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Molecular breath analysis helps speed up screening for IPF

24 May 2019

Real-time exhaled breath analysis using secondary electrospray ionization-mass spectrometry has validated previous findings of elevated lung tissue amino acid levels in idiopathic pulmonary fibrosis (IPF), claims a new study, suggesting that online breath analysis can be a practical tool for rapid screening for IPF.

Significantly increased levels of proline, 4-hydroxyproline, alanine, valine, leucine/isoleucine and allysine were found in breath of IPF patients. However, pyroglutamic acid and phenylalanine did not show significant differences.

“This coincides with the amino acid's abundance in pulmonary tissue indicating that our observations reflect progressing fibrosis,” the investigators said.

Amino acid levels were also correlated across patients, providing evidence of a common underlying pathway. Furthermore, a cross-validated area under the curve of 0.86 was achieved. This suggested that elevated amino acid levels in exhaled breath have the potential to be used as biomarkers for IPF.

According to the investigators, IPF diagnosis is complicated and its pathogenesis is poorly understood, with recent findings showing increased levels of proline and other amino acids in lung tissue of IPF patients. They believe that these could have diagnostic significance.

“Following these findings, we hypothesized that such altered metabolic profiles would be mirrored in exhaled breath and could therefore be captured noninvasively in real time,” they said.

The investigators sought to validate these results with the use of real-time exhaled breath analysis by secondary electrospray ionization-mass spectrometry, which offers a noninvasive, painless and fast insight into the metabolism. They conducted breath analysis in a matched 1:1 case–control study involving 21 patients with IPF and 21 control participants.

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Most Read Articles
10 Jan 2021
Regular practice of yoga postures confers benefits for glucose control, oxidative stress, inflammatory response, and sleep quality in patients with type 2 diabetes, a study has found.
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.