title: Exhaled breath profiling in diagnosing wheezy preschool children.
abstract: Although wheeze is common in preschool children, the underlying pathophysiology has not yet been disentangled. Volatile organic compounds (VOCs) in exhaled breath may serve as noninvasive markers of early wheeze. We aimed to assess the feasibility of VOC collection in preschool children, and to study whether a VOC profile can differentiate between children with and without recurrent wheeze. We included children (mean (range) age 3.3 (1.9-4.5) yrs) with (n=202) and without (n=50) recurrent wheeze. Exhaled VOCs were analysed by gas chromatography-time-of-flight mass spectrometry. VOC profiles were generated by ANOVA simultaneous component analysis (ASCA) and sparse logistic regression (SLR). Exhaled breath collection was possible in 98% of the children. In total, 913 different VOCs were detected. The signal-to-noise ratio improved after correction for age, sex and season using ASCA pre-processing. An SLR model with 28 VOCs correctly classified 83% of the children (84% sensitivity, 80% specificity). After six-fold cross-validation, 73% were correctly classified (79% sensitivity, 50% specificity). Assessment of VOCs in exhaled breath is feasible in young children. VOC profiles are able to distinguish children with and without recurrent wheeze with a reasonable accuracy. This proof of principle paves the way for additional research on VOCs in preschool wheezing.
authors.affiliation: Dept of Paediatric Pulmonology, School for Public Health and Primary Care, CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
authors.forename: Kim D G
authors.initials: KD
authors.lastname: van de Kant
authors.forename: Joep J B N
authors.initials: JJ
authors.lastname: van Berkel
authors.forename: Quirijn
authors.initials: Q
authors.lastname: Jöbsis
authors.forename: Valéria
authors.initials: V
authors.lastname: Lima Passos
authors.forename: Ester M M
authors.initials: EM
authors.lastname: Klaassen
authors.forename: Linda
authors.initials: L
authors.lastname: van der Sande
authors.forename: Onno C P
authors.initials: OC
authors.lastname: van Schayck
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.forename: Frederik Jan
authors.initials: FJ
authors.lastname: van Schooten
authors.forename: Eduard
authors.initials: E
authors.lastname: Derks
authors.forename: Edward
authors.initials: E
authors.lastname: Dompeling
authors.forename: Jan W
authors.initials: JW
authors.lastname: Dallinga
mesh_terms: D001944:Breath Tests; D002675:Child, Preschool; D045853:Exhalation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000175:diagnosis*; D055549:Volatile Organic Compounds / Q000032:analysis*
chemical_list: D055549:Volatile Organic Compounds