Development of a diagnostic and prognostic breath test for IPF
Currently, idiopathic pulmonary fibrosis (IPF) patients need regular hospital appointments to assess the effect of their treatment and the status of their disease. Once in hospital, patients are assessed through a combination of history, examination, functional assessment, blood tests and imaging. Some patients may need a lung biopsy to make a definitive diagnosis. Over 10 years ago our Breathing Matters’ Lawrence Matz Fellow, Dr Theresia Mikolasch, pioneered the introduction of relatively non-invasive cryoscopic lung biopsy in interstitial lung diseases (ILD), of which IPF is the most common. We now plan to extend this work and develop a non-invasive diagnostic breath test for ILD. In addition, this test may be used to monitor patients and so decrease the frequency of hospital visits and investigations. Our ultimate aim is to make these tests widely available for self-assessment at home.
Every breath we exhale contains information – information about what we have eaten, information about our dental health and, importantly, information about our lung health. This information is molecular; cells emit certain volatile organic compounds (VOCs) when they are stressed, or dividing, or producing factors the body needs. As these compounds are volatile, they are carried in the air and out of the lungs. Owlstone Medical have been analysing these VOCs for over 10 years and are in the process of associating particular compounds with particular diseases.
We wish to go one step further by, not only associating the VOCs with a particular disease, but also associating them with a particular disease process that is linked to our previous work and our drug development projects. Our researchers’ past published research in cancers has taught us a great deal on how common modifications on common proteins can manipulate the immune system to help the cancer grow and spread. These processes appear to be associated with normal wound healing; however, in cancers, these wound healing processes never stop.
Our unpublished data shows that the same persistent processes are likely to be occurring in IPF. We are therefore looking at the VOCs that these ‘manipulated’ immune cells are producing to see if they are producing the same as those seen in IPF patients. If they are, then not only do we have further evidence that these processes are occurring, but we also strengthen our diagnostic options.
To ensure success, we have partnered with Owlstone Medical, the leading international company for this type of analysis, who will be analysing the samples we send. We are extremely excited to see how this project develops, in the hope that we can bring breath analysis into community clinical practice and ultimately self-assessment.
A breath test has huge potential for the future of IPF diagnosis and treatment. It could potentially help us detect early diagnosis, early exacerbations, early decline so we can change treatment quickly, and ultimately help us towards a personalised medicine for every patient … the potential is endless …