title: Volatolomics of breath as an emerging frontier in pulmonary arterial hypertension.
abstract: There is accumulating evidence in support of the significant improvement in survival rates and clinical outcomes when pulmonary arterial hypertension (PAH) is diagnosed at early stages. Nevertheless, it remains a major clinical challenge and the outcomes are dependent on invasive right heart catheterisation.Resulting from pathophysiological processes and detectable in exhaled breath, volatile organic compounds (VOCs) have been proposed as noninvasive biomarkers for PAH. Studies have confirmed significant alterations of the exhaled VOCs among PAH patients when compared to controls and/or patients with other respiratory diseases. This suggests exhaled breath analysis as a potential noninvasive medical application in the field of PAH.In this article, we review and discuss the progress made so far in the field of exhaled volatolomics (the omics of VOCs) as a potential noninvasive diagnostics of PAH. In addition, we propose a model including possible biochemical pathways on the level of the remodelled artery, in which specific VOCs could be detectable in exhaled breath during the early phases of PAH. We debate the different analytical approaches used and recommend a diagram including a "bottom-top" strategy, from basic to translational studies, required for promoting the field.
authors.affiliation: Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Paris, France mnakhleh@gmail.com.|AP-HP, DHU TORINO, Service de Pneumologie, Hôpital Bicêtre, Paris, France.|Inserm UMR_S 999, LabEx LERMIT, Hôpital Marie Lannelongue, Paris, France.
authors.forename: Morad K
authors.initials: MK
authors.lastname: Nakhleh
authors.affiliation: Dept of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-IIT, Haifa, Israel.
authors.forename: Hossam
authors.initials: H
authors.lastname: Haick
authors.affiliation: Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Paris, France.|AP-HP, DHU TORINO, Service de Pneumologie, Hôpital Bicêtre, Paris, France.|Inserm UMR_S 999, LabEx LERMIT, Hôpital Marie Lannelongue, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
authors.affiliation: Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Paris, France.|AP-HP, DHU TORINO, Service de Pneumologie, Hôpital Bicêtre, Paris, France.|Inserm UMR_S 999, LabEx LERMIT, Hôpital Marie Lannelongue, Paris, France.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cohen-Kaminsky
mesh_terms: D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests / Q000379:methods; D042241:Early Diagnosis; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000503:physiopathology; D055549:Volatile Organic Compounds / Q000032:analysis*
chemical_list: D015415:Biomarkers; D055549:Volatile Organic Compounds