A mobile instrumentation platform to distinguish airway disorders

Schivo, Michael; Seichter, Felicia; Aksenov, Alexander A.; Pasamontes, Alberto; Peirano, Daniel J.; Mizaikoff, Boris; Kenyon, Nicholas J.; Davis, Cristina E.

doi:10.1088/1752-7155/7/1/017113

Cited by 18 publications

(22 citation statements)

References 67 publications

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“…Differences in exhaled breath condensate signals may allow us to differentiate between subjects with and without asthma, and may further allow us to eventually differentiate asthma from other airway diseases such as chronic obstructive pulmonary disease. [148][149][150] In our own clinics at the University of California, Davis, we routinely use measures of FeNO, a known marker of eosinophilic airway inflammation, as one part of our assessment of the patient's control of disease based on the American Thoracic Society's published clinical practice guidelines published in 2011. The technology for measuring FeNO has also been standardized.…”

Section: Future Directions In Understaning Viruses Non-allergen Asthmentioning

confidence: 99%

Viruses and non-allergen environmental triggers in asthma

Chau-Etchepare

Hoerger

Kühn

et al. 2019

Journal of Investigative Medicine

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Asthma is a complex inflammatory disease with many triggers. The best understood asthma inflammatory pathways involve signals characterized by peripheral eosinophilia and elevated immunoglobulin E levels (called T2-high or allergic asthma), though other asthma phenotypes exist (eg, T2-low or non-allergic asthma, eosinophilic or neutrophilic-predominant). Common triggers that lead to poor asthma control and exacerbations include respiratory viruses, aeroallergens, house dust, molds, and other organic and inorganic substances. Increasingly recognized non-allergen triggers include tobacco smoke, small particulate matter (eg, PM2.5), and volatile organic compounds. The interaction between respiratory viruses and non-allergen asthma triggers is not well understood, though it is likely a connection exists which may lead to asthma development and/or exacerbations. In this paper we describe common respiratory viruses and non-allergen triggers associated with asthma. In addition, we aim to show the possible interactions, and potential synergy, between viruses and non-allergen triggers. Finally, we introduce a new clinical approach that collects exhaled breath condensates to identify metabolomics associated with viruses and non-allergen triggers that may promote the early management of asthma symptoms.

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Section: Future Directions In Understaning Viruses Non-allergen Asthmentioning

confidence: 99%

Viruses and non-allergen environmental triggers in asthma

Chau-Etchepare

Hoerger

Kühn

et al. 2019

Journal of Investigative Medicine

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“…Using gas chromatography coupled with a differential mobility spectrometer sensor (GC‐DMS) to analyse VOCs in the exhaled breath samples of 13 individuals with asthma, five subjects with COPD and 13 healthy controls, Schivo et al. demonstrated that it was possible to differentiate patients with asthma from healthy individuals. However, the most discriminant compounds in this analysis could not be identified because there was no analyte diagnostic library for the GC‐DMS methodology at the time of the study in spite of the parameters which could be used for species identification.…”

Section: Discussionmentioning

confidence: 99%

“…In the aforementioned study performed by Schivo et al. , the authors hypothesized that GC‐DMS could be used to differentiate between individuals with asthma and individuals with COPD, using VOC profiles. However, they observed that after analysing the VOC profiles, it was not possible to distinguish between COPD and asthma.…”

Section: Discussionmentioning

confidence: 99%

Volatile organic compounds in asthma diagnosis: a systematic review and meta‐analysis

Rufo

Madureira

Fernandes

et al. 2015

Allergy

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To cite this article: Cavaleiro Rufo J, Madureira J, Oliveira Fernandes E, Moreira A. Volatile organic compounds in asthma diagnosis: a systematic review and meta-analysis. AbstractWe aimed to assess the value and classification rate of exhaled volatile organic compounds (VOCs) in asthma diagnosis. A PRISMA-oriented systematic search for published studies regarding exhaled VOCs in asthma diagnosis was conducted based on predefined criteria. Studies presenting sensitivity and specificity values for the test were included in the meta-analysis. Pooled diagnosis odds ratios (DOR), area under the curve (AUC) and positive and negative likelihood ratios (LR) for exhaled VOC profiles were calculated; and publication bias, threshold effect and heterogeneity were estimated. Eighteen studies were selected for the qualitative analysis and six met the criteria for inclusion in the quantitative analysis. Mean (95% CI) pooled DOR, positive and negative LR were 49.3 (15.9-153.3), 5.86 (3.07-11.21) and 0.16 (0.10-0.26), respectively. The AUC value was 0.94. Only three of the 18 reviewed studies performed an external validation of the model using a different data set. The results from the revised studies suggest that exhaled VOCs are promising biomarkers for asthma diagnosis and that several compounds, mainly alkanes, may be significantly associated with asthma inflammation. However, there are still various constraints associated with standardization and externally validated studies are needed to introduce exhaled VOC profiling in a clinical scenario.

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“…GC-IMS allows the detection of VOCs down to ultratrace level (µg/L – to pg/L – range). For years, IMS has been used to discover potential discriminatory breath VOC in lung cancer,69 70 chronic obstructive pulmonary disease (COPD)71 72 and asthma 72. Sampling takes place using a Spiroscout spirometer.…”

Section: Breath Profilingmentioning

confidence: 99%

Assessment of breath volatile organic compounds in acute cardiorespiratory breathlessness: a protocol describing a prospective real-world observational study

et al. 2019

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IntroductionPatients presenting with acute undifferentiated breathlessness are commonly encountered in admissions units across the UK. Existing blood biomarkers have clinical utility in distinguishing patients with single organ pathologies but have poor discriminatory power in multifactorial presentations. Evaluation of volatile organic compounds (VOCs) in exhaled breath offers the potential to develop biomarkers of disease states that underpin acute cardiorespiratory breathlessness, owing to their proximity to the cardiorespiratory system. To date, there has been no systematic evaluation of VOC in acute cardiorespiratory breathlessness. The proposed study will seek to use both offline and online VOC technologies to evaluate the predictive value of VOC in identifying common conditions that present with acute cardiorespiratory breathlessness.Methods and analysisA prospective real-world observational study carried out across three acute admissions units within Leicestershire. Participants with self-reported acute breathlessness, with a confirmed primary diagnosis of either acute heart failure, community-acquired pneumonia and acute exacerbation of asthma or chronic obstructive pulmonary disease will be recruited within 24 hours of admission. Additionally, school-age children admitted with severe asthma will be evaluated. All participants will undergo breath sampling on admission and on recovery following discharge. A range of online technologies including: proton transfer reaction mass spectrometry, gas chromatography ion mobility spectrometry, atmospheric pressure chemical ionisation-mass spectrometry and offline technologies including gas chromatography mass spectroscopy and comprehensive two-dimensional gas chromatography-mass spectrometry will be used for VOC discovery and replication. For offline technologies, a standardised CE-marked breath sampling device (ReCIVA) will be used. All recruited participants will be characterised using existing blood biomarkers including C reactive protein, brain-derived natriuretic peptide, troponin-I and blood eosinophil levels and further evaluated using a range of standardised questionnaires, lung function testing, sputum cell counts and other diagnostic tests pertinent to acute disease.Ethics and disseminationThe National Research Ethics Service Committee East Midlands has approved the study protocol (REC number: 16/LO/1747). Integrated Research Approval System (IRAS) 198921. Findings will be presented at academic conferences and published in peer-reviewed scientific journals. Dissemination will be facilitated via a partnership with the East Midlands Academic Health Sciences Network and via interaction with all UK-funded Medical Research Council and Engineering and Physical Sciences Research Council molecular pathology nodes.Trial registration numberNCT03672994.

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A mobile instrumentation platform to distinguish airway disorders

Cited by 18 publications

References 67 publications

Viruses and non-allergen environmental triggers in asthma

Viruses and non-allergen environmental triggers in asthma

Volatile organic compounds in asthma diagnosis: a systematic review and meta‐analysis

Assessment of breath volatile organic compounds in acute cardiorespiratory breathlessness: a protocol describing a prospective real-world observational study

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