Development of breath test for pneumoconiosis: a case-control study

Abstract

BackgroundLipid peroxidation plays an important role in the pathogenesis of pneumoconiosis. Volatile organic compounds (VOCs) generated from lipid peroxidation might be used to detect pneumoconiosis. The objective of this study was to develop a breath test for pneumoconiosis.MethodsA case-control study was designed. Breath and ambient air were analysed by gas chromatography/mass spectrometry. After blank correction to prevent contamination from ambient air, we used canonical discriminant analysis (CDA) to assess the discrimination accuracy and principal component analysis (PCA) to generate a prediction score. The prediction accuracy was calculated and validated using the International Classification of Radiographs of the Pneumoconiosis criteria combined with an abnormal pulmonary function test as a reference standard. We generated a receiver operator characteristic (ROC) curve and calculated the area under the ROC curve (AUC) to estimate the screening accuracy of the breath test.ResultsWe enrolled 200 stone workers. After excluding 5 subjects with asthma and 16 subjects who took steroids or nonsteroidal anti-inflammatory drugs, a total of 179 subjects were used in the final analyses, which included 25 cases and 154 controls. By CDA, 88.8% of subjects were correctly discriminated by their exposure status and the presence of pneumoconiosis. After excluding the VOCs of automobile exhaust and cigarette smoking, pentane and C5-C7 methylated alkanes constituted the major VOCs in the breath of persons with pneumoconiosis. Using the prediction score generated from PCA, the ROC-AUC was 0.88 (95% CI = 0.80—0.95), and the mean ROC-AUC of 5-fold cross-validation was 0.90. The breath test had good accuracy for pneumoconiosis diagnosis.ConclusionThe analysis of breath VOCs has potential in the screening of pneumoconiosis for its non-invasiveness and high accuracy. We suggest that a multi-centre study is warranted and that all procedures must be standardized before clinical application.

Biomarker Metabolites Discriminate between Physiological States of Field, Cave and White-nose Syndrome Diseased Bats

“…Lawal et al [ 52 ] studied VOC signatures from volatile emissions derived from the co-culture of lung epithelial cell line with bacterial pathogen Pseudomonas aeruginosa and found several alkanes associated with immune responses. Yang et al [ 53 ] found that lipid peroxidation-induced pentane and C5–C7 methylated alkanes constituted a specific fingerprint in the breath of pneumoconiosis patients. If induction of alkane emissions as an indicator of immune operation applies to similar physiological activities in Pd-infected bats, the higher emissions of methylated and ethylated alkanes in active bats might provide a chemical indicator of greater immune activity operating in healthy field bats than are measured in torpid WNS-diseased bats with altered immune responses.…”

Recent Advances in Targeting Clinical Volatile Organic Compounds (VOC)

“…An alternative to metal canisters, glass containers have been used for sampling breath [6]. Despite their fragility, they can be more performant than Tedlar bags as reporter by Scott-Thomas et al [7].…”

“…The high-speed MS detector time of flight (TOF) is often used as a detector for the GC × GC. Using MS with GC × GC separation (6) to detector (7). With permission from [35].…”

Breathomics for the clinician: the use of volatile organic compounds in respiratory diseases

“…Exhaled breath VOCs have been utilised in various other respiratory illnesses, nearly 90% of 25 patients with Pneumoconiosis were discriminated by their breath profile (ROC-AUC 0.88) 93 .…”