Abstract
Background Early and accurate diagnosis of interstitial lung diseases (ILDs) remains a major challenge. Better non-invasive diagnostic tools are highly 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 (HCs) was analysed using eNose technology (SpiroNose). Statistical analyses were done using Partial Least Square Discriminant Analysis (PLS-DA) and Receiver Operating Characteristic (ROC) analysis. An independent training and validation set (2:1) was used in larger subgroups.
Results A total of 322 ILD patients and 48 HCs were included; sarcoidosis (n=141), idiopathic pulmonary fibrosis (n=85), ILD associated with connective tissue disease (n=33), chronic hypersensitivity pneumonitis (n=25), idiopathic NSIP (n=10), interstitial pneumonia with autoimmune features (n=11), and other ILDs (n=17). eNose sensors discriminated between ILD and HCs, with an AUC of 1.0 in the training and validation set. 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 AUCs ranging from 0.85 to 0.99.
Conclusion 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 new biomarker in ILD, enabling timely diagnosis in the future.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. 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: Dr. Oppenheimer has nothing to disclose.
Conflict of interest: Dr. Oppenheimer has nothing to disclose.
Conflict of interest: Dr. Aerts has nothing to disclose.
Conflict of interest: Dr. Brinkman has nothing to disclose.
Conflict of interest: Dr. Maitland - van der Zee reports grants from GSK, grants and personal fees from Boehringer Ingelheim, personal fees from Astra Zeneca, outside the submitted work. All personal fees were paid to the AmsterdamUMC.
Conflict of interest: Dr. Wijsenbeek reports grants from Boehringer Ingelheim, during the conduct of the study; grants and other from Boehringer Ingelheim, grants and other from Hoffman la Roche, other from Galapagos, other from Respivant, outside the submitted work; All fees and grants were paid to the Erasmus MC.
- Received May 28, 2020.
- Accepted July 20, 2020.
- Copyright ©ERS 2020