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Exhaled volatile organic compounds in adult asthma: a systematic review

Exhaled volatile organic compounds in adult asthma: a systematic review
Exhaled volatile organic compounds in adult asthma: a systematic review

The search for biomarkers that can guide precision medicine in asthma, particularly those that can be translated to the clinic, has seen recent interest in exhaled volatile organic compounds (VOCs). Given the number of studies reporting "breathomics" findings and its growing integration in clinical trials, we performed a systematic review of the literature to summarise current evidence and understanding of breathomics technology in asthma.A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-oriented systematic search was performed (CRD42017084145) of MEDLINE, Embase and the Cochrane databases to search for any reports that assessed exhaled VOCs in adult asthma patients, using the following terms (asthma AND (volatile organic compounds AND exhaled) OR breathomics).Two authors independently determined the eligibility of 2957 unique records, of which 66 underwent full-text review. Data extraction and risk of bias assessment was performed on the 22 studies deemed to fulfil the search criteria. The studies are described in terms of methodology and the evidence narratively summarised under the following clinical headings: diagnostics, phenotyping, treatment stratification, treatment monitoring and exacerbation prediction/assessment.Our review found that most studies were designed to assess diagnostic potential rather than focus on underlying biology or treatable traits. Results are generally limited by a lack of methodological standardisation and external validation and by insufficiently powered studies, but there is consistency across the literature that exhaled VOCs are sensitive to underlying inflammation. Modern studies are applying robust breath analysis workflows to large multi-centre study designs, which should unlock the full potential of measurement of exhaled volatile organic compounds in airways diseases such as asthma.

0903-1936
Azim, Adnan
87c31e0e-c9bf-4258-9ae9-889e2382e7ba
Barber, Clair
ff31b460-34c3-466c-90e4-f70b3e954c82
Dennison, Paddy
30c232e3-c218-4dd8-979f-061ac70513d5
Riley, John
1e6b3139-3075-4d54-9d5d-cc506c78e997
Howarth, Peter
ff19c8c4-86b0-4a88-8f76-b3d87f142a21
Azim, Adnan
87c31e0e-c9bf-4258-9ae9-889e2382e7ba
Barber, Clair
ff31b460-34c3-466c-90e4-f70b3e954c82
Dennison, Paddy
30c232e3-c218-4dd8-979f-061ac70513d5
Riley, John
1e6b3139-3075-4d54-9d5d-cc506c78e997
Howarth, Peter
ff19c8c4-86b0-4a88-8f76-b3d87f142a21

Azim, Adnan, Barber, Clair, Dennison, Paddy, Riley, John and Howarth, Peter (2019) Exhaled volatile organic compounds in adult asthma: a systematic review. The European respiratory journal, 54 (3). (doi:10.1183/13993003.00056-2019).

Record type: Article

Abstract

The search for biomarkers that can guide precision medicine in asthma, particularly those that can be translated to the clinic, has seen recent interest in exhaled volatile organic compounds (VOCs). Given the number of studies reporting "breathomics" findings and its growing integration in clinical trials, we performed a systematic review of the literature to summarise current evidence and understanding of breathomics technology in asthma.A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-oriented systematic search was performed (CRD42017084145) of MEDLINE, Embase and the Cochrane databases to search for any reports that assessed exhaled VOCs in adult asthma patients, using the following terms (asthma AND (volatile organic compounds AND exhaled) OR breathomics).Two authors independently determined the eligibility of 2957 unique records, of which 66 underwent full-text review. Data extraction and risk of bias assessment was performed on the 22 studies deemed to fulfil the search criteria. The studies are described in terms of methodology and the evidence narratively summarised under the following clinical headings: diagnostics, phenotyping, treatment stratification, treatment monitoring and exacerbation prediction/assessment.Our review found that most studies were designed to assess diagnostic potential rather than focus on underlying biology or treatable traits. Results are generally limited by a lack of methodological standardisation and external validation and by insufficiently powered studies, but there is consistency across the literature that exhaled VOCs are sensitive to underlying inflammation. Modern studies are applying robust breath analysis workflows to large multi-centre study designs, which should unlock the full potential of measurement of exhaled volatile organic compounds in airways diseases such as asthma.

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More information

Accepted/In Press date: 13 June 2019
e-pub ahead of print date: 29 September 2019
Published date: September 2019

Identifiers

Local EPrints ID: 436151
URI: http://eprints.soton.ac.uk/id/eprint/436151
ISSN: 0903-1936
PURE UUID: 3950716e-23b8-41af-ad82-c8e68deb2bd3
ORCID for Clair Barber: ORCID iD orcid.org/0000-0001-5335-5129

Catalogue record

Date deposited: 29 Nov 2019 17:30
Last modified: 16 Mar 2024 04:49

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Contributors

Author: Adnan Azim
Author: Clair Barber ORCID iD
Author: Paddy Dennison
Author: John Riley
Author: Peter Howarth

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