Breath Analysis can determine exacerbation vs. stable disease
As COPD becomes more prominent among causes of death in Americans, further studies are performed to teach healthcare professionals more and more about the condition.
COPD is a condition that can be exacerbated by a number of factors. The characteristics of an exacerbation include:
- mostly driven by viral or bacterial airway infection
- have a negative impact on patients’ quality of life
- accelerate lung function decline
- increase mortality
- represent a huge economic burden to society
Currently, there is no diagnostic test or biomarker to confirm the presence of an exacerbation of COPD. The diagnosis of an exacerbation is based on the patient’s history and clinical findings, such as increased dyspnea, cough, sputum volume, and sputum purulence. However, these symptoms are nonspecific and may lead to the wrong treatment, over-treatment or non-treatment. A biomarker that identifies exacerbations of COPD would be useful for diagnosis and monitoring of individual patients, whilst representing an objective endpoint in clinical trials.
A recent analysis of exhaled air in patients with COPD measured metabolites via gas chromatography-mass spectrometry (GC-MS) or by cross-reactive gas-sensor technology (also called electronic nose or eNose).
Both GC-MS and eNose were utilized in the follow-up study, which evaluated persons age 45 or older with mild-to-severe COPD. The patient’s most recent exacerbation had to have occurred within the past three years, but must have concluded at least four weeks prior to the study. Patients were instructed to refrain from eating, drinking, or smoking for at least two hours prior to breath sampling.
When monitoring COPD patients with ambulatory treated exacerbations of COPD, exhaled breath metabolomic profiles as measured by GC-MS and eNose were different during an exacerbation as compared to baseline and recovery. Therefore, exhaled breath has the potential to serve as a noninvasive biomarker for COPD-exacerbations.
As almost certainly the first study of its kind, the researchers recommended further evaluation of both CS-MS and eNose.