Exhaled air molecular profiling in relation to inflammatory subtype and activity in COPD

Fens, Niki; Nijs, Selma B. de; Peters, Stephen P.; Dekker, Tamara; Knobel, Hugo H.; Vink, T. J.; Willard, N. P.; Zwinderman, A. H.; Krouwels, Frans H.; Janssen, Hans‐Gerd; Lutter, René; Sterk, Peter J.

doi:10.1183/09031936.00032911

Cited by 127 publications

(121 citation statements)

References 49 publications

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“…Patterns of exhaled volatile organic compounds also differ between asthmatics with fixed airflow limitation and patients with chronic obstructive pulmonary disease supporting their potential in the phenotyping of severe asthma [72,73]. Finally, exhaled nitric oxide fraction (FeNO) has been extensively evaluated in mild-to-moderate asthma and the ATS has recently published specific guidelines for FeNO use in these patients [74].…”

Section: Inflammation and Adaptive Immunitymentioning

confidence: 99%

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

et al. 2013

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Severe or therapy-resistant asthma is increasingly recognised as a major unmet need. A Task Force, supported by the European Respiratory Society and American Thoracic Society, reviewed the definition and provided recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults.A literature review was performed, followed by discussion by an expert committee according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach for development of specific clinical recommendations.When the diagnosis of asthma is confirmed and comorbidities addressed, severe asthma is defined as asthma that requires treatment with high dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming “uncontrolled” or that remains “uncontrolled” despite this therapy. Severe asthma is a heterogeneous condition consisting of phenotypes such as eosinophilic asthma. Specific recommendations on the use of sputum eosinophil count and exhaled nitric oxide to guide therapy, as well as treatment with anti-IgE antibody, methotrexate, macrolide antibiotics, antifungal agents and bronchial thermoplasty are provided.Coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy.

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Section: Inflammation and Adaptive Immunitymentioning

confidence: 99%

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

et al. 2013

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“…Exhaled VOCs can be of systemic origin, can be produced in the lung (e.g. under influence of oxidative stress and inflammatory response) or can be the result of bacterial metabolism [16][17][18][19][20][21]. Pre-clinical studies provide evidence that lung injury induces changes in exhaled metabolites [17,22].…”

Section: Introductionmentioning

confidence: 99%

Exhaled breath metabolomics as a noninvasive diagnostic tool for acute respiratory distress syndrome

et al. 2014

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There is a need for biological markers of the acute respiratory distress syndrome (ARDS). Exhaled breath contains hundreds of metabolites in the gas phase, some of which reflect (patho)physiological processes. We aimed to determine the diagnostic accuracy of metabolites in exhaled breath as biomarkers of ARDS.Breath from ventilated intensive care unit patients (n5101) was analysed using gas chromatography and mass spectrometry during the first day of admission. ARDS was defined by the Berlin definition. Training and temporal validation cohorts were used.23 patients in the training cohort (n553) had ARDS. Three breath metabolites, octane, acetaldehyde and 3-methylheptane, could discriminate between ARDS and controls with an area under the receiver operating characteristic curve (AUC) of 0.80. Temporal external validation (19 ARDS cases in a cohort of 48) resulted in an AUC of 0.78. Discrimination was insensitive to adjustment for severity of disease, a direct or indirect cause of ARDS, comorbidities, or ventilator settings. Combination with the lung injury prediction score increased the AUC to 0.91 and improved net reclassification by 1.17.Exhaled breath analysis showed good diagnostic accuracy for ARDS, which was externally validated. These data suggest that exhaled breath analysis could be used for the diagnostic assessment of ARDS. @ERSpublications Metabolites in the breath of ventilated patients may be used to diagnose the acute respiratory distress syndrome

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“…E-nose breathprints correlate strongly with airway inflammation, as identified by measuring sputum inflammatory markers [15]. Montuschi and colleagues' cited recent evidence of an e-nose identifying unique patterns to distinguish COPD from asthma [14 •• ].…”

Section: Diagnosismentioning

confidence: 99%

New Technologies in COPD Management

Spencer¹,

Barcomb²

2014

Curr Emerg Hosp Med Rep

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Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating disease that affects millions of Americans. Numerous technological advances have been made recently in this field. This article reviews the use of novel technologies in COPD patients, focusing on the medical literature from 2013. These advances affect the diagnosis, the management of acute exacerbations, and the long-term, outpatient care of this condition. Diagnostic advances are examined such as novel applications of computed tomography, plethysmography, and analysis of the breath. Acute interventions include oxygen therapy, extracorporeal gas exchange, and molecular or nanotechnology. Finally, a preponderance of recent literature focuses on telemedicine to facilitate monitoring and treatment. Emerging technologies have a significant potential to positively impact patient care.

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Exhaled air molecular profiling in relation to inflammatory subtype and activity in COPD

Cited by 127 publications

References 49 publications

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

Exhaled breath metabolomics as a noninvasive diagnostic tool for acute respiratory distress syndrome

New Technologies in COPD Management

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