Abstract
Background: Exacerbations are an important source of disability, symptoms, loss of quality of life and lung function, and high costs of care in patients with cystic fibrosis (CF).
Purpose: the aim was to assess the ability of noninvasive inflammation markers in exhaled breath to predict exacerbations in children with CF.
Methods: 49 children with CF aged 5-18 years were prospectively followed during one year. At 2 month-intervals, the following parameters were assessed: 1) lung function (forced expiratory volume in one second [FEV1] and forced vital capacity [FVC]) according to ERS/ATS standards; 2) exhaled breath condensate (EBC) was sampled and TNF-alpha, macrophage inhibiting factor (MIF), interleukin-6 (IL-6) and IL-8 were analysed; 3) 1 liter of exhaled breath was stabilized on carbon desorption tubes, and volatile organic compounds (VOCs) profiles were analyzed by gaschromotography time-of-flight mass spectrometry (GC-TOF-MS);
Results: The mean age was 10.3 years, and the mean FEV1 was 89,6% of predicted value. 17 of the 49 patients experienced no exacerbations (=35%) , whereas 32 children got one or more exacerbations.
Markers in EBC predicted 55% of the exacerbations correctly (sensitivity 70%, specificity 50%, 'conditionally specified models'). A combination of 9 most predictive VOCs was able to predict 79% of exacerbations correctly (sensitivity 81%, specificity 82%), provided that the time between the exhaled breath sampling and onset of exacerbations was not longer than 1 week.
Conclusion: CF exacerbations were best predicted by a set of 9 VOCs in exhaled breath, provided that the time interval between breath sampling and exacerbations was not longer than 7 days.
- Copyright ©ERS 2015
