Defining adult asthma endotypes by clinical features and patterns of volatile organic compounds in exhaled air.
Defining adult asthma endotypes by clinical features and patterns of volatile organic compounds in exhaled air.
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DOI：
10.1186/s12931-014-0136-8
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发表时间：
2014-11-28
影响因子：
5.8
通讯作者：
Menz G
中科院分区：
文献类型：
--
作者：
Meyer N;Dallinga JW;Nuss SJ;Moonen EJ;van Berkel JJ;Akdis C;van Schooten FJ;Menz G
使用基于临床和人口统计信息的聚类分析对成人哮喘患者进行的几种分类导致了不涉及分子机制的临床表型集群。呼出的空气中的挥发性有机化合物(VOC)是在炎症过程中因白细胞激活而产生的氧化应激而释放的。呼出空气中的VOC谱可以区分哮喘患者和健康受试者。在这项研究中，我们旨在通过结合呼出空气中VOC谱所研究的炎症机制和哮喘患者的临床信息来对新的哮喘内型进行分类。用气相色谱-质谱法分析了哮喘患者(n = 195例)和健康对照组(n = 40例)的呼气样品中挥发性有机化合物的含量。共对945种已确定的化合物进行了判别分析，以找出那些可以区分健康和哮喘受试者的化合物。根据临床资料和呼出空气中的VOCs进行两步聚类分析，形成哮喘内型。我们鉴定了16种VOCs，它们可以区分健康和哮喘患者，敏感性为100%，特异性为91.1%。根据呼出空气中VOCs和临床参数FEV1、FEV1在入院3周、过敏反应、刺柏症状评分和哮喘药物治疗后的变化进行聚类分析，形成7种不同的哮喘内型簇。我们确定了具有不同VOC特征但临床特征相似的哮喘集群，以及具有相似VOC特征但不同临床特征的内型。这项研究表明，哮喘的临床表现和呼吸道的炎症机制都应该被考虑到哮喘亚型的分类。本文的在线版本(doi：10.1186/s12931-0140136-8)包含补充材料，授权用户可以使用。
Several classifications of adult asthma patients using cluster analyses based on clinical and demographic information has resulted in clinical phenotypic clusters that do not address molecular mechanisms. Volatile organic compounds (VOC) in exhaled air are released during inflammation in response to oxidative stress as a result of activated leukocytes. VOC profiles in exhaled air could distinguish between asthma patients and healthy subjects. In this study, we aimed to classify new asthma endotypes by combining inflammatory mechanisms investigated by VOC profiles in exhaled air and clinical information of asthma patients. Breath samples were analyzed for VOC profiles by gas chromatography–mass spectrometry from asthma patients (n = 195) and healthy controls (n = 40). A total of 945 determined compounds were subjected to discriminant analysis to find those that could discriminate healthy from asthmatic subjects. 2-step cluster analysis based on clinical information and VOCs in exhaled air were used to form asthma endotypes. We identified 16 VOCs, which could distinguish between healthy and asthma subjects with a sensitivity of 100% and a specificity of 91.1%. Cluster analysis based on VOCs in exhaled air and the clinical parameters FEV1, FEV1 change after 3 weeks of hospitalization, allergic sensitization, Junipers symptoms score and asthma medications resulted in the formation of 7 different asthma endotype clusters. We identified asthma clusters with different VOC profiles but similar clinical characteristics and endotypes with similar VOC profiles, but distinct clinical characteristics. This study demonstrates that both, clinical presentation of asthma and inflammatory mechanisms in the airways should be considered for classification of asthma subtypes. The online version of this article (doi:10.1186/s12931-014-0136-8) contains supplementary material, which is available to authorized users.
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影响因子：
3.6
作者：
Robroeks, Charlotte M. H. H. T.;van Berkel, Joep J. B. N.;Dompeling, Edward
通讯作者：
Dompeling, Edward
影响因子：
14.2
作者：
Dougherty, Ryan H.;Sidhu, Sukhvinder S.;Raman, Kavita;Solon, Margaret;Solberg, Owen D.;Caughey, George H.;Woodruff, Prescott G.;Fahy, John V.
通讯作者：
Fahy, John V.
DOI：
10.1164/ajrccm.162.2.9909025
发表时间：
2000-08-01
影响因子：
24.7
作者：
Paredi, P;Kharitonov, SA;Barnes, PJ
通讯作者：
Barnes, PJ
影响因子：
168.9
作者：
Phillips, M;Gleeson, K;McVay, WP
通讯作者：
McVay, WP
DOI：
10.1038/nri2870
发表时间：
2010-12
期刊：
Nature reviews. Immunology
影响因子：
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作者：
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