Exhaled Biomarkers in Pediatric Asthma Monitoring
Summary
Pediatric asthma remains a leading chronic respiratory condition worldwide, characterised by variable airway inflammation, bronchoconstriction and oxidative stress. Exhaled biomarkers offer a non-invasive window into airway physiology and immune activity, facilitating both diagnosis and longitudinal monitoring without the need for invasive procedures. Key approaches include measurement of fractional exhaled nitric oxide (FeNO) to gauge eosinophilic inflammation, analysis of exhaled breath condensate (EBC) to capture non-volatile and volatile mediators, and assessment of particles in exhaled air (PExA) to sample distal airway lining fluid. Advances in electronic monitoring devices have enabled real-time tracking of exhaled markers, while omic-based analyses of volatile organic compounds (VOCs) are uncovering novel metabolic signatures of disease endotypes. Standardisation of collection and analytical protocols remains a challenge, but international consensus is emerging on optimal procedures for sampling, storage and quantification. Integration of exhaled biomarker profiles with clinical phenotyping and lung function testing promises a more personalised approach to paediatric asthma management, with potential applications in early detection of exacerbations, assessment of treatment response and stratification of high-risk populations. As global research efforts intensify, exhaled biomarkers are poised to transform routine care pathways and support remote monitoring strategies, especially in resource-limited settings.
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Exhaled Biomarkers in Pediatric Asthma Monitoring publication trend
The graph below shows the total number of articles in exhaled biomarkers in pediatric asthma monitoring across all publications each year (not limited to Nature Index journals).
Technical terms
Fractional Exhaled Nitric Oxide (FeNO): A breath test measuring nitric oxide concentration as a marker of eosinophilic airway inflammation.
Exhaled Breath Condensate (EBC): Fluid collected by cooling exhaled air, containing volatile and non-volatile biomarkers of airway inflammation and oxidative stress.
Volatile Organic Compounds (VOCs): Small organic molecules in exhaled breath that reflect metabolic and inflammatory processes in the respiratory tract.
Particles in Exhaled Air (PExA): Aerosolised droplets derived from distal airway lining fluid, analysed for particle characteristics and embedded biomarkers.
References
- Objective monitoring tools for improved management of childhood asthma. Respiratory Research (2024).
- The Role of Exhaled Breath Condensate in Chronic Inflammatory and Neoplastic Diseases of the Respiratory Tract. International Journal of Molecular Sciences (2024).
- Recommendations for asthma monitoring in children: A PeARL document endorsed by APAPARI, EAACI, INTERASMA, REG, and WAO. Pediatric Allergy and Immunology (2024).
- Particles in Exhaled Air (PExA): Clinical Uses and Future Implications. Diagnostics (2024).
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