Department of Respiratory Sciences, University of Leicester, Leicester, UK.
Institute for Lung Health, Leicester NIHR Biomedical Research Centre, Leicester, UK.
Thorax. 2021 May;76(5):514-521. doi: 10.1136/thoraxjnl-2020-215667. Epub 2021 Jan 7.
Exhaled breath analysis has the potential to provide valuable insight on the status of various metabolic pathways taking place in the lungs locally and other vital organs, via systemic circulation. For years, volatile organic compounds (VOCs) have been proposed as feasible alternative diagnostic and prognostic biomarkers for different respiratory pathologies.We reviewed the currently published literature on the discovery of exhaled breath VOCs and their utilisation in various respiratory diseasesKey barriers in the development of clinical breath tests include the lack of unified consensus for breath collection and analysis and the complexity of understanding the relationship between the exhaled VOCs and the underlying metabolic pathways. We present a comprehensive overview, in light of published literature and our experience from coordinating a national breathomics centre, of the progress made to date and some of the key challenges in the field and ways to overcome them. We particularly focus on the relevance of breathomics to clinicians and the valuable insights it adds to diagnostics and disease monitoring.Breathomics holds great promise and our findings merit further large-scale multicentre diagnostic studies using standardised protocols to help position this novel technology at the centre of respiratory disease diagnostics.
呼气分析有可能通过全身循环，提供有关肺部和其他重要器官局部发生的各种代谢途径状况的有价值的信息。多年来，挥发性有机化合物 (VOC) 一直被提议作为不同呼吸道疾病的可行替代诊断和预后生物标志物。我们回顾了目前关于呼气 VOC 发现及其在各种呼吸道疾病中的应用的文献。临床呼气测试发展的主要障碍包括缺乏统一的共识来进行呼气收集和分析，以及理解呼气 VOC 与潜在代谢途径之间关系的复杂性。根据已发表的文献和我们从协调国家呼吸组学中心获得的经验，我们全面概述了迄今为止的进展情况以及该领域的一些关键挑战以及克服这些挑战的方法。我们特别关注呼吸组学与临床医生的相关性，以及它为诊断和疾病监测带来的有价值的见解。呼吸组学具有很大的潜力，我们的研究结果值得进一步进行大规模多中心诊断研究，使用标准化方案来帮助将这项新技术置于呼吸道疾病诊断的中心位置。
