Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr-May:225:107583.
doi: 10.1016/j.rmed.2024.107583. Epub 2024 Mar 4.

Exhaled breath analyses for bronchial thermoplasty in severe asthma patients

Pieta C Wijsman  1 , Annika W M Goorsenberg  1 , Julia N S d'Hooghe  1 , Els J M Weersink  1 , Dominic W Fenn  1 , Anke H Maitland van der Zee  1 , Jouke T Annema  1 , Paul Brinkman  1 , Peter I Bonta  2
Affiliations
Free article

Exhaled breath analyses for bronchial thermoplasty in severe asthma patients

Pieta C Wijsman et al. Respir Med. 2024 Apr-May.
Free article

Abstract

Background: Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma. Although multiple trials have demonstrated clinical improvement after BT, optimal patient selection remains a challenge and the mechanism of action is incompletely understood. The aim of this study was to examine whether exhaled breath analysis can contribute to discriminate between BT-responders and non-responders at baseline and to explore pathophysiological insights of BT.

Methods: Exhaled breath was collected from patients at baseline and six months post-BT. Patients were defined as responders or non-responders based on a half point increase in asthma quality of life questionnaire scores. Gas chromatography-mass spectrometry was used for volatile organic compounds (VOCs) detection and analyses. Analytical workflow consisted of: 1) detection of VOCs that differentiate between responders and non-responders and those that differ between baseline and six months post-BT, 2) identification of VOCs of interest and 3) explore correlations between clinical biomarkers and VOCs.

Results: Data was available from 14 patients. Nonanal, 2-ethylhexanol and 3-thujol showed a significant difference in intensity between responders and non-responders at baseline (p = 0.04, p = 0.01 and p = 0.03, respectively). After BT, no difference was found in the compound intensity of these VOCs. A negative correlation was observed between nonanal and IgE and BALF eosinophils (r = -0.68, p < 0.01 and r = -0.61, p = 0.02 respectively) and 3-thujol with BALF neutrophils (r = -0.54, p = 0.04).

Conclusions: This explorative study identified discriminative VOCs in exhaled breath between BT responders and non-responders at baseline. Additionally, correlations were found between VOC's and inflammatory BALF cells. Once validated, these findings encourage research in breath analysis as a non-invasive easy to apply technique for identifying airway inflammatory profiles and eligibility for BT or immunotherapies in severe asthma.

Keywords: Asthma; Bronchial thermoplasty; Exhaled breath; Gas chromatography-mass spectrometry; Volatile organic compounds.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest PIB declares to have received financial support from the Netherlands LungFoundation (Grant number: 5.2.13.064JO), Stichting Astma Bestrijding (SAB): grant nr. 1018/041, The Netherlands Organization for Health Research and Development (ZonMw grant number: 90713477) and Boston Scientific Corporation during the conduct of this study. AHM reports grants from Health Holland, GSK and Boehringer Ingelheim outside the submitted work. PB reports grants from Amsterdam UMC, Vertex, Stichting Astma Bestrijding (SAB), Boehringer Ingelheim Grant, Eurostars, Horizon Europe Framework Programme (HORIZON) outside the submitted work. All other authors have no conflict of interest to disclose.