External validation of exhaled breath profiling using an electronic nose in the discrimination of asthma with fixed airways obstruction and chronic obstructive pulmonary disease

Abstract

External validation of exhaled breath molecular profiling shows high accuracy in distinguishing asthma and COPD in newly recruited patients with fixed airways obstruction. Exhaled air analysis may therefore reduce misdiagnosis in obstructive airways diseases, potentially leading to more appropriate management.

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

“…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].…”

Electronic nose detects heart failure from exhaled breath

“…Therefore, recent studies investigated whether noninvasive biomarkers of different diseases [4] might be determined with enoses. For the detection of volatile organic compounds (VOC) the measurements can be performed on breath [5], sweat [6] or other excreta from humans [7].…”

Wake-up call by breathomics in sleep apnoea

“…The required high-throughput ''omics'' tools are now available for use in blood, secretions and tissue [4], and these have already shown their value in discriminating various chronic respiratory diseases and different phenotypes within a disease [5,6]. The advantage of respiratory medicine is that our organ of interest is continuously exchanging molecular constituents with the environment.…”

“…The study by GREULICH et al [14] should be considered as a first step on the evidence-based route towards establishing diagnostic accuracy [26,27]. Subsequently, the data require external validation in an independent population, as has been done for asthma and chronic obstructive pulmonary disease [6]. But will it be applicable in daily practice?…”

“…The problem in chronic respiratory medicine has been that each of the disease domains by itself is characterised by multiple perturbed mechanisms in parallel or in series, so that adequately describing various disease states requires capturing this seeming ''chaos'' by: 1) high-throughput measurements in each of these disease domains; 2) sophisticated multi-scale mathematical integration of these data [3] to come to; 3) unbiased discovery of (changes in) mechanistic pathways. ''Omics'' techniques follow this approach [4][5][6].…”