A European Respiratory Society technical standard: exhaled biomarkers in lung disease

Ildiko Horváth; Peter J Barnes; Stelios Loukides; Peter J Sterk; Marieann Högman; Anna-Carin Olin; Anton Amann; Balazs Antus; Eugenio Baraldi; Andras Bikov; Agnes W Boots; Lieuwe D Bos; Paul Brinkman; Caterina Bucca; Giovanna E Carpagnano; Massimo Corradi; Simona Cristescu; Johan C de Jongste; Anh-Tuan Dinh-Xuan; Edward Dompeling; Niki Fens; Stephen Fowler; Jens M Hohlfeld; Olaf Holz; Quirijn Jöbsis; Kim Van De Kant; Hugo H Knobel; Konstantinos Kostikas; Lauri Lehtimäki; Jon Lundberg; Paolo Montuschi; Alain Van Muylem; Giorgio Pennazza; Petra Reinhold; Fabio L M Ricciardolo; Philippe Rosias; Marco Santonico; Marc P van der Schee; Frederik-Jan van Schooten; Antonio Spanevello; Thomy Tonia; Teunis J Vink

doi:10.1183/13993003.00965-2016

A European Respiratory Society technical standard: exhaled biomarkers in lung disease

Eur Respir J. 2017 Apr 26;49(4):1600965. doi: 10.1183/13993003.00965-2016. Print 2017 Apr.

Authors

Ildiko Horváth¹, Peter J Barnes², Stelios Loukides³, Peter J Sterk⁴, Marieann Högman⁵, Anna-Carin Olin⁶, Anton Amann⁷, Balazs Antus⁸, Eugenio Baraldi⁹, Andras Bikov¹⁰, Agnes W Boots¹¹, Lieuwe D Bos¹², Paul Brinkman⁴, Caterina Bucca¹³, Giovanna E Carpagnano¹⁴, Massimo Corradi¹⁵, Simona Cristescu¹⁶, Johan C de Jongste¹⁷, Anh-Tuan Dinh-Xuan¹⁸, Edward Dompeling¹⁹, Niki Fens⁴, Stephen Fowler²⁰, Jens M Hohlfeld^{21

22}, Olaf Holz²¹, Quirijn Jöbsis²³, Kim Van De Kant¹⁹, Hugo H Knobel²⁴, Konstantinos Kostikas²⁵, Lauri Lehtimäki²⁶, Jon Lundberg²⁷, Paolo Montuschi²⁸, Alain Van Muylem²⁹, Giorgio Pennazza³⁰, Petra Reinhold³¹, Fabio L M Ricciardolo³², Philippe Rosias^{19

33}, Marco Santonico³⁰, Marc P van der Schee⁴, Frederik-Jan van Schooten¹¹, Antonio Spanevello³⁴, Thomy Tonia³⁵, Teunis J Vink²⁴

Affiliations

¹ Dept of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary ildiko.horvath@koranyi.hu.
² National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, UK.
³ Pulmonary Dept, Nimits Hospital, Athens, Greece.
⁴ Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
⁵ Centre for Research & Development, Uppsala University/Gävleborg County Council, Gävle, Sweden.
⁶ Occupational and Environmental Medicine, Sahlgrenska Academy and University Hospital, Goteborg, Sweden.
⁷ Innsbruck Medical University, Innsbruck, Austria.
⁸ Dept of Pathophysiology, National Korányi Institute of Pulmonology, Budapest, Hungary.
⁹ Pediatric Pneumonolgy, University of Padova, Padova, Italy.
¹⁰ Dept of Pulmonology, Semmelweis University, Budapest, Hungary.
¹¹ Dept of Pharmacology and Toxicology, University of Maastricht, Maastricht, The Netherlands.
¹² Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
¹³ Biomedical Sciences and Human Oncology, Universita' di Torino, Turin, Italy.
¹⁴ Dept of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
¹⁵ University of Parma, Parma, Italy.
¹⁶ Dept of Molecular and Laser Physics, Institute for Molecules and Materials, Radboud University, Nijmegen, The Netherlands.
¹⁷ Dept of Pediatrics/Respiratory Medicine, Erasmus MC-Sophia Childrens' Hospital, Rotterdam, The Netherlands.
¹⁸ Physiology, Paris Descartes University Cochin Hospital, Paris, France.
¹⁹ Dept of Paediatrics/Family Medicine Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands.
²⁰ Respiratory Research Group, University of Manchester Wythenshawe Hospital, Manchester, UK.
²¹ Clinical Airway Research, Fraunhofer Institute of Toxicology and Experimental Medicine (ITEM), Hannover, Germany.
²² Medizinische Hochschule Hannover, Hannover, Germany.
²³ Department of Paediatric Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
²⁴ Philips Research, High Tech Campus 11, Eindhoven, The Netherlands.
²⁵ 2nd Respiratory Medicine Dept, University of Athens Medical School, Athens, Greece.
²⁶ Medical School, University of Tampere, Tampere, Finland.
²⁷ Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
²⁸ Pharmacology, Catholic University of the Sacred Heart, Rome, Italy.
²⁹ Hopital Erasme Cliniques Universitaires de Bruxelles, Bruxelles, Belgium.
³⁰ Faculty of Engineering, University Campus Bio-Medico, Rome, Italy.
³¹ Institute of Molecular Pathogenesis, Friedrich Loeffler Institut, Jena, Germany.
³² Clinic of Respiratory Disease, Dept of Clinical and Biological Sciences, University of Torino, Torino, Italy.
³³ Dept of Pediatrics, Maasland Hospital, Sittard, The Netherlands.
³⁴ Fondazione Salvatore Maugeri, Tradate, Italy.
³⁵ European Respiratory Society, Lausanne, Switzerland.

PMID: 28446552
DOI: 10.1183/13993003.00965-2016

Abstract

Breath tests cover the fraction of nitric oxide in expired gas (F_eNO), volatile organic compounds (VOCs), variables in exhaled breath condensate (EBC) and other measurements. For EBC and for F_eNO, official recommendations for standardised procedures are more than 10 years old and there is none for exhaled VOCs and particles. The aim of this document is to provide technical standards and recommendations for sample collection and analytic approaches and to highlight future research priorities in the field. For EBC and F_eNO, new developments and advances in technology have been evaluated in the current document. This report is not intended to provide clinical guidance on disease diagnosis and management.Clinicians and researchers with expertise in exhaled biomarkers were invited to participate. Published studies regarding methodology of breath tests were selected, discussed and evaluated in a consensus-based manner by the Task Force members.Recommendations for standardisation of sampling, analysing and reporting of data and suggestions for research to cover gaps in the evidence have been created and summarised.Application of breath biomarker measurement in a standardised manner will provide comparable results, thereby facilitating the potential use of these biomarkers in clinical practice.

Publication types

Practice Guideline
Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers / analysis
Breath Tests / methods*
Europe
Exhalation
Humans
Lung Diseases / diagnosis*
Lung Diseases / therapy
Nitric Oxide / analysis*
Societies, Medical
Volatile Organic Compounds / analysis*

Substances

Biomarkers
Volatile Organic Compounds
Nitric Oxide