EFFECT PROVIDED BY INHALED SALBUTAMOL ON EXHALED BREATH SIGNATURES IN ADULT PATIENTS WITH CYSTIC FIBROSIS

Introduction. Inhalers are often prescribed for patients with cystic fibrosis and the impaired ventilation function of the lungs. Volatile organic compounds in exhaled breath reflect changes in body chemistry and may be useful for monitoring the drug pharmacokinetics and pharmacodynamics. Aim. The aim of our study was to identify the differences in the volatile organic compounds in breath profiles before and 20 minutes after the inhalation of 400 μg of salbutamol in cystic fibrosis adults, using the proton-transfer-reaction time-of-flight mass spectrometry. Materials and Methods. Breath samples were collected from 96 adult patients with cystic fibrosis (50 males and 46 females, mean age 25.8±7.3 yrs) at baseline and 20 minutes after inhalation of 400 μg of salbutamol by proton-transfer-reaction time-of-flight mass spectrometry. Volatile organic compound profiles were listed as ions with various mass-to-charge ratios (m/z). Results and Discussion. 167 features in exhaled breath were detected in cystic fibrosis adults using proton mass spectrometry. Exhaled breath samples before and after 400 μg salbutamol inhalation differed in 76 volatile organic compounds concentrations (p<0.01). Representation of the following volatile organic compounds increased most significantly: m/z = 42.03 (acetonitrile), m/z = 44.04 (C2H5NH+) by percentage change 93.8% and 53.8%, respectively (p<0.001). In turn, the representation of m/z = 71.06, m/z = 181.01 (p-xylene) and m/z = 89.05 (acetoin) decreased most significantly at the percentage changes by 26.1%, 23.4%, and 23.0%, respectively (p<0.001). Conclusions. Our results demonstrate the effect of salbutamol on the composition of exhaled breath metabolites, which should be taken into account when collecting samples in subsequent studies. In addition, proton mass spectrometry could be a useful tool for non-invasive therapeutic drug monitoring.