 0.05). Conclusion: Urinary l-histidine could be a potential biomarker for ACO, regardless of the diversity of diagnostic definitions used.

AB - Purpose: Asthma-COPD overlap (ACO) is heterogeneous in nature and requires a unified diagnostic approach. We investigated the urinary levels of l-histidine, a precursor of histamine related to inflammatory responses, as a new candidate biomarker for diagnosing this condition. Patients and methods: We performed a prospective multicenter cohort study with retrospective analysis of 107 patients, who were divided into three groups: asthma, COPD, and ACO, according to the Spanish guidelines algorithm. Urinary l-histidine levels were measured using liquid chromatography-mass spectrometry. High-resolution metabolomic analysis, coupled with liquid chromatography-mass spectrometry and followed by multivariate statistical analysis, was performed on urine samples to discriminate between the metabolic profiles of the groups. Results: Urinary l-histidine levels were significantly higher in patients with ACO than in those with asthma or COPD, but the subgroups of ACO, classified according to disease origin, did not differ significantly. High urinary l-histidine level was a significant factor for the diagnosis of ACO even after adjusting for age, sex, and smoking amount. Among patients with airflow obstruction, the urinary l-histidine levels were elevated in patients with a documented history of asthma before the age of 40 years or bronchodilator responsiveness ≥400 mL; bronchodilator responsiveness ≥200 mL of forced expiratory volume in 1 second and exceeding baseline values by 12% on two or more visits; blood eosinophil count ≥300 cells⋅mm-3; and frequent exacerbations (P < 0.05). Conclusion: Urinary l-histidine could be a potential biomarker for ACO, regardless of the diversity of diagnostic definitions used.

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KW - Metabolomics

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