Abstract
Background: “breathomics” enables indirect analysis of metabolic patterns underlying a respiratory disease. In this study, we analyze exhaled breath condensate (EBC) in asthmatic children before (T0) and after (T1) a three-week course of inhaled beclomethasone dipropionate (BDP). Methods: we recruited steroid-naive asthmatic children for whom inhaled steroids were indicated and healthy children, evaluating asthma control, spirometry and EBC (in asthmatics at T0 and T1). A liquid-chromatography–mass-spectrometry untargeted analysis was applied to EBC and a mass spectrometry-based target analysis to urine samples. Results: metabolomic analysis discriminated asthmatic (n = 26) from healthy children (n = 16) at T0 and T1, discovering 108 and 65 features relevant for the discrimination, respectively. Searching metabolomics databases, seven putative biomarkers with a plausible role in asthma biochemical–metabolic processes were found. After BDP treatment, asthmatic children, in the face of an improved asthma control (p < 0.001) and lung function (p = 0.01), showed neither changes in EBC metabolomic profile nor in urinary endogenous steroid profile. Conclusions: “breathomics” can discriminate asthmatic from healthy children, with prostaglandin, fatty acid and glycerophospholipid as putative markers. The three-week course of BDP—in spite of a significant clinical improvement—was not associated with changes in EBC metabolic arrangement and urinary steroid profile.
Highlights
Pediatric asthma is a heterogeneous chronic inflammatory disease of the airways, characterized by a large number of observable characteristics related to a complex combination of underlying pathophysiological and/or molecular mechanisms, which involve several cell types, mediators and immune pathways [1,2,3]
An interesting application is the metabolomic analysis of exhaled breath condensate (“breathomics”)—a biologic fluid obtained by cooling down exhaled air with a composition that mirrors the physio-pathologic processes of the lung [18,19]
In spite of a significant clinical and functional improvement, we found no significant difference in the metabolomic profile within the group of asthmatic children after beclomethasone dipropionate (BDP)
Summary
Pediatric asthma is a heterogeneous chronic inflammatory disease of the airways, characterized by a large number of observable characteristics (phenotypes) related to a complex combination of underlying pathophysiological and/or molecular mechanisms (endotypes), which involve several cell types, mediators and immune pathways [1,2,3]. The different endotypes have been investigated in recent years through highly sophisticated analysis techniques, such as the “-omic sciences”, which have the Metabolites 2020, 10, 390; doi:10.3390/metabo10100390 www.mdpi.com/journal/metabolites. An interesting application is the metabolomic analysis of exhaled breath condensate (“breathomics”)—a biologic fluid obtained by cooling down exhaled air with a composition that mirrors the physio-pathologic processes of the lung [18,19]. Exhaled breath condensate (EBC) analysis enables an indirect noninvasive assessment of the lung and it is a technique with promising application, especially in pediatrics [19]. For pediatricians, it is very important to develop diagnostic techniques not requiring a high level of cooperation since even the application of spirometry, a key diagnostic technique in asthma, can be limited by poor children’s cooperation
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