呼出氣冷凝物揮發(fā)物可以對持續(xù)性哮喘進行敏感診斷
Exhaled breath condensate volatilome allows sensitive diagnosis of persistent asthma
João Cavaleiro Rufo ，Inês Paciência ,Francisca Castro Mendes, Mariana Farraia ,
Ana Rodolfo ,Diana Silva ,Eduardo de Oliveira Fernandes ,Luís Delgado ,André Moreira
First published: 29 August 2018 https://doi.org/10.1111/all.13596 Cited by: 8
Funding information:Authors gratefully acknowledge the funding by Fundação para a Ciência e Tecnologia through the ARIA project (PTDC/DTP‐SAP/1522/2012), through the scholarships SFRH/BD/108605/2015, awarded to JCR, and SFRH/BD/112269/2015, awarded to IP, and by the Project NORTE‐01‐0145‐FEDER‐000010—Health, Comfort and Energy in the Built Environment (HEBE), cofinanced by Programa Operacional Regional do Norte (NORTE2020), through Fundo Europeu de Desenvolvimento Regional (FEDER).
Abstract Background
The diagnosis and phenotyping of paediatric asthma are particularly complex due to the lack of currently available sensitive diagnostic tools. This often results in uncertainties associated with inhaled steroid therapy prescription. Therefore, this study aimed to investigate whether volatile organic compounds measured in exhaled breath condensate can be used as biomarkers for asthma diagnosis in the paediatric population.
由于目前缺乏敏感的診斷工具，兒童哮喘的診斷和分型特別復(fù)雜。這常常導致吸入類固醇治療處方的不確定性。因此，本研究旨在探討呼出冷凝物中測定的揮發(fā)性有機化合物是否可作為兒科人群哮喘診斷的生物標志物。
Methods
A total of 64 participants, aged 6‐18 years, were recruited on a random basis during visits to an outpatient allergy clinic and to a juvenile football team training session. Lung function, airway reversibility and skin prick tests were performed. Exhaled breath condensate samples were collected, and breathprints were assessed using an electronic nose. Information on medical diagnosis of asthma, rhinitis and atopic dermatitis was retrieved for each participant. A hierarchical cluster model based on the volatilome profiles was then created.
共有64名參與者，年齡6-18歲，在門診過敏門診和青少年足球隊訓練期間隨機招募。進行肺功能、氣道可逆性和皮刺試驗。收集呼出的呼吸冷凝液樣本，并用電子鼻評估呼吸印痕。每一位參與者的哮喘、鼻炎和特應(yīng)性皮炎的醫(yī)學診斷信息被檢索。然后建立了基于揮發(fā)物分布的層次聚類模型。
Results
A two‐cluster exhaled volatile organic compound‐based hierarchical model was able to significantly discriminate individuals with asthma from those without the disease (AUC = 0.81 [0.69‐0.93], P < 0.001). Individuals who had persistent asthma and were prescribed corticosteroid therapy by the physician were also significantly distinguished in the model (AUC = 0.81 [0.70‐0.92], P < 0.001). Despite being less specific, the method showed higher overall accuracy, sensitivity and AUC values when compared to spirometry with bronchodilation.
兩組呼出的揮發(fā)性有機化合物分級模型能夠顯著區(qū)分哮喘患者和無哮喘患者(AUC=0.81[0.69-0.93]，p<0.001)。在該模型中，那些患有持續(xù)性哮喘并由醫(yī)生給予皮質(zhì)類固醇治療的個體也有顯著差異(AUC=0.81[0.70-0.92]，P<0.001)。盡管方法的特異性較低，但與支氣管擴張肺量測定法相比，該方法顯示出更高的整體準確性、敏感性和AUC值。
Conclusions
Analysis of the exhaled breath condensate volatilome allowed the distinction of paediatric individuals with a medical diagnosis of asthma, identifying those in need of corticosteroid therapy.
通過對呼出的呼吸冷凝液揮發(fā)物的分析，可以鑒別出在醫(yī)學上診斷為哮喘的兒科個體，確定那些需要皮質(zhì)類固醇治療的個體。
