Molekulární diagnostika bronchiálního astmatu založená na obsahu cysteinylovaných leukotrienů a lipoxinů v kondenzátu vydechovaného vzduchu
Klíčová slova:bronchiální astma, molekulární diagnostika, vysokoúčinná kapalinová chromatografie, hmotnostní spektrometrie, lipoxiny, cysteinylované leukotrieny
This work was engaged to enhancing the diagnostics of bronchial asthma, with the main emphasis on non-invasive approaches, effective differentiation and phenotypic background. In particular, a methodology is described, based on monitoring of a highly specific matrix - exhaled breath condensate (EBC), applied to asthma patients. The previous method, based on the biomarkers of cysteinyl leukotrienes, was extended with anti-asthmatic lipoxines, yielding a novel correlation to different asthma phenotypes. Moreover, inverse relationship between the pro-inflammatory and anti-inflammatory biomarkers was found and herein depicted. The developed methodology was used in a clinical study, which confirmed its applicability for asthma phenotyping. The method also enables differentiating a severe form of refractory asthma, i.e. asthma irresponsive to any kind of currently available pharmacotherapy. It was also proved that the method can be used for monitoring of the disease genesis and the efficiency of an administered pharmacotherapy. Finally, the method allows a reliable differentiation of asthma and chronical obstructive pulmonary disease.