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Review
. 2020 Dec 24;10(1):32.
doi: 10.3390/jcm10010032.

Volatile Organic Compounds in Exhaled Breath as Fingerprints of Lung Cancer, Asthma and COPD

Affiliations
Review

Volatile Organic Compounds in Exhaled Breath as Fingerprints of Lung Cancer, Asthma and COPD

Ileana Andreea Ratiu et al. J Clin Med. .

Abstract

Lung cancer, chronic obstructive pulmonary disease (COPD) and asthma are inflammatory diseases that have risen worldwide, posing a major public health issue, encompassing not only physical and psychological morbidity and mortality, but also incurring significant societal costs. The leading cause of death worldwide by cancer is that of the lung, which, in large part, is a result of the disease often not being detected until a late stage. Although COPD and asthma are conditions with considerably lower mortality, they are extremely distressful to people and involve high healthcare overheads. Moreover, for these diseases, diagnostic methods are not only costly but are also invasive, thereby adding to people's stress. It has been appreciated for many decades that the analysis of trace volatile organic compounds (VOCs) in exhaled breath could potentially provide cheaper, rapid, and non-invasive screening procedures to diagnose and monitor the above diseases of the lung. However, after decades of research associated with breath biomarker discovery, no breath VOC tests are clinically available. Reasons for this include the little consensus as to which breath volatiles (or pattern of volatiles) can be used to discriminate people with lung diseases, and our limited understanding of the biological origin of the identified VOCs. Lung disease diagnosis using breath VOCs is challenging. Nevertheless, the numerous studies of breath volatiles and lung disease provide guidance as to what volatiles need further investigation for use in differential diagnosis, highlight the urgent need for non-invasive clinical breath tests, illustrate the way forward for future studies, and provide significant guidance to achieve the goal of developing non-invasive diagnostic tests for lung disease. This review provides an overview of these issues from evaluating key studies that have been undertaken in the years 2010-2019, in order to present objective and comprehensive updated information that presents the progress that has been made in this field. The potential of this approach is highlighted, while strengths, weaknesses, opportunities, and threats are discussed. This review will be of interest to chemists, biologists, medical doctors and researchers involved in the development of analytical instruments for breath diagnosis.

Keywords: analytical platforms; asthma; chronic obstructive pulmonary disease; lung cancer; markers of respiratory diseases.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Flow diagram presenting the method used for selecting the articles; (B) trend line highlighting the number of clinical studies as a function of year; (C) flower chart illustrating number of studies by origin of country.
Figure 2
Figure 2
Graphical representation of recorded sensitivity and specificity obtained in the clinical studies included in the review, by using different analytical techniques.
Figure 3
Figure 3
Multistep classification of lung cancer subtypes; common mutations that occur in adenocarcinoma tumors and the occurrence ratio caused by smoking tobacco for each subtype. Abbreviations: SCLS: small-cell lung carcinoma; NSCLC: non-small-cell lung carcinoma; EGFR: epidermal growth factor receptor; KRAS: Kirsten rat sarcoma; ALK: anaplastic lymphoma kinase; S: smokers; NS: non-smokers. Data adapted from Zago et al., Naidoo et al., Kenfield et al. [119,120,121,122].
Figure 4
Figure 4
Discrimination between asthma, COPD and lung cancer, based on emitted VOCs (part (A)) and classification of collected volatiles according with chemical classes (part (B)).
Figure 5
Figure 5
Network analyses of lung cancer studies distribution based on detected volatiles, where circles marked with S represent the number of the study, allotted similarly in Table 3; darker diamonds represent the common VOCs; pale diamonds depict the uncommon VOCs.
Figure 6
Figure 6
Network analyses presenting the distribution of VOCs between the three reviewed conditions (part (A)) and highlighting volatiles common dispensation in case of lung cancer (part (B)), COPD (part (C)) and asthma (part (C)). The circles noted with S (in part (BD)) represent number of the study, which are allocated similarly in Table 3, and the diamonds represent the components.

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References

    1. Garwood P. World No Tobacco Day 2019: Don’t Let Tobacco Take Your Breath Away. World Health Organization; Geneva, Switzerland: 2019. News Release.
    1. Wang H., Naghavi M., Allen C., Barber R.M., Carter A., Casey D.C., Charlson F.J., Chen A.Z., Coates M.M., Coggeshall M., et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459–1544. doi: 10.1016/S0140-6736(16)31012-1. - DOI - PMC - PubMed
    1. Vos T., Allen C., Arora M., Barber R.M., Brown A., Carter A., Casey D.C., Charlson F.J., Chen A.Z., Coggeshall M., et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1545–1602. doi: 10.1016/S0140-6736(16)31678-6. - DOI - PMC - PubMed
    1. Van de Kant K.D.G., van der Sande L.J.T.M., Jöbsis Q., van Schayck O.C.P., Dompeling E. Clinical use of exhaled volatile organic compounds in pulmonary diseases: A systematic review. Respir. Res. 2012;13 doi: 10.1186/1465-9921-13-117. - DOI - PMC - PubMed
    1. Pajewska-Szmyt M., Sinkiewicz-Darol E., Bernatowicz-Łojko U., Kowalkowski T., Gadzała-Kopciuch R., Buszewski B. QuEChERS extraction coupled to GC-MS for a fast determination of polychlorinated biphenyls in breast milk from Polish women. Environ. Sci. Pollut. Res. 2019;26:30988–30999. doi: 10.1007/s11356-019-06201-y. - DOI - PMC - PubMed

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