| Title: | The role of measuring exhaled breath biomarkers in sarcoidosis: a systematic review |
| Author(s): | Terrington DL; Hayton C; Peel A; Fowler SJ; Fraser W; Wilson AM; |
| Address: | "Norwich Medical School, University of East Anglia, Norwich, United Kingdom" |
| ISSN/ISBN: | 1752-7163 (Electronic) 1752-7155 (Linking) |
| Abstract: | "INTRODUCTION: Sarcoidosis is a chronic granulomatous disease of unknown aetiology with a variable clinical course and prognosis. There is a growing need to identify non-invasive biomarkers to differentiate between clinical phenotypes, identify those at risk of disease progression and monitor response to treatment. OBJECTIVES: We undertook a systematic review and meta-analysis to evaluate the utility of breath-based biomarkers in discriminating sarcoidosis from healthy controls, alongside correlation with existing non breath-based biomarkers used in clinical practice, radiological stage, markers of disease activity and response to treatment. METHODS: Electronic searches were undertaken during November 2017 using PubMed, Ebsco, Embase and Web of Science to capture relevant studies evaluating breath-based biomarkers in adult patients with sarcoidosis. RESULTS: 353 papers were screened; 21 met the inclusion criteria and assessed 25 different biomarkers alongside VOCs in exhaled breath gas or condensate. Considerable heterogeneity existed amongst the studies in terms of participant characteristics, sampling and analytical methods. Elevated biomarkers in sarcoidosis included 8-isoprostane, carbon monoxide, neopterin, TGF-beta1, TNFalpha, CysLT and several metallic elements including chromium, silicon and nickel. Three studies exploring VOCs were able to distinguish sarcoidosis from controls. Meta-analysis of four studies assessing alveolar nitric oxide showed no significant difference between sarcoidosis and healthy controls (2.22 ppb; 95% CI -0.83, 5.27) however, a high degree of heterogeneity was observed with an I (2) of 93.4% (p < 0.001). Inconsistent or statistically insignificant results were observed for correlations between several biomarkers and radiological stage, markers of disease activity or treatment. CONCLUSIONS: The evidence for using breath biomarkers to diagnose and monitor sarcoidosis remains inconclusive with many studies limited by small sample sizes and lack of standardisation. VOCs have shown promising potential but further research is required to evaluate their prognostic role" |
| Keywords: | Adult Aged Biomarkers/*analysis Breath Tests/*methods Cytokines/metabolism *Exhalation Female Humans Male Middle Aged Nitric Oxide/metabolism Oxidative Stress Publication Bias Sarcoidosis/*diagnosis Volatile Organic Compounds/analysis Young Adult; |
| Notes: | "MedlineTerrington, Dayle L Hayton, Conal Peel, Adam Fowler, Stephen J Fraser, William Wilson, Andrew M eng Meta-Analysis Systematic Review England 2019/03/23 J Breath Res. 2019 Jun 24; 13(3):036015. doi: 10.1088/1752-7163/ab1284" |
