PURPOSE OF THE STUDY.
The goal of this study was to investigate whether exhaled volatile organic compounds (VOCs) in exhaled breath are able to predict asthma exacerbations and to assess which combination of VOCs is the most predictive.
Children with asthma aged 6 to 16 years from the outpatient clinic of the Department of Pediatric Pulmonology, Maastricht University Medical Centre, were included. All children were known to have had a diagnosis of asthma for at least 6 months.
A 1-year longitudinal study was performed in 40 children with asthma. At 2-month intervals, exhaled nitric oxide fraction, VOC profiles in exhaled breath samples, lung function, and symptoms were determined. VOC profiles were analyzed by using gas chromatography–time-of-flight mass spectrometry.
Thirty-eight of 40 children completed the study. Sixteen children experienced an exacerbation. A total of 3434 different VOCs were detected in exhaled breath. The most optimal model of baseline measurements versus exacerbation within patients was based on 6 VOCs (sensitivity: 100%; specificity: 93%). The model of baseline values of patients with an exacerbation compared with those without consisted of 7 VOCs (sensitivity: 79%; specificity: 100%). The nitric oxide fraction and lung function were not predictive for exacerbations.
VOC profiling from exhaled breath is able to predict exacerbations of childhood asthma.
This longitudinal study is the first to analyze the ability of VOCs in exhaled breath to predict asthma exacerbations. The result indicates that a combination of 6 or 7 VOCs was able to predict exacerbations of childhood asthma both between and within patients with high sensitivity and specificity. The advantage of VOC analysis in exhaled breath is that sample collection is noninvasive and inflammatory markers are measured simultaneously. However, there was no mention of asthma severity classification. Therefore, it was not possible to explore the role of VOCs in different degrees of asthma severity. Biochemical origin and pathophysiological function of identified compounds in VOCs need to be clarified. In addition, validation studies in a larger population are needed to confirm the optimal combination of VOCs.
- Copyright © 2014 by the American Academy of Pediatrics