This study assessed whether exhaled volatile organic compound (VOC) profiles could detect longitudinal changes in severe asthma patients (n=25) starting benralizumab or dupilumab, comparing baseline to 4-month post-treatment breath samples using sparse partial least squares-discriminant analysis (sPLS-DA).
A 5-VOC model (methyl isobutyl ketone, 2-ethyl-1-hexanol, 5-methyl octadecane, 2-methylundecane, 1,1'-oxybis(decane)) distinguished baseline from post-treatment profiles with an AUROC of 0.89 (95% CI: 0.79–0.99); 2-ethyl-1-hexanol correlated positively with asthma control (ACQ, τ=0.40, p<0.01) and 1,1'-oxybis(decane) correlated negatively with blood eosinophil counts (τ=−0.30, p=0.04).
- Very small sample (n=25 from only 2 sites), limiting statistical power and generalizability. - Benralizumab and dupilumab were analyzed together, preventing drug-specific VOC conclusions. - No validation cohort; authors explicitly flag the need for larger confirmatory studies.
Exhaled breath VOC profiling may be a feasible, non-invasive tool for monitoring biological responses to biologic therapy in severe asthma, but results are preliminary and not yet ready for clinical application. Clinicians should await validation in larger, drug-stratified cohorts before drawing treatment conclusions.
Explore related topics
