Serum, urine, and breath-related biomarkers in the diagnosis of obstructive sleep apnea in children

Abstract

The scarcity of pediatric sleep laboratories has thus far precluded timely diagnosis and treatment of pediatric obstructive sleep apnea (OSA), thereby increasing the risk for residual OSA-associated morbidities. Recent developments in transcriptomics, proteomics, and exhaled condensate biomarker discovery will be reviewed in the context of exploring the validity of such methods towards development of reliable and validated diagnostic approaches for pediatric OSA. Gene expression arrays have revealed significant and reproducible changes in a restricted number of genes that should enable discriminatory ability in the recognition of OSA in children. Similarly, a number of urinary proteins have been identified that display outstanding receiver-operator properties towards the diagnosis of pediatric OSA. The technological improvements in both exhaled breath online high-pressure fast chromatography and biosensor surfaces with affinity for volatile compounds should also permit noninvasive diagnosis of pediatric OSA when combined and integrated with computational methods. It is likely that the modest efforts thus far realized in the context of biomarker discovery for the diagnosis and clinical monitoring of OSA in children will experience major acceleration in the upcoming years and lead to a completely novel paradigm in the screening and diagnosis of this disease.