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Gerard M. Turino, MD
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From the Department of Medicine, St. Luke’s Roosevelt Hospital Center.

Correspondence to: Gerard M. Turino, MD, Department of Medicine, St. Luke’s Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 100 Tenth Ave, Mara Center, 3rd Floor, New York, NY 10019; e-mail: gmt1@columbia.edu


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(4):1120. doi:10.1378/chest.11-2923
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To the Editor:

I thank Dr Spanbroek and colleagues for their comments on our recent article in CHEST.1 We chose two cohorts for the study because we had the opportunity to do so and could not predict the results. In fact, as pointed out, the cohorts were quite different in composition in terms of sex predominance and age variations and showed results, consistent in both cohorts, of significant increases in plasma levels of desmosine and isodesmosine (D/I) in subjects exposed to secondhand smoke. We are not aware of data showing differences between men and women in levels of D/I in normal subjects. There may be a relation between aging and increases in D/I in plasma in normal subjects, but we have not observed such a correlation in the current data available to us or in currently published studies. Larger series of studies of normal subjects of various ages may show such a relation to age, which has been suggested in aging rats.2

None of the secondhand smoke-exposed subjects were former smokers. The active smokers in both cohorts were free of respiratory symptoms and were considered to be in normal health.

The measurements of D/I in the subjects exposed to secondhand smoke were not only an average of two analyses but were based on recoveries of known amounts of spiked samples of plasma. This greatly improved accuracy and repeatability. Subsequent analyses using the pyridinoline standard3 showed acceptable similarities when compared with our previously published measurements.

A stable deuterium isotope, which is not yet available, is the ideal internal standard. We are in the process of synthesizing this standard (Yamada et al, unpublished data, November 2011). The deuterium used in the reference cited by the respondents was made by ion exchange reaction, which is not stable during hydrolysis. As pointed out, I agree that D/I remain an interesting marker for the evaluation of elastin breakdown and have so stated in a recent publication.4

Slowik N, Ma S, He J, et al. The effect of secondhand smoke exposure on markers of elastin degradation. Chest. 2011;1404:946-953 [CrossRef] [PubMed]
 
Atanasova M, Konova E, Georgieva M, et al. Age-related changes of anti-elastin antibodies in senescence-accelerated mice. Gerontology. 2010;563:310-318 [CrossRef] [PubMed]
 
Ma S, Turino GM, Lin YY. Quantitation of desmosine and isodesmosine in urine, plasma, and sputum by LC-MS/MS as biomarkers for elastin degradation. J Chromatogr B Analyt Technol Biomed Life Sci. 2011;87921:1893-1898 [CrossRef] [PubMed]
 
Turino GM, Ma S, Lin YY, Cantor JO, Luisetti M. Matrix elastin: a promising biomarker for COPD. Am J Respir Crit Care Med. 2011;1846:637-641 [CrossRef] [PubMed]
 

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References

Slowik N, Ma S, He J, et al. The effect of secondhand smoke exposure on markers of elastin degradation. Chest. 2011;1404:946-953 [CrossRef] [PubMed]
 
Atanasova M, Konova E, Georgieva M, et al. Age-related changes of anti-elastin antibodies in senescence-accelerated mice. Gerontology. 2010;563:310-318 [CrossRef] [PubMed]
 
Ma S, Turino GM, Lin YY. Quantitation of desmosine and isodesmosine in urine, plasma, and sputum by LC-MS/MS as biomarkers for elastin degradation. J Chromatogr B Analyt Technol Biomed Life Sci. 2011;87921:1893-1898 [CrossRef] [PubMed]
 
Turino GM, Ma S, Lin YY, Cantor JO, Luisetti M. Matrix elastin: a promising biomarker for COPD. Am J Respir Crit Care Med. 2011;1846:637-641 [CrossRef] [PubMed]
 
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