Reviews and feature articleBreathomics in the setting of asthma and chronic obstructive pulmonary disease
Section snippets
Definitions
Metabolomics is the study of the metabolic content of a given system, whether that be a cell, organ system, or organism. In exhaled breath gas analysis we detect volatile organic compounds (VOCs) that can arise from or be affected by metabolism, and the term breathomics is currently used to describe this.20 However, it must be emphasized that exhaled breath VOCs do not exclusively represent lung metabolism. Here we describe the sources of breath VOCs and the implications for sampling.
Origins of exhaled breath VOCs
The VOC
Diagnosis: Classifying patients with asthma/COPD versus control subjects
All work to date has been performed in patients with an established diagnosis of asthma or COPD and in control subjects to generate proof of concept that breath VOCs are different in health and disease. In general, there are often potentially relevant clinical parameters that can differ between the case and control groups that could confound the results, such as medication use, comorbidities, and smoking. If breath signals are to prove useful as (composite) biomarkers for diagnosis, they must
Conclusions
Most studies on breathomics in patients with obstructive airways diseases have focused on the diagnosis of asthma or COPD. The major limitation of all except one46 of these studies is that most were not intended to provide a new diagnosis. Furthermore, the disease label might not be as important as the identification of treatable traits.19 There is a clear need for noninvasive biomarkers in patient stratification. Exhaled breath analysis as a substitute for sputum eosinophils can lead to
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Disclosure of potential conflict of interest: P. Sterk has received a grant from Innovative Medicines Initiative. The rest of the authors declare that they have no relevant conflicts of interest.