Exhaled Breath Olfactory Signature of Pulmonary Arterial Hypertension (SNOOPY2)

April 30, 2021 updated by: Assistance Publique - Hôpitaux de Paris

Exhaled Breath Olfactory Signature of Pulmonary Arterial Hypertension Detected by an Artificial Nose: A Clinical Validation Study

In this prospective case-control study, the investigators will evaluate the diagnostic performance of a novel electronic nose (E-nose) for the detection of Pulmonary Arterial Hypertension (PAH). This study is designed to:

  1. Assess the performance of the E-nose to discriminate controls from patients with PAH
  2. Assess the performance of the E-nose to discriminate between different subtypes of pulmonary hypertension (PH), namely idiopathic PAH, heritable PAH with BMPR2 mutation and chronic thromboembolic PH
  3. Assess the performance of the E-nose to discriminate controls from asymptomatic patients with PH who carry BMPR2 mutations.

Study Overview

Detailed Description

Pulmonary arterial hypertension (PAH) is a progressive and rare severe disease (prevalence of 15-50 per million) due to obstruction of small pulmonary arteries, leading to an increase in pulmonary artery pressure with the ultimate consequence right heart failure. Despite recent advances in therapeutic care, there is no cure and most patients die or require lung transplantation within 5 years of diagnosis. Currently, right heart catheterisation is required to diagnose PAH and monitor response to treatment. Right heart catheterisation is an invasive test, and alternatives such as echocardiography have not yielded sufficient accuracy both for early diagnosis and disease monitoring. Currently, PAH is often diagnosed at an advanced stage of the disease. There is often a delay in diagnosis of several years between the first symptoms and the identification of the disease due to the non-specific nature of symptoms. Hence, there is the need to improve the time between the first signs and definitive diagnosis of the disease. Early diagnosis of PAH remains a challenge due to the low sensitivity and specificity of biomarkers available currently.

The main objective is to validate the results obtained in the previous preliminary proof of concept study - that PAH patients display a unique olfactory signature that can be detected by an artificial E- nose.

Secondary objectives are to investigate the ability of the E-nose to:

  • Discriminate patients with idiopathic PAH from those with heritable PAH due to BMPR2 mutations
  • Discriminate patients with chronic thromboembolic pulmonary hypertension (CTEPH) from healthy controls, and patients with idiopathic and/or heritable PAH.
  • Detect development of PAH in BMPR2 mutation carriers
  • Determine whether the olfactory signature can stratify subgroups of patients by correlating the olfactory signature to different biological and clinical parameters (hemodynamic measurements, NYHA class, duration of treatment, 6-minute walk distance, response to nitric oxide, BNP levels).

Study Type

Interventional

Enrollment (Actual)

273

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Le Kremlin-Bicêtre, France, 94275
        • AP-HP, Bicêtre Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Patients group (Group A)

  • Age 18 to 65 years inclusive
  • Idiopathic or heritable PAH confirmed by right heart catheterization
  • Affiliated to a social security (excluding AME)

Healthy control group (Group B)

  • Age 18 to 65 years inclusive
  • No known allergy
  • No history of known pathology
  • No chronic disease in active phase
  • No history of respiratory illness
  • Not genetically linked with the patient
  • Affiliated to a social security (excluding AME)

At risk group (Group C)

  • Age between 18 and 65 years old inclusive
  • Subjects included in the protocol Delphi2 or Subject satisfying the inclusion and non-inclusion criteria of the DELPHI2 study
  • Affiliated to a social security (excluding AME)

Patient group (Group D)

  • Age between 18 and 65 years old inclusive
  • Post-embolic HTP
  • Affiliated to a social security scheme (excluding AME)

Exclusion Criteria:

Any patient/subject presenting :

  • Connective tissue disease
  • HIV infection
  • Portal hypertension
  • Congenital heart disease
  • Asthma and other coexisting lung diseases
  • Pregnant or breastfeeding woman
  • Alcohol addiction (if consumption >3 glasses/day for men and >2 glasses/day for women)
  • Smoking addiction (if consumption >5 cigarettes/day)
  • Having had a CT scan in the week prior to the inclusion visit
  • Subjects who have consumed coffee, alcohol, or a cigarette in less than 3 hours

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: idiopathic PAH
Exhaled Breath Olfactory Signature Detected by an Artificial Nose
Experimental: heritable PAH with BMPR2 mutation
Exhaled Breath Olfactory Signature Detected by an Artificial Nose
Experimental: chronic thromboembolic PH
Exhaled Breath Olfactory Signature Detected by an Artificial Nose
Experimental: Controls
Exhaled Breath Olfactory Signature Detected by an Artificial Nose

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Volatile organic compounds in exhaled breath in patients of each group detected using sensor array on the basis of cross-reactive gold-nanoparticles coated with organic ligands.
Time Frame: Up to 4 hours
The primary endpoint will be the ability of the E-nose to discriminate patients with PAH from healthy controls by their olfactory signature from the profile of volatile organic compounds in exhaled breath.
Up to 4 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Marc Humbert, MD,PhD, Assistance Publique - Hôpitaux de Paris

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 4, 2016

Primary Completion (Actual)

August 28, 2018

Study Completion (Actual)

September 4, 2018

Study Registration Dates

First Submitted

February 23, 2016

First Submitted That Met QC Criteria

May 24, 2016

First Posted (Estimate)

May 25, 2016

Study Record Updates

Last Update Posted (Actual)

May 4, 2021

Last Update Submitted That Met QC Criteria

April 30, 2021

Last Verified

December 1, 2016

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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