Breathprinting-Based Diagnosis, Selected Case Study: Nonneoplastic Chronic Diseases
基于電子鼻技術(shù)呼吸氣味印記診斷非腫瘤性慢性疾病研究
Raffaele Antonelli Incalzi, Antonio De Vincentis, Claudio Pedone
DEPARTMENT OF GERIATRICS, CAMPUS BIO-MEDICO UNIVERSITY, ROME, ITALY
1 Respiratory Diseases
1.1 Summary
Research initially focusing on the identification of selected volatile organic compounds (VOCs) is currently bending toward studies comprehensively assessing the breath patterns (breath-prints - BPs) of respiratory diseases through e-noses. Distinctive BPs characterize young asthmatic patients versus controls, but BP only minimally changes with disease severity, and it’s unclear whether the same conclusion applies to other asthma populations (elderly, late onset, etc.). In COPD, BP provides highly reproducible findings that strongly correlate with spirometric parameters. BP clearly distinguishes COPD patients from controls, and changes depending upon whether inhaled therapy includes a steroid. In OSAS, BP can capture both early and late metabolic effects of nocturnal ventilation. Overall, available evidence suggests BP may conveniently help in diagnosing selected respiratory diseases (to confirm asthma or to exclude COPD or OSAS), to determine severity (COPD), or to track responses to therapies (COPD and OSAS). Furthermore, BP could qualify as a diagnostic surrogate in elderly, mainly disabled and multimorbid subjects, who are not able to perform spirometry. However, these conclusions stem from relatively few data, the majority of which were obtained in selected populations, free from the confounding effects of comorbidities and therapies. Analogously, results in infectious diseases and interstitial lung disease, albeit promising, still lack the desirable consistency. Large cooperative efforts are needed to overcome these limitations, and disclose the full diagnostic potential of the e-nose in respiratory diseases.
初專注于確定所選揮發(fā)性有機(jī)化合物(VOC)的研究目前正致力于通過電子鼻全面評估呼吸疾病的呼吸模式(呼吸圖-bps)的研究。與對照組相比，年輕哮喘患者具有*的血壓特征，但血壓僅隨疾病嚴(yán)重程度的輕微變化，目前尚不清楚相同的結(jié)論是否適用于其他哮喘人群(老年人、晚發(fā)病等)。在慢性阻塞性肺病中，血壓提供了高度可重復(fù)的發(fā)現(xiàn)，與肺計量參數(shù)密切相關(guān)。血壓清楚地將慢性阻塞性肺病患者與對照組區(qū)分開來，并根據(jù)吸入療法是否包括類固醇而改變。在OSAS中，血壓可以捕捉夜間通氣的早期和晚期代謝效應(yīng)。總的來說，現(xiàn)有證據(jù)表明，BP可以方便地幫助診斷選定的呼吸系統(tǒng)疾病(確認(rèn)哮喘或排除慢性阻塞性肺病或OSAS)，確定嚴(yán)重程度(慢性阻塞性肺病)，或跟蹤對治療的反應(yīng)(慢性阻塞性肺病和OSAS)。此外，對于不能進(jìn)行肺活量測定的老年人，主要是殘疾和多病態(tài)受試者，BP可以作為診斷替代物。然而，這些結(jié)論來源于相對較少的數(shù)據(jù)，其中大多數(shù)數(shù)據(jù)是在選定的人群中獲得的，沒有共病和治療的混雜效應(yīng)。類似地，導(dǎo)致傳染病和間質(zhì)性肺病，雖然有希望，但仍然缺乏理想的一致性。為了克服這些局限性，并充分揭示電子鼻在呼吸道疾病中的診斷潛力，需要進(jìn)行大量的合作。
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