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Respir Res

Title:		The use of exhaled air analysis in discriminating interstitial lung diseases: a pilot study
Author(s):		Plantier L; Smolinska A; Fijten R; Flamant M; Dallinga J; Mercadier JJ; Pachen D; d'Ortho MP; van Schooten FJ; Crestani B; Boots AW;
Address:		"Department of Pulmonology and Lung Function Testing, CHRU, Tours, France. Universite de Tours, Tours, France. Centre d'Etude des Pathologies Respiratoires, INSERM UMR1100, Tours, France. Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. Department of Radiation Oncology (Maastro) GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, 6229 ET, Maastricht, The Netherlands. Service de Physiologie - Explorations Fonctionnelle, Assistance Publique-Hopitaux de Paris, Hopital Bichat, Paris, France. Universite de Paris, INSERM UMR 1141, NeuroDiderot, France. Service de Pneumologie A, DHU FIRE, Assistance Publique-Hopitaux de Paris, Hopital Bichat, Paris, France. Universite Paris Diderot, PRES Sorbonne Paris Cite, Paris, France. INSERM UMR1152, Labex Inflamex, Paris, France. Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. a.boots@maastrichtuniversity.nl"
Journal Title:		Respir Res
Year:		2022
Volume:		20220120
Issue:		1
Page Number:		12 -
DOI:		10.1186/s12931-021-01923-5
ISSN/ISBN:		1465-993X (Electronic) 1465-9921 (Print) 1465-9921 (Linking)
Abstract:		"BACKGROUND: Fibrotic Interstitial lung diseases (ILD) are a heterogeneous group of chronic lung diseases characterized by diverse degrees of lung inflammation and remodeling. They include idiopathic ILD such as idiopathic pulmonary fibrosis (IPF), and ILD secondary to chronic inflammatory diseases such as connective tissue disease (CTD). Precise differential diagnosis of ILD is critical since anti-inflammatory and immunosuppressive drugs, which are beneficial in inflammatory ILD, are detrimental in IPF. However, differential diagnosis of ILD is still difficult and often requires an invasive lung biopsy. The primary aim of this study is to identify volatile organic compounds (VOCs) patterns in exhaled air to non-invasively discriminate IPF and CTD-ILD. As secondary aim, the association between the IPF and CTD-ILD discriminating VOC patterns and functional impairment is investigated. METHODS: Fifty-three IPF patients, 53 CTD-ILD patients and 51 controls donated exhaled air, which was analyzed for its VOC content using gas chromatograph- time of flight- mass spectrometry. RESULTS: By applying multivariate analysis, a discriminative profile of 34 VOCs was observed to discriminate between IPF patients and healthy controls whereas 11 VOCs were able to distinguish between CTD-ILD patients and healthy controls. The separation between IPF and CTD-ILD could be made using 16 discriminating VOCs, that also displayed a significant correlation with total lung capacity and the 6 min' walk distance. CONCLUSIONS: This study reports for the first time that specific VOC profiles can be found to differentiate IPF and CTD-ILD from both healthy controls and each other. Moreover, an ILD-specific VOC profile was strongly correlated with functional parameters. Future research applying larger cohorts of patients suffering from a larger variety of ILDs should confirm the potential use of breathomics to facilitate fast, non-invasive and proper differential diagnosis of specific ILDs in the future as first step towards personalized medicine for these complex diseases"
Keywords:		"Adult Aged Aged, 80 and over Air/*analysis Breath Tests/*methods Diagnosis, Differential *Exhalation Female Humans Lung Diseases, Interstitial/diagnosis/*metabolism Male Middle Aged Pilot Projects Prospective Studies Tomography, X-Ray Computed Vital Capac;"
Notes:		"MedlinePlantier, L Smolinska, A Fijten, R Flamant, M Dallinga, J Mercadier, J J Pachen, D d'Ortho, M P van Schooten, F J Crestani, B Boots, A W eng Observational Study England 2022/01/22 Respir Res. 2022 Jan 20; 23(1):12. doi: 10.1186/s12931-021-01923-5"