Bannier Michiel A G E, Kienhorst Sophie, Jöbsis Quirijn, van de Kant Kim D G, van Schooten Frederik-Jan, Smolinska Agnieszka, Dompeling Edward
Department of Paediatrics, Division of Paediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre+, 6229 HX Maastricht, The Netherlands.
Department of Pharmacology and Toxicology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6229 ER Maastricht, The Netherlands.
J Clin Med. 2022 Aug 31;11(17):5160. doi: 10.3390/jcm11175160.
Exhaled breath analysis has great potential in diagnosing various respiratory and non-respiratory diseases. In this study, we investigated the influence of inhaled corticosteroids (ICS) on exhaled volatile organic compounds (VOCs) of wheezing preschool children. Furthermore, we assessed whether exhaled VOCs could predict a clinical steroid response in wheezing preschool children. We performed a crossover 8-week ICS trial, in which 147 children were included. Complete data were available for 89 children, of which 46 children were defined as steroid-responsive. Exhaled VOCs were measured by GC-tof-MS. Statistical analysis by means of Random Forest was used to investigate the effect of ICS on exhaled VOCs. A set of 20 VOCs could best discriminate between measurements before and after ICS treatment, with a sensitivity of 73% and specificity of 67% (area under ROC curve = 0.72). Most discriminative VOCs were branched C11H24, butanal, octanal, acetic acid and methylated pentane. Other VOCs predominantly included alkanes. Regularised multivariate analysis of variance (rMANOVA) was used to determine treatment response, which showed a significant effect between responders and non-responders (p < 0.01). These results show that ICS significantly altered the exhaled breath profiles of wheezing preschool children, irrespective of clinical treatment response. Furthermore, exhaled VOCs were capable of determining corticosteroid responsiveness in wheezing preschool children.
呼气分析在诊断各种呼吸道和非呼吸道疾病方面具有巨大潜力。在本研究中，我们调查了吸入性糖皮质激素（ICS）对喘息学龄前儿童呼出挥发性有机化合物（VOCs）的影响。此外，我们评估了呼出的VOCs是否可以预测喘息学龄前儿童的临床类固醇反应。我们进行了一项为期8周的ICS交叉试验，纳入了147名儿童。89名儿童有完整的数据，其中46名儿童被定义为类固醇反应者。通过气相色谱-飞行时间质谱法测量呼出的VOCs。采用随机森林进行统计分析，以研究ICS对呼出VOCs的影响。一组20种VOCs能够最好地区分ICS治疗前后的测量结果，灵敏度为73%，特异性为67%（ROC曲线下面积 = 0.72）。最具鉴别力的VOCs是支链C11H24、丁醛、辛醛、乙酸和甲基戊烷。其他VOCs主要包括烷烃。使用正则化多变量方差分析（rMANOVA）来确定治疗反应，结果显示反应者和无反应者之间存在显著差异（p < 0.01）。这些结果表明，ICS显著改变了喘息学龄前儿童的呼气特征，无论临床治疗反应如何。此外，呼出的VOCs能够确定喘息学龄前儿童的皮质类固醇反应性。
