Volatile organic compounds associated with diagnosis and disease characteristics in asthma – A systematic review

Adam M. Peel, Maxim Wilkinson, Ashnish Sinha, Yoon K. Loke, Stephen J. Fowler, Andrew M. Wilson

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Abstract

Background: Metabolomics refers to study of the metabolome, the entire set of metabolites produced by a biological system. The application of metabolomics to exhaled breath samples - breathomics - is a rapidly growing field with potential application to asthma diagnosis and management.

Objectives: We aimed to review the adult asthma breathomic literature and present a comprehensive list of volatile organic compounds identified by asthma breathomic models.

Methods: We undertook a systematic search for literature on exhaled volatile organic compounds in adult asthma. We assessed the quality of studies and performed a qualitative synthesis.

Results: We identified twenty studies; these were methodologically heterogenous with a variable risk of bias. Studies almost universally reported breathomics to be capable of differentiating - with moderate or greater accuracy - between samples from healthy controls and those with asthma; and to be capable of phenotyping disease. However, there was little concordance in the compounds upon which discriminatory models were based.

Conclusion: Results to-date are promising but validation in independent prospective cohorts is needed. This may be challenging given the high levels of inter-individual variation. However, large-scale, multi-centre studies are underway and validation efforts have been aided by the publication of technical standards likely to increase inter-study comparability. Successful validation of breathomic models for diagnosis and phenotyping would constitute an important step towards personalised medicine in asthma.
Original languageEnglish
Article number105984
JournalRespiratory Medicine
Volume169
Early online date16 May 2020
DOIs
Publication statusPublished - Aug 2020

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