This study is to investigate breath analysis (breath metabolomics) combined with established bioinformatic tools as a platform for companion diagnostics.
Age 0 ≤ 22 years at study entry and signed informed consent
Acute disease: - Acute signs for a respiratory disease, indicated by e.g. increased work of breathing (e.g. dyspnea, increased respiratory rate), cough or wheezing.
Chronic disease: - Suspected or confirmed chronic airway disease (e.g. asthma).
Acute disease: - Acute presentation or report within 24 hours of any signs of neurological deficit (motor function, sensoneural, or verbal).
Physical or intellectual impairment precluding protocol adherence.
Known malignancy, active smoker (passive smoke exposure is not an exclusion criterium), known inflammatory diseases (e.g. autoimmune disease) that require medical and/or pharmacological treatment and is associated with an inflammatory response, relevant congenital defects
Known malignancy, active smoker (passive smoke exposure is not an exclusion criterium), known inflammatory diseases (e.g. autoimmune disease) that require medical and/or pharmacological treatment and is associated with an inflammatory response, relevant congenital defects.
Known malignancy, active smoker (passive smoke exposure is not an exclusion criterium), relevant congenital defects.
Participants presenting with an acute disease in the emergency department at the University of Basel Children's Hospital (UKBB). Participants with chronic diseases recorded at the University of Basel Children's Hospital (UKBB).
Cohort
Prospective
Real-time SESI-MS breath analysis
Diagnostic testParticipants will be asked to refrain from eating, drinking, chewing gum use or brushing their teeth at least 1 hour before the measurements will be performed. Room temperature and lighting will be set at the same level for all measurements. Participants will exhale through a disposable mouthpiece into a commercially available SESI source (FIT S.L., Spain). While performing full exhalations, the subjects will keep the pressure through the sampling line at a fixed value monitored by a digital manometer. Breath prints will be collected in real-time recording multiple replicates (typically six in positive and negative ion mode). The whole procedure is absolutely non-invasive and is usually accomplished without any effort in around 15 min per subject.
Off-line breath analysis
Diagnostic testIn young children below the age of 4 not capable of completing the on-line exhalation maneuvers, or in cases when the patient needs cannot approach the mass spectrometer, the sample will be collected off-line. They will be asked to exhale into a bag that will be transported to the lab and deflated into the mass spectrometer for analysis. Exhaled breath of patients under anesthesia will also collected using available ventilation system in the operation theatre.
Blood analysis
Diagnostic testBlood analysis done in patients who undergo regular blood sampling needed for clinical routine laboratory controls. This includes i) children and adolescents receiving medications which require TDM ii) patients with acute diseases such as TD1 and pneumonia and iii) patients with chronic diseases such as asthma bronchiale. For those patients where a blood sample is drawn during the clinical routine, an additional blood sample consisting of only several blood drops will be collected using the same blood sampling line. No additional venous puncture for research purpose will be done.
Saliva analysis
Diagnostic testDuring the diagnostic and therapeutic work-up of T1D patients, saliva samples are collected during the clinical routine. For those patients, additional samples will be obtained by clinically trained investigators.
Urine analysis
Diagnostic testDuring the diagnostic and therapeutic work-up of T1D patients, urine samples are collected during the clinical routine. For those patients, additional samples will be obtained by clinically trained investigators.
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Treatment groupsSee each treatment group below.
Days of hospitalization
In the presentation of an acute disease the primary outcome will be days of hospitalization and its association with the exhaled breath pattern.
Change in Mass spectrometric profile of exhaled breath patterns
In the chronic presentation of the diseases, the mass spectrometric profile of exhaled breath patterns is analyzed
Change in Concentration of exhaled metabolites of pharmacotherapy
Concentration of exhaled metabolites of pharmacotherapy (breath metabolomics data)
Identification of chemical structure of exhaled molecules (acetone, glucose)
Identification of chemical structure of exhaled molecules (acetone, glucose)
Correlations of identified molecules (acetone, glucose) in exhaled breath with body fluids (blood, saliva, urine) for T1D acute disease (mmol/l)
Correlations of identified molecules (acetone, glucose) in exhaled breath with body fluids (blood, saliva, urine) for T1D acute disease (mmol/l)
Change in clinical endpoint lung function (Forced Expiratory Pressure in 1 Second FEV1 l/s) for correlation between clinical endpoint and the abundance of exhaled metabolites
Change in clinical endpoint lung function (Forced Expiratory Pressure in 1 Second FEV1 l/s) for correlation between clinical endpoint and the abundance of exhaled metabolites
Change in clinical endpoint (body temperature, Celsius) for correlation between clinical endpoint and the abundance of exhaled metabolites
Change in clinical endpoint (body temperature) for correlation between clinical endpoint and the abundance of exhaled metabolites
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University Children's Hospital Basel
Lead sponsor
Swiss National Science Foundation
Collaborator
Fondation Botnar (Switzerland)
Collaborator
