Elevated Nitrite/Nitrate Ratio as a Potential Biomarker for the Differential Diagnosis of Pleural Effusions
Pleural effusions (PEs) are common in clinical practice and can be due to many different underlying diseases such as cancer, congestive heart failure, or pneumonia. An accurate differential diagnostic categorization is essential, as the treatment and prognosis of PEs largely depend on its cause. In...
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MDPI AG
2022-07-01
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| Series: | Antioxidants |
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| Online Access: | https://www.mdpi.com/2076-3921/11/7/1327 |
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| author | Mu-Rong Chao Yuan-Jhe Chang Ying-Ming Shih Jian-Lian Chen Cheng-Chieh Yen Chiung-Wen Hu |
| author_facet | Mu-Rong Chao Yuan-Jhe Chang Ying-Ming Shih Jian-Lian Chen Cheng-Chieh Yen Chiung-Wen Hu |
| author_sort | Mu-Rong Chao |
| collection | DOAJ |
| description | Pleural effusions (PEs) are common in clinical practice and can be due to many different underlying diseases such as cancer, congestive heart failure, or pneumonia. An accurate differential diagnostic categorization is essential, as the treatment and prognosis of PEs largely depend on its cause. In this study, we tested the hypothesis that nitrite and nitrate concentrations in PEs are associated with the inflammation and infection conditions. We therefore measured the nitrite and nitrate levels in 143 PE samples using a sensitive liquid chromatography-tandem mass spectrometry method and investigated their diagnostic potential in differentiating PEs. The results showed that nitrite concentrations and nitrite/nitrate ratios were higher in exudates than in transudates (NO<sub>2</sub><sup>−</sup>: 2.12 vs. 1.49 μM; NO<sub>2</sub><sup>−</sup>/NO<sub>3</sub><sup>−</sup>: 23.3 vs. 14.0). Both the nitrite concentrations and the nitrite/nitrate ratios were positively correlated with the three Light’s criteria. Moreover, the receiver operating characteristic curve analysis revealed that the nitrite/nitrate ratio with an area under the curve of 0.71 could be a potential diagnostic biomarker in separating infectious PEs (IPEs) from other types of PEs. Taken together, the nitrite/nitrate ratio not only reflected the statuses of inflammation, but also the nitrate reduction by pathogenic bacteria infection in the pleural cavity. The nitrite/nitrate ratio could be a better biomarker in the differential diagnosis of PEs than the nitrite concentration alone. |
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| issn | 2076-3921 |
| language | English |
| last_indexed | 2024-03-09T12:20:07Z |
| publishDate | 2022-07-01 |
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| series | Antioxidants |
| spelling | doaj.art-b14c4ea6e5ad43be9d0673bd6023939c2023-11-30T22:42:27ZengMDPI AGAntioxidants2076-39212022-07-01117132710.3390/antiox11071327Elevated Nitrite/Nitrate Ratio as a Potential Biomarker for the Differential Diagnosis of Pleural EffusionsMu-Rong Chao0Yuan-Jhe Chang1Ying-Ming Shih2Jian-Lian Chen3Cheng-Chieh Yen4Chiung-Wen Hu5Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, TaiwanDepartment of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, TaiwanDivision of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, TaiwanSchool of Pharmacy, China Medical University, Taichung 404, TaiwanDepartment of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, TaiwanDepartment of Public Health, Chung Shan Medical University, Taichung 402, TaiwanPleural effusions (PEs) are common in clinical practice and can be due to many different underlying diseases such as cancer, congestive heart failure, or pneumonia. An accurate differential diagnostic categorization is essential, as the treatment and prognosis of PEs largely depend on its cause. In this study, we tested the hypothesis that nitrite and nitrate concentrations in PEs are associated with the inflammation and infection conditions. We therefore measured the nitrite and nitrate levels in 143 PE samples using a sensitive liquid chromatography-tandem mass spectrometry method and investigated their diagnostic potential in differentiating PEs. The results showed that nitrite concentrations and nitrite/nitrate ratios were higher in exudates than in transudates (NO<sub>2</sub><sup>−</sup>: 2.12 vs. 1.49 μM; NO<sub>2</sub><sup>−</sup>/NO<sub>3</sub><sup>−</sup>: 23.3 vs. 14.0). Both the nitrite concentrations and the nitrite/nitrate ratios were positively correlated with the three Light’s criteria. Moreover, the receiver operating characteristic curve analysis revealed that the nitrite/nitrate ratio with an area under the curve of 0.71 could be a potential diagnostic biomarker in separating infectious PEs (IPEs) from other types of PEs. Taken together, the nitrite/nitrate ratio not only reflected the statuses of inflammation, but also the nitrate reduction by pathogenic bacteria infection in the pleural cavity. The nitrite/nitrate ratio could be a better biomarker in the differential diagnosis of PEs than the nitrite concentration alone.https://www.mdpi.com/2076-3921/11/7/1327nitritenitrateexudatestransudatesinfectionLC-MS/MS |
| spellingShingle | Mu-Rong Chao Yuan-Jhe Chang Ying-Ming Shih Jian-Lian Chen Cheng-Chieh Yen Chiung-Wen Hu Elevated Nitrite/Nitrate Ratio as a Potential Biomarker for the Differential Diagnosis of Pleural Effusions Antioxidants nitrite nitrate exudates transudates infection LC-MS/MS |
| title | Elevated Nitrite/Nitrate Ratio as a Potential Biomarker for the Differential Diagnosis of Pleural Effusions |
| title_full | Elevated Nitrite/Nitrate Ratio as a Potential Biomarker for the Differential Diagnosis of Pleural Effusions |
| title_fullStr | Elevated Nitrite/Nitrate Ratio as a Potential Biomarker for the Differential Diagnosis of Pleural Effusions |
| title_full_unstemmed | Elevated Nitrite/Nitrate Ratio as a Potential Biomarker for the Differential Diagnosis of Pleural Effusions |
| title_short | Elevated Nitrite/Nitrate Ratio as a Potential Biomarker for the Differential Diagnosis of Pleural Effusions |
| title_sort | elevated nitrite nitrate ratio as a potential biomarker for the differential diagnosis of pleural effusions |
| topic | nitrite nitrate exudates transudates infection LC-MS/MS |
| url | https://www.mdpi.com/2076-3921/11/7/1327 |
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