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呼出气冷凝物挥发物可以对持续性哮喘进行敏感诊断

来源: João Cavaleiro Rufo ,Inês Paciência et al  发布日期: 2019-09-04  访问量: 45


由于目前缺乏敏感的诊断工具,儿童哮喘的诊断和分型特别复杂。这常常导致吸入类固醇治疗处方的不确定性。因此,本研究旨在探讨呼出冷凝物中测定的挥发性有机化合物是否可作为儿科人群哮喘诊断的生物标志物。 ...
标签: 电子鼻、呼出气冷凝物、挥发性有机物、哮喘
 

呼出气冷凝物挥发物可以对持续性哮喘进行敏感诊断

 

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诊断工具,儿童哮喘的诊断和分型特别复杂。这常常导致吸入类固醇治疗处方的不确定性。因此,本研究旨在探讨呼出冷凝物中测定的挥发性有机化合物是否可作为儿科人群哮喘诊断的生物标志物。

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名参与者,年龄6-18岁,在门诊过敏门诊和青少年足球队训练期间随机招募。进行肺功能、气道可逆性和皮刺试验。收集呼出的呼吸冷凝液样本,并用电子鼻评估呼吸印痕。每一位参与者的哮喘、鼻炎和特应性皮炎的医学诊断信息被检索。然后建立了基于挥发物分布的层次聚类模型。

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.

两组呼出的挥发性有机化合物分级模型能够显著区分哮喘患者和无哮喘患者(AUC=0.81[0.69-0.93],p<0.001)。在该模型中,那些患有持续性哮喘并由医生给予皮质类固醇治疗的个体也有显著差异(AUC=0.81[0.70-0.92],P<0.001)。尽管方法的特异性较低,但与支气管扩张肺量测定法相比,该方法显示出更高的整体准确性、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.
通过对呼出的呼吸冷凝液挥发物的分析,可以鉴别出在医学上诊断为哮喘的儿科个体,确定那些需要皮质类固醇治疗的个体。


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