Exhaled breath profiling in patients with COPD and OSA overlap syndrome: a pilot study
电子鼻技术用于COPD和OSA重叠综合征患者呼出气体分析研究
Silvano Dragonieri, Vitaliano N Quaranta, Pierluigi Carratu, Teresa Ranieri and Onofrio Resta
Department of Respiratory Diseases, University of Bari, Piazza Giulio Cesare 11,Bari, Italy
: silvano.dragonieri@uniba.it
Keywords: exhaled breath, volatile organic compounds, electronic nose, OSA, COPD, overlap syndrome
Abstract
The analysis of volatile organic compounds (VOCs) by an electronic nose (Cyranose 320) is a groundbreaking method that provides distinct exhaled molecular patterns in several respiratory and systemic diseases. It has been shown that an e-nose can detect obstructive sleep apnea (OSA) as well as chronic obstructive pulmonary disease (COPD). OSA and COPD are sometimes associated into the so-called overlap syndrome (OVS). In this pilot study we hypothesized that an e-nose could
discriminate the exhaled breath of patients with OVS from that of subjects with OSA and COPD alone. Thirteen patients with OSA, 15 patients with COPD and 13 with OVS participated in a crosssectional study. Exhaled breath was collected by a formerly validated method and sampled by using an electronic nose (Cyranose 320). Raw data were analyzed by canonical discriminant analysis on principal component reduction. Cross-validation accuracy (CVA) and ROC-curves were calculated.
External validation in newly recruited patients (6 OSA, 6 OVS and 6 COPD) was tested using the previous training set. Breathprints of patients with OSA clustered distinctly from those with OVS (CVA = 96.2%) as well as those with COPD (CVA = 82.1%). Breathprints from OVS were not significantly separated from those of COPD (CVA = 67.9%). External validation confirmed the above findings. The e-nose can distinguish with high accuracy the exhaled VOC-profile of patients with OSA from those with OVS as well as those with COPD. This warrants future studies to confirm the potential of this technique in the non-invasive detection of sleep apnea.
用电子鼻(Cyranose320)分析挥发性有机化合物(VOCs)是一种突破性的方法，可在多种呼吸系统疾病中提供不同的呼出分子模式。研究表明，电子鼻可以检测阻塞性睡眠呼吸暂停(OSA)和慢性阻塞性肺疾病(COPD)。OSA和慢性阻塞性肺病有时与所谓的重叠综合征(OVS)有关。在这项初步研究中，我们假设电子鼻可以区分OVS患者的呼气与OSA和COPD患者的呼气。13例OSA患者、15例COPD患者和13例OVS患者参与了一项横断面研究。通过先前验证的方法收集呼出的呼吸，并使用电子鼻(Cyranose320)取样。对原始数据进行主成分约简的典型判别分析。计算了交叉验证精度(CVA)和ROC曲线。
在新招募的患者(6例OSA，6例OVS和6例COPD)中，使用先前的训练集对外部验证进行测试。OSA患者的呼吸图与OVS患者(CVA=96.2%)和COPD患者(CVA=82.1%)明显聚集。卵母细胞的呼吸印痕与慢性阻塞性肺病的呼吸印痕没有明显的分离(cva=67.9%)。外部验证证实了上述发现。电子鼻可以很准确地区分OSA患者和OVS患者以及慢性阻塞性肺病患者呼出的VOC特征。这就需要未来的研究来证实这种技术在无创检测睡眠呼吸暂停中的潜力。
