1
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Zhou J, Ge D, Chu Y, Liu Y, Lu Y, Chu Y. Distinguish Esophageal Cancer Cells through VOCs Induced by Methionine Regulation. J Proteome Res 2024. [PMID: 38864484 DOI: 10.1021/acs.jproteome.4c00270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Detection of exhaled volatile organic compounds (VOCs) is promising for noninvasive screening of esophageal cancer (EC). Cellular VOC analysis can be used to investigate potential biomarkers. Considering the crucial role of methionine (Met) during cancer development, exploring associated abnormal metabolic phenotypes becomes imperative. In this work, we employed headspace solid-phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) to investigate the volatile metabolic profiles of EC cells (KYSE150) and normal esophageal epithelial cells (HEECs) under a Met regulation strategy. Using untargeted approaches, we analyzed the metabolic VOCs of the two cell types and explored the differential VOCs between them. Subsequently, we utilized targeted approaches to analyze the differential VOCs in both cell types under gradient Met culture conditions. The results revealed that there were five/six differential VOCs between cells under Met-containing/Met-free culture conditions. And the difference in levels of two characteristic VOCs (1-butanol and ethyl 2-methylbutyrate) between the two cell types intensified with the increase of the Met concentration. Notably, this is the first report on VOC analysis of EC cells and the first to consider the effect of Met on volatile metabolic profiles. The present work indicates that EC cells can be distinguished through VOCs induced by Met regulation, which holds promise for providing novel insights into diagnostic strategies.
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Affiliation(s)
- Jijuan Zhou
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui, China
- University of Science and Technology of China, Hefei 230026, Anhui, China
| | - Dianlong Ge
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei 230031, Anhui, China
| | - Yajing Chu
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui, China
- University of Science and Technology of China, Hefei 230026, Anhui, China
| | - Yue Liu
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui, China
- University of Science and Technology of China, Hefei 230026, Anhui, China
| | - Yan Lu
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei 230031, Anhui, China
| | - Yannan Chu
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui, China
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei 230031, Anhui, China
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2
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Chen J, Ji Y, Liu Y, Cen Z, Chen Y, Zhang Y, Li X, Li X. Exhaled volatolomics profiling facilitates personalized screening for gastric cancer. Cancer Lett 2024; 590:216881. [PMID: 38614384 DOI: 10.1016/j.canlet.2024.216881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 04/15/2024]
Abstract
Gastric cancer (GC) is one of the most fatal cancers, characterized by non-specific early symptoms and difficulty in detection. However, there are no valid non-invasive screening tools available for GC. Here we establish a non-invasive method that employs exhaled volatolomics and ensemble learning to detect GC. We developed a comprehensive mass spectrometry-based procedure and determined of a wide range of volatolomics from 314 breath samples. The discovery, identification and verification research screened a biomarker panel to distinguish GC from controls. This panel has achieved 0.90 (0.87-0.94, 95%CI) accuracy, with an area under curve (AUC) of 0.92 (0.89-0.94, 95%CI) in discovery cohort and 0.88 (0.83-0.91, 95%CI) accuracy with an AUC of 0.91 (0.87-0.93, 95%CI) in replication cohort, which outperformed traditional serum markers. Single-cell sequencing and gene set enrichment analysis revealed that these exhaled markers originated from aldehyde oxidation and pyruvate metabolism. Our approach advances the design of exhaled analysis for GC detection and holds promise as a non-invasive method to the clinic.
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Affiliation(s)
- Jian Chen
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China
| | - Yongyan Ji
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China
| | - Yongqian Liu
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China
| | - Zhengnan Cen
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China
| | - Yuanwen Chen
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, PR China
| | - Yixuan Zhang
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, PR China
| | - Xiaowen Li
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, PR China.
| | - Xiang Li
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China.
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3
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Song HW, Moon D, Won Y, Cha YK, Yoo J, Park TH, Oh JH. A pattern recognition artificial olfactory system based on human olfactory receptors and organic synaptic devices. SCIENCE ADVANCES 2024; 10:eadl2882. [PMID: 38781346 PMCID: PMC11114221 DOI: 10.1126/sciadv.adl2882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 04/18/2024] [Indexed: 05/25/2024]
Abstract
Neuromorphic sensors, designed to emulate natural sensory systems, hold the promise of revolutionizing data extraction by facilitating rapid and energy-efficient analysis of extensive datasets. However, a challenge lies in accurately distinguishing specific analytes within mixtures of chemically similar compounds using existing neuromorphic chemical sensors. In this study, we present an artificial olfactory system (AOS), developed through the integration of human olfactory receptors (hORs) and artificial synapses. This AOS is engineered by interfacing an hOR-functionalized extended gate with an organic synaptic device. The AOS generates distinct patterns for odorants and mixtures thereof, at the molecular chain length level, attributed to specific hOR-odorant binding affinities. This approach enables precise pattern recognition via training and inference simulations. These findings establish a foundation for the development of high-performance sensor platforms and artificial sensory systems, which are ideal for applications in wearable and implantable devices.
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Affiliation(s)
- Hyun Woo Song
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
| | - Dongseok Moon
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
| | - Yousang Won
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
| | - Yeon Kyung Cha
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea
- Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea
| | - Jin Yoo
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
| | - Tai Hyun Park
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Joon Hak Oh
- School of Chemical and Biological Engineering, Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
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4
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Belluomo I, Whitlock SE, Myridakis A, Parker AG, Converso V, Perkins MJ, Langford VS, Španěl P, Hanna GB. Combining Thermal Desorption with Selected Ion Flow Tube Mass Spectrometry for Analyses of Breath Volatile Organic Compounds. Anal Chem 2024; 96:1397-1401. [PMID: 38243802 PMCID: PMC10831795 DOI: 10.1021/acs.analchem.3c04286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/21/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024]
Abstract
An instrument integrating thermal desorption (TD) to selected ion flow tube mass spectrometry (SIFT-MS) is presented, and its application to analyze volatile organic compounds (VOCs) in human breath is demonstrated for the first time. The rationale behind this development is the need to analyze breath samples in large-scale multicenter clinical projects involving thousands of patients recruited in different hospitals. Following adapted guidelines for validating analytical techniques, we developed and validated a targeted analytical method for 21 compounds of diverse chemical class, chosen for their clinical and biological relevance. Validation has been carried out by two independent laboratories, using calibration standards and real breath samples from healthy volunteers. The merging of SIFT-MS and TD integrates the rapid analytical capabilities of SIFT-MS with the capacity to collect breath samples across multiple hospitals. Thanks to these features, the novel instrument has the potential to be easily employed in clinical practice.
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Affiliation(s)
- Ilaria Belluomo
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United
Kingdom
| | - Sophia E. Whitlock
- Syft
Technologies Limited, 68 St. Asaph Street, Christchurch 8011, New Zealand
| | - Antonis Myridakis
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United
Kingdom
| | - Aaron G. Parker
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United
Kingdom
| | - Valerio Converso
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United
Kingdom
| | - Mark J. Perkins
- Element
Lab Solutions, Wellbrook
Court, Girton Road, Cambridge CB3 0NA, United Kingdom
| | - Vaughan S. Langford
- Syft
Technologies Limited, 68 St. Asaph Street, Christchurch 8011, New Zealand
| | - Patrik Španěl
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United
Kingdom
- J.
Heyrovský Institute of Physical Chemistry of the Czech Academy
of Sciences, 182 23 Prague, Czechia
| | - George B. Hanna
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United
Kingdom
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5
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Vassilenko V, Moura PC, Raposo M. Diagnosis of Carcinogenic Pathologies through Breath Biomarkers: Present and Future Trends. Biomedicines 2023; 11:3029. [PMID: 38002028 PMCID: PMC10669878 DOI: 10.3390/biomedicines11113029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
The assessment of volatile breath biomarkers has been targeted with a lot of interest by the scientific and medical communities during the past decades due to their suitability for an accurate, painless, non-invasive, and rapid diagnosis of health states and pathological conditions. This paper reviews the most relevant bibliographic sources aiming to gather the most pertinent volatile organic compounds (VOCs) already identified as putative cancer biomarkers. Here, a total of 265 VOCs and the respective bibliographic sources are addressed regarding their scientifically proven suitability to diagnose a total of six carcinogenic diseases, namely lung, breast, gastric, colorectal, prostate, and squamous cell (oesophageal and laryngeal) cancers. In addition, future trends in the identification of five other forms of cancer, such as bladder, liver, ovarian, pancreatic, and thyroid cancer, through perspective volatile breath biomarkers are equally presented and discussed. All the results already achieved in the detection, identification, and quantification of endogenous metabolites produced by all kinds of normal and abnormal processes in the human body denote a promising and auspicious future for this alternative diagnostic tool, whose future passes by the development and employment of newer and more accurate collection and analysis techniques, and the certification for utilisation in real clinical scenarios.
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Affiliation(s)
- Valentina Vassilenko
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
| | - Pedro Catalão Moura
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
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6
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Liu Q, Li S, Li Y, Yu L, Zhao Y, Wu Z, Fan Y, Li X, Wang Y, Zhang X, Zhang Y. Identification of urinary volatile organic compounds as a potential non-invasive biomarker for esophageal cancer. Sci Rep 2023; 13:18587. [PMID: 37903959 PMCID: PMC10616168 DOI: 10.1038/s41598-023-45989-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/26/2023] [Indexed: 11/01/2023] Open
Abstract
Early diagnosis of esophageal cancer (EC) is extremely challenging. The study presented herein aimed to assess whether urinary volatile organic compounds (VOCs) may be emerging diagnostic biomarkers for EC. Urine samples were collected from EC patients and healthy controls (HCs). Gas chromatography-ion mobility spectrometry (GC-IMS) was next utilised for volatile organic compound detection and predictive models were constructed using machine learning algorithms. ROC curve analysis indicated that an 8-VOCs based machine learning model could aid the diagnosis of EC, with the Random Forests having a maximum AUC of 0.874 and sensitivities and specificities of 84.2% and 90.6%, respectively. Urine VOC analysis aids in the diagnosis of EC.
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Affiliation(s)
- Qi Liu
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Shuhai Li
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yaping Li
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Longchen Yu
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yuxiao Zhao
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Zhihong Wu
- Department of Traditional Chinese Medicine, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China.
| | - Yingjing Fan
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Xinyang Li
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yifeng Wang
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Xin Zhang
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China
| | - Yi Zhang
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China.
- Shandong Engineering Research Center of Biomarker and Artificial Intelligence Application, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China.
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7
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Mirza AH, Akhtar M, Aguren J, Marino J, Bruno JG. Advancements in Rapid and Affordable Diagnostic Testing for Respiratory Infectious Diseases: Evaluation of Aptamer Beacon Technology for Rapid and Sensitive Detection of SAR-CoV-2 in Breath Condensate. J Fluoresc 2023:10.1007/s10895-023-03453-3. [PMID: 37864614 DOI: 10.1007/s10895-023-03453-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/26/2023] [Indexed: 10/23/2023]
Abstract
The demand for rapid and efficient diagnostic point-of-care tests for respiratory infectious diseases has become increasingly critical in the current landscape. The emphasis on accessibility has been underscored over the past year, making it crucial to have biological components that exhibit fast and accurate kinetics. The foundation for precise, swift, and effective testing relies on the availability of highly responsive biological agents. Two published aptamer DNA sequences designated Song and MSA52 and their truncated internal stem-loop structures were studied for their potential to serve as aptamer beacons for rapid COVID detection. The candidate beacons were covalently labeled with Atto 633 dye attached to their 5' ends and Iowa Black quencher attached to their 3' ends. The whole aptamer structures exhibited the greatest fluorescence signal intensities and higher fluorescence background than their truncated internal stem-loop beacon structures suggesting that the distance between fluorophores and quenchers was greater for the whole aptamer beacon candidates versus the isolated stem-loop structures. Beacon candidates were tested against two heat- or gamma radiation-killed SARS-CoV-2 Washington 1/2020 virus samples and three different COVID spike (S) proteins to test their effectiveness. Despite the higher background fluorescence, the whole aptamer beacons showed better signal-to-noise ratios and were selected for further investigation. Limit of detection (LOD) studies revealed that both the whole Song and whole MSA52 aptamer beacon candidates had a LOD of 9.61 × 103 genome equivalents in phosphate-buffered saline using the red channel of a Promega Quantus™ fluorometer which correlated well with confirmatory spectrofluorometry. Cross-reactivity studies using numerous COVID variants, related coronaviruses, and other common respiratory pathogens suggested greater COVID selectivity for the whole MSA52 versus the whole Song aptamer beacon candidate, indicating promise for specific COVID detection. Importantly, both whole aptamer beacon candidates exhibited very rapid "bind and detect" fluorescence increases within the first 1-2 min of mixing the beacons with killed SARS-CoV-2 viruses in 100 µl samples. Overall, this work illustrates the strong potential for aptamer beacons for rapid, on-site detection and presumptive diagnosis of COVID in breath condensates or other small liquid samples. This research highlights the strong potential of aptamer beacons for addressing the need for fast and convenient diagnostic tools in global health contexts, especially in resource-limited settings.
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Affiliation(s)
- Asma H Mirza
- Steradian Technologies, Inc, 2450 Holcombe Street Suite J, Houston, TX, 77021, USA
| | - Moneeb Akhtar
- Steradian Technologies, Inc, 2450 Holcombe Street Suite J, Houston, TX, 77021, USA
| | - Jerry Aguren
- Steradian Technologies, Inc, 2450 Holcombe Street Suite J, Houston, TX, 77021, USA
| | - John Marino
- Steradian Technologies, Inc, 2450 Holcombe Street Suite J, Houston, TX, 77021, USA
| | - John G Bruno
- Nanohmics, Inc, 6201 E. Oltorf Street Suite 400, Austin, TX, 78741, USA.
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8
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Romano A, Fehervari M, Boshier PR. Influence of ventilatory parameters on the concentration of exhaled volatile organic compounds in mechanically ventilated patients. Analyst 2023; 148:4020-4029. [PMID: 37497696 DOI: 10.1039/d3an00786c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Analysis of volatile organic compounds (VOC) within exhaled breath is subject to numerous sources of methodological and physiological variability. Whilst breathing pattern is expected to influence the concentrations of selected exhaled VOCs, it remains challenging to investigate respiratory rate and depth accurately in awake subjects. Online breath sampling was performed in 20 mechanically ventilated patients using proton transfer reaction time-of-flight mass spectrometry (PTR-ToF-MS). The effect of variation in respiratory rate (RR) and tidal volume (TV) on the VOC release profiles was examined. A panel of nineteen VOCs were selected, including isoprene, acetone, propofol, volatile aldehydes, acids and phenols. Variation in RR had the greatest influence on exhaled isoprene levels, with maximum and average concentrations being inversely correlated with RR. Variations in RR had a statistically significant impact on acetone, C3-C7 linear aldehydes and acetic acid. In comparison, phenols (including propofol), C8-C10 aldehydes and C3-C6 carboxylic acids were not influenced by RR. Isoprene was the only compound to be influenced by variation in TV. These findings, obtained under controlled conditions, provide useful guidelines for the optimisation of breath sampling protocols to be applied on awake patients.
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Affiliation(s)
- Andrea Romano
- Department Surgery and Cancer, Imperial College, London, UK
| | | | - Piers R Boshier
- Department Surgery and Cancer, Imperial College, London, UK
- Francis Crick Institute, London, UK
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9
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Popov E, Polishchuk A, Kovalev A, Vitkin V. Raman Spectroscopy for Urea Breath Test. BIOSENSORS 2023; 13:609. [PMID: 37366973 DOI: 10.3390/bios13060609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/28/2023]
Abstract
The urea breath test is a non-invasive diagnostic method for Helicobacter pylori infections, which relies on the change in the proportion of 13CO2 in exhaled air. Nondispersive infrared sensors are commonly used for the urea breath test in laboratory equipment, but Raman spectroscopy demonstrated potential for more accurate measurements. The accuracy of the Helicobacter pylori detection via the urea breath test using 13CO2 as a biomarker is affected by measurement errors, including equipment error and δ13C measurement uncertainty. We present a Raman scattering-based gas analyzer capable of δ13C measurements in exhaled air. The technical details of the various measurement conditions have been discussed. Standard gas samples were measured. 12CO2 and 13CO2 calibration coefficients were determined. The Raman spectrum of the exhaled air was measured and the δ13C change (in the process of the urea breath test) was calculated. The total error measured was 6% and does not exceed the limit of 10% that was analytically calculated.
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Affiliation(s)
- Evgeniy Popov
- Institute of Advanced Data Transfer Systems, ITMO University, Birzhevaya Liniya 14, 199034 Saint Petersburg, Russia
| | - Anton Polishchuk
- Institute of Advanced Data Transfer Systems, ITMO University, Birzhevaya Liniya 14, 199034 Saint Petersburg, Russia
| | - Anton Kovalev
- Institute of Advanced Data Transfer Systems, ITMO University, Birzhevaya Liniya 14, 199034 Saint Petersburg, Russia
| | - Vladimir Vitkin
- Institute of Advanced Data Transfer Systems, ITMO University, Birzhevaya Liniya 14, 199034 Saint Petersburg, Russia
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10
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Ding X, Lin G, Wang P, Chen H, Li N, Yang Z, Qiu M. Diagnosis of primary lung cancer and benign pulmonary nodules: a comparison of the breath test and 18F-FDG PET-CT. Front Oncol 2023; 13:1204435. [PMID: 37333820 PMCID: PMC10272389 DOI: 10.3389/fonc.2023.1204435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
With the application of low-dose computed tomography in lung cancer screening, pulmonary nodules have become increasingly detected. Accurate discrimination between primary lung cancer and benign nodules poses a significant clinical challenge. This study aimed to investigate the viability of exhaled breath as a diagnostic tool for pulmonary nodules and compare the breath test with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)-computed tomography (CT). Exhaled breath was collected by Tedlar bags and analyzed by high-pressure photon ionization time-of-flight mass spectrometry (HPPI-TOFMS). A retrospective cohort (n = 100) and a prospective cohort (n = 63) of patients with pulmonary nodules were established. In the validation cohort, the breath test achieved an area under the receiver operating characteristic curve (AUC) of 0.872 (95% CI 0.760-0.983) and a combination of 16 volatile organic compounds achieved an AUC of 0.744 (95% CI 0.7586-0.901). For PET-CT, the SUVmax alone had an AUC of 0.608 (95% CI 0.433-0.784) while after combining with CT image features, 18F-FDG PET-CT had an AUC of 0.821 (95% CI 0.662-0.979). Overall, the study demonstrated the efficacy of a breath test utilizing HPPI-TOFMS for discriminating lung cancer from benign pulmonary nodules. Furthermore, the accuracy achieved by the exhaled breath test was comparable with 18F-FDG PET-CT.
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Affiliation(s)
- Xiangxiang Ding
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
- Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Guihu Lin
- Department of Thoracic Surgery, Aerospace 731 Hospital, Beijing, China
| | - Peiyu Wang
- Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
- Thoracic Oncology Institute, Peking University People’s Hospital, Beijing, China
| | - Haibin Chen
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, Beijing, China
| | - Nan Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
- Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Zhi Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
- Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Mantang Qiu
- Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
- Thoracic Oncology Institute, Peking University People’s Hospital, Beijing, China
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, Beijing, China
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11
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Škapars R, Gašenko E, Broza YY, Sīviņš A, Poļaka I, Bogdanova I, Pčolkins A, Veliks V, Folkmanis V, Lesčinska A, Liepniece-Karele I, Haick H, Rumba-Rozenfelde I, Leja M. Breath Volatile Organic Compounds in Surveillance of Gastric Cancer Patients following Radical Surgical Management. Diagnostics (Basel) 2023; 13:diagnostics13101670. [PMID: 37238155 DOI: 10.3390/diagnostics13101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/20/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
As of today, there is a lack of a perfect non-invasive test for the surveillance of patients for potential relapse following curative treatment. Breath volatile organic compounds (VOCs) have been demonstrated to be an accurate diagnostic tool for gastric cancer (GC) detection; here, we aimed to prove the yield of the markers in surveillance, i.e., following curative surgical management. Patients were sampled in regular intervals before and within 3 years following curative surgery for GC; gas chromatography-mass spectrometry (GC-MS) and nanosensor technologies were used for the VOC assessment. GC-MS measurements revealed a single VOC (14b-Pregnane) that significantly decreased at 12 months, and three VOCs (Isochiapin B, Dotriacontane, Threitol, 2-O-octyl-) that decreased at 18 months following surgery. The nanomaterial-based sensors S9 and S14 revealed changes in the breath VOC content 9 months after surgery. Our study results confirm the cancer origin of the particular VOCs, as well as suggest the value of breath VOC testing for cancer patient surveillance, either during the treatment phase or thereafter, for potential relapse.
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Affiliation(s)
- Roberts Škapars
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Department of Abdominal and Soft Tissue Surgery, Oncology Center of Latvia, Riga East University Hospital, LV-1038 Riga, Latvia
| | - Evita Gašenko
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Department of Abdominal and Soft Tissue Surgery, Oncology Center of Latvia, Riga East University Hospital, LV-1038 Riga, Latvia
| | - Yoav Y Broza
- Department of Chemical Engineering and Russel Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Armands Sīviņš
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Department of Abdominal and Soft Tissue Surgery, Oncology Center of Latvia, Riga East University Hospital, LV-1038 Riga, Latvia
| | - Inese Poļaka
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
| | - Inga Bogdanova
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Department of Abdominal and Soft Tissue Surgery, Oncology Center of Latvia, Riga East University Hospital, LV-1038 Riga, Latvia
| | - Andrejs Pčolkins
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Department of Abdominal and Soft Tissue Surgery, Oncology Center of Latvia, Riga East University Hospital, LV-1038 Riga, Latvia
| | - Viktors Veliks
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
| | - Valdis Folkmanis
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
| | - Anna Lesčinska
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Department of Abdominal and Soft Tissue Surgery, Oncology Center of Latvia, Riga East University Hospital, LV-1038 Riga, Latvia
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Department of Abdominal and Soft Tissue Surgery, Oncology Center of Latvia, Riga East University Hospital, LV-1038 Riga, Latvia
| | - Hossam Haick
- Department of Chemical Engineering and Russel Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Ingrīda Rumba-Rozenfelde
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
| | - Mārcis Leja
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
- Department of Abdominal and Soft Tissue Surgery, Oncology Center of Latvia, Riga East University Hospital, LV-1038 Riga, Latvia
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12
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Zhu Q, Xu H, Huang L, Luo J, Li H, Yang R, Liu X, Liu F. Identification and detection of plasma extracellular vesicles-derived biomarkers for esophageal squamous cell carcinoma diagnosis. Biosens Bioelectron 2023; 225:115088. [PMID: 36739741 DOI: 10.1016/j.bios.2023.115088] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
Esophageal cancer is a malignant tumor with two-thirds of patients having a local recurrence or distant metastasis. To date, diagnostic biomarkers with high sensitivity and specificity are lacking. Extracellular vesicles (EVs) have shown their potential values as disease biomarkers as they carry specific proteins and RNAs derived from cancer cells. In this study, we investigate ESCC precision diagnostics from the insights of circulating EVs, and integrate the ultrafast EV isolation approach (EXODUS) and ELISA for fast detection and screening of ESCC patients. First, we isolate and characterize the high-purity plasma EVs with EXODUS and identify 401 proteins and 372 proteins from ESCC patient and healthy individuals, respectively. Further looking into the differentially expressed proteins (DEPs) of ESCC patients and enriched KEGG pathways, we discover EV-CD14 as a potential diagnostic biomarker for ESCC, which has been further validated as a significantly differentially expressed protein by Western Blot and immunogold labelling TEM. For fast screening and detection of ESCC towards clinical applications, we apply ELISA method to diagnose ESCC from 60 clinical samples based on circulating EV-CD14, which shows a high AUC value up to 96.0% for detection of ESCC in a test set (30 samples), and displays a high accuracy rate up to 90% for prediction of ESCC in a screening test (30 samples). Our results suggest that the circulating EV-CD14 may highly be related to the initiation and progression of ESCC, providing a novel method for the diagnosis and prognosis of ESCC towards clinical translations.
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Affiliation(s)
- Qingfu Zhu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Hao Xu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Liu Huang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Jiaxin Luo
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Hengrui Li
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Rui Yang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiaoling Liu
- Center for Biological Science and Technology, Advanced Institute of Natural Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Fei Liu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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13
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Sani SN, Zhou W, Ismail BB, Zhang Y, Chen Z, Zhang B, Bao C, Zhang H, Wang X. LC-MS/MS Based Volatile Organic Compound Biomarkers Analysis for Early Detection of Lung Cancer. Cancers (Basel) 2023; 15:cancers15041186. [PMID: 36831528 PMCID: PMC9954752 DOI: 10.3390/cancers15041186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
(1) Background: lung cancer is the world's deadliest cancer, but early diagnosis helps to improve the cure rate and thus reduce the mortality rate. Annual low-dose computed tomography (LD-CT) screening is an efficient lung cancer-screening program for a high-risk population. However, LD-CT has often been characterized by a higher degree of false-positive results. To meet these challenges, a volatolomic approach, in particular, the breath volatile organic compounds (VOCs) fingerprint analysis, has recently received increased attention for its application in early lung cancer screening thanks to its convenience, non-invasiveness, and being well tolerated by patients. (2) Methods: a LC-MS/MS-based volatolomics analysis was carried out according to P/N 5046800 standard based breath analysis of VOC as novel cancer biomarkers for distinguishing early-stage lung cancer from the healthy control group. The discriminatory accuracy of identified VOCs was assessed using subject work characterization and a random forest risk prediction model. (3) Results: the proposed technique has good performance compared with existing approaches, the differences between the exhaled VOCs of the early lung cancer patients before operation, three to seven days after the operation, as well as four to six weeks after operation under fasting and 1 h after the meal were compared with the healthy controls. The results showed that only 1 h after a meal, the concentration of seven VOCs, including 3-hydroxy-2-butanone (TG-4), glycolaldehyde (TG-7), 2-pentanone (TG-8), acrolein (TG-11), nonaldehyde (TG-19), decanal (TG-20), and crotonaldehyde (TG-22), differ significantly between lung cancer patients and control, with the invasive adenocarcinoma of the lung (IAC) having the most significant difference. (4) Conclusions: this novel, non-invasive approach can improve the detection rate of early lung cancer, and LC-MS/MS-based breath analysis could be a promising method for clinical application.
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Affiliation(s)
- Shuaibu Nazifi Sani
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou 310027, China
| | - Wei Zhou
- Biochemical Analysis Laboratory, Breath (Hangzhou) Technology Co., Ltd., Hangzhou 310000, China
| | - Balarabe B. Ismail
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | | | - Zhijun Chen
- Zhejiang Zhoushan Hospital, Zhoushan 316021, China
| | - Binjie Zhang
- Zhejiang Zhoushan Hospital, Zhoushan 316021, China
| | - Changqian Bao
- Department of Hematology, The Second Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou 310009, China
| | - Houde Zhang
- Department Gastroenterology, Nanshan Hospital, Guandong Medical University, Shenzhen 518052, China
- Correspondence: (H.Z.); (X.W.)
| | - Xiaozhi Wang
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou 310027, China
- Correspondence: (H.Z.); (X.W.)
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14
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Smith D, Španěl P, Demarais N, Langford VS, McEwan MJ. Recent developments and applications of selected ion flow tube mass spectrometry (SIFT-MS). MASS SPECTROMETRY REVIEWS 2023:e21835. [PMID: 36776107 DOI: 10.1002/mas.21835] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/09/2022] [Accepted: 12/12/2022] [Indexed: 06/18/2023]
Abstract
Selected ion flow tube mass spectrometry (SIFT-MS) is now recognized as the most versatile analytical technique for the identification and quantification of trace gases down to the parts-per-trillion by volume, pptv, range. This statement is supported by the wide reach of its applications, from real-time analysis, obviating sample collection of very humid exhaled breath, to its adoption in industrial scenarios for air quality monitoring. This review touches on the recent extensions to the underpinning ion chemistry kinetics library and the alternative challenge of using nitrogen carrier gas instead of helium. The addition of reagent anions in the Voice200 series of SIFT-MS instruments has enhanced the analytical capability, thus allowing analyses of volatile trace compounds in humid air that cannot be analyzed using reagent cations alone, as clarified by outlining the anion chemistry involved. Case studies are reviewed of breath analysis and bacterial culture volatile organic compound (VOC), emissions, environmental applications such as air, water, and soil analysis, workplace safety such as transport container fumigants, airborne contamination in semiconductor fabrication, food flavor and spoilage, drugs contamination and VOC emissions from packaging to demonstrate the stated qualities and uniqueness of the new generation SIFT-MS instrumentation. Finally, some advancements that can be made to improve the analytical capability and reach of SIFT-MS are mentioned.
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Affiliation(s)
- David Smith
- J. Heyrovský Institute of Physical Chemistry, Czech Academy of Sciences, Prague, Czechia
| | - Patrik Španěl
- J. Heyrovský Institute of Physical Chemistry, Czech Academy of Sciences, Prague, Czechia
| | | | | | - Murray J McEwan
- Syft Technologies Limited, Christchurch, New Zealand
- Department of Chemistry, University of Canterbury, Christchurch, New Zealand
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15
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Wen Q, Myridakis A, Boshier PR, Zuffa S, Belluomo I, Parker AG, Chin ST, Hakim S, Markar SR, Hanna GB. A Complete Pipeline for Untargeted Urinary Volatolomic Profiling with Sorptive Extraction and Dual Polar and Nonpolar Column Methodologies Coupled with Gas Chromatography Time-of-Flight Mass Spectrometry. Anal Chem 2023; 95:758-765. [PMID: 36602225 PMCID: PMC9850407 DOI: 10.1021/acs.analchem.2c02873] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Volatolomics offers an opportunity for noninvasive detection and monitoring of human disease. While gas chromatography-mass spectrometry (GC-MS) remains the technique of choice for analyzing volatile organic compounds (VOCs), barriers to wider adoption in clinical practice still exist, including: sample preparation and introduction techniques, VOC extraction, throughput, volatolome coverage, biological interpretation, and quality control (QC). Therefore, we developed a complete pipeline for untargeted urinary volatolomic profiling. We optimized a novel extraction technique using HiSorb sorptive extraction, which exhibited high analytical performance and throughput. We achieved a broader VOC coverage by using HiSorb coupled with a set of complementary chromatographic methods and time-of-flight mass spectrometry. Furthermore, we developed a data preprocessing strategy by evaluating internal standard normalization, batch correction, and we adopted strict QC measures including removal of nonlinearly responding, irreproducible, or contaminated metabolic features, ensuring the acquisition of high-quality data. The applicability of this pipeline was evaluated in a clinical cohort consisting of pancreatic ductal adenocarcinoma (PDAC) patients (n = 28) and controls (n = 33), identifying four urinary candidate biomarkers (2-pentanone, hexanal, 3-hexanone, and p-cymene), which can successfully discriminate the cancer and noncancer subjects. This study presents an optimized, high-throughput, and quality-controlled pipeline for untargeted urinary volatolomic profiling. Use of the pipeline to discriminate PDAC from control subjects provides proof of principal of its clinical utility and potential for application in future biomarker discovery studies.
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Affiliation(s)
- Qing Wen
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom
| | - Antonis Myridakis
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom
| | - Piers R. Boshier
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom
| | - Simone Zuffa
- Department
of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2AZ, United Kingdom
| | - Ilaria Belluomo
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom
| | - Aaron G. Parker
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom
| | - Sung-Tong Chin
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom
| | - Stephanie Hakim
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom
| | - Sheraz R. Markar
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom,Nuffield
Department of Surgical Sciences, University
of Oxford, Oxford OX3 9DU, United Kingdom
| | - George B. Hanna
- Department
of Surgery and Cancer, Imperial College
London, London W12 0HS, United Kingdom,
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16
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Tıplamaz S, Eyüboğlu İP, Ünal C, Soyer Ö, Beksaç MS, Akkiprik M. Presence of fetal DNA in maternal exhaled breath condensate. Prenat Diagn 2023; 43:28-35. [PMID: 36464942 DOI: 10.1002/pd.6277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/12/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Cell-free DNA has been found in all body fluids, but DNAs emerging from locations that are not in direct contact with breath in exhaled breath condensate (EBC) are yet to be found. The potential of EBC for prenatal and cancer screening prompted us to investigate whether fetal DNA is present in maternal EBC. METHOD A total of 20 pregnant women's EBC and blood samples were collected. Four Y chromosome-specific assays were tested on all EBC and plasma samples by quantitative PCR (qPCR). The best-performing assay was used for digital droplet PCR (ddPCR) on all EBC and the six plasma samples. RESULTS The sex of the fetuses was accurately determined from plasma samples. DNA sequences could not be properly amplified in EBC samples by the qPCR. By ddPCR, the Y chromosome sequence was amplified in two of the 11 EBC samples, from women carrying male fetuses (2/11), and the Y chromosome sequence was not amplified in the EBC of women carrying female fetuses (9/9). Exhaled breath condensate ddPCR result's specificity was 100%, the detection rate of Y chromosome was 18.18% (2/11), and the corrected accuracy was 59.09%. CONCLUSION Our finding of "the presence of fetal DNA in maternal EBC", despite the low detection rate, might have a major impact on prenatal diagnosis and cancer screening.
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Affiliation(s)
- Sıtkı Tıplamaz
- Department of Medical Biology and Genetics, Faculty of Medicine, Marmara University, İstanbul, Turkey.,Department of Forensic Medicine, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - İrem Peker Eyüboğlu
- Department of Medical Biology and Genetics, Faculty of Medicine, Marmara University, İstanbul, Turkey
| | - Canan Ünal
- Department of Obstetrics and Gynecology, Division of Perinatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.,Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Özge Soyer
- Department of Obstetrics and Gynecology, Division of Perinatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Sinan Beksaç
- Department of Obstetrics and Gynecology, Division of Perinatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Akkiprik
- Department of Medical Biology and Genetics, Faculty of Medicine, Marmara University, İstanbul, Turkey
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Metabolism-dependent ferroptosis promotes mitochondrial dysfunction and inflammation in CD4 + T lymphocytes in HIV-infected immune non-responders. EBioMedicine 2022; 86:104382. [PMID: 36462403 PMCID: PMC9718960 DOI: 10.1016/j.ebiom.2022.104382] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/29/2022] [Accepted: 11/09/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND HIV immune non-responders (INRs) are described as a failure to reestablish a pool of CD4+ T lymphocytes (CD4 cells) after antiretroviral therapy (ART), which is related to poor clinical results. Ferroptosis is a newly discovered form of cell death characterised by iron-dependent lipid peroxidation and the accumulation of reactive oxygen species (ROS). The mechanism of unrecoverable CD4 cells in INRs and whether ferroptosis plays a role are not fully understood. METHODS Ninety-two people living with HIV (PLHIVs) who experienced four-year ART with sustained viral suppression, including 27 INRs, 34 partial responders (PRs), and 31 complete responders (CRs); and 26 uninfected control participants (UCs) were analysed for 16 immune parameters with flow cytometry. Then plasma lipid, iron and oxidation, and antioxidant indicators were detected by ELISA, and CD4 cells were sorted out and visualised under transmission electron microscopy. Finally, ferroptosis inhibitors were added, and alterations in CD4 cell phenotype and function were observed. FINDINGS We found decreased recent thymic emigrants (RTE), over-activation and over-proliferation phenotypes, diminished killing function, decreased IL-7R and more severe inflammation; increased lipid peroxidation in the mitochondria and disruptions of the mitochondrial structure, showing typical features of ferroptosis in CD4 cells in INRs. Additionally, ferroptosis inhibitors could reduce inflammation and repair mitochondrial damage. Meanwhile, ELISA results showed increased plasma free fatty acids (FFA) and an imbalance of oxidative and antioxidant systems in INRs. Flow cytometry results displayed alterations of both transferrin receptor (CD71) and lipid transporter (CD36) expressions on the surface of CD4 cells. Mechanistically, there was a stronger correlation between CD36 expression and mitochondrial lipid peroxidation production, ferroptosis makers, and inflammation indicators; while amino acid transporter (CD98) was more related to killing functions; and CD71 was more closely related to activation status in CD4 cells. INTERPRETATION Cellular metabolism was closely correlated with its diverse functions in INRs. Ferroptosis was observed in CD4 cells of INRs, and inhibiting ferroptosis through modulating mitochondrial disorders and inflammation may offer an alternative immunological strategy for reinvigorating CD4 cells in INRs. FUNDING This research was supported by the 13th Five-year Plan, Ministry of Science and Technology of China (2018ZX10302-102), Beijing Municipal Administration of Hospitals' Ascent Plan (DFL20191802), and Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX202126).
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18
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Mass spectrometry for breath analysis. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Hewitt MJ, Belluomo I, Zuffa S, Boshier PR, Myridakis A. Variation of volatile organic compound levels within ambient room air and its impact upon the standardisation of breath sampling. Sci Rep 2022; 12:15887. [PMID: 36151300 PMCID: PMC9508138 DOI: 10.1038/s41598-022-20365-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
The interest around analysis of volatile organic compounds (VOCs) within breath has increased in the last two decades. Uncertainty remains around standardisation of sampling and whether VOCs within room air can influence breath VOC profiles. To assess the abundance of VOCs within room air in common breath sampling locations within a hospital setting and whether this influences the composition of breath. A secondary objective is to investigate diurnal variation in room air VOCs. Room air was collected using a sampling pump and thermal desorption (TD) tubes in the morning and afternoon from five locations. Breath samples were collected in the morning only. TD tubes were analysed using gas chromatography coupled with time-of-flight mass spectrometry (GC-TOF-MS). A total of 113 VOCs were identified from the collected samples. Multivariate analysis demonstrated clear separation between breath and room air. Room air composition changed throughout the day and different locations were characterized by specific VOCs, which were not influencing breath profiles. Breath did not demonstrate separation based on location, suggesting that sampling can be performed across different locations without affecting results.
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Affiliation(s)
| | - Ilaria Belluomo
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Simone Zuffa
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Antonis Myridakis
- Department of Surgery and Cancer, Imperial College London, London, UK.
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20
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The Human Skin Volatolome: A Systematic Review of Untargeted Mass Spectrometry Analysis. Metabolites 2022; 12:metabo12090824. [PMID: 36144228 PMCID: PMC9504915 DOI: 10.3390/metabo12090824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 11/16/2022] Open
Abstract
The analysis of volatile organic compounds (VOCs) can provide important clinical information (entirely non-invasively); however, the exact extent to which VOCs from human skin can be signatures of health and disease is unknown. This systematic review summarises the published literature concerning the methodology, application, and volatile profiles of skin VOC studies. An online literature search was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis, to identify human skin VOC studies using untargeted mass spectrometry (MS) methods. The principal outcome was chemically verified VOCs detected from the skin. Each VOC was cross-referenced using the CAS number against the Human Metabolome and KEGG databases to evaluate biological origins. A total of 29 studies identified 822 skin VOCs from 935 participants. Skin VOCs were commonly sampled from the hand (n = 9) or forearm (n = 7) using an absorbent patch (n = 15) with analysis by gas chromatography MS (n = 23). Twenty-two studies profiled the skin VOCs of healthy subjects, demonstrating a volatolome consisting of aldehydes (18%), carboxylic acids (12%), alkanes (12%), fatty alcohols (9%), ketones (7%), benzenes and derivatives (6%), alkenes (2%), and menthane monoterpenoids (2%). Of the VOCs identified, 13% had putative endogenous origins, 46% had tentative exogenous origins, and 40% were metabolites from mixed metabolic pathways. This review has comprehensively profiled the human skin volatolome, demonstrating the presence of a distinct VOC signature of healthy skin, which can be used as a reference for future researchers seeking to unlock the clinical potential of skin volatolomics. As significant proportions of identified VOCs have putative exogenous origins, strategies to minimise their presence through methodological refinements and identifying confounding compounds are discussed.
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21
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Shahsavari D, Kudaravalli P, Yap JEL, Vega KJ. Expanding beyond endoscopy: A review of non-invasive modalities in Barrett’s esophagus screening and surveillance. World J Gastroenterol 2022; 28:4516-4526. [PMID: 36157931 PMCID: PMC9476875 DOI: 10.3748/wjg.v28.i32.4516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/14/2022] [Accepted: 07/26/2022] [Indexed: 02/06/2023] Open
Abstract
Barrett’s esophagus (BE) is a condition that results from replacement of the damaged normal squamous esophageal mucosa to intestinal columnar mucosa and is the most significant predisposing factor for development of esophageal adenocarcinoma. Current guidelines recommend endoscopic evaluation for screening and surveillance based on various risk factors which has limitations such as invasiveness, availability of a trained specialist, patient logistics and cost. Trans-nasal endoscopy is a less invasive modality but still has similar limitations such as limited availability of trained specialist and costs. Non-endoscopic modalities, in comparison, require minimal intervention, can be done in an office visit and has the potential to be a more ideal choice for mass public screening and surveillance, particularly in patents at low risk for BE. These include newer generations of esophageal capsule endoscopy which provides direct visualization of BE, and tethered capsule endomicroscopy which can obtain high-resolution images of the esophagus. Various cell collection devices coupled with biomarkers have been used for BE screening. Cytosponge, in combination with TFF3, as well as EsophaCap and EsoCheck have shown promising results in various studies when used with various biomarkers. Other modalities including circulatory microRNAs and volatile organic compounds that have demonstrated favorable outcomes. Use of these cell collection methods for BE surveillance is a potential area of future research.
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Affiliation(s)
- Dariush Shahsavari
- Division of Gastroenterology and Hepatology, Augusta University-Medical College of Georgia, Augusta, GA 30912, United States
| | - Praneeth Kudaravalli
- Division of Gastroenterology and Hepatology, Augusta University-Medical College of Georgia, Augusta, GA 30912, United States
| | - John Erikson L Yap
- Division of Gastroenterology and Hepatology, Augusta University-Medical College of Georgia, Augusta, GA 30912, United States
| | - Kenneth J Vega
- Division of Gastroenterology and Hepatology, Augusta University-Medical College of Georgia, Augusta, GA 30912, United States
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Prognostic, Diagnostic and Predictive Biomarkers in the Barrett’s Oesophagus-Adenocarcinoma Disease Sequence. Cancers (Basel) 2022; 14:cancers14143427. [PMID: 35884487 PMCID: PMC9315596 DOI: 10.3390/cancers14143427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/16/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Oesophageal adenocarcinoma (OAC) is a type of cancer of the oesophagus (food pipe) which is associated with poor patient outcomes. Barrett’s oesophagus (BO) is a precancerous condition of the oesophagus associated with chronic heartburn. Currently, surveillance programs exist which monitor patients with BO to prevent it from developing into OAC. However, these surveillance programs are expensive and unpleasant for patients. Prognostic biomarkers are signs which could be measured to determine the chance of someone with BO developing OAC, allowing more targeted surveillance. Similarly, diagnostic biomarkers are indicators which could be measured to see if someone has OAC. Developing new diagnostic biomarkers could allow wider population testing. Only a small proportion of patients with OAC respond to treatment before surgery. Predictive biomarkers could be measured to predict whether someone would respond to the treatments, allowing more individualized therapy. This review focuses on potential biomarkers which could improve patient outcomes in BO/OAC. Abstract Oesophageal adenocarcinoma (OAC) incidence has increased dramatically in the developed world, yet outcomes remain poor. Extensive endoscopic surveillance programs among patients with Barrett’s oesophagus (BO), the precursor lesion to OAC, have aimed to both prevent the development of OAC via radiofrequency ablation (RFA) and allow earlier detection of disease. However, given the low annual progression rate and the costs of endoscopy/RFA, improvement is needed. Prognostic biomarkers to stratify BO patients based on their likelihood to progress would enable a more targeted approach to surveillance and RFA of high-risk precursor lesions, improving the cost–risk–benefit ratio. Similarly, diagnostic biomarkers for OAC could enable earlier diagnosis of disease by allowing broader population screening. Current standard treatment for locally advanced OAC includes neoadjuvant chemotherapy (+/− radiotherapy) despite only a minority of patients benefiting from neoadjuvant treatment. Accordingly, biomarkers predictive of response to neoadjuvant therapy could improve patient outcomes by reducing time to surgery and unnecessary toxicity for the patients who would have received no benefit from the therapy. In this mini-review, we will discuss the emerging biomarkers which promise to dramatically improve patient outcomes along the BO-OAC disease sequence.
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Yang H, Mou Y, Hu B. Diagnostic Ability of Volatile Organic Compounds in Digestive Cancer: A Systematic Review With Meta-Analysis. Clin Med Insights Oncol 2022; 16:11795549221105027. [PMID: 35754925 PMCID: PMC9218909 DOI: 10.1177/11795549221105027] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/16/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Volatile organic compounds (VOCs) have been involved in cancer diagnosis via breath, urine, and feces. We aimed to assess the diagnostic ability of VOCs on digestive cancers. Methods: We systematically reviewed prospective clinical trials evaluating VOCs’ diagnostic ability on esophageal, gastric, colorectal, hepatic, and pancreatic cancer (PC). Databases including PubMed and Ovid-Medline were searched. Results: A total of 35 trials with 5314 patient-times qualified for inclusion. The pooled sensitivity of VOCs diagnosing gastroesophageal cancer from healthy controls is 0.89 (95% confidence interval [CI]: 0.82-0.94), the pooled specificity is 0.890 (95% CI: 0.84-0.93), and area under the curve (AUC) of the summary receiver operating characteristic curve is 0.95 (95% CI: 0.93-0.95). The pooled sensitivity of VOCs diagnosing colorectal cancer from heathy controls is 0.92 (95% CI: 0.85-0.96), the pooled specificity is 0.88 (95% CI: 0.77-0.94), and the AUC is 0.96 (95% CI: 0.94-0.97). The pooled sensitivity of VOCs distinguishing gastrointestinal (GI) cancer from precancerous lesions is 0.84 (95% CI: 0.67-0.92), the pooled specificity is 0.74 (95% CI: 0.43-0.91), and the AUC is 0.87 (95% CI: 0.84-0.89). The pooled sensitivity of VOCs diagnosing hepatocellular carcinoma is 0.68 (95% CI: 0.52-0.81), the pooled specificity is 0.81 (95% CI: 0.47-0.96), and the AUC is 0.78 (95% CI: 0.74-0.81). The pooled sensitivity of VOCs diagnosing PC is 0.88 (95% CI: 0.80-0.93), the pooled specificity is 0.82 (95% CI: 0.62-0.93), and the AUC is 0.92 (95% CI: 0.89-0.94). Conclusions: Volatile organic compounds have potential role in diagnosing GI cancer with comparatively high sensitivity, specificity, and AUC (PROSPERO registration number: CRD42021260039).
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Affiliation(s)
- Hang Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Mou
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
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Yang H, Zhou X, Hu B. The 'reversibility' of chronic atrophic gastritis after the eradication of Helicobacter pylori. Postgrad Med 2022; 134:474-479. [PMID: 35382697 DOI: 10.1080/00325481.2022.2063604] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Gram-negative bacterium Helicobacter pylori (H. pylori) infection is lifelong and usually acquired in childhood, which is etiologically linked to gastric cancer (GC). H. pylori gastritis is defined as an infectious disease with varying severity in virtually all infected subjects. Chronic atrophic gastritis (CAG) is the precancerous condition with the decrease or the loss of gastric glands, which can further be replaced by metaplasia or fibrosis. Patients with advanced stages of CAG are at higher risk of GC and should be followed up with a high-quality endoscopy every 3 years. H. pylori infection is the most common cause and its eradication is recommended, which may contribute to the regression of CAG. However, it is controversial whether CAG is reversible after eradication therapy. In the review, we discuss recent studies which provide important insights into whether CAG is 'reversibility' and when it may progress into GC after eradicating H. pylori.
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Affiliation(s)
- Hang Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinyue Zhou
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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2021 White Paper on Recent Issues in Bioanalysis: ISR for Biomarkers, Liquid Biopsies, Spectral Cytometry, Inhalation/Oral & Multispecific Biotherapeutics, Accuracy/LLOQ for Flow Cytometry ( Part 2 - Recommendations on Biomarkers/CDx Assays Development & Validation, Cytometry Validation & Innovation, Biotherapeutics PK LBA Regulated Bioanalysis, Critical Reagents & Positive Controls Generation). Bioanalysis 2022; 14:627-692. [PMID: 35578974 DOI: 10.4155/bio-2022-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The 15th edition of the Workshop on Recent Issues in Bioanalysis (15th WRIB) was held on 27 September to 1 October 2021. Even with a last-minute move from in-person to virtual, an overwhelmingly high number of nearly 900 professionals representing pharma and biotech companies, contract research organizations (CROs), and multiple regulatory agencies still eagerly convened to actively discuss the most current topics of interest in bioanalysis. The 15th WRIB included three Main Workshops and seven Specialized Workshops that together spanned 1 week in order to allow exhaustive and thorough coverage of all major issues in bioanalysis, biomarkers, immunogenicity, gene therapy, cell therapy and vaccines. Moreover, in-depth workshops on biomarker assay development and validation (BAV) (focused on clarifying the confusion created by the increased use of the term "context of use" [COU]); mass spectrometry of proteins (therapeutic, biomarker and transgene); state-of-the-art cytometry innovation and validation; and critical reagent and positive control generation were the special features of the 15th edition. This 2021 White Paper encompasses recommendations emerging from the extensive discussions held during the workshop, and is aimed to provide the bioanalytical community with key information and practical solutions on topics and issues addressed, in an effort to enable advances in scientific excellence, improved quality and better regulatory compliance. Due to its length, the 2021 edition of this comprehensive White Paper has been divided into three parts for editorial reasons. This publication (Part 2) covers the recommendations on ISR for Biomarkers, Liquid Biopsies, Spectral Cytometry, Inhalation/Oral & Multispecific Biotherapeutics, Accuracy/LLOQ for Flow Cytometry. Part 1A (Endogenous Compounds, Small Molecules, Complex Methods, Regulated Mass Spec of Large Molecules, Small Molecule, PoC), Part 1B (Regulatory Agencies' Inputs on Bioanalysis, Biomarkers, Immunogenicity, Gene & Cell Therapy and Vaccine) and Part 3 (TAb/NAb, Viral Vector CDx, Shedding Assays; CRISPR/Cas9 & CAR-T Immunogenicity; PCR & Vaccine Assay Performance; ADA Assay Comparability & Cut Point Appropriateness) are published in volume 14 of Bioanalysis, issues 9 and 11 (2022), respectively.
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Wang P, Huang Q, Meng S, Mu T, Liu Z, He M, Li Q, Zhao S, Wang S, Qiu M. Identification of lung cancer breath biomarkers based on perioperative breathomics testing: A prospective observational study. EClinicalMedicine 2022; 47:101384. [PMID: 35480076 PMCID: PMC9035731 DOI: 10.1016/j.eclinm.2022.101384] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Breathomics testing has been considered a promising method for detection and screening for lung cancer. This study aimed to identify breath biomarkers of lung cancer through perioperative dynamic breathomics testing. METHODS The discovery study was prospectively conducted between Sept 1, 2020 and Dec 31, 2020 in Peking University People's Hospital in China. High-pressure photon ionisation time-of-flight mass spectrometry was used for breathomics testing before surgery and 4 weeks after surgery. 28 volatile organic compounds (VOCs) were selected as candidates based on a literature review. VOCs that changed significantly postoperatively in patients with lung cancer were selected as potential breath biomarkers. An external validation was conducted to evaluate the performance of these VOCs for lung cancer diagnosis. Multivariable logistic regression was used to establish diagnostic models based on selected VOCs. FINDINGS In the discovery study of 84 patients with lung cancer, perioperative breathomics demonstrated 16 VOCs as lung cancer breath biomarkers. They were classified as aldehydes, hydrocarbons, ketones, carboxylic acids, and furan. In the external validation study including 157 patients with lung cancer and 368 healthy individuals, patients with lung cancer showed elevated spectrum peak intensity of the 16 VOCs after adjusting for age, sex, smoking, and comorbidities. The diagnostic model including 16 VOCs achieved an area under the curve (AUC) of 0.952, sensitivity of 89.2%, specificity of 89.1%, and accuracy of 89.1% in lung cancer diagnosis. The diagnostic model including the top eight VOCs achieved an AUC of 0.931, sensitivity of 86.0%, specificity of 87.2%, and accuracy of 86.9%. INTERPRETATION Perioperative dynamic breathomics is an effective approach for identifying lung cancer breath biomarkers. 16 lung cancer-related breath VOCs (aldehydes, hydrocarbons, ketones, carboxylic acids, and furan) were identified and validated. Further studies are warranted to investigate the underlying mechanisms of identified VOCs. FUNDING National Natural Science Foundation of China (82173386) and Peking University People's Hospital Scientific Research Development Founds (RDH2021-07).
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Affiliation(s)
- Peiyu Wang
- Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing 100044, China
| | - Qi Huang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, Henan 450003, China
| | - Shushi Meng
- Department of Thoracic Surgery, Beijing Haidian Hospital, Beijing 100080, China
| | - Teng Mu
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, Henan 450003, China
| | - Zheng Liu
- Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing 100044, China
| | - Mengqi He
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, Beijing 100074, China
| | - Qingyun Li
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, Beijing 100074, China
| | - Song Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, Henan 450003, China
- Corresponding authors at: Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, Henan 450003, China.
| | - Shaodong Wang
- Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing 100044, China
- Corresponding authors at: Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing 100044, China
| | - Mantang Qiu
- Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing 100044, China
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, Beijing 100074, China
- Corresponding authors at: Department of Thoracic Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing 100044, China
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Urinary Volatile Organic Compound Testing in Fast-Track Patients with Suspected Colorectal Cancer. Cancers (Basel) 2022; 14:cancers14092127. [PMID: 35565258 PMCID: PMC9099958 DOI: 10.3390/cancers14092127] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary The current pathway for the investigation of possible colorectal cancer includes the use of colonoscopy. This is an invasive and unpleasant procedure, and currently, a large number of those performed are normal. Previous research has demonstrated that urinary volatile organic compounds (VOCs) can be used to detect cancer, including colorectal cancer. However, these studies have only taken place in patients already known to have cancer. This study aimed to assess the role of urinary VOC analysis in the NHS two weeks wait for cancer pathway. Three analytical techniques were used to analyze urine samples of 558 patients during the standard NHS assessment pathway. It demonstrated that gas chromatography-mass spectrometry (GCMS) has excellent sensitivity and specificity for the identification of cancer and polyps in this patient group. These results show a potential role for urinary VOC analysis in the NHS cancer screening pathway, to reduce the need for invasive colonoscopy testing. Abstract Colorectal symptoms are common but only infrequently represent serious pathology, including colorectal cancer (CRC). A large number of invasive tests are presently performed for reassurance. We investigated the feasibility of urinary volatile organic compound (VOC) testing as a potential triage tool in patients fast-tracked for assessment for possible CRC. A prospective, multi-center, observational feasibility study was performed across three sites. Patients referred to NHS fast-track pathways for potential CRC provided a urine sample that underwent Gas Chromatography-Mass Spectrometry (GC-MS), Field Asymmetric Ion Mobility Spectrometry (FAIMS), and Selected Ion Flow Tube Mass Spectrometry (SIFT-MS) analysis. Patients underwent colonoscopy and/or CT colonography and were grouped as either CRC, adenomatous polyp(s), or controls to explore the diagnostic accuracy of VOC output data supported by an artificial neural network (ANN) model. 558 patients participated with 23 (4%) CRC diagnosed. 59% of colonoscopies and 86% of CT colonographies showed no abnormalities. Urinary VOC testing was feasible, acceptable to patients, and applicable within the clinical fast track pathway. GC-MS showed the highest clinical utility for CRC and polyp detection vs. controls (sensitivity = 0.878, specificity = 0.882, AUROC = 0.896) but it is labour intensive. Urinary VOC testing and analysis are feasible within NHS fast-track CRC pathways. Clinically meaningful differences between patients with cancer, polyps, or no pathology were identified suggesting VOC analysis may have future utility as a triage tool.
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Gómez-Cortés JC, Díaz-Carmona JJ, Padilla-Medina JA, Calderon AE, Gutiérrez AIB, Gutiérrez-López M, Prado-Olivarez J. Electrical Impedance Tomography Technical Contributions for Detection and 3D Geometric Localization of Breast Tumors: A Systematic Review. MICROMACHINES 2022; 13:mi13040496. [PMID: 35457801 PMCID: PMC9025021 DOI: 10.3390/mi13040496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/30/2022]
Abstract
Impedance measuring acquisition systems focused on breast tumor detection, as well as image processing techniques for 3D imaging, are reviewed in this paper in order to define potential opportunity areas for future research. The description of reported works using electrical impedance tomography (EIT)-based techniques and methodologies for 3D bioimpedance imaging of breast tissues with tumors is presented. The review is based on searching and analyzing related works reported in the most important research databases and is structured according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) parameters and statements. Nineteen papers reporting breast tumor detection and location using EIT were systematically selected and analyzed in this review. Clinical trials in the experimental stage did not produce results in most of analyzed proposals (about 80%), wherein statistical criteria comparison was not possible, such as specificity, sensitivity and predictive values. A 3D representation of bioimpedance is a potential tool for medical applications in malignant breast tumors detection being capable to estimate an ap-proximate the tumor volume and geometric location, in contrast with a tumor area computing capacity, but not the tumor extension depth, in a 2D representation.
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Larracy R, Phinyomark A, Scheme E. Infrared cavity ring-down spectroscopy for detecting non-small cell lung cancer in exhaled breath. J Breath Res 2022; 16. [PMID: 35294929 DOI: 10.1088/1752-7163/ac5e4f] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/16/2022] [Indexed: 12/24/2022]
Abstract
Early diagnosis of lung cancer greatly improves the likelihood of survival and remission, but limitations in existing technologies like low-dose computed tomography have prevented the implementation of widespread screening programs. Breath-based solutions that seek disease biomarkers in exhaled volatile organic compound (VOC) profiles show promise as affordable, accessible and non-invasive alternatives to traditional imaging. In this pilot work, we present a lung cancer detection framework using cavity ring-down spectroscopy (CRDS), an effective and practical laser absorption spectroscopy technique that has the ability to advance breath screening into clinical reality. The main aims of this work were to 1) test the utility of infrared CRDS breath profiles for discriminating non-small cell lung cancer (NSCLC) patients from controls, 2) compare models with VOCs as predictors to those with patterns from the CRDS spectra (breathprints) as predictors, and 3) present a robust approach for identifying relevant disease biomarkers. First, based on a proposed learning curve technique that estimated the limits of a model's performance at multiple sample sizes (10-158), the CRDS-based models developed in this work were found to achieve classification performance comparable or superior to like mass spectroscopy and sensor-based systems. Second, using 158 collected samples (62 NSCLC subjects and 96 controls), the accuracy range for the VOC-based model was 65.19%-85.44% (51.61%-66.13% sensitivity and 73.96%-97.92% specificity), depending on the employed cross-validation technique. The model based on breathprint predictors generally performed better, with accuracy ranging from 71.52%-86.08% (58.06%-82.26% sensitivity and 80.21%-88.54% specificity). Lastly, using a protocol based on consensus feature selection, three VOCs (isopropanol, dimethyl sulfide, and butyric acid) and two breathprint features (from a local binary pattern transformation of the spectra) were identified as possible NSCLC biomarkers. This research demonstrates the potential of infrared CRDS breath profiles and the developed early-stage classification techniques for NSCLC biomarker detection and screening.
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Affiliation(s)
- Robyn Larracy
- University of New Brunswick Institute of Biomedical Engineering, 25 Dineen Drive, Fredericton, New Brunswick, E3B 5A3, CANADA
| | - Angkoon Phinyomark
- University of New Brunswick Institute of Biomedical Engineering, 25 Dineen Drive, Fredericton, New Brunswick, E3B 5A3, CANADA
| | - Erik Scheme
- University of New Brunswick Institute of Biomedical Engineering, 25 Dineen Drive, Fredericton, New Brunswick, E3B 5A3, CANADA
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Ge D, Zhou J, Chu Y, Lu Y, Zou X, Xia L, Liu Y, Huang C, Shen C, Zhang L, Wang H, Chu Y. Distinguish oral-source VOCs and control their potential impact on breath biomarkers. Anal Bioanal Chem 2022; 414:2275-2284. [DOI: 10.1007/s00216-021-03866-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 12/19/2022]
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Rankin-Turner S, McMeniman CJ. A headspace collection chamber for whole body volatilomics. Analyst 2022; 147:5210-5222. [DOI: 10.1039/d2an01227h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The human body secretes a complex blend of volatile organic compounds (VOCs) via the skin, breath and bodily fluids. In this study, we have developed a headspace collection chamber for whole body volatilome profiling.
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Affiliation(s)
- Stephanie Rankin-Turner
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Conor J. McMeniman
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Zhang ZJ, Li PW, Liu LP, Ru LH, Tang HX, Feng WS. Amine-functionalized UiO-66 as a fluorescent sensor for highly selective detecting volatile organic compound biomarker of lung cancer. J SOLID STATE CHEM 2022. [DOI: 10.1016/j.jssc.2021.122623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Volatile organic compounds as a potential screening tool for neoplasm of the digestive system: a meta-analysis. Sci Rep 2021; 11:23716. [PMID: 34887450 PMCID: PMC8660806 DOI: 10.1038/s41598-021-02906-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/24/2021] [Indexed: 02/02/2023] Open
Abstract
This meta-analysis was aimed to estimate the diagnostic performance of volatile organic compounds (VOCs) as a potential novel tool to screen for the neoplasm of the digestive system. An integrated literature search was performed by two independent investigators to identify all relevant studies investigating VOCs in diagnosing neoplasm of the digestive system from inception to 7th December 2020. STATA and Revman software were used for data analysis. The methodological quality of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A bivariate mixed model was used and meta-regression and subgroup analysis were performed to identify possible sources of heterogeneity. A total of 36 studies comprised of 1712 cases of neoplasm and 3215 controls were included in our meta-analysis. Bivariate analysis showed a pooled sensitivity of 0.87 (95% confidence interval (CI) 0.83–0.90), specificity of 0.86 (95% CI 0.82–0.89), a positive likelihood ratio of 6.18 (95% CI 4.68–8.17), and a negative likelihood ratio of 0.15 (95% CI 0.12–0.20). The diagnostic odds ratio and the area under the summary ROC curve for diagnosing neoplasm of the digestive system were 40.61 (95% CI 24.77–66.57) and 0.93 (95% CI 0.90–0.95), respectively. Our analyses revealed that VOCs analysis could be considered as a potential novel tool to screen for malignant diseases of the digestive system.
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Dima AC, Balaban DV, Dima A. Diagnostic Application of Volatile Organic Compounds as Potential Biomarkers for Detecting Digestive Neoplasia: A Systematic Review. Diagnostics (Basel) 2021; 11:diagnostics11122317. [PMID: 34943554 PMCID: PMC8700395 DOI: 10.3390/diagnostics11122317] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 02/07/2023] Open
Abstract
Volatile organic compounds (VOCs) are part of the exhaled breath that were proposed as non-invasive breath biomarkers via different human discharge products like saliva, breath, urine, blood, or tissues. Particularly, due to the non-invasive approach, VOCs were considered as potential biomarkers for non-invasive early cancer detection. We herein aimed to review the data over VOCs utility in digestive neoplasia as early diagnosis or monitoring biomarkers. A systematic literature search was done using MEDLINE via PubMed, Cochrane Library, and Thomson Reuters' Web of Science Core Collection. We identified sixteen articles that were included in the final analysis. Based on the current knowledge, we cannot identify a single VOC as a specific non-invasive biomarker for digestive neoplasia. Several combinations of up to twelve VOCs seem promising for accurately detecting some neoplasia types. A combination of different VOCs breath expression are promising tools for digestive neoplasia screening.
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Affiliation(s)
- Augustin Catalin Dima
- Department of General Surgery and Department of Gastroenterology, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania;
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Daniel Vasile Balaban
- Department of General Surgery and Department of Gastroenterology, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania;
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence:
| | - Alina Dima
- Department of Rheumatology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
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Chang K, Jackson CS, Vega KJ. Barrett's Esophagus: Diagnosis, Management, and Key Updates. Gastroenterol Clin North Am 2021; 50:751-768. [PMID: 34717869 DOI: 10.1016/j.gtc.2021.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Barrett's esophagus (BE) is the precursor lesion for esophageal adenocarcinoma (EAC) development. Unfortunately, BE screening/surveillance has not provided the anticipated EAC reduction benefit. Noninvasive techniques are increasingly available or undergoing testing to screen for BE among those with/without known risk factors, and the use of artificial intelligence platforms to aid endoscopic screening and surveillance will likely become routine, minimizing missed cases or lesions. Management of high-grade dysplasia and intramucosal EAC is clear with endoscopic eradication therapy preferred to surgery. BE with low-grade dysplasia can be managed with removal of visible lesions combined with endoscopic eradication therapy or endoscopic surveillance at present.
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Affiliation(s)
- Karen Chang
- Department of Internal Medicine, University of California, Riverside School of Medicine, 900 University Avenue, Riverside, CA 92521, USA
| | - Christian S Jackson
- Section of Gastroenterology, Loma Linda VA Healthcare System, 11201 Benton Street, 2A-38, Loma Linda, CA 92357, USA
| | - Kenneth J Vega
- Division of Gastroenterology & Hepatology, Augusta University-Medical College of Georgia, 1120 15th Street, AD-2226, Augusta, GA 30912, USA.
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Decrue F, Singh KD, Gisler A, Awchi M, Zeng J, Usemann J, Frey U, Sinues P. Combination of Exhaled Breath Analysis with Parallel Lung Function and FeNO Measurements in Infants. Anal Chem 2021; 93:15579-15583. [PMID: 34780695 DOI: 10.1021/acs.analchem.1c02036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Breath analysis by secondary electrospray ionization-high resolution mass spectrometry (SESI-HRMS) offers the possibility to measure comprehensive metabolic profiles. The technology is currently being deployed in several clinical settings in Switzerland and China. However, patients are required to exhale directly into the device located in a dedicated room. Consequently, clinical implementation in patients incapable of performing necessary exhalation maneuvers (e.g., infants) or immobile (e.g., too weak, elderly, or in intensive care) remains a challenge. The aim of this study was to develop a method to extend such breath analysis capabilities to this subpopulation of patients by collecting breath samples remotely (offline) and promptly (within 10 min) transfer them to SESI-HRMS for chemical analysis. We initially assessed the method in adults by comparing breath mass spectra collected offline with Nalophan bags against spectra of breath samples collected in real time. In total, 13 adults provided 176 pairs of real-time and offline measurements. Lin's concordance correlation coefficient (CCC) was used to estimate the agreement between offline and real-time analyses. Here, 1249 mass spectral features (55% of total detected) exhibited Lin's CCC > 0.6. Subsequently, the method was successfully deployed to analyze breath samples from infants (n = 16), obtaining as a result SESI-HRMS breath profiles. To demonstrate the clinical feasibility of the method, we measured in parallel other clinical variables: (i) lung function, which characterizes the breathing patterns, and (ii) nitric oxide, which is a surrogate marker of airway inflammation. As a showcase, we focused our analysis on the exhaled oxidative stress marker 4-hydroxynonenal and its association with nitric oxide and minute ventilation.
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Affiliation(s)
- Fabienne Decrue
- University of Basel Children's Hospital (UKBB), Basel 4056, Switzerland.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
| | - Kapil Dev Singh
- University of Basel Children's Hospital (UKBB), Basel 4056, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil 4123, Switzerland
| | - Amanda Gisler
- University of Basel Children's Hospital (UKBB), Basel 4056, Switzerland.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
| | - Mo Awchi
- University of Basel Children's Hospital (UKBB), Basel 4056, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil 4123, Switzerland
| | - Jiafa Zeng
- University of Basel Children's Hospital (UKBB), Basel 4056, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil 4123, Switzerland
| | - Jakob Usemann
- University of Basel Children's Hospital (UKBB), Basel 4056, Switzerland.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
| | - Urs Frey
- University of Basel Children's Hospital (UKBB), Basel 4056, Switzerland.,Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil 4123, Switzerland
| | - Pablo Sinues
- University of Basel Children's Hospital (UKBB), Basel 4056, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil 4123, Switzerland
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Zhang J, Tian Y, Luo Z, Qian C, Li W, Duan Y. Breath volatile organic compound analysis: an emerging method for gastric cancer detection. J Breath Res 2021; 15. [PMID: 34610588 DOI: 10.1088/1752-7163/ac2cde] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 10/05/2021] [Indexed: 12/14/2022]
Abstract
Gastric cancer is a common malignancy, being the fifth most frequently diagnosed cancer and the fourth leading cause of cancer-related deaths worldwide. Diagnosis of gastric cancer at the early stage is critical to effectively improve the survival rate. However, a substantial proportion of patients with gastric cancer in the early stages lack specific symptoms or are asymptomatic. Moreover, the imaging techniques currently used for gastric cancer screening, such as computed tomography and barium examination, are usually radioactive and have low sensitivity and specificity. Even though endoscopy has high accuracy for gastric cancer screening, its application is limited by the invasiveness of the technique. Breath analysis is an economic, effective, easy to perform, non-invasive detection method, and has no undesirable side effects on subjects. Extensive worldwide research has been conducted on breath volatile organic compounds (VOCs), which reveals its prospect as a potential method for gastric cancer detection. Many interesting results have been obtained and innovative methods have been introduced in this subject; hence, an extensive review would be beneficial. By providing a comprehensive list of breath VOCs identified by gastric cancer would promote further research in this field. This review summarizes the commonly used technologies for exhaled breath analysis, focusing on the application of analytical instruments in the detection of breath VOCs in gastric cancers, and the alterations in the profile of breath biomarkers in gastric cancer patients are discussed as well.
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Affiliation(s)
- Jing Zhang
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Yonghui Tian
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Zewei Luo
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
| | - Cheng Qian
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, College of Urban and Environmental Sciences, Northwest University, Xi'an 710127, People's Republic of China
| | - Wenwen Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yixiang Duan
- Research Center of Analytical Instrumentation, Key Laboratory of Synthetic and Natural Functional Molecule Chemistry of Ministry of Education, College of Chemistry & Materials Science, Northwest University, Xi'an 710069, People's Republic of China
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Huang Q, Wang S, Li Q, Wang P, Li J, Meng S, Li H, Wu H, Qi Y, Li X, Yang Y, Zhao S, Qiu M. Assessment of Breathomics Testing Using High-Pressure Photon Ionization Time-of-Flight Mass Spectrometry to Detect Esophageal Cancer. JAMA Netw Open 2021; 4:e2127042. [PMID: 34609496 PMCID: PMC8493434 DOI: 10.1001/jamanetworkopen.2021.27042] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE A triage test is needed to increase the detection rate for esophageal cancer. OBJECTIVE To investigate whether breathomics can detect esophageal cancer among patients without a previous diagnosis of cancer using high-pressure photon ionization time-of-flight mass spectrometry (HPPI-TOFMS). DESIGN, SETTING, AND PARTICIPANTS This diagnostic study included participants who planned to receive an upper endoscopy or surgery of the esophagus at a single center in China. Exhaled breath was collected with a self-designed collector and air bags before participants underwent these procedures. Sample collection and analyses were performed by trained researchers following a standardized protocol. Participants were randomly divided into a discovery data set and a validation data set. Data were collected from December 2020 to March 2021. EXPOSURES Breath samples were analyzed by HPPI-TOFMS, and the support vector machine algorithm was used to construct a detection model. MAIN OUTCOMES AND MEASURES The accuracy of breathomics was measured by the sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve. RESULTS Exhaled breath samples were obtained from 675 patients (216 [32%] with esophageal cancer; 459 [68%] with noncancer diseases). Of all patients, 206 (31%) were women, and the mean (SD) age was 64.0 (11.9) years. In the validation data set, esophageal cancer was detected with an accuracy of 93.33%, sensitivity of 97.83%, specificity of 83.72%, positive predictive value of 94.74%, negative predictive value of 92.78%, and area under the receiver operating characteristic curve of 0.89. Notably, for 16 patients with high-grade intraepithelial neoplasia, 12 (75%) were predicted to have esophageal cancer. CONCLUSIONS AND RELEVANCE In this diagnostic study, testing breathomics using HPPI-TOFMS was feasible for esophageal cancer detection and totally noninvasive, which could help to improve the diagnosis of esophageal cancer.
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Affiliation(s)
- Qi Huang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shaodong Wang
- Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
| | - Qingyun Li
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, Beijing, China
| | - Peiyu Wang
- Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
| | - Jianfeng Li
- Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
| | - Shushi Meng
- Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
| | - Hang Li
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, Beijing, China
| | - Hao Wu
- Department of Thoracic Surgery, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yu Qi
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiangnan Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yang Yang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Song Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mantang Qiu
- Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
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Hanna GB, Cross AJ. Editorial: volatile organic compound analysis to improve faecal immunochemical testing in the detection of colorectal cancer. Aliment Pharmacol Ther 2021; 54:504-505. [PMID: 34331792 DOI: 10.1111/apt.16471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
LINKED CONTENTThis article is linked to Chandrapalan et al papers. To view these articles, visit https://doi.org/10.1111/apt.16405 and https://doi.org/10.1111/apt.16511
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Affiliation(s)
- George B Hanna
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Amanda J Cross
- Department of Surgery and Cancer, Imperial College London, London, UK
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Kamal F, Kumar S, Edwards MR, Veselkov K, Belluomo I, Kebadze T, Romano A, Trujillo-Torralbo MB, Shahridan Faiez T, Walton R, Ritchie AI, Wiseman DJ, Laponogov I, Donaldson G, Wedzicha JA, Johnston SL, Singanayagam A, Hanna GB. Virus-induced Volatile Organic Compounds are Detectable in Exhaled Breath During Pulmonary Infection. Am J Respir Crit Care Med 2021; 204:1075-1085. [PMID: 34319857 DOI: 10.1164/rccm.202103-0660oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a condition punctuated by acute exacerbations commonly triggered by viral and/or bacterial infection. Early identification of exacerbation trigger is important to guide appropriate therapy but currently available tests are slow and imprecise. Volatile organic compounds (VOCs) can be detected in exhaled breath and have the potential to be rapid tissue-specific biomarkers of infection aetiology. METHODS We used serial sampling within in vitro and in vivo studies to elucidate the dynamic changes that occur in VOC production during acute respiratory viral infection. Highly sensitive gas-chromatography mass spectrometry (GC-MS) techniques were used to measure VOC production from infected airway epithelial cell cultures and in exhaled breath samples of healthy subjects experimentally challenged with rhinovirus A16 and COPD subjects with naturally-occurring exacerbations. RESULTS We identified a novel VOC signature comprising of decane and other related long chain alkane compounds that is induced during rhinovirus infection of cultured airway epithelial cells and is also increased in the exhaled breath of healthy subjects experimentally challenged with rhinovirus and of COPD patients during naturally-occurring viral exacerbations. These compounds correlated with magnitude of anti-viral immune responses, virus burden and exacerbation severity but were not induced by bacterial infection, suggesting they represent a specific virus-inducible signature. CONCLUSION Our study highlights the potential for measurement of exhaled breath VOCs as rapid, non-invasive biomarkers of viral infection. Further studies are needed to determine whether measurement of these signatures could be used to guide more targeted therapy with antibiotic/antiviral agents for COPD exacerbations.
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Affiliation(s)
- Faisal Kamal
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Sacheen Kumar
- Imperial College, London, Airway Disease Infection Section, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Michael R Edwards
- Imperial College London, Airway Disease Infection, London, United Kingdom of Great Britain and Northern Ireland
| | - Kirill Veselkov
- Imperial College, London, Airway Disease Infection Section, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Ilaria Belluomo
- Imperial College, London, Airway Disease Infection Section, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Tatiana Kebadze
- National Heart & Lung and Wright Felming Institute of Infection & Immunity, Respiratory Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Andrea Romano
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Maria-Belen Trujillo-Torralbo
- Imperial College London, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Tasnim Shahridan Faiez
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Ross Walton
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Andrew I Ritchie
- Imperial College London, Airway Disease Infection, London, United Kingdom of Great Britain and Northern Ireland
| | - Dexter J Wiseman
- Imperial College London, Airway Diseases Section, London, United Kingdom of Great Britain and Northern Ireland
| | - Ivan Laponogov
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Gavin Donaldson
- Imperial College London, Airways Disease Section, London, United Kingdom of Great Britain and Northern Ireland
| | - Jadwiga A Wedzicha
- Imperial College London, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Sebastian L Johnston
- National Heart & Lung and Wright Felming Institute of Infection & Immunity, Respiratory Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Aran Singanayagam
- Imperial College, London, London, United Kingdom of Great Britain and Northern Ireland
| | - George B Hanna
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland;
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41
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Belluomo I, Boshier PR, Myridakis A, Vadhwana B, Markar SR, Spanel P, Hanna GB. Selected ion flow tube mass spectrometry for targeted analysis of volatile organic compounds in human breath. Nat Protoc 2021; 16:3419-3438. [PMID: 34089020 DOI: 10.1038/s41596-021-00542-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/22/2021] [Indexed: 02/05/2023]
Abstract
The analysis of volatile organic compounds (VOCs) within breath for noninvasive disease detection and monitoring is an emergent research field that has the potential to reshape current clinical practice. However, adoption of breath testing has been limited by a lack of standardization. This protocol provides a comprehensive workflow for online and offline breath analysis using selected ion flow tube mass spectrometry (SIFT-MS). Following the suggested protocol, 50 human breath samples can be analyzed and interpreted in <3 h. Key advantages of SIFT-MS are exploited, including the acquisition of real-time results and direct compound quantification without need for calibration curves. The protocol includes details of methods developed for targeted analysis of disease-specific VOCs, specifically short-chain fatty acids, aldehydes, phenols, alcohols and alkanes. A procedure to make custom breath collection bags is also described. This standardized protocol for VOC analysis using SIFT-MS is intended to provide a basis for wider application and the use of breath analysis in clinical studies.
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Affiliation(s)
- Ilaria Belluomo
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Antonis Myridakis
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Bhamini Vadhwana
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sheraz R Markar
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Patrik Spanel
- Department of Surgery and Cancer, Imperial College London, London, UK
- J. Heyrovský Institute of Physical Chemistry, Czech Academy of Sciences, Prague, Czechia
| | - George B Hanna
- Department of Surgery and Cancer, Imperial College London, London, UK.
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42
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Phillips AW, Griffin SM. Three decades of oesophagogastric cancer care: now a curable disease. Br J Surg 2021; 108:595-597. [PMID: 33748863 DOI: 10.1093/bjs/znab091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/16/2021] [Indexed: 12/31/2022]
Affiliation(s)
- A W Phillips
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, UK.,School of Medical Education, Newcastle University, Newcastle upon Tyne, UK
| | - S M Griffin
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, UK
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43
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Lin GP, Vadhwana B, Belluomo I, Boshier PR, Španěl P, Hanna GB. Cross Platform Analysis of Volatile Organic Compounds Using Selected Ion Flow Tube and Proton-Transfer-Reaction Mass Spectrometry. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2021; 32:1215-1223. [PMID: 33831301 DOI: 10.1021/jasms.1c00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Volatile breath metabolites serve as potential disease biomarkers. Online mass spectrometry (MS) presents real-time quantification of breath volatile organic compounds (VOCs). The study aims to assess the relationship between two online analytical mass spectrometry techniques in the quantification of target breath metabolites: selected ion flow tube mass spectrometry (SIFT-MS) and proton-transfer-reaction time-of-flight mass spectrometry (PTR-ToF-MS). The two following techniques were employed: (i) direct injection with bag sampling using SIFT-MS and PTR-ToF-MS and (ii) direct injection and thermal desorption (TD) tube comparison using PTR-ToF-MS. The concentration of abundant breath metabolites, acetone and isoprene, demonstrated a strong positive linear correlation between both mass spectrometry techniques (r = 0.97, r = 0.89, respectively; p < 0.001) and between direct injection and TD tube (r = 0.97, r = 0.92, respectively; p < 0.001) breath sampling techniques. This was reflected for the majority of short chain fatty acids and alcohols tested (r > 0.80, p < 0.001). Analyte concentrations were notably higher with the direct injection of a sampling bag compared to the TD method. All metabolites produced a high degree of agreement in the detection range of VOCs between SIFT-MS and PTR-ToF-MS, with the majority of compounds falling within 95% of the limits of agreement with Bland-Altman analysis. The cross platform analysis of exhaled breath demonstrates strong positive correlation coefficients, linear regression, and agreement in target metabolite detection rates between both breath sampling techniques. The study demonstrates the transferability of using data outputs between SIFT-MS and PTR-ToF-MS. It supports the implementation of a TD platform in multi-site studies for breath biomarker research in order to facilitate sample transport between clinics and the laboratory.
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Affiliation(s)
- Geng-Ping Lin
- Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London W2 1PE, United Kingdom
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Chang Gung University, Tao-Yuan City 33305, Taiwan
| | - Bhamini Vadhwana
- Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London W2 1PE, United Kingdom
| | - Ilaria Belluomo
- Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London W2 1PE, United Kingdom
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London W2 1PE, United Kingdom
| | - Patrik Španěl
- Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London W2 1PE, United Kingdom
- J. Heyrovský Institute of Physical Chemistry of the Czech Academy of Sciences, Prague 182 23, Czech Republic
| | - George B Hanna
- Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London W2 1PE, United Kingdom
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Drabińska N, Flynn C, Ratcliffe N, Belluomo I, Myridakis A, Gould O, Fois M, Smart A, Devine T, Costello BDL. A literature survey of all volatiles from healthy human breath and bodily fluids: the human volatilome. J Breath Res 2021; 15. [PMID: 33761469 DOI: 10.1088/1752-7163/abf1d0] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/24/2021] [Indexed: 02/06/2023]
Abstract
This paper comprises an updated version of the 2014 review which reported 1846 volatile organic compounds (VOCs) identified from healthy humans. In total over 900 additional VOCs have been reported since the 2014 review and the VOCs from semen have been added. The numbers of VOCs found in breath and the other bodily fluids are: blood 379, breath 1488, faeces 443, milk 290, saliva 549, semen 196, skin 623 and urine 444. Compounds were assigned CAS registry numbers and named according to a common convention where possible. The compounds have been included in a single table with the source reference(s) for each VOC, an update on our 2014 paper. VOCs have also been grouped into tables according to their chemical class or functionality to permit easy comparison. Careful use of the database is needed, as a number of the identified VOCs only have level 2-putative assignment, and only a small fraction of the reported VOCs have been validated by standards. Some clear differences are observed, for instance, a lack of esters in urine with a high number in faeces and breath. However, the lack of compounds from matrices such a semen and milk compared to breath for example could be due to the techniques used or reflect the intensity of effort e.g. there are few publications on VOCs from milk and semen compared to a large number for breath. The large number of volatiles reported from skin is partly due to the methodologies used, e.g. by collecting skin sebum (with dissolved VOCs and semi VOCs) onto glass beads or cotton pads and then heating to a high temperature to desorb VOCs. All compounds have been included as reported (unless there was a clear discrepancy between name and chemical structure), but there may be some mistaken assignations arising from the original publications, particularly for isomers. It is the authors' intention that this work will not only be a useful database of VOCs listed in the literature but will stimulate further study of VOCs from healthy individuals; for example more work is required to confirm the identification of these VOCs adhering to the principles outlined in the metabolomics standards initiative. Establishing a list of volatiles emanating from healthy individuals and increased understanding of VOC metabolic pathways is an important step for differentiating between diseases using VOCs.
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Affiliation(s)
- Natalia Drabińska
- Division of Food Sciences, Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Tuwima 10, 10-747 Olsztyn, Poland
| | - Cheryl Flynn
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Norman Ratcliffe
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Ilaria Belluomo
- Department of Surgery and Cancer, Imperial College London, St. Mary's Campus, QEQM Building, London W2 1NY, United Kingdom
| | - Antonis Myridakis
- Department of Surgery and Cancer, Imperial College London, St. Mary's Campus, QEQM Building, London W2 1NY, United Kingdom
| | - Oliver Gould
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Matteo Fois
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Amy Smart
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Terry Devine
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - Ben De Lacy Costello
- Centre of Research in Biosciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
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Hintzen KFH, Grote J, Wintjens AGWE, Lubbers T, Eussen MMM, van Schooten FJ, Bouvy ND, Peeters A. Breath analysis for the detection of digestive tract malignancies: systematic review. BJS Open 2021; 5:6226007. [PMID: 33855362 PMCID: PMC8047095 DOI: 10.1093/bjsopen/zrab013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/27/2020] [Accepted: 02/03/2021] [Indexed: 01/01/2023] Open
Abstract
Background In recent decades there has been growing interest in the use of volatile organic compounds (VOCs) in exhaled breath as biomarkers for the diagnosis of multiple variants of cancer. This review aimed to evaluate the diagnostic accuracy and current status of VOC analysis in exhaled breath for the detection of cancer in the digestive tract. Methods PubMed and the Cochrane Library database were searched for VOC analysis studies, in which exhaled air was used to detect gastro-oesophageal, liver, pancreatic, and intestinal cancer in humans, Quality assessment was performed using the QUADAS-2 criteria. Data on diagnostic performance, VOCs with discriminative power, and methodological information were extracted from the included articles. Results Twenty-three articles were included (gastro-oesophageal cancer n = 14, liver cancer n = 1, pancreatic cancer n = 2, colorectal cancer n = 6). Methodological issues included different modalities of patient preparation and sampling and platform used. The sensitivity and specificity of VOC analysis ranged from 66.7 to 100 per cent and from 48.1 to 97.9 per cent respectively. Owing to heterogeneity of the studies, no pooling of the results could be performed. Of the VOCs found, 32 were identified in more than one study. Nineteen were reported as cancer type-specific, whereas 13 were found in different cancer types. Overall, decanal, nonanal, and acetone were the most frequently identified. Conclusion The literature on VOC analysis has documented a lack of standardization in study designs. Heterogeneity between the studies and insufficient validation of the results make interpretation of the outcomes challenging. To reach clinical applicability, future studies on breath analysis should provide an accurate description of the methodology and validate their findings.
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Affiliation(s)
- K F H Hintzen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Pharmacology and Toxicology, Maastricht University, Maastricht, the Netherlands
| | - J Grote
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - A G W E Wintjens
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - T Lubbers
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - M M M Eussen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - F J van Schooten
- Department of Pharmacology and Toxicology, Maastricht University, Maastricht, the Netherlands
| | - N D Bouvy
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - A Peeters
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, the Netherlands
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Woodfield G, Belluomo I, Boshier PR, Waller A, Fayyad M, von Wagner C, Cross AJ, Hanna GB. Feasibility and acceptability of breath research in primary care: a prospective, cross-sectional, observational study. BMJ Open 2021; 11:e044691. [PMID: 33849851 PMCID: PMC8051376 DOI: 10.1136/bmjopen-2020-044691] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/02/2021] [Accepted: 03/23/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To examine the feasibility and acceptability of breath research in primary care. DESIGN Non-randomised, prospective, mixed-methods cross-sectional observational study. SETTING Twenty-six urban primary care practices. PARTICIPANTS 1002 patients aged 18-90 years with gastrointestinal symptoms. MAIN OUTCOME MEASURES During the first 6 months of the study (phase 1), feasibility of patient enrolment using face-to-face, telephone or SMS-messaging (Short Message Service) enrolment strategies, as well as processes for breath testing at local primary care practices, were evaluated. A mixed-method iterative study design was adopted and outcomes evaluated using weekly Plan-Do-Study-Act cycles, focus groups and general practitioner (GP) questionnaires.During the second 6 months of the study (phase 2), patient and GP acceptability of the breath test and testing process was assessed using questionnaires. In addition a 'single practice' recruitment model was compared with a 'hub and spoke' centralised recruitment model with regards to enrolment ability and patient acceptability.Throughout the study feasibility of the collection of a large number of breath samples by clinical staff over multiple study sites was evaluated and quantified by the analysis of these samples using mass spectrometry. RESULTS 1002 patients were recruited within 192 sampling days. Both 'single practice' and 'hub and spoke' recruitment models were effective with an average of 5.3 and 4.3 patients accrued per day, respectively. The 'hub and spoke' model with SMS messaging was the most efficient combined method of patient accrual. Acceptability of the test was high among both patients and GPs. The methodology for collection, handling and analysis of breath samples was effective, with 95% of samples meeting quality criteria. CONCLUSIONS Large-scale breath testing in primary care was feasible and acceptable. This study provides a practical framework to guide the design of Phase III trials examining the performance of breath testing in primary care.
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Affiliation(s)
- Georgia Woodfield
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ilaria Belluomo
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Annabelle Waller
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Maya Fayyad
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Christian von Wagner
- Institute of Epidemiology and Health Care, University College London, London, London, UK
| | - Amanda J Cross
- School of Public Health, Imperial College London, London, UK
| | - George B Hanna
- Department of Surgery and Cancer, Imperial College London, London, UK
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Tsou PH, Lin ZL, Pan YC, Yang HC, Chang CJ, Liang SK, Wen YF, Chang CH, Chang LY, Yu KL, Liu CJ, Keng LT, Lee MR, Ko JC, Huang GH, Li YK. Exploring Volatile Organic Compounds in Breath for High-Accuracy Prediction of Lung Cancer. Cancers (Basel) 2021; 13:1431. [PMID: 33801001 PMCID: PMC8003836 DOI: 10.3390/cancers13061431] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Lung cancer is silent in its early stages and fatal in its advanced stages. The current examinations for lung cancer are usually based on imaging. Conventional chest X-rays lack accuracy, and chest computed tomography (CT) is associated with radiation exposure and cost, limiting screening effectiveness. Breathomics, a noninvasive strategy, has recently been studied extensively. Volatile organic compounds (VOCs) derived from human breath can reflect metabolic changes caused by diseases and possibly serve as biomarkers of lung cancer. (2) Methods: The selected ion flow tube mass spectrometry (SIFT-MS) technique was used to quantitatively analyze 116 VOCs in breath samples from 148 patients with histologically confirmed lung cancers and 168 healthy volunteers. We used eXtreme Gradient Boosting (XGBoost), a machine learning method, to build a model for predicting lung cancer occurrence based on quantitative VOC measurements. (3) Results: The proposed prediction model achieved better performance than other previous approaches, with an accuracy, sensitivity, specificity, and area under the curve (AUC) of 0.89, 0.82, 0.94, and 0.95, respectively. When we further adjusted the confounding effect of environmental VOCs on the relationship between participants' exhaled VOCs and lung cancer occurrence, our model was improved to reach 0.92 accuracy, 0.96 sensitivity, 0.88 specificity, and 0.98 AUC. (4) Conclusion: A quantitative VOCs databank integrated with the application of an XGBoost classifier provides a persuasive platform for lung cancer prediction.
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Affiliation(s)
- Ping-Hsien Tsou
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Zong-Lin Lin
- Institute of Statistics, National Yang Ming Chiao Tung University, Hsin-Chu 30010, Taiwan;
| | - Yu-Chiang Pan
- Center for Emergent Functional Matter Science, National Yang Ming Chiao Tung University, Hsin-Chu 30010, Taiwan;
| | - Hui-Chen Yang
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Chien-Jen Chang
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Sheng-Kai Liang
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Yueh-Feng Wen
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Chia-Hao Chang
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Lih-Yu Chang
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Kai-Lun Yu
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Chia-Jung Liu
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Li-Ta Keng
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Jen-Chung Ko
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu 30059, Taiwan; (P.-H.T.); (H.-C.Y.); (C.-J.C.); (S.-K.L.); (Y.-F.W.); (C.-H.C.); (L.-Y.C.); (K.-L.Y.); (C.-J.L.); (L.-T.K.); (M.-R.L.)
| | - Guan-Hua Huang
- Institute of Statistics, National Yang Ming Chiao Tung University, Hsin-Chu 30010, Taiwan;
- Center for Emergent Functional Matter Science, National Yang Ming Chiao Tung University, Hsin-Chu 30010, Taiwan;
| | - Yaw-Kuen Li
- Center for Emergent Functional Matter Science, National Yang Ming Chiao Tung University, Hsin-Chu 30010, Taiwan;
- Department of Applied Chemistry, National Yang Ming Chiao Tung University, Hsin-Chu 30010, Taiwan
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Yusuf A, Fitzgerald RC. Screening for Barrett's Oesophagus: Are We Ready for it? ACTA ACUST UNITED AC 2021; 19:321-336. [PMID: 33746508 PMCID: PMC7962426 DOI: 10.1007/s11938-021-00342-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 01/10/2023]
Abstract
Purpose of review The targeted approach adopted for Barrett’s oesophagus (BO) screening is sub-optimal considering the large proportion of BO cases that are currently missed. We reviewed the literature highlighting recent technological advancements in efforts to counteract this challenge. We also provided insights into strategies that can improve the outcomes from current BO screening practises. Recent findings The standard method for BO detection, endoscopy, is invasive and expensive and therefore inappropriate for mass screening. On the other hand, endoscopy is more cost-effective for screening a high-risk population. A consensus has however not been reached on who should be screened. Risk prediction algorithms have been tested as an enrichment pre-screening tool reporting modest AUC’s but require more prospective evaluation studies. Less invasive endoscopy methods like trans-nasal endoscopy, oesophageal capsule endsocopy and non-endoscopic cell collection devices like the Cytosponge coupled with biomarker analysis have shown promise in BO detection with randomised clinical trial evidence. Summary A three-tier precision cancer programme whereby risk prediction algorithms and non-endoscopic minimally invasive cell collection devices are used to triage test a wider pool of individuals may improve the detection rate of current screening practises with minimal cost implications.
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Affiliation(s)
- Aisha Yusuf
- Medical Research Council Cancer Unit, Hutchison/Medical Research Council Research Centre, University of Cambridge, Cambridge, CB2 0XZ United Kingdom
| | - Rebecca C Fitzgerald
- Medical Research Council Cancer Unit, Hutchison/Medical Research Council Research Centre, University of Cambridge, Cambridge, CB2 0XZ United Kingdom
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Antonowicz S, Bodai Z, Wiggins T, Markar SR, Boshier PR, Goh YM, Adam ME, Lu H, Kudo H, Rosini F, Goldin R, Moralli D, Green CM, Peters CJ, Habib N, Gabra H, Fitzgerald RC, Takats Z, Hanna GB. Endogenous aldehyde accumulation generates genotoxicity and exhaled biomarkers in esophageal adenocarcinoma. Nat Commun 2021; 12:1454. [PMID: 33674602 PMCID: PMC7935981 DOI: 10.1038/s41467-021-21800-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 01/28/2021] [Indexed: 01/23/2023] Open
Abstract
Volatile aldehydes are enriched in esophageal adenocarcinoma (EAC) patients' breath and could improve early diagnosis, however the mechanisms of their production are unknown. Here, we show that weak aldehyde detoxification characterizes EAC, which is sufficient to cause endogenous aldehyde accumulation in vitro. Two aldehyde groups are significantly enriched in EAC biopsies and adjacent tissue: (i) short-chain alkanals, and (ii) medium-chain alkanals, including decanal. The short-chain alkanals form DNA-adducts, which demonstrates genotoxicity and confirms inadequate detoxification. Metformin, a putative aldehyde scavenger, reduces this toxicity. Tissue and breath concentrations of the medium-chain alkanal decanal are correlated, and increased decanal is linked to reduced ALDH3A2 expression, TP53 deletion, and adverse clinical features. Thus, we present a model for increased exhaled aldehydes based on endogenous accumulation from reduced detoxification, which also causes therapeutically actionable genotoxicity. These results support EAC early diagnosis trials using exhaled aldehyde analysis.
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Affiliation(s)
- Stefan Antonowicz
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Zsolt Bodai
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Tom Wiggins
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sheraz R Markar
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Piers R Boshier
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Yan Mei Goh
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Mina E Adam
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Haonan Lu
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hiromi Kudo
- Department of Surgery and Cancer, Imperial College London, London, UK
- Centre for Pathology, Imperial College London, London, UK
| | | | - Robert Goldin
- Centre for Pathology, Imperial College London, London, UK
| | - Daniela Moralli
- Chromosome Dynamics Core, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Catherine M Green
- Chromosome Dynamics Core, Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Chris J Peters
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nagy Habib
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hani Gabra
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Rebecca C Fitzgerald
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge, UK
| | - Zoltan Takats
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - George B Hanna
- Department of Surgery and Cancer, Imperial College London, London, UK.
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50
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Xiang L, Wu S, Hua Q, Bao C, Liu H. Volatile Organic Compounds in Human Exhaled Breath to Diagnose Gastrointestinal Cancer: A Meta-Analysis. Front Oncol 2021; 11:606915. [PMID: 33747921 PMCID: PMC7970758 DOI: 10.3389/fonc.2021.606915] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/21/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction Human exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses. This article was primarily to assess the feasibility of utilizing exhaled VOCs analysis for gastrointestinal cancer (GIC) diagnosis. Methods PRISMA-based system searches were conducted for related studies of exhaled VOCs in GIC diagnosis based on predetermined criteria. Relevant articles on colorectal cancer and gastroesophageal cancer were summarized, and meta analysis was performed on articles providing sensitivity and specificity data. Results From 2,227 articles, 14 were found to meet inclusion criteria, six of which were on colorectal cancer (CRC) and eight on Gastroesophageal cancer(GEC). Five articles could provide specific data of sensitivity and specificity in GEC, which were used for meta-analysis. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated based on the combination of these data, and were 85.0% [95% confidence interval (CI): 79.0%-90.0%], 89.0% (95%CI: 86.0%-91.0%), 41.30 (21.56-79.10), and 0.93, respectively. Conclusion VOCs can distinguish gastrointestinal cancers from other gastrointestinal diseases, opening up a new avenue for the diagnosis and identification of gastrointestinal cancers, and the analysis of VOCs in exhaled breath has potential clinical application in screening. VOCs are promising tumor biomarkers for GIC diagnosis. Furthermore, limitations like the heterogeneity of diagnostic VOCs between studies should be minded.
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Affiliation(s)
- Lijuan Xiang
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Sihan Wu
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Oncology, Affiliated Provincial Hospital of Anhui Medical University, Hefei, China
| | - Qingling Hua
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - Chuyang Bao
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hu Liu
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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