Detection of inflammation by measuring volatile organic compounds in exhaled breath of patients with cystic fibrosis

Abstract

Cystic fibrosis (CF) is a progressive disease characterized by chronic infections and pulmonary exacerbations, causing lung function decline and permanent tissue damage. Adequate intervention, targeting exacerbation through antibiotic treatment is needed to preserve quality of life. Volatile Organic Compounds (VOCs) in exhaled breath have been suggested as a new biomarker for pathogen colonization and respiratory inflammation. Detection of pulmonary exacerbation through exhaled breath analysis, using gas chromatography with mass spectrometry (GC-MS) and electric nose (eNose), will allow for less invasive detection of inflammation and avoid inadequate or unnecessary treatment. This review assessed the potential of VOCs for predicting pulmonary exacerbation in patients with CF based on recent studies in this field. Studies included showed variety in study objectives, study population, methodology and results on VOC findings. Results show promising findings in exacerbation identification and prediction. However, no ambiguous conclusion could be drawn after comparing the collected data, therefore not providing selected VOCs or VOC-patterns specific for exacerbation detection. Variation in results substantiates the observation that exhaled breath analysis is far from clinical implementation. Future research should make use of universal protocols, include larger cohorts and longitudinal data, and focus on discrimination between pathogen- and exacerbation-specific VOCs by setting up fitting cohort studies and comparing findings to in-vitro studies.