Breathomics, the multidimensional molecular analysis of exhaled breath, includes analysis of exhaled breath
with gas-chromatography/mass spectrometry (GC/MS) and electronic noses (e-noses), and metabolomics of exhaled
breath condensate (EBC), a non-invasive technique which provides information on the composition of airway lining fluid,
generally by high-resolution nuclear magnetic resonance (NMR) spectroscopy or MS methods. Metabolomics is the identification
and quantification of small molecular weight metabolites in a biofluid. Specific profiles of volatile compounds
in exhaled breath and metabolites in EBC (breathprints) are potentially useful surrogate markers of inflammatory respiratory
diseases. Electronic noses (e-noses) are artificial sensor systems, usually consisting of chemical cross-reactive sensor
arrays for characterization of patterns of breath volatile compounds, and algorithms for breathprints classification. E-noses
are handheld, portable, and provide real-time data. E-nose breathprints can reflect respiratory inflammation.
E-noses and NMR-based metabolomics of EBC can distinguish patients with respiratory diseases such as asthma, COPD,
and lung cancer, or diseases with a clinically relevant respiratory component including cystic fibrosis and primary ciliary
dyskinesia, and healthy individuals. Breathomics has also been reported to identify patients affected by different types of
respiratory diseases. Patterns of breath volatile compounds detected by e-nose and EBC metabolic profiles have been associated
with asthma phenotypes. In combination with other -omics platforms, breathomics might provide a molecular approach
to respiratory disease phenotyping and a molecular basis to tailored pharmacotherapeutic strategies. Breathomics
might also contribute to identify new surrogate markers of respiratory inflammation, thus, facilitating drug discovery.
Validation in newly recruited, prospective independent cohorts is essential for development of e-nose and EBC NMRbased
Keywords: Electronic nose, Chemical sensors, Volatile organic compounds, Biomarkers, Pattern recognition, Exhaled breath
condensate, Metabolomics, NMR spectroscopy, Breathomics, Respiratory medicine, Asthma, Chronic obstructive pulmonary
disease, Lung cancer.
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