| Title: | Exhaled volatile organic compounds as markers for medication use in asthma |
| Author(s): | Brinkman P; Ahmed WM; Gomez C; Knobel HH; Weda H; Vink TJ; Nijsen TM; Wheelock CE; Dahlen SE; Montuschi P; Knowles RG; Vijverberg SJ; Maitland-van der Zee AH; Sterk PJ; Fowler SJ; Group UBS; |
| Address: | "Dept of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands p.brinkman@amsterdamumc.nl. Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. Institute of Environmental Medicine and the Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden. Division of Physiological Chemistry 2, Dept of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden. Philips Signify, Eindhoven, The Netherlands. Philips Research, Eindhoven, The Netherlands. Dept of Pharmacology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. Knowles Consulting, Stevenage Bioscience Catalyst, Stevenage, UK. Dept of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands" |
| DOI: | 10.1183/13993003.00544-2019 |
| ISSN/ISBN: | 1399-3003 (Electronic) 0903-1936 (Linking) |
| Abstract: | "INTRODUCTION: Asthma is a heterogeneous condition, characterised by chronic inflammation of the airways, typically managed with inhaled bronchodilators and corticosteroids. In the case of uncontrolled asthma, oral corticosteroids (OCSs) are often prescribed. Good adherence and inhalation technique are associated with improved outcomes; however, it is difficult to monitor appropriate drug intake and effectiveness in individual patients. Exhaled breath contains thousands of volatile organic compounds (VOCs) that reflect changes in the body's chemistry and may be useful for monitoring drug pharmacokinetics/pharmacodynamics. We aimed to investigate the association of exhaled VOCs in severe asthma patients from the U-BIOPRED cohort (by gas chromatography coupled with time-of-flight mass spectrometry) with urinary levels of salbutamol and OCSs (by liquid chromatography coupled with high-resolution mass spectrometry). METHODS: Samples were collected at baseline and after 12-18 months of follow-up. Statistical analysis was based on univariate and multivariate modelling, followed by area under the receiver operating characteristic curve (AUC) calculation. Results were verified through longitudinal replication and independent validation. RESULTS: Data were available for 78 patients (baseline n=48, replication n=30 and validation n=30). Baseline AUC values were 82.1% (95% CI 70.4-93.9%) for salbutamol and 78.8% (95% CI 65.8-91.8%) for OCS. These outcomes could be adequately replicated and validated. Additional regression analysis between qualified exhaled VOCs and urinary concentrations of salbutamol and prednisone showed statistically significant correlations (p<0.01). CONCLUSION: We have linked exhaled VOCs to urinary detection of salbutamol and OCSs. This merits further development of breathomics into a point-of-care tool for therapeutic drug monitoring" |
| Keywords: | *Asthma/diagnosis/drug therapy Breath Tests Exhalation Gas Chromatography-Mass Spectrometry Humans *Volatile Organic Compounds/analysis; |
| Notes: | "MedlineBrinkman, Paul Ahmed, Waqar M Gomez, Cristina Knobel, Hugo H Weda, Hans Vink, Teunis J Nijsen, Tamara M Wheelock, Craig E Dahlen, Sven-Erik Montuschi, Paolo Knowles, Richard G Vijverberg, Susanne J Maitland-van der Zee, Anke H Sterk, Peter J Fowler, Stephen J eng Research Support, Non-U.S. Gov't England 2019/09/14 Eur Respir J. 2020 Feb 27; 55(2):1900544. doi: 10.1183/13993003.00544-2019. Print 2020 Feb" |
