Breathomics from exhaled volatile organic compounds in pediatric asthma

Abstract

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.

Enhancing Disease Diagnosis: Biomedical Applications of Surface-Enhanced Raman Scattering

“…Although eNose provides breathprints that can be used to detect asthma and chronic obstructive pulmonary disease (COPD) [136], it does not identify individual VOC markers within a complex mixture. Ion mobility spectrometry (IMS) is a relatively sensitive method though it is destructive, may not be ideal for complex VOC mixtures and its long term reproducibility is yet to be demonstrated [137]. Currently, GC-MS is the gold standard for global profiling of exhaled VOCs related to abnormal metabolism and extrapolated to cancers, diabetes etc.…”

Precision Medicine in Childhood Asthma: Omic Studies of Treatment Response

“…Additionally, since the lung microbiome is difficult to sample, the nasal, the salivary, or even the gut microbiome could be examined as non-invasive alternatives to the lung microbiome due to the relationship between the upper and the lower airways [84,85] and the gut-lung axis [72]. Although proteomics and breathomics have been used for profiling of asthma [60,86,87], during the reviewed period, no study has been focused on treatment response in children with asthma. Breathomics and sputum or salivary proteomics could be straightforwardly applicable in the clinics in terms of non-invasiveness, which provides an outstanding benefit in the management of pediatric asthma.…”

“…High-throughput analytical techniques, such as mass spectrophotometry, nuclear magnetic resonance, or spectroscopic methods, allow the characterizing of metabolites in invasive samples like blood and in non-invasive ones such as exhaled air (breathomics). This recent omic has been successfully applied for the profiling of asthma [59][60][61] and may contribute to understanding asthma treatment response.…”

Asthma breathomics—promising biomarkers in need of validation

“…It would seem then that the review by Neerincx et al succeeded in capturing the majority of relevant literature; the additionally identified study adds little to their findings. The abstracts identified by our search present results largely relating to the ability of VOCs to differentiate between states of disease control, the results of which were conflicting.…”

“…I read with interest the engaging review by Neerincx et al—Breathomics from exhaled volatile organic compounds (VOCs) in pediatric asthma. The results are encouraging suggesting good predictive accuracy for VOC profiles in asthma diagnosis.…”