A breath test for an early asthma diagnosis in preschoolers

Volatile Organic Compounds (VOCs) in exhaled breath as a tool for an early asthma diagnosis; standardisation, pathogenetic mechanisms, and new VOC sensing techniques.

In a public private partnership between Maastricht UMC+ and Interscience B.V., this project developed a breath test by means of the SIFT-MS technique for an early asthma diagnosis in preschool children.

Asthma is the most common chronic disease in children. Especially in preschool children, asthma-like symptoms are common (360,000 children in the Netherlands, 15 million children in the EU). Most preschoolers outgrow their symptoms when they are 5-6 years of age (also called ‘viral or transient wheeze’), a smaller part (1/3 part) keeps symptoms and has asthma. Currently, a reliable asthma diagnosis in young children is not possible, which leads to under diagnosis/under treatment of asthma and over treatment of children with viral wheeze. They demonstrated the proof-of-principle that exhaled inflammation markers (volatile organic compounds, VOCs) enable an early asthma diagnosis in young wheezing children (ADEM1 study).

The aim of the current proposal was:

to optimise standardisation of VOC measurements in order to further increase diagnostic accuracy of exhaled VOCs in wheezing preschool children
the development of a SIFT-MS technology based breath test for an early asthma diagnosis in young children
the unravelling of the pathways underlying the most predictive VOCs of an early asthma diagnosis

This will lead to the final goal (beyond the scope of this proposal) of constructing a reliable, non-invasive asthma diagnostic instrument for use in primary and secondary/tertiary care. An early asthma diagnosis will improve the quality of treatment and thereby the prognosis and quality of life of wheezing children and their parents. Moreover, it will considerably reduce unnecessary burden and costs of the health care system.

The end results showed that SIFT-MS is a new valuable VOC sensing technique for detection of asthma in (preschool) children. Moreover, specific bacteria were associated with the subsequent development of asthma (Gemmiger and Escherichia).

Summary

Underdiagnosis and undertreatment of asthma in preschoolers is common. This project studied the ability of a breath test based on SIFT-MS technique to diagnose asthma at an early age. They found that a reliable asthma diagnosis based on the breath test is possible already at an early age.

Technology Readiness Level (TRL)

7 - 9

Time period

45 months

Partners