Exhaled volatilome analysis as a useful tool to discriminate asthma with other coexisting atopic diseases in women of childbearing age

Rosa Alba Sola Martínez ,Manuel Cánovas Díaz,José Antonio Noguera-Velasco ,Manuel Rolandi Sánchez-Solís ,Pedro Jiménez‐Guerrero ,Julia Gallego‐Jara ,Luis García‐Marcos ,Gema Lozano‐Terol ,Eva Morales,Esther Cantero‐Cano ,Teresa De Diego

doi:10.1038/s41598-021-92933-2

Rosa Alba Sola Martínez , Manuel Cánovas Díaz + Show 9 more

Open Access

https://doi.org/10.1038/s41598-021-92933-2

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Abstract

The prevalence of asthma is considerably high among women of childbearing age. Most asthmatic women also often have other atopic disorders. Therefore, the differentiation between patients with atopic diseases without asthma and asthmatics with coexisting diseases is essential to avoid underdiagnosis of asthma and to design strategies to reduce symptom severity and improve quality of life of patients. Hence, we aimed for the first time to conduct an analysis of volatile organic compounds in exhaled breath of women of childbearing age as a new approach to discriminate between asthmatics with other coexisting atopic diseases and non-asthmatics (with or without atopic diseases), which could be a helpful tool for more accurate asthma detection and monitoring using a noninvasive technique in the near future. In this study, exhaled air samples of 336 women (training set (n = 211) and validation set (n = 125)) were collected and analyzed by thermal desorption coupled with gas chromatography-mass spectrometry. ASCA (ANOVA (analysis of variance) simultaneous component analysis) and LASSO + LS (least absolute shrinkage and selection operator + logistic regression) were employed for data analysis. Fifteen statistically significant models (p-value < 0.05 in permutation tests) that discriminated asthma with other coexisting atopic diseases in women of childbearing age were generated. Acetone, 2-ethyl-1-hexanol and a tetrahydroisoquinoline derivative were selected as discriminants of asthma with other coexisting atopic diseases. In addition, carbon disulfide, a tetrahydroisoquinoline derivative, 2-ethyl-1-hexanol and decane discriminated asthma disease among patients with other atopic disorders. Results of this study indicate that refined metabolomic analysis of exhaled breath allows asthma with other coexisting atopic diseases discrimination in women of reproductive age.

Highlights

The prevalence of asthma is considerably high among women of childbearing age
Representation of multiple correspondence analysis (MCA) conducted with an open cohort of 18- to 45-year-old women constructed using European Health Survey in Spain 2014 (EHSS)-2014 data collection is shown in Fig. 2B. 6.9% of women of childbearing age were asthmatics
This study has shown that discrimination between asthmatics with other coexisting atopic diseases and non-asthmatics using exhaled breath analysis is feasible when metabolomics best practices are implemented

Summary

Introduction

The prevalence of asthma is considerably high among women of childbearing age. Most asthmatic women often have other atopic disorders. Blood eosinophil count has been suggested as a useful tool for asthma diagnosis, levels can be influenced by several factors[19,20] Techniques such as induced sputum, bronchoscopy with bronchoalveolar lavage (BAL) and biopsy are suitable for airway inflammation and oxidative stress assessment, but only induced sputum is a noninvase technique[21,22]. In this sense, scientific community is searching for new alternative noninvasive techniques or biomarkers for asthma phenotypes identification, treatment monitoring, exacerbations prediction, differential diagnosis of other pathologies with similar symptoms and personalized diagnosis when patients suffer from comorbidities such as rhinosinusitis or other atopic disorders[6,22,23]

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