Department of Health Risk Analysis and Toxicology, Faculty of Health, Medicine and Life Sciences, Research Institute NUTRIM, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Respir Med. 2010 Apr;104(4):557-63. doi: 10.1016/j.rmed.2009.10.018. Epub 2009 Nov 10.
Chronic obstructive pulmonary disease (COPD) is an inflammatory condition characterized by oxidative stress and the formation of volatile organic compounds (VOCs) secreted via the lungs. We recently developed a methodological approach able to identify profiles of VOCs in breath unique for patient groups. Here we applied this recently developed methodology regarding diagnosis of COPD patients.
Fifty COPD patients and 29 controls provided their breath and VOCs were analyzed by gas chromatography-mass spectrometry to identify relevant VOCs. An additional 16 COPD patients and 16 controls were sampled in order to validate the model, and 15 steroid naïve COPD patients were sampled to determine whether steroid use affects performance.
1179 different VOCs were detected, of which 13 were sufficient to correctly classify all 79 subjects. Six of these 13 VOCs classified 92% of the subjects correctly (sensitivity: 98%, specificity: 88%) and correctly classified 29 of 32 subjects (sensitivity: 100%, specificity: 81%) from the independent validation population. Fourteen out of 15 steroid naïve COPD patients were correctly classified thus excluding treatment influences.
This is the first study distinguishing COPD subjects from controls solely based on the presence of VOCs in breath. Analysis of VOCs might be highly relevant for diagnosis of COPD.
慢性阻塞性肺疾病(COPD)是一种炎症性疾病,其特征为氧化应激和通过肺部分泌的挥发性有机化合物(VOCs)的形成。我们最近开发了一种能够识别患者群体特有的呼吸VOCs 谱的方法学方法。在此,我们将该新开发的方法应用于 COPD 患者的诊断。
50 名 COPD 患者和 29 名对照者提供了他们的呼吸样本,通过气相色谱-质谱法分析 VOCs 以识别相关 VOCs。另外 16 名 COPD 患者和 16 名对照者进行了采样以验证模型,并且对 15 名未使用类固醇的 COPD 患者进行了采样以确定类固醇的使用是否会影响性能。
检测到 1179 种不同的 VOC,其中 13 种 VOC 足以正确分类所有 79 名受试者。这 13 种 VOC 中有 6 种可以正确分类 92%的受试者(敏感性:98%,特异性:88%),并且可以正确分类来自独立验证人群的 32 名受试者中的 29 名(敏感性:100%,特异性:81%)。15 名未使用类固醇的 COPD 患者中有 14 名被正确分类,从而排除了治疗影响。
这是第一项仅基于呼吸中 VOCs 的存在来区分 COPD 患者和对照者的研究。VOCs 的分析可能与 COPD 的诊断密切相关。