Abstract
Background Asthma and chronic obstructive pulmonary disease (COPD) are among the most common respiratory diseases. To improve the early detection of exacerbations and the clinical course of asthma and COPD new biomarkers are needed. The development of non-invasive metabolomics of exhaled air into a point-of-care tool is an appealing option. However, risk factors for obstructive pulmonary diseases can potentially introduce confounding markers due to altered volatile organic compounds (VOCs) patterns linked to these risk factors instead of the disease. We conducted a systematic review and presented a comprehensive list of VOCs associated with these risk factors.
Methods A PRISMA-oriented systematic search was conducted across PubMed, Embase, and Cochrane Libraries between 2000 and 2022. Studies published in full-length, evaluating VOCs in exhaled breath were included. A narrative synthesis of the data was conducted, and the Newcastle-Ottawa Scale was used to assess the quality of included studies.
Results The search yielded 2209 records, based on the inclusion/exclusion criteria, 24 articles were included in the qualitative synthesis. In total, 232 individual VOCs associated with risk factors for obstructive pulmonary diseases were found, 58 compounds were reported more than once and twelve were reported as potential markers of asthma and/or COPD in other studies. Critical appraisal found that the identified studies were methodologically heterogeneous and had a variable risk of bias.
Conclusion We identified a series of exhaled VOCs associated with risk factors for asthma and/or COPD. Identification of these VOCs is necessary for the further development of exhaled metabolites-based point-of-care tests in these obstructive pulmonary diseases.
Footnotes
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Conflict of interest: S Shahbazi Khamas and AH Alizadeh Bahmani have nothing to disclose. SJH Vijverberg has received research funding from Dutch Lung Foundation, she is the chair of Young Investigators of Netherlands Respiratory Society (unpaid), and she is early career member representative of the Pediatrics Assembly of the European Respiratory Society (unpaid). P Brinkman has received funding from Amsterdam UMC, Vertex, Stichting Astma Bestrijding, Boehringer Ingelheim, Eurostars, and Horizon Europe Framework Program. AHM van der Zee received unrestricted research grants from Vertex and Boehringer Ingelheim, received funding from Dutch Lung Foundation, Stichting Astma Bestrijding, and Innovative Medicine Initiative (IMI) 3TR research grant; received consulting fees (paid to institution) from AstraZeneca and Boehringer Ingelheim, and received honoraria (paid to institution) for lectures by GSK. She is also the PI of P4O2 (Precision Medicine for more Oxygen) public-private partnership sponsored by Health Holland involving many private partners who contribute in cash and/or in kind. Partners in the Precision Medicine for more Oxygen (P4O2) consortium are the Amsterdam UMC, Leiden University Medical Center, Maastricht UMC+, Maastricht University, UMC Groningen, UMC Utrecht, Utrecht University, TNO, Aparito, Boehringer Ingelheim, Breathomix, Clear, Danone Nutricia Research, Fluidda, MonitAir, Ncardia, Ortec Logiqcare, Philips, Proefdiervrij, Quantib-U, RespiQ, Roche, Smartfish, SODAQ, Thirona, TopMD, Lung Alliance Netherlands (LAN) and the Lung Foundation Netherlands (Longfonds). The consortium is additionally funded by the PPP Allowance made available by Health~Holland, Top Sector Life Sciences Health (LSHM20104; LSHM20068), to stimulate public-private partnerships and by Novartis.), and she is the president of the federation of innovative drug research in the Netherlands (FIGON) (unpaid) and president of the European Association of Systems Medicine (EASYM).
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- Received March 6, 2023.
- Accepted April 21, 2023.
- Copyright ©The authors 2023
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