Related Experiment Video
Updated: Mar 8, 2026
Breath Collection from Children for Disease Biomarker Discovery
Published on: February 14, 2019
Can exhaled volatile organic compounds predict asthma exacerbations in children?
Dillys van Vliet1, Agnieszka Smolinska2,3, Quirijn Jöbsis1
1Department of Pediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Insights
Exhaled volatile organic compounds (VOCs) can predict asthma exacerbations in children up to 14 days in advance. This non-invasive breath test shows promise for improving asthma management and control in pediatric patients.
Area of Science:
- Pulmonary Medicine
- Biomarker Discovery
- Analytical Chemistry
Background:
- Asthma control in children often falls short of guideline targets.
- Non-invasive monitoring of airway inflammation is crucial for improving asthma management.
- Identifying predictive biomarkers for asthma exacerbations is a key research area.
Purpose of the Study:
- To identify volatile organic compounds (VOCs) in exhaled breath that predict asthma exacerbations in children.
- To determine the chemical identity of these predictive VOC biomarkers.
- To assess the potential of VOC analysis for early asthma exacerbation detection.
Main Methods:
- A prospective observational study involving 96 asthmatic children over one year.
- Exhaled breath volatile organic compounds (VOCs) analyzed using gas chromatography time-of-flight mass spectrometry.
- Random Forest classification and ROC-curve analysis used to identify predictive VOCs.
Main Results:
- A set of 7 VOCs (aldehydes, hydrocarbon, ketone, aromatic, unidentified) showed predictive power for asthma exacerbations.
- The model achieved 88% sensitivity and 75% specificity for predicting exacerbations 14 days prior.
- The area under the ROC-curve was 90%, indicating strong predictive performance.
Conclusions:
- Exhaled VOCs demonstrate potential for predicting pediatric asthma exacerbations within a 14-day window.
- This non-invasive method could aid in proactive asthma management.
- Further validation in larger cohorts is recommended before clinical implementation.
Background:
Asthma control does not yet meet the goals of asthma management guidelines. Non-invasive monitoring of airway inflammation may help to improve the level of asthma control in children.
Objectives:
(1) To identify a set of exhaled volatile organic compounds (VOCs) that is most predictive for an asthma exacerbation in children. (2) To elucidate the chemical identity of predictive biomarkers.
Methods:
In a one-year prospective observational study, 96 asthmatic children participated . During clinical visits at 2 month intervals, asthma control, fractional exhaled nitric oxide, lung function (FEV1, FEV1/VC) and VOCs in exhaled breath were determined by means of gas chromatography time-of-flight mass spectrometry. Random Forrest classification modeling was used to select predictive VOCs, followed by plotting of receiver operating characteristic-curves (ROC-curves).
Results:
An inverse relationship was found between the predictive power of a set of VOCs and the time between sampling of exhaled breath and the onset of exacerbation. The sensitivity and specificity of the model predicting exacerbations 14 days after sampling were 88% and 75%, respectively. The area under the ROC-curve was 90%. The sensitivity for prediction of asthma exacerbations within 21 days after sampling was 63%. In total, 7 VOCs were selected for the classification model: 3 aldehydes, 1 hydrocarbon, 1 ketone, 1 aromatic compound, and 1 unidentified VOC.
Conclusion:
VOCs in exhaled breath showed potential for predicting asthma exacerbations in children within 14 days after sampling. Before using this in clinical practice, the validity of predicting asthma exacerbations should be studied in a larger cohort.
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