Exhaled volatile organic compounds analysis by e-nose can detect idiopathic pulmonary fibrosis

Abstract

The current diagnostic work-up and monitoring of idiopathic pulmonary fibrosis (IPF) is often invasive and time consuming. Breath analysis by e-nose technology has shown potential in the diagnosis of numerous respiratory diseases. In this pilot study, we investigated whether exhaled breath analysis by an e-nose could discriminate among patients with IPF, healthy controls and COPD. Second, we verified whether these classification could be repeated in a set of newly recruited patients as external validation. Third, we evaluated any significant relationships between exhaled VOCs and Bronchoalveolar lavage fluid (BALF) in IPF patients. We enrolled 32 patients with well-characterized IPF, 33 individuals with COPD and 36 healthy controls. An electronic nose (Cyranose 320) was used to analyze exhaled breath samples. Raw data were processed by Principal component reduction and linear discriminant analysis. External validation in newly recruited patients (10 IPF, 10 COPD and 10 controls) was tested using the previous training set. Exhaled VOC-profiles of patients with IPF were distinct from those of healthy controls (CVA = 98.5%) as well as those with COPD (CVA = 80.0%). External validation confirmed the above findings (IPF vs COPD vs healthy controls, CVA 96.7%). Moreover, a significant inversely proportional correlation was shown between BALF total cell count and both Principal Components 1 and 2 (r = 0.543, r2 = 0.295, p < 0.01; r = 0.501, r2 = 0.251; p < 0.01, respectively). The exhaled breath Volatile Organic Compounds- profile of patients with IPF can be detected by an electronic nose. This suggests that breath analysis has potential for diagnosis and/or monitoring of IPF.

The smell of lung disease: a review of the current status of electronic nose technology

“…Results were confirmed in a validation cohort [ 57 ]. A few other studies compared individual ILDs with healthy controls and COPD patients [ 58 – 61 ]. Breathprints of patients with idiopathic pulmonary fibrosis (IPF), ILD associated with connective tissue disease and pneumoconiosis were significantly different from healthy controls [ 59 – 61 ].…”

“…A few other studies compared individual ILDs with healthy controls and COPD patients [ 58 – 61 ]. Breathprints of patients with idiopathic pulmonary fibrosis (IPF), ILD associated with connective tissue disease and pneumoconiosis were significantly different from healthy controls [ 59 – 61 ]. In sarcoidosis patients, the breathprint of patients with untreated sarcoidosis differed from healthy controls, implying that eNose technology may be used for initial diagnosis.…”

Short-Term Effect of Cigarette Smoke on Exhaled Volatile Organic Compounds Profile Analyzed by an Electronic Nose

“…The first is our relatively small number of enrolled subjects. However, based on previous observations, [ 10 , 11 ] and based on our sample size estimation, we believe that our total population of 24 individuals might warrant further investigations including larger cohorts and a validation group.…”

Smelling the Disease: Diagnostic Potential of Breath Analysis

“…The concept of an E-nose as an intelligent system containing an array of sensors was first reported in 1982 by Persaud and Dodd [86], while the term 'electronic nose' was first used in 1987 [87]. Various studies have reported the use of E-noses in the food industry [88,89], changes in the environment [90], and medical diagnostics [91][92][93], which have sparked worldwide interest in the intriguing application of this technology. E-noses are made up of a collection of typically nonspecific sensors that interact with VOCs in different ways: each VOC generates a unique fingerprint because of its interaction with the sensor array, which is further analyzed using a pattern recognition system to determine its nature and origin.…”