Exhaled Volatile Organic Compounds for Asthma Control Classification in Children with Moderate to Severe Asthma: Results from the SysPharmPediA Study

Shahbazi Khamas, Shahriyar; Van Dijk, Yoni; Abdel-Aziz, Mahmoud I.; Neerincx, Anne H.; Maarten Blankestijn, Jelle; Vijverberg, Susanne J.H.; Hashimoto, Simone; Bush, Andrew; Kraneveld, Aletta D.; Hedman, Anna M.; Toncheva, Antoaneta A.; Almqvist, Catarina; Wolff, Christine; Murray, Clare S.; Hedlin, Gunilla; Roberts, Graham; Adcock, Ian M.; Korta-Murua, Javier; Bønnelykke, Klaus; Fleming, Louise J.; Pino-Yanes, Maria; Gorenjak, Mario; Kabesch, Michael; Sardón-Prado, Olaia; Montuschi, Paolo; Singer, Florian; Elosegui, Paula Corcuera; Fowler, Stephen J.; Brandstetter, Susanne; Harner, Susanne; Dahlén, Sven-Erik; Potočnik, Uroš; Frey, Urs; van Aalderen, Wim; Brinkman, Paul; Maitland-van der Zee, Anke-Hilse

doi:10.1164/rccm.202312-2270oc

Cited by 3 publications

(1 citation statement)

References 56 publications

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“…Breath sampling with the SPIRITAS has been performed in the Pediatric Asthma Non-invasive Diagnostic Approaches (PANDA) study. With data gathered from this study, external validation of three relevant VOCs that discriminated between controlled and uncontrolled asthma in children (acetophenone, ethylbenzene and styrene) was performed, indicating that sampling and identification of discriminative VOCs with the SPIRITAS in pediatric populations is feasible [31].…”

Section: Strengthsmentioning

confidence: 99%

Characterization of the SPIRITAS: A Disposable Sampling Setup for Volatile Organic Compound Collection and Analysis

Mager,

van Dijk,

Varan

et al. 2024

Separations

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Analyzing exhaled breath for volatile organic compounds (VOCs) using thermal desorption–gas chromatography–mass spectrometry (TD-GC-MS) offers a non-invasive diagnostic approach for various diseases. Despite its promise, the method faces challenges like sampling heterogeneity and high costs. Following the European Respiratory Society’s advocacy for methodological standardization, we developed the SPIRITAS (Standardized Product for Inexpensive Respiratory InvesTigation: A breath Sampler), a low-cost, disposable breath sampler. This study evaluates the SPIRITAS’s effectiveness in detecting targeted VOCs. We tested the SPIRITAS using the Peppermint Experiment, a standardized protocol that allows for comparison between different breath sampling and analytical practices by assessing the ability to detect five peppermint-specific VOCs after ingestion of a 200-milligram peppermint oil capsule. We included ten subjects and performed six breath samples per participant, including a baseline measurement taken before ingestion. We used the Wilcoxon signed-rank test to evaluate whether baseline values were significantly lower than the peak values of the targeted VOCs. Additionally, we conducted an experiment utilizing humidified medical-grade air to identify any VOCs attributable to the SPIRITAS setup itself. Results showed successful detection of four out of five targeted “peppermint-associated” VOCs: alpha-pinene (p ≤ 0.01), beta-pinene (p ≤ 0.01), menthone (p = 0.01), and menthol (p = 0.02), indicating significant differences between the baseline and peak values in the volunteers’ breath. However, detection of eucalyptol was inconsistent. In addition, we identified 16 VOCs that were released by the SPIRITAS, one of which remains unidentified. Our findings underscore the SPIRITAS’s potential for clinical applications, paving the way for broader biomarker research. The combination of ease of use, low cost, reduced risk of contamination, and standardization makes SPIRITAS very suitable for large-scale international studies. Furthermore, we have demonstrated the SPIRITAS’s effectiveness in detecting specific VOCs and identified 16 compounds originating from the SPIRITAS, ensuring that these compounds would not be mis-qualified as potential biomarkers in future clinical studies.

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Section: Strengthsmentioning

confidence: 99%

Characterization of the SPIRITAS: A Disposable Sampling Setup for Volatile Organic Compound Collection and Analysis

Mager,

van Dijk,

Varan

et al. 2024

Separations

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Progress and challenges of developing volatile metabolites from exhaled breath as a biomarker platform

Chou,

Godbeer,

Allsworth

et al. 2024

Metabolomics

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Background The multitude of metabolites generated by physiological processes in the body can serve as valuable biomarkers for many clinical purposes. They can provide a window into relevant metabolic pathways for health and disease, as well as be candidate therapeutic targets. A subset of these metabolites generated in the human body are volatile, known as volatile organic compounds (VOCs), which can be detected in exhaled breath. These can diffuse from their point of origin throughout the body into the bloodstream and exchange into the air in the lungs. For this reason, breath VOC analysis has become a focus of biomedical research hoping to translate new useful biomarkers by taking advantage of the non-invasive nature of breath sampling, as well as the rapid rate of collection over short periods of time that can occur. Despite the promise of breath analysis as an additional platform for metabolomic analysis, no VOC breath biomarkers have successfully been implemented into a clinical setting as of the time of this review. Aim of review This review aims to summarize the progress made to address the major methodological challenges, including standardization, that have historically limited the translation of breath VOC biomarkers into the clinic. We highlight what steps can be taken to improve these issues within new and ongoing breath research to promote the successful development of the VOCs in breath as a robust source of candidate biomarkers. We also highlight key recent papers across select fields, critically reviewing the progress made in the past few years to advance breath research. Key scientific concepts of review VOCs are a set of metabolites that can be sampled in exhaled breath to act as advantageous biomarkers in a variety of clinical contexts.

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External Validation of Potential Breath Biomarkers for Asthma: A Step Forward Toward the Clinical Implementation of Breath Analysis

Sola-Martínez,

Turner,

de Diego Puente

2024

Am J Respir Crit Care Med

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Exhaled Volatile Organic Compounds for Asthma Control Classification in Children with Moderate to Severe Asthma: Results from the SysPharmPediA Study

Cited by 3 publications

References 56 publications

Characterization of the SPIRITAS: A Disposable Sampling Setup for Volatile Organic Compound Collection and Analysis

Characterization of the SPIRITAS: A Disposable Sampling Setup for Volatile Organic Compound Collection and Analysis

Progress and challenges of developing volatile metabolites from exhaled breath as a biomarker platform

External Validation of Potential Breath Biomarkers for Asthma: A Step Forward Toward the Clinical Implementation of Breath Analysis

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