Changes in exhaled volatile organic compounds following indirect bronchial challenge in suspected asthma

Peel, Adam, Wang, Ran, Ahmed, Waqar, White, Iain, Wilkinson, Maxim, Loke, Yoon K., Wilson, Andrew M. and Fowler, Stephen J. (2023) Changes in exhaled volatile organic compounds following indirect bronchial challenge in suspected asthma. Thorax, 78 (10). pp. 966-973. ISSN 0040-6376

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Abstract

Background: Inhaled mannitol provokes bronchoconstriction via mediators released during osmotic degranulation of inflammatory cells, and, hence represents a useful diagnostic test for asthma and model for acute attacks. We hypothesised that the mannitol challenge would trigger changes in exhaled volatile organic compounds (VOCs), generating both candidate biomarkers and novel insights into their origin.   Methods: Participants with a clinical diagnosis of asthma, or undergoing investigation for suspected asthma, were recruited. Inhaled mannitol challenges were performed, followed by a sham challenge after 2 weeks in participants with bronchial hyper-responsiveness (BHR). VOCs were collected before and after challenges and analysed using gas chromatography–mass spectrometry.   Results: Forty-six patients (mean (SD) age 52 (16) years) completed a mannitol challenge, of which 16 (35%) were positive, and 15 of these completed a sham challenge. Quantities of 16 of 51 identified VOCs changed following mannitol challenge (p<0.05), of which 11 contributed to a multivariate sparse partial least square discriminative analysis model, with a classification error rate of 13.8%. Five of these 16 VOCs also changed (p<0.05) in quantity following the sham challenge, along with four further VOCs. In patients with BHR to mannitol distinct postchallenge VOC signatures were observed compared with post-sham challenge.   Conclusion: Inhalation of mannitol was associated with changes in breath VOCs, and in people with BHR resulted in a distinct exhaled breath profile when compared with a sham challenge. These differentially expressed VOCs are likely associated with acute airway inflammation and/or bronchoconstriction and merit further investigation as potential biomarkers in asthma.

Item Type: Article
Additional Information: Funding: Support provided by Asthma UK Centre for Applied Research (AUK-AC-2018-01). SJF, WA and RW are supported by the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC) (Grant Number: IS-BRC-1215-20007). IW is supported by the Slovenian research agency (ARRS) through program P1-0034: Analytics and Chemical Characterization of Materials and Processes.
Uncontrolled Keywords: asthma,pulmonary and respiratory medicine ,/dk/atira/pure/subjectarea/asjc/2700/2740
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group
Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: LivePure Connector
Date Deposited: 20 Mar 2023 11:34
Last Modified: 13 Nov 2023 17:55
URI: https://ueaeprints.uea.ac.uk/id/eprint/91578
DOI: 10.1136/thorax-2022-219708

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