title: Breathomics in lung disease.
abstract: Volatile organic compounds (VOCs) are produced by virtually all metabolic processes of the body. As such, they have potential to serve as noninvasive metabolic biomarkers. Since exhaled VOCs are either derived from the respiratory tract itself or have passed the lungs from the circulation, they are candidate biomarkers in the diagnosis and monitoring of pulmonary diseases in particular. Good examples of the possibilities of exhaled volatiles in pulmonary medicine are provided by the potential use of VOCs to discriminate between patients with lung cancer and healthy control subjects and to noninvasively diagnose infectious diseases and the association between VOCs and markers of disease activity that has been established in obstructive lung diseases. Several steps are, however, required prior to implementation of breath-based diagnostics in daily clinical practice. First, VOCs should be studied in the intention-to-diagnose population, because biomarkers are likely to be affected by multiple (comorbid) conditions. Second, breath collection and analysis procedures need to be standardized to allow pooling of data. Finally, apart from probabilistic analysis for diagnostic purposes, detailed examination of the nature of volatile biomarkers not only will improve our understanding of the pathophysiologic origins of these markers and the nature of potential confounders but also can enable the development of sensors that exhibit maximum sensitivity and specificity toward specific applications. By adhering to such an approach, exhaled biomarkers can be validated in the diagnosis, monitoring, and treatment of patients in pulmonary medicine and contribute to the development of personalized medicine.
authors.affiliation: Department of Respiratory Medicine, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam; Department of Pediatric Respiratory Medicine and Allergy, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam; Department of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: m.p.vanderschee@amc.uva.nl.
authors.forename: Marc Philippe
authors.initials: MP
authors.lastname: van der Schee
authors.affiliation: Department of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands; The Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands.; Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Tamara
authors.initials: T
authors.lastname: Paff
authors.affiliation: Department of Respiratory Medicine, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam.
authors.forename: Paul
authors.initials: P
authors.lastname: Brinkman
authors.affiliation: Department of Pediatric Respiratory Medicine and Allergy, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam.
authors.forename: Willem Marinus Christiaan
authors.initials: WMC
authors.lastname: van Aalderen
authors.affiliation: Department of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Eric Gerardus
authors.initials: EG
authors.lastname: Haarman
authors.affiliation: Department of Respiratory Medicine, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam.
authors.forename: Peter Jan
authors.initials: PJ
authors.lastname: Sterk
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D001944:Breath Tests; D045853:Exhalation; D006801:Humans; D008168:Lung / Q000378:metabolism*; D008171:Lung Diseases / Q000175:diagnosis* / Q000378:metabolism; D015272:Pulmonary Medicine / Q000379:methods*
chemical_list: D015415:Biomarkers