Breathomics in Asthmatic Children Treated with Inhaled Corticosteroids

• Main Authors: Valentina Agnese Ferraro, Silvia Carraro, Paola Pirillo, Antonina Gucciardi, Gabriele Poloniato, Matteo Stocchero, Giuseppe Giordano, Stefania Zanconato, Eugenio Baraldi
• Format: Article
• Language: English
• Published: MDPI AG 2020-09-01
• Series: Metabolites
• Subjects: pediatric asthma; breathomics; inhaled corticosteroids; endogenous steroid profile
• Online Access: https://www.mdpi.com/2218-1989/10/10/390

Background: “breathomics” enables indirect analysis of metabolic patterns underlying a respiratory disease. In this study, we analyze exhaled breath condensate (EBC) in asthmatic children before (T0) and after (T1) a three-week course of inhaled beclomethasone dipropionate (BDP). Methods: we recruited steroid-naive asthmatic children for whom inhaled steroids were indicated and healthy children, evaluating asthma control, spirometry and EBC (in asthmatics at T0 and T1). A liquid-chromatography–mass-spectrometry untargeted analysis was applied to EBC and a mass spectrometry-based target analysis to urine samples. Results: metabolomic analysis discriminated asthmatic (<i>n</i> = 26) from healthy children (<i>n</i> = 16) at T0 and T1, discovering 108 and 65 features relevant for the discrimination, respectively. Searching metabolomics databases, seven putative biomarkers with a plausible role in asthma biochemical–metabolic processes were found. After BDP treatment, asthmatic children, in the face of an improved asthma control (<i>p</i> < 0.001) and lung function (<i>p</i> = 0.01), showed neither changes in EBC metabolomic profile nor in urinary endogenous steroid profile. Conclusions: “breathomics” can discriminate asthmatic from healthy children, with prostaglandin, fatty acid and glycerophospholipid as putative markers. The three-week course of BDP—in spite of a significant clinical improvement—was not associated with changes in EBC metabolic arrangement and urinary steroid profile.