Exhaled breath profiles in the monitoring of loss of control and clinical recovery in asthma

Autor: Teunis J. Vink, Lieuwe D. J. Bos, René Lutter, Anirban Sinha, Marije G Gerritsen, Niki Fens, M. A. van de Pol, M. M. Sneeboer, F.H.C. de Jongh, Hugo H. Knobel, Christof J. Majoor, Paul Brinkman, Tamara Dekker, Barbara Smids, Peter J. Sterk
Přispěvatelé: AII - Inflammatory diseases, Graduate School, AII - Amsterdam institute for Infection and Immunity, Pulmonology, Other departments, Neonatology, ARD - Amsterdam Reproduction and Development, ACS - Heart failure & arrhythmias
Rok vydání: 2017
Předmět:
Zdroj: Clinical and experimental allergy, 47(9), 1159-1169. Wiley-Blackwell
ISSN: 1365-2222
0954-7894
Popis: SummaryBackground Asthma is a chronic inflammatory airway disease, associated with episodes of exacerbations. Therapy with inhaled corticosteroids (ICS) targets airway inflammation, which aims to maintain and restore asthma control. Clinical features are only modestly associated with airways inflammation. Therefore, we hypothesized that exhaled volatile metabolites identify longitudinal changes between clinically stable episodes and loss of asthma control. Objectives To determine whether exhaled volatile organic compounds (VOCs) as measured by gas-chromatography/mass-spectrometry (GC/MS) and electronic nose (eNose) technology discriminate between clinically stable and unstable episodes of asthma. Methods Twenty-three patients with (partly) controlled mild to moderate persistent asthma using ICS were included in this prospective steroid withdrawal study. Exhaled metabolites were measured at baseline, during loss of control and after recovery. Standardized sampling of exhaled air was performed, after which samples were analysed by GC/MS and eNose. Univariate analysis of covariance (ANCOVA), followed by multivariate principal component analysis (PCA) was used to reduce data dimensionality. Next paired t tests were utilized to analyse within-subject breath profile differences at the different time-points. Finally, associations between exhaled metabolites and sputum inflammation markers were examined. Results Breath profiles by eNose showed 95% (21/22) correct classification for baseline vs loss of control and 86% (19/22) for loss of control vs recovery. Breath profiles using GC/MS showed accuracies of 68% (14/22) and 77% (17/22) for baseline vs loss of control and loss of control vs recovery, respectively. Significant associations between exhaled metabolites captured by GC/MS and sputum eosinophils were found (Pearson r≥.46, P
Databáze: OpenAIRE
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