Altered exhaled biomarker profiles in children during and after rhinovirus-induced wheeze

Schee, Marc P. van der; Hashimoto, Simone; Schuurman, A.C.; Driel, Janine S. Repelaer van; Adriaens, Nora; Amelsfoort, Romy M. van; Snoeren, Tessa; Regenboog, Martine; Sprikkelman, A. B.; Haarman, Eric G.; Aalderen, W. M. C. van; Sterk, Peter J.

doi:10.1183/09031936.00044414

Cited by 47 publications

(60 citation statements)

References 37 publications

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“…The EUROPA birth cohort assessed whether acute preschool wheeze is associated with a distinct VOC profile . For this reason, breath profiles of 178 wheezing and non‐wheezing children were investigated using eNose.…”

Section: Current Statusmentioning

confidence: 99%

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Breathomics from exhaled volatile organic compounds in pediatric asthma

Neerincx

Vijverberg

Bos

et al. 2017

Pediatric Pulmonology

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Asthma is the most common chronic disease in children, and is characterized by airway inflammation, bronchial hyperresponsiveness, and airflow obstruction. Asthma diagnosis, phenotyping, and monitoring are still challenging with currently available methods, such as spirometry, F NO or sputum analysis. The analysis of volatile organic compounds (VOCs) in exhaled breath could be an interesting non-invasive approach, but has not yet reached clinical practice. This review describes the current status of breath analysis in the diagnosis and monitoring of pediatric asthma. Furthermore, features of an ideal breath test, different breath analysis techniques, and important methodological issues are discussed. Although only a (small) number of studies have been performed in pediatric asthma, of which the majority is focusing on asthma diagnosis, these studies show moderate to good prediction accuracy (80-100%, with models including 6-28 VOCs), thereby qualifying breathomics for future application. However, standardization of procedures, longitudinal studies, as well as external validation are needed in order to further develop breathomics into clinical tools. Such a non-invasive tool may be the next step toward stratified and personalized medicine in pediatric respiratory disease.

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Section: Current Statusmentioning

confidence: 99%

“…This group is relevant as rhinovirus induced wheeze is associated with a higher risk of an asthma diagnosis at school age. This could indicate that low grade pulmonary inflammation associated with asthma can be monitored by breath analysis enabling detection of the earliest signs of asthma …”

Section: Current Statusmentioning

confidence: 99%

Breathomics from exhaled volatile organic compounds in pediatric asthma

Neerincx

Vijverberg

Bos

et al. 2017

Pediatric Pulmonology

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“…The technique used to measure these compounds is usually gas chromatography coupled with mass spectrometry (GC-MS), and this method has been found to differentiate between adults with asthma, COPD, and healthy controls [16, 17]. In children with asthma, VOC analysis enabled prediction of subsequent exacerbations [18] and interestingly, young pre-school children with rhinovirus-induced wheeze were found to have altered exhaled biomarkers both during symptoms and after resolution, possibly reflecting the altered molecular profile which underlies an increased risk of developing asthma [19]. Breath analysis by eNose has even been found to predict response to steroids in patients with asthma more accurately than sputum eosinophils or FeNO [20].…”

Section: Exhaled Breathmentioning

confidence: 99%

Biomarkers for the Phenotyping and Monitoring of Asthma in Children

James

Hedlin

2016

Curr Treat Options Allergy

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Opinion statementAn important issue in relation to the utility and reliability of biomarkers for asthma monitoring is how asthma is defined and characterized. What kind of asthma, or at what stage of the disease is a particular biomarker supposed to add information? Often, the purpose, or usefulness of a biomarker is not made clear. Diagnosis, severity evaluation, and monitoring are all different clinical uses for a biomarker, and confusion may arise when a biomarker is suitable for one of these but not another. When the utility of available biomarkers are discussed, these different roles need to be clarified. Our opinion is that there are four aspects of relevance to asthma, for which biomarkers are required: to diagnose allergies, to evaluate inflammation in the airways, to evaluate hyper-responsiveness, and for certain measures of lung function, such as lung clearance index. These types of biomarkers are needed for the phenotyping and monitoring of asthma. Another important role for biomarkers is, as mentioned above, to monitor asthma in order to follow treatment effects on inflammation and hyper-responsiveness as objective adjuncts to the patients’ own symptom reports and lung function. This review will mainly focus on biomarkers that reflect airway inflammation. In spite of the numerous studies that have been conducted, we still have to remember that the value of biomarkers available for routine use, such as eosinophil counts in blood and sputum and exhaled nitric oxide, have to be interpreted in relation to reported symptoms and lung function. Measures of bronchial hyper-responsiveness, performed either by direct (methacholine challenge) or indirect (exercise or mannitol challenge) methods, could be considered biomarkers but will not be included in this review. On the other hand, diagnosing allergy is not usually useful for monitoring asthma although it is of fundamental importance for the interpretation of most biomarkers that are suitable for monitoring. We have therefore included the different approaches for diagnosing and evaluating allergic sensitization in this review.

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“…Furthermore, children with preschool wheeze have different VOC profile when compared with healthy children [18], as a possible consequence of a prolonged inflammatory response associated with viral infection. In order to challenge if acute preschool wheeze is accompanied by a differential VOC profile and if this profile is maintained after resolution of symptoms in children with rhinoviruses infection, VAN DER SCHEE et al [19] assessed exhaled VOC in 81 wheezy children during and after recovery of an acute episode of the lower respiratory tract and in 97 controls. Wheezy children showed a significantly different VOC profile compared with controls, regardless of the presence or absence of rhinoviruses infection.…”

Section: Viral Wheeze Exhaled Biomarker Profiles and Prediction Of Amentioning

confidence: 99%

Asthma in childhood

Benedictis

Attanasi

2016

Eur Respir Rev

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Several topics on childhood asthma were addressed in the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress. With regard to the relationship between lower respiratory tract infections and asthma, it emerges that is the number of respiratory episodes in the first years of life, but not the particular viral trigger, to be associated with later asthma development. Understanding which characteristics of individual patients are associated with an increased risk for asthma exacerbation is a critical step to implement strategies preventing these seasonal events. Recent data suggest the possibility that exhaled volatile organic compounds may qualify as biomarkers in detecting early signs of asthma. Adding information of exhaled volatile organic compounds and expression of inflammation genes to a clinical tool significantly improves asthma prediction in preschool wheezy children. Personal communication with children and adolescents is likely more important than the tools actually used for monitoring asthma. Systemic corticosteroids do not affect the long-term prognosis in children with first viral-induced wheezing episode and should be used cautiously during acute episodes. Finally, stress and a polymorphism upstream of a specific gene are both associated with reduced bronchodilator response in children with asthma. @ERSpublications New research reports must be integrated into medical communication to assist clinicians to improve asthma management http://ow.ly/XACHS

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Altered exhaled biomarker profiles in children during and after rhinovirus-induced wheeze

Cited by 47 publications

References 37 publications

Breathomics from exhaled volatile organic compounds in pediatric asthma

Breathomics from exhaled volatile organic compounds in pediatric asthma

Biomarkers for the Phenotyping and Monitoring of Asthma in Children

Asthma in childhood

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