The potential of volatile organic compound analysis for pathogen detection and disease monitoring in patients with cystic fibrosis

ABSTRACT

Introduction

Airway infection with pathogens and its associated pulmonary exacerbations (PEX) are the major causes of morbidity and premature death in cystic fibrosis (CF). Preventing or postponing chronic infections requires early diagnosis. However, limitations of conventional microbiology-based methods can hamper identification of exacerbations and specific pathogen detection. Analyzing volatile organic compounds (VOCs) in breath samples may be an interesting tool in this regard, as VOC-biomarkers can characterize specific airway infections in CF.

Areas covered

We address the current achievements in VOC-analysis and discuss studies assessing VOC-biomarkers and fingerprints, i.e. a combination of multiple VOCs, in breath samples aiming at pathogen and PEX detection in people with CF (pwCF). We aim to provide bases for further research in this interesting field.

Expert opinion

Overall, VOC-based analysis is a promising tool for diagnosis of infection and inflammation with potential to monitor disease progression in pwCF. Advantages over conventional diagnostic methods, including easy and non-invasive sampling procedures, may help to drive prompt, suitable therapeutic approaches in the future. Our review shall encourage further research, including validation of VOC-based methods. Specifically, longitudinal validation under standardized conditions is of interest in order to ensure repeatability and enable inclusion in CF diagnostic routine.

KEYWORDS:

• Breath analysis
• cystic fibrosis
• pathogens
• Pseudomonas aeruginosa
• volatile organic compounds

Article highlights

• VOC analysis is a promising tool for improving the diagnosis of lung infection and pulmonary exacerbations in CF, for which reviewed studies mainly showed favorable sensitivity and specificity.

• However, at present, VOC analysis in CF has not progressed beyond experimental stage and the design of published studies is predominantly cross-sectional.

• Longitudinal, multicenter studies are required to better evaluate the diagnostic potential of VOC analysis in CF and for standardization of methods.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Data availability

Data sharing is not applicable to this article, as this constitutes a review, in which no new data were created or analyzed.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17476348.2022.2104249

Additional information

Funding

This paper was not funded.