Pilotstudie zum Stellenwert der Ionenmobilitätsspektrometrie in der Untersuchung der Ausatemluft von Patienten mit Obstruktivem Schlafapnoesyndrom im Vergleich mit gesunden Kontrollen

Das Obstruktive Schlafapnoesyndrom (OSAS) ist ein in der Gesamtbevölkerung weit verbreitetes Krankheitsbild, welches in der Regel mit exzessiver Tagesschläfrigkeit und hoher Beeinträchtigung von Lebensqualität und Leistungsfähigkeit der betroffenen Patienten einhergeht. Um das Krankheitsbild OSAS zw...

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Bibliographic Details
Main Author: Fischer, Hannes Benjamin
Contributors: Koczulla, Rembert (Prof. Dr. med.); Greulich, Timm (PD Dr. med.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2019
Online Access:PDF Full Text
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The Obstructive Sleep Apnea Syndrome (OSAS) is a widely spread disease among the total population. Its clinical presentation usually comes along with excessive daytime sleepiness and impacts negatively on health and quality of life. Gold standard in the diagnosis of OSAS is a polysomnographic examination, which is work-intensive, time-consuming and expensive. Non-invasive analysis of Volatile Organic Compounds (VOCs) represents an innovative alternative to facilitate diagnosis of OSAS. In this study we used ion mobility spectrometry coupled to a multicapillary column (MCC-IMS) as well as the electronic nose system Cyranose 320 to analyze and compare VOC profiles of 15 patients with OSAS and 15 healthy controls (HC). All the VOCs have been emitted by four different biological materials (Exhaled breath (EB), Exhaled breath condensate (EBC), Pharyngeal washings (PW) und serum). Data analysis was performed by Leave-One-Out-Cross-Validation (LOO-CV). Furthermore, we performed laboratory analysis of the serum parameters CRP, IL-6, IL-8 and TNF-α to compare both study groups. Within the recruited sample, we could demonstrate that MCC-IMS and Cyranose 320 were able to distinguish breathprints of OSAS-patients and healthy controls. In addition it was possible to significantly separate both of the groups by means of headspace VOC profiles coming from EBC, PW and serum. Regarding cross-validated MCC-IMS data, we were able to assign volatile organic substances to recorded analytes via database matching. Best separation between OSAS and HC could be achieved by 2-Methylfuran referring to the measurement series of EB and serum. In reference to EBC, the chemical compounds 2-Undecanon and n-Decan have featured the most significant distinction between both groups. With regard to PW, we could identify Toluene to have the strongest power to separate between OSAS and HC. Furthermore, we were able to detect same chemical compounds in various of the analyzed biological materials: 2-Methylfuran (EB, PW and serum), Toluene (PW and serum), Hexanal and 3-Methylbutanal/3-Methylbutyraldehyd (EB and PW) as well as Acetone (EB and EBC). Analysis of the serum parameters CRP, IL-6, IL-8 and TNF-α could not demonstrate significant distinction among healthy controls and patients with OSAS. In conclusion, it can be said that MCC-IMS and Cyranose 320 are able to detect significant distinctions in the VOC profiles of patients with OSAS and healthy controls. These findings could be ascertained among four different biological materials (EB, EBC, PW and serum) what can be seen as an indication for a changing overall VOC profile within the scope of OSAS. The results of this study can support further exploration of OSAS VOC profiles and contribute non-invasive diagnosis of the disease.