Department of Oral Medicine, Dental Radiology and Oral Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
Department of Operative and Preventive Dentistry, Charité Universitätsmedizin Berlin, Berlin, Germany.
Clin Oral Investig. 2018 Mar;22(2):721-731. doi: 10.1007/s00784-017-2147-6. Epub 2017 Jun 10.
The aim of the study was to investigate whether specific volatile organic compounds (VOCs) can be detected in oral candidiasis patients using breath analysis in order to develop a point-of-care diagnostic tool.
PATIENTS/METHODS: Breath samples of 10 diseased patients and 10 subjects carrying no Candida spp. were analyzed using gas chromatography and mass spectrometry. In infected patients, breath tests were performed before and after antifungal therapy.
Breath testing was positive for 143 volatiles in both healthy subjects and diseased patients. Among those, specific signature volatiles known to be emitted by Candida spp. in vitro were not detected. Even though no specific signature was retrieved from the diseased patients, a pattern containing nine compounds (2-methyl-2-butanol, hexanal, longifolene, methyl acetate, 1-heptene, acetophenone, decane, 3-methyl-1-butanol, chlorbenzene) was identified, which showed characteristic changes after antifungal therapy.
Focusing on the identified pattern, breath analysis may be applied to confirm the absence of Candida spp. after therapy in terms of a confirmatory test supplementing clinical examination, thereby replacing microbial testing. However, microbial testing will still be needed to initially confirm clinical diagnoses, as no specific signature was found.
A breath test may help in avoiding extended antifungal administration resulting in resistance development and might be useful in the monitoring of disease recurrences in vulnerable groups.
本研究旨在通过口腔念珠菌病患者的呼吸分析来检测是否存在特定挥发性有机化合物（VOC），以便开发即时诊断工具。
患者/方法：使用气相色谱和质谱分析了 10 名患病患者和 10 名未携带念珠菌属患者的呼吸样本。在感染患者中，在抗真菌治疗前后进行了呼吸测试。
健康受试者和患病患者的呼吸测试均对 143 种挥发性物质呈阳性。在这些物质中，未检测到体外已知由念珠菌属产生的特定特征挥发性物质。尽管从患病患者中未检索到特定特征，但识别出一种包含九种化合物的模式（2-甲基-2-丁醇、己醛、长叶烯、乙酸甲酯、1-庚烯、苯乙酮、癸烷、3-甲基-1-丁醇、氯苯），这些化合物在抗真菌治疗后显示出特征性变化。
专注于已识别的模式，呼吸分析可用于在临床检查的补充下确认治疗后是否不存在念珠菌属，从而替代微生物测试。然而，仍需要微生物测试来初步确认临床诊断，因为未发现特定特征。
呼吸测试可能有助于避免因耐药性发展而延长抗真菌治疗，并可能有助于监测易患人群的疾病复发。
