Metabolomic differences of exhaled breath condensate among children with and without asthma

Abstract

Background There remains an unmet need in objective tests for diagnosing asthma in children. The objective of this study was to investigate the potential of metabolomic profiles of exhaled breath condensate (EBC) to discriminate stable asthma in Asian children in the community. Methods One hundred and sixty‐five Asian children (92 stable asthma and 73 non‐asthmatic controls) participating in a population‐based cohort were enrolled and divided into training and validation sets. Nuclear magnetic resonance‐based metabolomic profiles of EBC samples were analyzed by using orthogonal partial least squares discriminant analysis. Results EBC metabolomic signature (lactate, formate, butyrate, and isobutyrate) had an area under the receiver operator characteristic curve (AUC) of 0.826 in discriminating children with and without asthma in the training set, which significantly outperformed FeNO (AUC = 0.574; P < .001) and FEV1/FVC % predicted (AUC = 0.569; P < .001). The AUC for EBC metabolomic signature was 0.745 in the validation set, which was slightly but not significantly lower than in the testing set (P = .282). We further extrapolated two potentially involved metabolic pathways, including pyruvate (P = 1.67 × 10−3; impact: 0.14) and methane (P = 1.89 × 10−3; impact: 0.15), as the most likely divergent metabolisms between children with and without asthma. Conclusion This study provided evidence supporting the role of EBC metabolomic signature to discriminate stable asthma in Asian children in the community, with a discriminative property outperforming conventional clinical tests such as FeNO or spirometry.

Malondialdehyde and anion patterns in exhaled breath condensate among subway workers

“…Finally, an approach combining multiple biomarkers in EBC is mandatory, as multiple and intricated metabolic pathways are often influenced by exposure to different environmental stressors [ 6 ]. For example, the metabolomics approach usually outperforms the discrimination between asthmatic and non-asthmatics compared to conventional clinical tests using either exhaled NO or standard spirometry [ 68 ]. The additional interest to focus on a pattern of different metabolites in EBC relates to the fact that it gives insight into the actual functional status of the lungs and comparison with basal levels could indicate atypical physiological status [ 6 ].…”

Research Progress of Metabolomics in Asthma

“…Recent work has shown that EBC metabolomics can distinguish asthmatics from healthy individuals and can subdivide subtypes of severe asthma [ 82 , 83 ], which has important implications for clinical phenotypic diagnosis and treatment. Another clinical trial showed that the relative abundance of four metabolites, i.e., lactate, formate, butyrate, and isobutyrate, were significantly higher in EBCs of children with asthma than in healthy controls [ 22 ]. Three metabolites (prostaglandins, fatty acids, and glycerol phospholipids) can be used as biomarkers of breathomics to distinguish asthma children from healthy children [ 23 ].…”

Comments on metabolomics in asthma and atopic dermatitis, and patient care during the COVID‐19 pandemic

“…Metabolomics can be defined as a method “providing promising opportunities for comprehensive analysis of endogenous metabolites in biological samples”. 3 The first study by Zheng Peiyan et al 4 aimed at identifying potential biomarkers for allergic asthma, and monitoring subcutaneous immunotherapy (SCIT). They initially performed untargeted metabolomics in 15 asthmatic and 15 healthy children.…”

“…The two initial editor's choices of this issue address metabolomics in asthma and in eczema. Metabolomics can be defined as a method “providing promising opportunities for comprehensive analysis of endogenous metabolites in biological samples” 3 . The first study by Zheng Peiyan et al 4 aimed at identifying potential biomarkers for allergic asthma, and monitoring subcutaneous immunotherapy (SCIT).…”

“…Further studies addressing metabolomics in asthma have been recently published in PAI, notably with the characterization of metabolites not only in exhaled breath condensates 3 but also in correlation with viral infections 5,6 . It is of note that other microorganisms such as those present in the gut microbiota do also secrete metabolites potentially influencing asthma 7 .…”