Exhaled breath analysis by use of eNose technology: A novel diagnostic tool for interstitial lung disease

Karen Moor, JC (Judith) Oppenheimer, Gizal Nakshbandi, Joachim Aerts, P Brinkman, AH Maitland-van der Zee, Marlies Wijsenbeek - Lourens

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Introduction: Early and accurate diagnosis of interstitial lung diseases (ILDs) remains a major challenge. Better noninvasive diagnostic tools are much needed. We aimed to assess the accuracy of exhaled breath analysis using eNose technology to discriminate between ILD patients and healthy controls, and to distinguish ILD subgroups. Methods: In this cross-sectional study, exhaled breath of consecutive ILD patients and healthy controls was analysed using eNose technology (SpiroNose). Statistical analyses were done using partial least square discriminant analysis and receiver operating characteristic analysis. Independent training and validation sets (2:1) were used in larger subgroups. Results: A total of 322 ILD patients and 48 healthy controls were included: sarcoidosis (n=141), idiopathic pulmonary fibrosis (IPF) (n=85), connective tissue disease-Associated ILD (n=33), chronic hypersensitivity pneumonitis (n=25), idiopathic nonspecific interstitial pneumonia (n=10), interstitial pneumonia with autoimmune features (n=11) and other ILDs (n=17). eNose sensors discriminated between ILD and healthy controls, with an area under the curve (AUC) of 1.00 in the training and validation sets. Comparison of patients with IPF and patients with other ILDs yielded an AUC of 0.91 (95% CI 0.85-0.96) in the training set and an AUC of 0.87 (95% CI 0.77-0.96) in the validation set. The eNose reliably distinguished between individual diseases, with AUC values ranging from 0.85 to 0.99. Conclusions: eNose technology can completely distinguish ILD patients from healthy controls and can accurately discriminate between different ILD subgroups. Hence, exhaled breath analysis using eNose technology could be a novel biomarker in ILD, enabling timely diagnosis in the future.

Original languageEnglish
Article number2002042
JournalEuropean Respiratory Journal
Issue number1
Publication statusPublished - 2021

Bibliographical note

Funding Information:
Support statement: The lease for the SpiroNose was financially supported by Boehringer Ingelheim. Funding information for this article has been deposited with the Crossref Funder Registry.

Publisher Copyright:
© 2021 European Respiratory Society. All rights reserved.

Research programs

  • EMC OR-01


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