Exhaled Breath Profiling Enables Discrimination of Chronic Obstructive Pulmonary Disease and Asthma
Exhaled Breath Profiling Enables Discrimination of Chronic Obstructive Pulmonary Disease and Asthma
复制标题
DOI：
10.1164/rccm.200906-0939oc
复制
发表时间：
2009-12-01
影响因子：
24.7
通讯作者：
Sterk, Peter J.
中科院分区：
文献类型：
--
作者：
Fens, Niki;Zwinderman, Aeilko H.;Sterk, Peter J.
慢性阻塞性肺疾病（COPD）和哮喘可以表现出重叠的临床特征。呼出的空气中含有挥发性有机化合物（VOC），可以作为非侵入性生物标志物。通过电子鼻的综合分析可以评估VOC概况，从而产生呼出的分子指纹目的：我们假设电子鼻呼吸纹可以区分COPD和哮喘患者。方法：90名受试者参加了一项横断面研究：30名COPD患者（年龄，61.6 ± 9.3岁; FEV 1，1.72 ± 0.69 L），20例哮喘患者（年龄，35.4 ± 15.1岁; FEV 1，3.32 ± 0.86 L），20例非吸烟对照受试者（年龄，56.7 ± 9.3岁; FEV 1，3.44 ± 0.76 L）和20名吸烟对照受试者（年龄，56.1 ± 5.9岁; FEV 1，3.58 ± 0.78）。在通过吸气VOC过滤器进行5分钟潮式呼吸后，将呼气肺活量收集在Tedlar袋中并通过电子鼻采样。通过主成分减少的判别分析来分析呼吸纹，从而得到交叉验证的准确度值（准确度）。重复性和再现性进行了评估，通过测量样品的两个device. Measures和主要结果：从哮喘患者的呼吸纹与COPD患者（准确性96%; P < 0.001），从非吸烟对照组（准确性，95%; P < 0.001），从吸烟对照组（准确性，92.5%; P < 0.001）。COPD患者的呼气特征与无症状吸烟者的呼气特征部分重叠（准确性，66%; P = 0.006）。测量结果是可重复的和reproducible.Conclusions：呼出气的分子谱可以区分COPD和哮喘患者和对照组。我们的数据表明，电子鼻在阻塞性气道疾病的鉴别诊断和无症状吸烟者的风险评估中具有潜力。
Rationale Chronic obstructive pulmonary disease (COPD) and asthma can exhibit overlapping clinical features. Exhaled air contains volatile organic compounds (VOCs) that may qualify as noninvasive biomarkers. VOC profiles can be assessed using integrative analysis by electronic nose, resulting in exhaled molecular fingerprints (breathprints).Objectives: We hypothesized that breathprints by electronic nose can discriminate patients with COPD and asthma.Methods: Ninety subjects participated in a cross-sectional study: 30 patients with COPD (age, 61.6+/-9.3 years; FEV1, 1.72+/-0.69 L), 20 patients with asthma (age, 35.4+/-15.1 years; FEV1, 3.32+/-0.86 L), 20 nonsmoking control subjects (age, 56.7+/-9.3 years; FEV1, 3.44+/-0.76 L), and 20 smoking control subjects (age, 56.1+/-5.9 years; FEV1, 3.58+/-0.78). After 5 minutes of tidal breathing through an inspiratory VOC filter, an expiratory vital capacity was collected in a Tedlar bag and sampled by electronic nose. Breathprints were analyzed by discriminant analysis on principal component reduction resulting in cross-validated accuracy values (accuracy). Repeatability and reproducibility were assessed by measuring samples in duplicate by two devices.Measurements and Main Results: Breathprints from patients with asthma were separated from patients with COPD (accuracy 96%; P < 0.001), from nonsmoking control subjects (accuracy, 95%; P < 0.001), and from smoking control subjects (accuracy, 92.5%; P < 0.001). Exhaled breath profiles of patients with COPD partially overlapped with those of asymptomatic smokers (accuracy, 66%; P = 0.006). Measurements were repeatable and reproducible.Conclusions: Molecular profiling of exhaled air can distinguish patients with COPD and asthma and control subjects. Our data demonstrate a potential of electronic noses in the differential diagnosis of obstructive airway diseases and in the risk assessment in asymptomatic smokers.Clinical trial registered with www.trialregister.nI (NTR 1282).