TY - JOUR
T1 - Diagnostic Performance of Electronic Nose Technology in Sarcoidosis
AU - van der Sar, Iris G.
AU - Moor, Catharina C.
AU - Oppenheimer, Judith C.
AU - Luijendijk, Megan L.
AU - van Daele, Paul L. A.
AU - Maitland-van der Zee, Anke H.
AU - Brinkman, Paul
AU - Wijsenbeek, Marlies S.
N1 - Funding Information: Author contributions: All authors are responsible for all content of the manuscript. All were involved in acquisition, analysis, and/or interpretation of the data presented in the manuscript, as well as critical revision of the manuscript. All authors approved submission of the final version of the manuscript, and all agreed to be accountable for all aspects of the submitted work. Financial/nonfinancial disclosures: The authors have reported to CHEST the following: I. G. v. d. S. reports grants from Boehringer Ingelheim outside the submitted work and paid to her institution. C. C. M. reports grants and other from Boehringer Ingelheim paid to her institution. A. H. M.-v. d. Z. has received a research grant from Breathomix within the context of the P402 project (as described here); received research grants from GSK, Boehringer Ingelheim, AstraZeneca, and Vertex, all outside the submitted work; is the Principal Investigator of a P4O2 (Precision Medicine for More Oxygen) public private partnership sponsored by Health Holland involving many private partners that contribute in cash and/or in kind (Boehringer Ingelheim, Breathomix, Fluidda, ORTEC LogiqCare, Philips, Quantib-U, Roche, Smartfish, SODAQ, Thirona, TopMD, and Novartis); and has served in advisory boards for AstraZeneca, GSK, and Boehringer Ingelheim with money paid to her institution. P. B. reports grants from Amsterdam UMC, Stichting Astma Bestrijding, Boehringer Ingelheim, and Vertex Pharmaceuticals, all outside the submitted work. M. S. W. reports grants and other from Boehringer Ingelheim and Hoffman-La Roche; and other from Respivant, Galapagos, Safara, Novartis, and Bristol Myers Squibb, all outside the submitted work and paid to her institution. None declared (J. C. O. M. L. L. P. L. A. v. D.). Role of the sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. Additional information: The e-Appendexes and e-Figures can be found in the Supplemental Materials section of the online article. FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study. Funding Information: Financial/nonfinancial disclosures: The authors have reported to CHEST the following: I. G. v. d. S. reports grants from Boehringer Ingelheim outside the submitted work and paid to her institution. C. C. M. reports grants and other from Boehringer Ingelheim paid to her institution. A. H. M.-v. d. Z. has received a research grant from Breathomix within the context of the P402 project (as described here); received research grants from GSK , Boehringer Ingelheim , AstraZeneca , and Vertex , all outside the submitted work; is the Principal Investigator of a P4O2 (Precision Medicine for More Oxygen) public private partnership sponsored by Health Holland involving many private partners that contribute in cash and/or in kind (Boehringer Ingelheim, Breathomix, Fluidda, ORTEC LogiqCare, Philips, Quantib-U, Roche, Smartfish, SODAQ, Thirona, TopMD, and Novartis); and has served in advisory boards for AstraZeneca, GSK, and Boehringer Ingelheim with money paid to her institution. P. B. reports grants from Amsterdam UMC , Stichting Astma Bestrijding , Boehringer Ingelheim , and Vertex Pharmaceuticals , all outside the submitted work. M. S. W. reports grants and other from Boehringer Ingelheim and Hoffman-La Roche ; and other from Respivant, Galapagos , Safara, Novartis , and Bristol Myers Squibb , all outside the submitted work and paid to her institution. None declared (J. C. O., M. L. L., P. L. A. v. D.). Publisher Copyright: © 2021 The Author(s)
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background: Diagnosing sarcoidosis can be challenging, and a noninvasive diagnostic method is lacking. The electronic nose (eNose) technology profiles volatile organic compounds in exhaled breath and has potential as a point-of-care diagnostic tool. Research Question: Can eNose technology be used to distinguish accurately between sarcoidosis, interstitial lung disease (ILD), and healthy control subjects, and between sarcoidosis subgroups? Study Design and Methods: In this cross-sectional study, exhaled breath of patients with sarcoidosis and ILD and healthy control subjects was analyzed by using an eNose (SpiroNose). Clinical characteristics were collected from medical files. Partial least squares discriminant and receiver-operating characteristic analyses were applied to a training and independent validation cohort. Results: The study included 252 patients with sarcoidosis, 317 with ILD, and 48 healthy control subjects. In the validation cohorts, eNose distinguished sarcoidosis from control subjects with an area under the curve (AUC) of 1.00 and pulmonary sarcoidosis from other ILD (AUC, 0.87; 95% CI, 0.82-0.93) and hypersensitivity pneumonitis (AUC, 0.88; 95% CI, 0.75-1.00). Exhaled breath of sarcoidosis patients with and without pulmonary involvement, pulmonary fibrosis, multiple organ involvement, pathology-supported diagnosis, and immunosuppressive treatment revealed no distinctive differences. Breath profiles differed between patients with a slightly and highly elevated soluble IL-2 receptor level (median cutoff, 772.0 U/mL; AUC, 0.78; 95% CI, 0.64-0.92). Interpretation: Patients with sarcoidosis can be distinguished from ILD and healthy control subjects by using eNose technology, indicating that this method may facilitate accurate diagnosis in the future. Further research is warranted to understand the value of eNose in monitoring sarcoidosis activity.
AB - Background: Diagnosing sarcoidosis can be challenging, and a noninvasive diagnostic method is lacking. The electronic nose (eNose) technology profiles volatile organic compounds in exhaled breath and has potential as a point-of-care diagnostic tool. Research Question: Can eNose technology be used to distinguish accurately between sarcoidosis, interstitial lung disease (ILD), and healthy control subjects, and between sarcoidosis subgroups? Study Design and Methods: In this cross-sectional study, exhaled breath of patients with sarcoidosis and ILD and healthy control subjects was analyzed by using an eNose (SpiroNose). Clinical characteristics were collected from medical files. Partial least squares discriminant and receiver-operating characteristic analyses were applied to a training and independent validation cohort. Results: The study included 252 patients with sarcoidosis, 317 with ILD, and 48 healthy control subjects. In the validation cohorts, eNose distinguished sarcoidosis from control subjects with an area under the curve (AUC) of 1.00 and pulmonary sarcoidosis from other ILD (AUC, 0.87; 95% CI, 0.82-0.93) and hypersensitivity pneumonitis (AUC, 0.88; 95% CI, 0.75-1.00). Exhaled breath of sarcoidosis patients with and without pulmonary involvement, pulmonary fibrosis, multiple organ involvement, pathology-supported diagnosis, and immunosuppressive treatment revealed no distinctive differences. Breath profiles differed between patients with a slightly and highly elevated soluble IL-2 receptor level (median cutoff, 772.0 U/mL; AUC, 0.78; 95% CI, 0.64-0.92). Interpretation: Patients with sarcoidosis can be distinguished from ILD and healthy control subjects by using eNose technology, indicating that this method may facilitate accurate diagnosis in the future. Further research is warranted to understand the value of eNose in monitoring sarcoidosis activity.
KW - breath test
KW - diagnostic tool
KW - electronic nose
KW - interstitial lung disease
KW - sarcoidosis
UR - http://www.scopus.com/inward/record.url?scp=85125288145&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.chest.2021.10.025
DO - https://doi.org/10.1016/j.chest.2021.10.025
M3 - Article
C2 - 34756945
SN - 0012-3692
VL - 161
SP - 738
EP - 747
JO - Chest
JF - Chest
IS - 3
ER -