Abstract
Introduction Early and accurate diagnosis of interstitial lung diseases (ILDs) remains a major challenge. Better noninvasive diagnostic tools are much needed. We aimed to assess the accuracy of exhaled breath analysis using eNose technology to discriminate between ILD patients and healthy controls, and to distinguish ILD subgroups.
Methods In this cross-sectional study, exhaled breath of consecutive ILD patients and healthy controls was analysed using eNose technology (SpiroNose). Statistical analyses were done using partial least square discriminant analysis and receiver operating characteristic analysis. Independent training and validation sets (2:1) were used in larger subgroups.
Results A total of 322 ILD patients and 48 healthy controls were included: sarcoidosis (n=141), idiopathic pulmonary fibrosis (IPF) (n=85), connective tissue disease-associated ILD (n=33), chronic hypersensitivity pneumonitis (n=25), idiopathic nonspecific interstitial pneumonia (n=10), interstitial pneumonia with autoimmune features (n=11) and other ILDs (n=17). eNose sensors discriminated between ILD and healthy controls, with an area under the curve (AUC) of 1.00 in the training and validation sets. Comparison of patients with IPF and patients with other ILDs yielded an AUC of 0.91 (95% CI 0.85–0.96) in the training set and an AUC of 0.87 (95% CI 0.77–0.96) in the validation set. The eNose reliably distinguished between individual diseases, with AUC values ranging from 0.85 to 0.99.
Conclusions eNose technology can completely distinguish ILD patients from healthy controls and can accurately discriminate between different ILD subgroups. Hence, exhaled breath analysis using eNose technology could be a novel biomarker in ILD, enabling timely diagnosis in the future.
Abstract
Exhaled breath analysis using eNose technology can accurately discriminate between different ILD subgroups and individual diseases. eNose technology could be a novel diagnostic tool in ILD, enabling timely diagnosis in the future. https://bit.ly/3jJs2hf
Footnotes
This article has supplementary material available from erj.ersjournals.com
This study is registered at the Netherlands Trial Register with identifier NL7860.
Conflict of interest: C.C. Moor reports grants from Boehringer Ingelheim, during the conduct of the study; grants and other from Boehringer Ingelheim, outside the submitted work; all fees and grants were paid to the Erasmus MC.
Conflict of interest: J.C. Oppenheimer has nothing to disclose.
Conflict of interest: G. Nakshbandi has nothing to disclose.
Conflict of interest: J.G.J.V. Aerts has nothing to disclose.
Conflict of interest: P. Brinkman has nothing to disclose.
Conflict of interest: A-H. Maitland-van der Zee reports grants from GSK, grants and personal fees from Boehringer Ingelheim, personal fees from AstraZeneca, outside the submitted work; all personal fees were paid to the Amsterdam UMC.
Conflict of interest: M.S. Wijsenbeek reports grants from Boehringer Ingelheim, during the conduct of the study; grants and other from Boehringer Ingelheim and Hoffman la Roche, other from Galapagos and Respivant, outside the submitted work; all fees and grants were paid to the Erasmus MC.
Support statement: The lease for the SpiroNose was financially supported by Boehringer Ingelheim. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received May 28, 2020.
- Accepted July 20, 2020.
- Copyright ©ERS 2021