Changes in urinary glutathione sulfonamide (GSA) levels between admission and discharge of patients with cystic fibrosis

Tamara L Blake; Peter D Sly; Isabella Andersen; Claire E Wainwright; David W Reid; Scott C Bell; Briana R Smith; Anthony J Kettle; Nina Dickerhof

doi:10.1016/j.jcf.2024.04.009

Changes in urinary glutathione sulfonamide (GSA) levels between admission and discharge of patients with cystic fibrosis

J Cyst Fibros. 2024 Apr 23:S1569-1993(24)00054-7. doi: 10.1016/j.jcf.2024.04.009. Online ahead of print.

Authors

Tamara L Blake¹, Peter D Sly², Isabella Andersen², Claire E Wainwright³, David W Reid⁴, Scott C Bell⁵, Briana R Smith⁶, Anthony J Kettle⁶, Nina Dickerhof⁶

Affiliations

¹ Children's Health and Environment Program, Child Health Research Centre, University of Queensland, 62 Graham St, South Brisbane, Australia, 4101. Electronic address: t.blake@uq.edu.au.
² Children's Health and Environment Program, Child Health Research Centre, University of Queensland, 62 Graham St, South Brisbane, Australia, 4101.
³ Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, 501 Stanley St, South Brisbane, Australia, 4101.
⁴ Department of Thoracic Medicine, The Prince Charles Hospital, Staib Rd, Chermside, Australia, 4032.
⁵ Department of Thoracic Medicine, The Prince Charles Hospital, Staib Rd, Chermside, Australia, 4032; Translational Research Institute, 37 Kent St, Woolloongabba, Australia, 4102.
⁶ Mātai Hāora - Centre for Redox Biology, Department of Pathology and Biomedical Science, University of Otago Christchurch, New Zealand, 8140.

PMID: 38658253
DOI: 10.1016/j.jcf.2024.04.009

Abstract

There is an urgent need to develop sensitive, non-invasive biomarkers that can track airway inflammatory activity for patients with cystic fibrosis (CF). Urinary glutathione sulfonamide (GSA) levels correlate well with GSA levels in BAL samples and other markers of neutrophilic inflammation, suggesting that this biomarker may be suitable for tracking disease activity in this population. We recruited 102 children (median 11.5 years-old) and 64 adults (median 32.5 years-old) who were admitted to hospital for management of an acute pulmonary exacerbation and/or eradication of infectious agents such as Pseudomonas aeruginosa or Staphylococcus aureus. Our aim was to explore how urinary GSA levels changed across admission timepoints. Urine samples were collected at admission and discharge, and GSA measured by liquid chromatography with mass spectrometry. Paired admission-discharge results were compared using Wilcoxon signed-rank test. Paired admission-discharge samples were available for 53 children and 60 adults. A statistically significant difference was observed between admission-discharge for children and adults. Spearman's correlation analysis identified a correlation between urinary GSA levels and sex and S. aureus infection for children only. Our preliminary findings suggest that urinary GSA is responsive to the resolution of an acute pulmonary exacerbation and therefore warrants further studies in this population.

Keywords: Adults; Children; Cystic fibrosis; Exacerbation; Glutathione sulfonamide; Oxidative stress.