| Title: | Defining adult asthma endotypes by clinical features and patterns of volatile organic compounds in exhaled air |
| Author(s): | Meyer N; Dallinga JW; Nuss SJ; Moonen EJ; van Berkel JJ; Akdis C; van Schooten FJ; Menz G; |
| Address: | "High Altitude Clinic (Hochgebirgsklinik) Davos, Davos-Wolfgang, Switzerland. norbert.meyer@insel.ch. Clinic for Rheumatology, Immunology and Allergology, Divison of Allergology, University Hospital of Bern, Bern, Switzerland. norbert.meyer@insel.ch. Department of Toxicology, Nutrition and Toxicology Research Institute Maastricht (Nutrim), Maastricht University Medical Center, Maastricht, The Netherlands. j.dallinga@maastrichtuniversity.nl. High Altitude Clinic (Hochgebirgsklinik) Davos, Davos-Wolfgang, Switzerland. sarah.janine.nuss@gmail.com. Department of Toxicology, Nutrition and Toxicology Research Institute Maastricht (Nutrim), Maastricht University Medical Center, Maastricht, The Netherlands. e.moonen@maastrichtuniversity.nl. Department of Toxicology, Nutrition and Toxicology Research Institute Maastricht (Nutrim), Maastricht University Medical Center, Maastricht, The Netherlands. j.vanberkel@maastrichtuniversitiy.nl. Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Christine-Kuhne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland. akdisac@siaf.uzh.ch. Department of Toxicology, Nutrition and Toxicology Research Institute Maastricht (Nutrim), Maastricht University Medical Center, Maastricht, The Netherlands. f.vanschooten@maastrichtuniversity.nl. High Altitude Clinic (Hochgebirgsklinik) Davos, Davos-Wolfgang, Switzerland. guenter.menz@hgk.ch" |
| DOI: | 10.1186/s12931-014-0136-8 |
| ISSN/ISBN: | 1465-993X (Electronic) 1465-9921 (Print) 1465-9921 (Linking) |
| Abstract: | "BACKGROUND: Several classifications of adult asthma patients using cluster analyses based on clinical and demographic information has resulted in clinical phenotypic clusters that do not address molecular mechanisms. Volatile organic compounds (VOC) in exhaled air are released during inflammation in response to oxidative stress as a result of activated leukocytes. VOC profiles in exhaled air could distinguish between asthma patients and healthy subjects. In this study, we aimed to classify new asthma endotypes by combining inflammatory mechanisms investigated by VOC profiles in exhaled air and clinical information of asthma patients. METHODS: Breath samples were analyzed for VOC profiles by gas chromatography-mass spectrometry from asthma patients (n = 195) and healthy controls (n = 40). A total of 945 determined compounds were subjected to discriminant analysis to find those that could discriminate healthy from asthmatic subjects. 2-step cluster analysis based on clinical information and VOCs in exhaled air were used to form asthma endotypes. RESULTS: We identified 16 VOCs, which could distinguish between healthy and asthma subjects with a sensitivity of 100% and a specificity of 91.1%. Cluster analysis based on VOCs in exhaled air and the clinical parameters FEV1, FEV1 change after 3 weeks of hospitalization, allergic sensitization, Junipers symptoms score and asthma medications resulted in the formation of 7 different asthma endotype clusters. We identified asthma clusters with different VOC profiles but similar clinical characteristics and endotypes with similar VOC profiles, but distinct clinical characteristics. CONCLUSION: This study demonstrates that both, clinical presentation of asthma and inflammatory mechanisms in the airways should be considered for classification of asthma subtypes" |
| Keywords: | Adult Asthma/classification/*diagnosis/metabolism/physiopathology Biomarkers/analysis *Breath Tests Case-Control Studies Cluster Analysis Discriminant Analysis *Exhalation Female Forced Expiratory Volume Gas Chromatography-Mass Spectrometry Humans Lung/*m; |
| Notes: | "MedlineMeyer, Norbert Dallinga, Jan W Nuss, Sarah Janine Moonen, Edwin J C van Berkel, Joep J B N Akdis, Cezmi van Schooten, Frederik Jan Menz, Gunter eng England 2014/11/29 Respir Res. 2014 Nov 28; 15(1):136. doi: 10.1186/s12931-014-0136-8" |
