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Chest

Title:		Diagnostic Performance of Electronic Nose Technology in Sarcoidosis
Author(s):		van der Sar IG; Moor CC; Oppenheimer JC; Luijendijk ML; van Daele PLA; Maitland-van der Zee AH; Brinkman P; Wijsenbeek MS;
Address:		"Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. Department of Immunology, Erasmus Medical Center, Rotterdam, The Netherlands. Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: m.wijsenbeek-lourens@erasmusmc.nl"
Journal Title:		Chest
Year:		2022
Volume:		20211028
Issue:		3
Page Number:		738 - 747
DOI:		10.1016/j.chest.2021.10.025
ISSN/ISBN:		1931-3543 (Electronic) 0012-3692 (Print) 0012-3692 (Linking)
Abstract:		"BACKGROUND: Diagnosing sarcoidosis can be challenging, and a noninvasive diagnostic method is lacking. The electronic nose (eNose) technology profiles volatile organic compounds in exhaled breath and has potential as a point-of-care diagnostic tool. RESEARCH QUESTION: Can eNose technology be used to distinguish accurately between sarcoidosis, interstitial lung disease (ILD), and healthy control subjects, and between sarcoidosis subgroups? STUDY DESIGN AND METHODS: In this cross-sectional study, exhaled breath of patients with sarcoidosis and ILD and healthy control subjects was analyzed by using an eNose (SpiroNose). Clinical characteristics were collected from medical files. Partial least squares discriminant and receiver-operating characteristic analyses were applied to a training and independent validation cohort. RESULTS: The study included 252 patients with sarcoidosis, 317 with ILD, and 48 healthy control subjects. In the validation cohorts, eNose distinguished sarcoidosis from control subjects with an area under the curve (AUC) of 1.00 and pulmonary sarcoidosis from other ILD (AUC, 0.87; 95% CI, 0.82-0.93) and hypersensitivity pneumonitis (AUC, 0.88; 95% CI, 0.75-1.00). Exhaled breath of sarcoidosis patients with and without pulmonary involvement, pulmonary fibrosis, multiple organ involvement, pathology-supported diagnosis, and immunosuppressive treatment revealed no distinctive differences. Breath profiles differed between patients with a slightly and highly elevated soluble IL-2 receptor level (median cutoff, 772.0 U/mL; AUC, 0.78; 95% CI, 0.64-0.92). INTERPRETATION: Patients with sarcoidosis can be distinguished from ILD and healthy control subjects by using eNose technology, indicating that this method may facilitate accurate diagnosis in the future. Further research is warranted to understand the value of eNose in monitoring sarcoidosis activity"
Keywords:		"Breath Tests/methods Cross-Sectional Studies Electronic Nose Exhalation Humans *Sarcoidosis, Pulmonary/diagnosis Technology *Volatile Organic Compounds/analysis breath test diagnostic tool interstitial lung disease sarcoidosis;"
Notes:		"Medlinevan der Sar, Iris G Moor, Catharina C Oppenheimer, Judith C Luijendijk, Megan L van Daele, Paul L A Maitland-van der Zee, Anke H Brinkman, Paul Wijsenbeek, Marlies S eng 2021/11/11 Chest. 2022 Mar; 161(3):738-747. doi: 10.1016/j.chest.2021.10.025. Epub 2021 Oct 28"