Exhaled Breath Condensate: An Overview

Hunt, J.F.

doi:10.1016/j.iac.2007.09.001

Cited by 145 publications

(115 citation statements)

References 19 publications

(25 reference statements)

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“…This ALF is believed to have been derived from the respiratory surface lining fluids when energy from air turbulence vibrates the respiratory wall, and creates ne bulised droplets. ALF droplets may also be released when closed airway or alveoli suddenly open during inspiration, providing energy to overcome surface tension [ 3 ]. The constituents of ALF are assumed to represent the respiratory tree lining fluids and their relative percentage is the essence of EBC studies.…”

Section: Methodological Issues Of Ebc Origins Of Ebcmentioning

confidence: 99%

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Exhaled breath condensate: a comprehensive update

Ahmadzai

Huang²,

Hettiarachchi³

et al. 2013

Clinical Chemistry and Laboratory Medicine

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Since the late 1990s, a surge in interest in the analysis of exhaled breath condensate (EBC) resulted in the American Thoracic Society and European Respiratory Society (ATS/ERS) organising a Task Force in 2001 to develop guidelines on EBC collection and measurement of biomarkers. This Task Force published their guidelines in 2005 based on literature and expert opinions at that time, and multiple shortcomings and knowledge deficits were also identified. The clinical application of EBC collection and its biomarkers are currently still limited by several of these knowledge gaps, hence further guidelines for standardisation are required to ensure external validity. Using related articles produced since the publication of the ATS/ERS Task Force report, this paper attempts to provide a comprehensive update to the original guideline and review the methodological shortcomings identified. This review can hopefully serve as a yardstick for future studies involving this emerging clinical tool.

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Section: Methodological Issues Of Ebc Origins Of Ebcmentioning

confidence: 99%

“…It is thought that these indicators are redundant when multiple biomarkers are measured concurrently, as their ratios may serve as a reference or when a highly sensitive and specific assay is used [ 3 ]. Currently, many laboratories have yet to incorporate this complicated calculation method in their studies [ 21 ].…”

Section: Dilution Reference Indicatorsmentioning

confidence: 99%

Exhaled breath condensate: a comprehensive update

Ahmadzai

Huang²,

Hettiarachchi³

et al. 2013

Clinical Chemistry and Laboratory Medicine

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“…The collection of exhaled breath condensate (EBC) is a non-invasive method for obtaining samples from fluids lining the respiratory surfaces. Condensed exhaled breath is a promising source in which biomarkers of respiratory diseases may be identified (6).…”

Section: Introductionmentioning

confidence: 99%

Proteomics of exhaled breath: methodological nuances and pitfalls

Kurova¹,

Анаев²,

Kononikhin³

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: The analysis of exhaled breath condensate (EBC) can be an alternative to traditional endoscopic sampling of lower respiratory tract secretions. This is a simple non-invasive method of diagnosing respiratory diseases, in particular, respiratory inflammatory processes. Methods: Samples were collected with a special device-condenser (ECoScreen, VIASYS Healthcare, Germany), then treated with trypsin according to the proteomics protocol for standard protein mixtures and analyzed by nanoflow high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) with a 7-Tesla Finnigan LTQ-FT mass spectrometer (Thermo Electron, Germany). Mascot software (Matrixscience) was used for screening the database NCBInr for proteins corresponding to the peptide maps that were obtained. Results: EBCs from 17 young healthy non-smoking donors were collected. Different methods for concentrating protein were compared in order to optimize EBC preparations for proteomic analysis. The procedure that was chosen allowed identification of proteins exhaled by healthy people. The major proteins in the condensates were cytoskeletal keratins. Another 12 proteins were identified in EBC from healthy non-smokers. Some keratins were found in the ambient air and may be considered exogenous components of exhaled air. Conclusions: Knowledge of the normal proteome of exhaled breath allows one to look for biomarkers of different disease states in EBC. Proteins in ambient air can be identified in the respiratory tract and should be excluded from the analysis of the proteome of EBC. The results obtained allowed us to choose the most effective procedure of sample preparation when working with samples containing very low protein concentrations. Clin Chem Lab Med 2009;47:706-12.

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“…Furthermore, analysis of the components of exhaled breath condensate (EBC) such as airway pH or oxidative-related mediators may assess airway inflammation although there are still problems of dilution repeatability and reproducibility that preclude their use in clinical trials [5]. EBC is easy to collect noninvasively during normal tidal breathing for 10 minutes.…”

Section: Outcomes In Asthma Trialsmentioning

confidence: 99%

Innovations in Outcomes and Designs of Clinical Trials for Respiratory Drug Development

Lins¹

2017

J Clin Respir Dis Care

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Clinical trials for the development of respiratory drugs have for years been reliant upon measurements of physiologic tests, combined with the use of questionnaires. New drugs were mostly administered by inhalation and increasingly in fixed combinations. However, these lung function tests have a lack of sensitivity for patient-relevant clinical outcomes. Moreover, new insights in phenotypes and endotypes of these diseases in the basic mechanisms and the discovery of new targets for therapy, have led to the need for a more personalized patient-centered approach and precision medicine.In recent years, a great number of techniques have been proposed but some need further validation. These include fractional exhaled nitric oxide, health-related quality of life and the use of biomarkers like blood and sputum eosinophils and neutrophils, IgE, sIgE, periostin, copeptin and specific cytokines. Additionally, exhaled breath condensate and lung deposition studies by functional residual imaging and by local bronchial pharmacokinetics can be used. In rare diseases like cystic fibrosis, Lung Clearance Index and CT and PET scan fusion images seem to be valuable outcome measurements. Lastly leverage of lung function tests can be done by using body plethysmography, measuring respiratory impedance, variability and the use of modeling and simulation.The need for a patient-centric approach through all stages of clinical development is becoming mandatory. So, an evolution from classical randomized clinical trials (RCTs) to more efficient and patient-relevant designs will be seen more in the future. RCTs will remain necessary for regulatory submission but more efficient and adaptive designs with lower heterogeneity and the use of pragmatic trials are needed. This evolution from undefined targets to a more targeted approach will lead us closer to precision medicine.In this overview, the unmet medical need for better outcomes and study designs in the development of treatments for respiratory diseases, are discussed.

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Exhaled Breath Condensate: An Overview

Cited by 145 publications

References 19 publications

Exhaled breath condensate: a comprehensive update

Exhaled breath condensate: a comprehensive update

Proteomics of exhaled breath: methodological nuances and pitfalls

Innovations in Outcomes and Designs of Clinical Trials for Respiratory Drug Development

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