Exhaled breath condensate volatilome allows sensitive diagnosis of persistent asthma

Rufo, João Cavaleiro; Paciência, Inês; Mendes, Francisca de Castro; Farraia, Mariana; Rodolfo, Ana; Silva, Diana; Fernandes, Eduardo de Oliveira; Delgado, Luís; Moreira, André

doi:10.1111/all.13596

Cited by 35 publications

(23 citation statements)

References 37 publications

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“…In addition, a combination of multiple biomarkers may be useful to identify comprehensive individual signatures in ILD patients, which leads to a more personalized medicine [11]. Moreover, exhaled breath-based methods have been studied in the past decades for their applicability in the assessment of airway inflammation and as possible diagnostic tools in several inflammatory lung diseases, e.g., asthma or COPD [26,27]. In this case, a large number of biomarkers in breath have been examined as possible indicators of inflammation, to diagnose and monitor the diseases as well as to evaluate the response to treatment [28].…”

Section: Discussionmentioning

confidence: 99%

Exploring the Ability of Electronic Nose Technology to Recognize Interstitial Lung Diseases (ILD) by Non-Invasive Breath Screening of Exhaled Volatile Compounds (VOC): A Pilot Study from the European IPF Registry (eurIPFreg) and Biobank

Krauss

Haberer

Maurer

et al. 2019

JCM

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Background: There is an increasing interest in employing electronic nose technology in the diagnosis and monitoring of lung diseases. Interstitial lung diseases (ILD) are challenging in regard to setting an accurate diagnosis in a timely manner. Thus, there is a high unmet need in non-invasive diagnostic tests. This single-center explorative study aimed to evaluate the usefulness of electronic nose (Aeonose®) in the diagnosis of ILDs. Methods: Exhaled volatile organic compound (VOC) signatures were obtained by Aeonose® in 174 ILD patients, 23 patients with chronic obstructive pulmonary disease (COPD), and 33 healthy controls (HC). Results: By dichotomous comparison of VOC’s between ILD, COPD, and HC, a discriminating algorithm was established. In addition, direct analyses between the ILD subgroups, e.g., cryptogenic organizing pneumonia (COP, n = 28), idiopathic pulmonary fibrosis (IPF, n = 51), and connective tissue disease-associated ILD (CTD-ILD, n = 25) were performed. Area under the Curve (AUC) and Matthews’s correlation coefficient (MCC) were used to interpret the data. In direct comparison of the different ILD subgroups to HC, the algorithms developed on the basis of the Aeonose® signatures allowed safe separation between IPF vs. HC (AUC of 0.95, MCC of 0.73), COP vs. HC (AUC 0.89, MCC 0.67), and CTD-ILD vs. HC (AUC 0.90, MCC 0.69). Additionally, to a case-control study design, the breath patterns of ILD subgroups were compared to each other. Following this approach, the sensitivity and specificity showed a relevant drop, which results in a poorer performance of the algorithm to separate the different ILD subgroups (IPF vs. COP with MCC 0.49, IPF vs. CTD-ILD with MCC 0.55, and COP vs. CT-ILD with MCC 0.40). Conclusions: The Aeonose® showed some potential in separating ILD subgroups from HC. Unfortunately, when applying the algorithm to distinguish ILD subgroups from each other, the device showed low specificity. We suggest that artificial intelligence or principle compound analysis-based studies of a much broader data set of patients with ILDs may be much better suited to train these devices.

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Section: Discussionmentioning

confidence: 99%

Exploring the Ability of Electronic Nose Technology to Recognize Interstitial Lung Diseases (ILD) by Non-Invasive Breath Screening of Exhaled Volatile Compounds (VOC): A Pilot Study from the European IPF Registry (eurIPFreg) and Biobank

Krauss

Haberer

Maurer

et al. 2019

JCM

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“…Rufo et al . developed a hierarchical model through the use of an electronic nose that analyzed exhaled breath condensate VOCs from children, being able to discriminate children with asthma, defined by medical diagnosis, and those with persistent asthma, based on corticosteroid therapy [52]. Another study conducted in children, revealed that 8 volatile organic compounds were increased in EBC of children with asthma [53].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children

et al. 2019

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Detection and quantification of microRNAs (miRNAs) in exhaled breath condensate (EBC) has been poorly explored. Therefore we aimed to assess miRNAs in EBC as potential biomarkers to diagnose and endotype asthma in school aged children. In a cross sectional, nested case control study, all the asthmatic children (n = 71) and a random sample of controls (n = 115), aged 7 to 12 years, attending 71 classrooms from 20 local schools were selected and arbitrarily allocated to the development or validation set. Participants underwent skin-prick testing, spirometry with bronchodilation, had exhaled level of nitric oxide determined and EBC collected. Based on previous studies eleven miRNAs were chosen and analyzed in EBC by reverse transcription-quantitative real-time PCR. Principal component analysis was applied to identify miRNAs profiles and associations were estimated using regression models. In the development set (n = 89) two clusters of miRNAs were identified. After adjustments, cluster 1 and three of its clustered miRNAs, miR-126-3p, miR-133a-3p and miR-145-5p were positively associated with asthma. Moreover miR-21-5p was negatively associated with symptomatic asthma and positively associated with positive bronchodilation without symptoms. An association was also found between miR-126-3p, cluster 2 and one of its clustered miRNA, miR-146-5p, with higher FEF25-75 reversibility. These findings were confirmed in the validation set (n = 97) where two identical clusters of miRNAs were identified. Additional significant associations were observed between miR-155-5p with symptomatic asthma, negative bronchodilation with symptoms and positive bronchodilation without symptoms. We showed that microRNAs can be measured in EBC of children and may be used as potential biomarkers of asthma, assisting asthma endotype establishment.

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“…This tool has the potential to assess asthma control and tailoring asthma treatment 147,148 . In a study including participants between 6 and 18 years of age, Cavaleiro Rufo et al showed that the exhaled breath condensate volatilome analysis by an eNose has good accuracy for asthma identification being able to distinguish individuals with diagnosed pediatric asthma from those without the disease 149 . Farraia et al demonstrated that the analysis of the exhaled volatile organic compounds profiles using an eNose could be used as a fast and noninvasive complementary assessment tool for the detection of uncontrolled asthma 147 .…”

Section: Asthma Diagnosis Precision Medicine and Biomarkersmentioning

confidence: 99%

Advances and recent developments in asthma in 2020

Cevhertas

Öğülür

Maurer

et al. 2020

Allergy

102

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In this review, we discuss recent publications on asthma and review the studies that have reported on the different aspects of the prevalence, risk factors and prevention, mechanisms, diagnosis, and treatment of asthma. Many risk and protective factors and molecular mechanisms are involved in the development of asthma. Emerging concepts and challenges in implementing the exposome paradigm and its application in allergic diseases and asthma are reviewed, including genetic and epigenetic factors, microbial dysbiosis, and environmental exposure, particularly to indoor and outdoor substances. The most relevant experimental studies further advancing the understanding of molecular and immune mechanisms with potential new targets for the development of therapeutics are discussed. A reliable diagnosis of asthma, disease endotyping, and monitoring its severity are of great importance in the management of asthma. Correct evaluation and management of asthma comorbidity/ multimorbidity, including interaction with asthma phenotypes and its value for the precision medicine approach and validation of predictive biomarkers, are further detailed. Novel approaches and strategies in asthma treatment linked to mechanisms and endotypes of asthma, particularly biologicals, are critically appraised. Finally, due to the recent pandemics and its impact on patient management, we discuss the challenges, relationships, and molecular mechanisms between asthma, allergies, SARS-CoV-2, and COVID-19.

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Exhaled breath condensate volatilome allows sensitive diagnosis of persistent asthma

Abstract: Analysis of the exhaled breath condensate volatilome allowed the distinction of paediatric individuals with a medical diagnosis of asthma, identifying those in need of corticosteroid therapy.

Cited by 35 publications

References 37 publications

Exploring the Ability of Electronic Nose Technology to Recognize Interstitial Lung Diseases (ILD) by Non-Invasive Breath Screening of Exhaled Volatile Compounds (VOC): A Pilot Study from the European IPF Registry (eurIPFreg) and Biobank

Exploring the Ability of Electronic Nose Technology to Recognize Interstitial Lung Diseases (ILD) by Non-Invasive Breath Screening of Exhaled Volatile Compounds (VOC): A Pilot Study from the European IPF Registry (eurIPFreg) and Biobank

Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children

Advances and recent developments in asthma in 2020

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