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Djukanović R, Brinkman P, Kolmert J, Gomez C, Schofield J, Brandsma J, Shapanis A, Skipp PJS, Postle A, Wheelock C, Dahlen SE, Sterk PJ, Brown T, Jackson DJ, Mansur A, Pavord I, Patel M, Brightling C, Siddiqui S, Bradding P, Sabroe I, Saralaya D, Chishimba L, Porter J, Robinson D, Fowler S, Howarth PH, Little L, Oliver T, Hill K, Stanton L, Allen A, Ellis D, Griffiths G, Harrison T, Akenroye A, Lasky-Su J, Heaney L, Chaudhuri R, Kurukulaaratchy R. Biomarker Predictors of Clinical Efficacy of the Anti-IgE Biologic Omalizumab in Severe Asthma in Adults: Results of the SoMOSA Study. Am J Respir Crit Care Med 2024; 210:288-297. [PMID: 38635834 DOI: 10.1164/rccm.202310-1730oc] [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: 10/03/2023] [Accepted: 04/18/2024] [Indexed: 04/20/2024] Open
Abstract
Background: The anti-IgE monoclonal antibody omalizumab is widely used for severe asthma. This study aimed to identify biomarkers that predict clinical improvement during 1 year of omalizumab treatment. Methods: One-year open-label Study of Mechanisms of action of Omalizumab in Severe Asthma (SoMOSA) involving 216 patients with severe (Global Initiative for Asthma step 4/5) uncontrolled atopic asthma (at least two severe exacerbations in the previous year) taking high-dose inhaled corticosteroids and long-acting β-agonists with or without maintenance oral corticosteroids. It had two phases: 0-16 weeks, to assess early clinical improvement by Global Evaluation of Therapeutic Effectiveness (GETE); and 16-52 weeks, to assess late responses based on ⩾50% reduction in exacerbations or mOCS dose. All participants provided samples (exhaled breath, blood, sputum, urine) before and after 16 weeks of omalizumab treatment. Measurements and Main Results: A total of 191 patients completed phase 1; 63% had early improvement. Of 173 who completed phase 2, 69% had reduced exacerbations by ⩾50% and 57% (37 of 65) taking mOCSs had reduced their dose by ⩾50%. The primary outcomes 2,3-dinor-11-β-PGF2α, GETE score, and standard clinical biomarkers (blood and sputum eosinophils, exhaled nitric oxide, serum IgE) did not predict either clinical response. Five volatile organic compounds and five plasma lipid biomarkers strongly predicted the ⩾50% reduction in exacerbations (receiver operating characteristic areas under the curve of 0.780 and 0.922, respectively) and early responses (areas under the curve of 0.835 and 0.949, respectively). In an independent cohort, gas chromatography/mass spectrometry biomarkers differentiated between severe and mild asthma. Conclusions: This is the first discovery of omics biomarkers that predict improvement in asthma with biologic agent treatment. Prospective validation and development for clinical use is justified.
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Affiliation(s)
- Ratko Djukanović
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and National Institute for Health and Care Research Southampton Biomedical Research Centre, Southampton, United Kingdom
| | - Paul Brinkman
- Department of Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
| | - Johan Kolmert
- Institute of Environmental Medicine, Karolinska Institutet, and the Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Cristina Gomez
- Institute of Environmental Medicine, Karolinska Institutet, and the Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - James Schofield
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and National Institute for Health and Care Research Southampton Biomedical Research Centre, Southampton, United Kingdom
- Biological Sciences, University of Southampton, Southampton, United Kingdom
| | - Joost Brandsma
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and National Institute for Health and Care Research Southampton Biomedical Research Centre, Southampton, United Kingdom
| | - Andy Shapanis
- Biological Sciences, University of Southampton, Southampton, United Kingdom
| | - Paul J S Skipp
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and National Institute for Health and Care Research Southampton Biomedical Research Centre, Southampton, United Kingdom
- Biological Sciences, University of Southampton, Southampton, United Kingdom
| | - Anthony Postle
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and National Institute for Health and Care Research Southampton Biomedical Research Centre, Southampton, United Kingdom
| | - Craig Wheelock
- Institute of Environmental Medicine, Karolinska Institutet, and the Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Sven-Erik Dahlen
- Institute of Environmental Medicine, Karolinska Institutet, and the Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Peter J Sterk
- Department of Respiratory Medicine, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
| | - Thomas Brown
- Portsmouth Hospitals University National Health Service Trust, Queen Alexandra Hospital, Portsmouth, United Kingdom
| | - David J Jackson
- Guy's Severe Asthma Centre, School of Immunology & Microbial Sciences, King's College London, London, United Kingdom
| | - Adel Mansur
- University of Birmingham and Heartlands Hospital, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom
| | - Ian Pavord
- Oxford Respiratory National Institute for Health and Care Research Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mitesh Patel
- Respiratory Medicine and R&D, University Hospitals Plymouth National Health Service Trust, Plymouth, United Kingdom
| | - Christopher Brightling
- Institute for Lung Health and Leicester National Institute for Health and Care Research Biomedical Research Centre, University of Leicester, Leicester, United Kingdom
| | - Salman Siddiqui
- Institute for Lung Health and Leicester National Institute for Health and Care Research Biomedical Research Centre, University of Leicester, Leicester, United Kingdom
| | - Peter Bradding
- Institute for Lung Health and Leicester National Institute for Health and Care Research Biomedical Research Centre, University of Leicester, Leicester, United Kingdom
| | - Ian Sabroe
- Clinical Research Facility, Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield, United Kingdom
| | - Dinesh Saralaya
- Bradford Institute for Health Research and the National Patient Recruitment Centre, Bradford, United Kingdom
| | - Livingstone Chishimba
- Clinical Sciences, Liverpool University Hospitals National Health Service Foundation Trust, Liverpool, United Kingdom
| | - Joanna Porter
- University College London Respiratory and National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Douglas Robinson
- University College London Respiratory and National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
| | - Stephen Fowler
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre and National Institute for Health and Care Research Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service Foundation Trust, Manchester, United Kingdom
| | - Peter H Howarth
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and National Institute for Health and Care Research Southampton Biomedical Research Centre, Southampton, United Kingdom
| | - Louisa Little
- Southampton Clinical Trials Unit, University of Southampton, and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Thomas Oliver
- Southampton Clinical Trials Unit, University of Southampton, and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Kayleigh Hill
- Southampton Clinical Trials Unit, University of Southampton, and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Louise Stanton
- Southampton Clinical Trials Unit, University of Southampton, and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Alexander Allen
- Southampton Clinical Trials Unit, University of Southampton, and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Deborah Ellis
- Southampton Clinical Trials Unit, University of Southampton, and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton, and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Tim Harrison
- Nottingham Respiratory National Institute for Health and Care Research Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom
| | - Ayobami Akenroye
- Division of Allergy and Clinical Immunology and
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Liam Heaney
- Wellcome-Wolfson Institute for Experimental Medicine, Belfast, Northern Ireland; and
| | - Rekha Chaudhuri
- Gartnavel General Hospital and School of Infection & Immunity, University of Glasgow, Glasgow, United Kingdom
| | - Ramesh Kurukulaaratchy
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and National Institute for Health and Care Research Southampton Biomedical Research Centre, Southampton, United Kingdom
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Jia Z, Ong WQ, Zhang F, Du F, Thavasi V, Thirumalai V. A study of 9 common breath VOCs in 504 healthy subjects using PTR-TOF-MS. Metabolomics 2024; 20:79. [PMID: 39046579 DOI: 10.1007/s11306-024-02139-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/06/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION This study employs Proton-Transfer-Reaction Mass Spectrometry (PTR-MS) to analyze exhaled breath profiles of 504 healthy adults, focusing on nine common volatile organic compounds (VOCs): acetone, acetaldehyde, acetonitrile, ethanol, isoprene, methanol, propanol, phenol, and toluene. PTR-MS offers real-time VOC measurement, crucial for understanding breath biomarkers and their applications in health assessment. OBJECTIVES The study aims to investigate how demographic factors-gender, age, and smoking history-affect VOC concentrations in exhaled breath. The objective is to enhance our understanding of breath biomarkers and their potential for health monitoring and clinical diagnosis. METHODS Exhaled breath samples were collected using PTR-MS, measuring concentrations of nine VOCs. The data were analyzed to discern distribution patterns across demographic groups. RESULTS Males showed higher average VOC levels for certain compounds. Propanol and methanol concentrations significantly increased with age. Smoking history influenced VOC levels, with differences among non-smokers, current smokers, and ex-smokers. CONCLUSION This research provides valuable insights into demographic influences on exhaled VOC profiles, emphasizing the potential of breath analysis for health assessment. PTR-MS's real-time measurement capabilities are crucial for capturing dynamic VOC changes, offering advantages over conventional methods. These findings lay a foundation for advancements in non-invasive disease detection, highlighting the importance of considering demographics in breath biomarker research.
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Affiliation(s)
- Zhunan Jia
- Breathonix Pte Ltd, Singapore, Singapore
- University of Oklahoma, Norman, OK, USA
| | | | | | - Fang Du
- Breathonix Pte Ltd, Singapore, Singapore
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Juste-Dolz A, Teixeira W, Pallás-Tamarit Y, Carballido-Fernández M, Carrascosa J, Morán-Porcar Á, Redón-Badenas MÁ, Pla-Roses MG, Tirado-Balaguer MD, Remolar-Quintana MJ, Ortiz-Carrera J, Ibañez-Echevarría E, Maquieira A, Giménez-Romero D. Real-world evaluation of a QCM-based biosensor for exhaled air. Anal Bioanal Chem 2024:10.1007/s00216-024-05407-5. [PMID: 38922434 DOI: 10.1007/s00216-024-05407-5] [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: 03/07/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024]
Abstract
The biosensor, named "virusmeter" in this study, integrates quartz crystal microbalance technology with an immune-functionalized chip to distinguish between symptomatic patients with respiratory diseases and healthy individuals by analyzing exhaled air samples. Renowned for its compact design, rapidity, and noninvasive nature, this device yields results within a 5-min timeframe. Evaluated under controlled conditions with 54 hospitalized symptomatic COVID-19 patients and 128 control subjects, the biosensor demonstrated good overall sensitivity (98.15%, 95% CI 90.1-100.0) and specificity (96.87%, 95% CI 92.2-99.1). This proof-of-concept presents an innovative approach with significant potential for leveraging piezoelectric sensors to diagnose respiratory diseases.
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Affiliation(s)
- Augusto Juste-Dolz
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Camino de Vera s/n, 46022, Valencia, Spain
| | - William Teixeira
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Camino de Vera s/n, 46022, Valencia, Spain
| | - Yeray Pallás-Tamarit
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Camino de Vera s/n, 46022, Valencia, Spain
| | - Mario Carballido-Fernández
- Hospital General Universitario de Castellón, Avinguda de Benicàssim, 128, 12004, Castellón de la Plana, Spain
- Universidad CEU Cardenal Herrera, Calle Grecia, 31, 12006, Castellón de la Plana, Spain
| | - Javier Carrascosa
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Camino de Vera s/n, 46022, Valencia, Spain
| | - Ángela Morán-Porcar
- Hospital General Universitario de Castellón, Avinguda de Benicàssim, 128, 12004, Castellón de la Plana, Spain
| | - María Ángeles Redón-Badenas
- Hospital General Universitario de Castellón, Avinguda de Benicàssim, 128, 12004, Castellón de la Plana, Spain
| | - María Gracia Pla-Roses
- Hospital General Universitario de Castellón, Avinguda de Benicàssim, 128, 12004, Castellón de la Plana, Spain
| | | | - María José Remolar-Quintana
- Hospital General Universitario de Castellón, Avinguda de Benicàssim, 128, 12004, Castellón de la Plana, Spain
| | - Jon Ortiz-Carrera
- La Fe University and Polytechnic Hospital, Avinguda de Fernando Abril Martorell, nº 106, 46026, Valencia, Spain
| | - Ethel Ibañez-Echevarría
- La Fe University and Polytechnic Hospital, Avinguda de Fernando Abril Martorell, nº 106, 46026, Valencia, Spain
| | - Angel Maquieira
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Camino de Vera s/n, 46022, Valencia, Spain.
- Departamento de Química, Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain.
| | - David Giménez-Romero
- Departamento de Química-Física, Universitat de València, Calle Doctor Moliner 50, 46100, Burjassot, Spain.
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Shahbazi Khamas S, Alizadeh Bahmani AH, Vijverberg SJ, Brinkman P, Maitland-van der Zee AH. Exhaled volatile organic compounds associated with risk factors for obstructive pulmonary diseases: a systematic review. ERJ Open Res 2023; 9:00143-2023. [PMID: 37650089 PMCID: PMC10463028 DOI: 10.1183/23120541.00143-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/21/2023] [Indexed: 09/01/2023] Open
Abstract
Background Asthma and COPD are among the most common respiratory diseases. To improve the early detection of exacerbations and the clinical course of asthma and COPD new biomarkers are needed. The development of noninvasive metabolomics of exhaled air into a point-of-care tool is an appealing option. However, risk factors for obstructive pulmonary diseases can potentially introduce confounding markers due to altered volatile organic compound (VOC) patterns being linked to these risk factors instead of the disease. We conducted a systematic review and presented a comprehensive list of VOCs associated with these risk factors. Methods A PRISMA-oriented systematic search was conducted across PubMed, Embase and Cochrane Libraries between 2000 and 2022. Full-length studies evaluating VOCs in exhaled breath were included. A narrative synthesis of the data was conducted, and the Newcastle-Ottawa Scale was used to assess the quality of included studies. Results The search yielded 2209 records and, based on the inclusion/exclusion criteria, 24 articles were included in the qualitative synthesis. In total, 232 individual VOCs associated with risk factors for obstructive pulmonary diseases were found; 58 compounds were reported more than once and 12 were reported as potential markers of asthma and/or COPD in other studies. Critical appraisal found that the identified studies were methodologically heterogeneous and had a variable risk of bias. Conclusion We identified a series of exhaled VOCs associated with risk factors for asthma and/or COPD. Identification of these VOCs is necessary for the further development of exhaled metabolites-based point-of-care tests in these obstructive pulmonary diseases.
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Affiliation(s)
- Shahriyar Shahbazi Khamas
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Amir Hossein Alizadeh Bahmani
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Susanne J.H. Vijverberg
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Paul Brinkman
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
- These authors contributed equally
| | - Anke H. Maitland-van der Zee
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
- These authors contributed equally
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Chung J, Akter S, Han S, Shin Y, Choi TG, Kang I, Kim SS. Diagnosis by Volatile Organic Compounds in Exhaled Breath in Exhaled Breath from Patients with Gastric and Colorectal Cancers. Int J Mol Sci 2022; 24:ijms24010129. [PMID: 36613569 PMCID: PMC9820758 DOI: 10.3390/ijms24010129] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
One in three cancer deaths worldwide are caused by gastric and colorectal cancer malignancies. Although the incidence and fatality rates differ significantly from country to country, the rates of these cancers in East Asian nations such as South Korea and Japan have been increasing each year. Above all, the biggest danger of this disease is how challenging it is to recognize in its early stages. Moreover, most patients with these cancers do not present with any disease symptoms before receiving a definitive diagnosis. Currently, volatile organic compounds (VOCs) are being used for the early prediction of several other diseases, and research has been carried out on these applications. Exhaled VOCs from patients possess remarkable potential as novel biomarkers, and their analysis could be transformative in the prevention and early diagnosis of colon and stomach cancers. VOCs have been spotlighted in recent studies due to their ease of use. Diagnosis on the basis of patient VOC analysis takes less time than methods using gas chromatography, and results in the literature demonstrate that it is possible to determine whether a patient has certain diseases by using organic compounds in their breath as indicators. This study describes how VOCs can be used to precisely detect cancers; as more data are accumulated, the accuracy of this method will increase, and it can be applied in more fields.
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Affiliation(s)
- Jinwook Chung
- Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Salima Akter
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Sunhee Han
- Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Yoonhwa Shin
- Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Tae Gyu Choi
- Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Insug Kang
- Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
- Correspondence: (I.K.); (S.S.K.); Tel.: +82-2-961-0524 (S.S.K.)
| | - Sung Soo Kim
- Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
- Correspondence: (I.K.); (S.S.K.); Tel.: +82-2-961-0524 (S.S.K.)
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Gunes HY, Caliskan DK, Sakar HA, Yuzkat N. Does smoking affect the onset time of sensory blocks or the duration of motor blocks in parturient women? A randomized controlled trial. Niger J Clin Pract 2022; 25:2039-2045. [PMID: 36537463 DOI: 10.4103/njcp.njcp_527_22] [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] [Indexed: 06/17/2023]
Abstract
BACKGROUND In general, smoking or exposure to secondhand smoke is still common worldwide, and the rate of smoking in women of childbearing age is gradually increasing. Cesarean section rates have been increasing in recent years, and anesthesia guidelines recommend regional anesthesia for cesarean sections. Since nicotine and local anesthetics have different effects on ligand-gated ion channels, smoking may affect spinal anesthesia in pregnant women. Aim: The aim of this study was to investigate the effects of smoking on spinal anesthesia, which is applied for cesarean sections in pregnant women. Patients and. METHODS After approval from the institution's ethics committee, 100 pregnant women were divided into two groups: current smokers (Group S, smoker) (n = 50) and lifelong nonsmokers (Group NS, nonsmoker) (n = 50). The dose of local anesthetic was adjusted according to the height of each patient. After free cerebrospinal fluid flow was observed, all patients were given 20 μμg of fentanyl in 0.05 mg/cm hyperbaric 0.5% bupivacaine within 10 seconds. The onset of sensory and motor block, the duration of sensory and motor block, and the visual analogue scale (VAS) score were monitored. RESULTS Data from 100 parturient women were investigated. Even though the median time required for the onset of sensory block to occur was significantly higher in Group S (P = 0.019), the duration of motor block was found to be shorter (P = 0.003); however, the duration of sensory block was similar in both groups (P = 0.771). VAS scores were significantly higher in Group S (P = 0.001). CONCLUSIONS In conclusion, the pregnant women who smoked had longer motor block onset times, shorter motor block durations, higher VAS scores, and lower patient satisfaction levels.
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Affiliation(s)
- H Y Gunes
- Department of Anesthesiology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
| | - D K Caliskan
- Department of Anesthesiology, Van Research and Training Hospital, University of Health Sciences, Van, Turkey
| | - H A Sakar
- Department of Anesthesiology, Van Research and Training Hospital, University of Health Sciences, Van, Turkey
| | - N Yuzkat
- Department of Anesthesiology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey
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Gasparri R, Capuano R, Guaglio A, Caminiti V, Canini F, Catini A, Sedda G, Paolesse R, Di Natale C, Spaggiari L. Volatolomic urinary profile analysis for diagnosis of the early stage of lung cancer. J Breath Res 2022; 16. [PMID: 35952625 DOI: 10.1088/1752-7163/ac88ec] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022]
Abstract
Nowadays in clinical practice there is a pressing need for potential biomarkers that can identify lung cancer at early stage before becoming symptomatic or detectable by conventional means. Several researchers have independently pointed out that the volatile organic compounds (VOCs) profile can be considered as a lung cancer fingerprint useful for diagnosis. In particular, 16% of volatiles contributing to the human volatilome are found in urine, which is therefore an ideal sample medium. Its analysis through non-invasive, relatively low-cost and straightforward techniques could offer great potential for the early diagnosis of lung cancer. In this study, urinary VOCs were analysed with a gas chromatography-ion mobility spectrometer (GC-IMS) and an electronic nose (e-nose) made by a matrix of twelve quartz microbalances (QMBs) complemented by a photoionization detector (PID). This clinical prospective study involved 127 individuals, divided into two groups: 46 with lung cancer stage I-II-III confirmed by computerized tomography (CT) or positron emission tomography-(PET) imaging techniques and histology (biopsy), and 81 healthy controls. Both instruments provided a multivariate signal which, after being analysed by a machine learning algorithm, identified eight VOCs that could distinguish lung cancer patients from healthy ones. The eight VOCs are 2-pentanone, 2-hexenal, 2-hexen-1-ol, hept-4-en-2-ol, 2-heptanone, 3-octen-2-one, 4-methylpentanol, 4-methyl-octane. Results show that GC-IMS identifies lung cancer with respect to the control group with a diagnostic accuracy of 88%. Sensitivity resulted as being 85%, and specificity was 90% - Area Under the Receiver Operating Characteristics (AUROC): 0.91. The contribution made by the e-nose was also important, even though the results were slightly less sensitive with an accuracy of 71.6%. Moreover, of the eight VOCs identified as potential biomarkers, five VOCs had a high sensitivity (p≤ 0.06) for early stage (stage I) lung cancer.
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Affiliation(s)
- Roberto Gasparri
- Department of Thoracic Surgery, Istituto Europeo di Oncologia, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Rosamaria Capuano
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Alessandra Guaglio
- General toracic surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Milano, Lombardia, 20141, ITALY
| | - Valentina Caminiti
- Department of Thoracic Surgery, European Institute of Oncology, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Federico Canini
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Alexandro Catini
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Giulia Sedda
- Department of Thoracic Surgery, European Institute of Oncology, Via Giuseppe Ripamonti, 435, Milan, Milan, 20141, ITALY
| | - Roberto Paolesse
- Department of Chemical Science and Technology, Via della Ricerca Scientifica, University of Rome 'Tor Vergata', Rome, Rome, 00133, ITALY
| | - Corrado Di Natale
- Department of Electronic Engineering, Universita di Roma 'Tor Vergata', via di tor Vergata 133, 00133 Roma, Roma, 00133, ITALY
| | - Lorenzo Spaggiari
- Division of Thoracic Surgery, European Institute of Oncology, Via Ripamonti 435, Milano, Lombardia, 20141, ITALY
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Issitt T, Wiggins L, Veysey M, Sweeney S, Brackenbury W, Redeker K. Volatile compounds in human breath: critical review and meta-analysis. J Breath Res 2022; 16. [PMID: 35120340 DOI: 10.1088/1752-7163/ac5230] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/04/2022] [Indexed: 11/12/2022]
Abstract
Volatile compounds contained in human breath reflect the inner workings of the body. A large number of studies have been published that link individual components of breath to disease, but diagnostic applications remain limited, in part due to inconsistent and conflicting identification of breath biomarkers. New approaches are therefore required to identify effective biomarker targets. Here, volatile organic compounds have been identified in the literature from four metabolically and physiologically distinct diseases and grouped into chemical functional groups (e.g. - methylated hydrocarbons or aldehydes; based on known metabolic and enzymatic pathways) to support biomarker discovery and provide new insight on existing data. Using this functional grouping approach, principal component analysis doubled explanatory capacity from 19.1% to 38% relative to single individual compound approaches. Random forest and linear discriminant analysis reveal 93% classification accuracy for cancer. This review and meta-analysis provides insight for future research design by identifying volatile functional groups associated with disease. By incorporating our understanding of the complexities of the human body, along with accounting for variability in methodological and analytical approaches, this work demonstrates that a suite of targeted, functional volatile biomarkers, rather than individual biomarker compounds, will improve accuracy and success in diagnostic research and application.
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Affiliation(s)
- Theo Issitt
- Biology, University of York, University of York, York, York, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Laura Wiggins
- Biology, University of York, University of York, York, York, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Martin Veysey
- The University of Newcastle, School of Medicine & Public Health, Callaghan, New South Wales, 2308, AUSTRALIA
| | - Sean Sweeney
- Biology, University of York, University of York, York, York, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - William Brackenbury
- Biology, University of York, University of York, York, York, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Kelly Redeker
- Biology, University of York, Biology Dept. University of York, York, York, North Yorkshire, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
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9
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Paleczek A, Rydosz AM. Review of the algorithms used in exhaled breath analysis for the detection of diabetes. J Breath Res 2022; 16. [PMID: 34996056 DOI: 10.1088/1752-7163/ac4916] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/07/2022] [Indexed: 11/11/2022]
Abstract
Currently, intensive work is underway on the development of truly noninvasive medical diagnostic systems, including respiratory analysers based on the detection of biomarkers of several diseases including diabetes. In terms of diabetes, acetone is considered as a one of the potential biomarker, although is not the single one. Therefore, the selective detection is crucial. Most often, the analysers of exhaled breath are based on the utilization of several commercially available gas sensors or on specially designed and manufactured gas sensors to obtain the highest selectivity and sensitivity to diabetes biomarkers present in the exhaled air. An important part of each system are the algorithms that are trained to detect diabetes based on data obtained from sensor matrices. The prepared review of the literature showed that there are many limitations in the development of the versatile breath analyser, such as high metabolic variability between patients, but the results obtained by researchers using the algorithms described in this paper are very promising and most of them achieve over 90% accuracy in the detection of diabetes in exhaled air. This paper summarizes the results using various measurement systems, feature extraction and feature selection methods as well as algorithms such as Support Vector Machines, k-Nearest Neighbours and various variations of Neural Networks for the detection of diabetes in patient samples and simulated artificial breath samples.
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Affiliation(s)
- Anna Paleczek
- Institute of Electronics, AGH University of Science and Technology Faculty of Computer Science Electronics and Telecommunications, al. A. Mickiewicza 30, Krakow, 30-059, POLAND
| | - Artur Maciej Rydosz
- Institute of Electronics, AGH University of Science and Technology Faculty of Computer Science Electronics and Telecommunications, Al. Mickiewicza 30, Krakow, 30-059, POLAND
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Flexible Impedimetric Electronic Nose for High-Accurate Determination of Individual Volatile Organic Compounds by Tuning the Graphene Sensitive Properties. CHEMOSENSORS 2021. [DOI: 10.3390/chemosensors9120360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We investigated functionalized graphene materials to create highly sensitive sensors for volatile organic compounds (VOCs) such as formaldehyde, methanol, ethanol, acetone, and isopropanol. First, we prepared VOC-sensitive films consisting of mechanically exfoliated graphene (eG) and chemical graphene oxide (GO), which have different concentrations of structural defects. We deposited the films on silver interdigitated electrodes on Kapton substrate and submitted them to thermal treatment. Next, we measured the sensitive properties of the resulting sensors towards specific VOCs by impedance spectroscopy. We obtained the eG- and GO-based electronic nose composed of two eG films- and four GO film-based sensors with variable sensitivity to individual VOCs. The smallest relative change in impedance was 5% for the sensor based on eG film annealed at 180 °C toward 10 ppm formaldehyde, whereas the highest relative change was 257% for the sensor based on two-layers deposited GO film annealed at 200 °C toward 80 ppm ethanol. At 10 ppm VOC, the GO film-based sensors were sensitive enough to distinguish between individual VOCs, which implied excellent selectivity, as confirmed by Principle Component Analysis (PCA). According to a PCA-Support Vector Machine-based signal processing method, the electronic nose provided identification accuracy of 100% for individual VOCs. The proposed electronic nose can be used to detect multiple VOCs selectively because each sensor is sensitive to VOCs and has significant cross-selectivity to others.
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11
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Gashimova E, Osipova A, Temerdashev A, Porkhanov V, Polyakov I, Perunov D, Dmitrieva E. Exhaled breath analysis using GC-MS and an electronic nose for lung cancer diagnostics. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2021; 13:4793-4804. [PMID: 34581316 DOI: 10.1039/d1ay01163d] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Exhaled breath analysis is an interesting and promising approach for the diagnostics of various diseases. Being non-invasive, convenient and simple, this approach has tremendous potential utility for further translation into clinical practice. In this study, gas chromatography-mass spectrometry (GC-MS) and quartz microbalance sensor-based "electronic nose" were applied for analysis of the exhaled breath of 40 lung cancer patients and 40 healthy individuals. It was found that the electronic nose was unable to distinguish the samples of different groups. However, the application of GC-MS allowed identifying statistically significant differences in compound peak areas and their ratios for investigated groups. Diagnostic models were created using random forest classifier based on peak areas and their ratios with the sensitivity and specificity of peak areas (ratios) of 85.7-96.5% (75.0-93.1%) and 73.3-85.1% (90.0-92.5%) on training data and 63.6-75.0% (72.7-100.0%) and 50.0-69.2% (76.9-84.6%) on test data, respectively. The exhaled breath samples of lung cancer patients and healthy volunteers could be distinguished by GC-MS with the use of individual compounds, but application of their ratios could help to determine specific differences between investigated groups and the level the influence of individual metabolism features alternating from one person to another as well as daily instrument reproducibility deviations. The electronic nose has to be significantly improved to apply it to lung cancer diagnostics of exhaled breath analysis and the influence of water vapour has to be lowered to increase the sensitivity of the sensors to detect lung cancer biomarkers.
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Affiliation(s)
- Elina Gashimova
- Department of Analytical Chemistry, Kuban State University, Krasnodar, Russia.
| | - Anna Osipova
- Department of Analytical Chemistry, Kuban State University, Krasnodar, Russia.
| | - Azamat Temerdashev
- Department of Analytical Chemistry, Kuban State University, Krasnodar, Russia.
| | - Vladimir Porkhanov
- Research Institute - Regional Clinical Hospital, No 1 n.a. Prof. S.V. Ochapovsky, Krasnodar, Russia
| | - Igor Polyakov
- Research Institute - Regional Clinical Hospital, No 1 n.a. Prof. S.V. Ochapovsky, Krasnodar, Russia
| | - Dmitry Perunov
- Research Institute - Regional Clinical Hospital, No 1 n.a. Prof. S.V. Ochapovsky, Krasnodar, Russia
| | - Ekaterina Dmitrieva
- Department of Analytical Chemistry, Kuban State University, Krasnodar, Russia.
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12
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Longo V, Forleo A, Ferramosca A, Notari T, Pappalardo S, Siciliano P, Capone S, Montano L. Blood, urine and semen Volatile Organic Compound (VOC) pattern analysis for assessing health environmental impact in highly polluted areas in Italy. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 286:117410. [PMID: 34052646 DOI: 10.1016/j.envpol.2021.117410] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 05/04/2023]
Abstract
Volatile Organic Compound (VOC) analysis is usually applied in pollution assessment by checking for toxic or harmful volatile compounds in air, water and soil samples. In this study, exogenous VOCs and their derivatives, metabolized by cells, were valued into specific body fluids. In particular, the VOC profiles of blood, urine and human semen samples collected from young men living in two high pollution areas in Italy, i.e. Land of Fires and Valley of Sacco River, were fingerprinted. The analysis is based on Headspace Solid Phase MicroExtraction (HS-SPME) followed by Gas Chromatography-Mass Spectrometric detection (GC-MS). The volatile composition of the three body fluids showed that some VOCs are in common between blood, urine and human semen samples, whereas others are present only in a body fluid. Some compounds, as well as also some chemical classes show a higher affinity for a specific body fluid. Statistical analysis allowed to discriminate the two contaminated areas and identify those compounds which significantly contribute to the two areas classification. Some of these compounds are toxic and found prevalently in Valley of Sacco River samples, correspondingly to sperm analysis results for young men living in this zona worse than those living in Land of Fires.
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Affiliation(s)
- Valentina Longo
- National Research Council of Italy, Institute for Microelectronics and Microsystems (CNR-IMM), Lecce, Italy.
| | - Angiola Forleo
- National Research Council of Italy, Institute for Microelectronics and Microsystems (CNR-IMM), Lecce, Italy
| | - Alessandra Ferramosca
- Department of Environmental and Biological Sciences and Technologies, University of Salento, Lecce, Italy
| | - Tiziana Notari
- Reproductive Medicine Unit of Check Up Polydiagnostic Center, Via A. De Luca 5, Salerno, Italy
| | | | - Pietro Siciliano
- National Research Council of Italy, Institute for Microelectronics and Microsystems (CNR-IMM), Lecce, Italy
| | - Simonetta Capone
- National Research Council of Italy, Institute for Microelectronics and Microsystems (CNR-IMM), Lecce, Italy
| | - Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL) Salerno, Coordination Unit of the Network for Environmental and Reproductive Health (EcoFoodFertility Project), Italy "Oliveto Citra Hospital", Salerno, Italy; PhD Program in Evolutionary Biology and Ecology,University of Rome Tor Vergata, Rome, Italy
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13
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Bekki K, Uchiyama S, Inaba Y, Ushiyama A. Analysis of furans and pyridines from new generation heated tobacco product in Japan. Environ Health Prev Med 2021; 26:89. [PMID: 34517815 PMCID: PMC8438973 DOI: 10.1186/s12199-021-01008-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background In recent years, heated tobacco products (HTPs), which are widely used in Japan, have been sold by various brands using additives such as flavors. It has been reported that the components of mainstream smoke are different from those of conventional cigarettes. In this study, we established an analytical method for furans and pyridines in the mainstream smoke, which are characteristic of HTPs and particularly harmful among the generated components, and investigated the amount of component to which the smokers are exposed. Methods We established a simple analytical method for simultaneous analysis of gaseous and particulate compounds in the mainstream smoke of HTPs (IQOS, glo, ploom S) in Japan by combining a sorbent cartridge and glass fiber filter (Cambridge filter pad (CFP)). Both the sorbent cartridge and CFP were extracted using 2-propanol and analyzed via GC-MS/MS to determine the concentration of furans and pyridines generated from each HTP. Results The results showed that the levels of target furans such as furfural, 2-furanmethanol, 2(5H)-furanone, and 5-methylfurfural tended to be higher in the mainstream smoke of glo than in standard cigarettes (3R4F). Pyridine, which is generated at a high level in 3R4F as a combustion component, and 4-ethenylpyridine (EP), which is a known marker of environmental tobacco smoke, were detected. Among these components, 2-furanmethanol and pyridine are classified as Group 2B (possibly carcinogenic to humans) by the International Agency for Research on Cancer (IARC). Therefore, it is possible that they will contribute to the health effects caused by use of HTPs. Conclusions Using the new collection and analytical method for furans and pyridines in the mainstream smoke of HTPs, the level of each compound to which smokers are exposed could be clarified. By comprehensively combining information on the amount of ingredients and toxicity, it will be possible to perform a more detailed calculation of the health risks of using HTPs. In addition, the components detected in this study may be the causative substances of indoor pollution through exhaled smoke and sidestream smoke; therefore, environmental research on the chemicals generated from HTPs would be warranted in future studies. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-01008-1.
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Affiliation(s)
- Kanae Bekki
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - Shigehisa Uchiyama
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Yohei Inaba
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Akira Ushiyama
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
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14
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Brasier N, Osthoff M, De Ieso F, Eckstein J. Next-Generation Digital Biomarkers for Tuberculosis and Antibiotic Stewardship: Perspective on Novel Molecular Digital Biomarkers in Sweat, Saliva, and Exhaled Breath. J Med Internet Res 2021; 23:e25907. [PMID: 34420925 PMCID: PMC8414294 DOI: 10.2196/25907] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/25/2021] [Accepted: 05/24/2021] [Indexed: 01/18/2023] Open
Abstract
The internet of health care things enables a remote connection between health care professionals and patients wearing smart biosensors. Wearable smart devices are potentially affordable, sensitive, specific, user-friendly, rapid, robust, lab-independent, and deliverable to the end user for point-of-care testing. The datasets derived from these devices are known as digital biomarkers. They represent a novel patient-centered approach to collecting longitudinal, context-derived health insights. Adding automated, analytical smartphone applications will enable their use in high-, middle-, and low-income countries. So far, digital biomarkers have been focused primarily on accelerometer data and heart rate due to well-established sensors originating from the consumer market. Novel emerging smart biosensors will detect biomarkers (or compounds) independent of a lab and noninvasively in sweat, saliva, and exhaled breath. These molecular digital biomarkers are a promising novel approach to reduce the burden from 2 major infectious diseases with urgent unmet needs: tuberculosis and infections with multidrug resistant pathogens. Active tuberculosis (aTbc) is one of the deadliest diseases from an infectious agent. However, a simple and reliable test for its detection is still missing. Furthermore, inappropriate antimicrobial use leads to the development of antimicrobial resistance, which is associated with high mortality and health care costs. From this perspective, we discuss the innovative approach of a noninvasive and lab-independent collection of novel biomarkers to detect aTbc, which at the same time may additionally serve as a scalable therapeutic drug monitoring approach for antibiotics. These molecular digital biomarkers are next-generation digital biomarkers and have the potential to shape the future of infectious diseases.
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Affiliation(s)
- Noe Brasier
- Department of Digitalization & ICT, University Hospital Basel, Basel, Switzerland.,Institute for Translational Medicine, ETH Zurich, Zurich, Switzerland
| | - Michael Osthoff
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Fiorangelo De Ieso
- Department of Digitalization & ICT, University Hospital Basel, Basel, Switzerland.,Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Jens Eckstein
- Department of Digitalization & ICT, University Hospital Basel, Basel, Switzerland.,Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
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15
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Zhang X, Ren X, Zhong Y, Chingin K, Chen H. Rapid and sensitive detection of acetone in exhaled breath through the ambient reaction with water radical cations. Analyst 2021; 146:5037-5044. [PMID: 34231556 DOI: 10.1039/d1an00402f] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The levels of acetone and other ketones in exhaled human breath can be associated with various metabolic conditions, e.g. ketosis, lung cancer, dietary fat loss and diabetes. In this study, ketones in breath samples were charged through the reaction with water radical cations to form [M + H2O]˙+ ions, which were detected by mass spectrometry. Our experimental data indicate that under the optimized experimental conditions, the limit of detection for acetone using our approach is 0.14 ng L-1 (∼0.06 ppb). The linear dynamic range of detection spans four orders of magnitude. The developed approach was applied to real-time semi-quantitative analysis of acetone in the exhaled breath of human volunteers, revealing significantly higher levels of acetone in the breath of smokers compared to non-smokers. The developed approach features the obviation of sample collection, easy operation, high speed of analysis (10 s per run), high sensitivity, and spectral interpretation, which indicates the potential of ambient corona discharge ionization mass spectrometry as a selective, sensitive and noninvasive technique for the determination of exhaled ketones in clinical diagnosis including lung cancer, diabetes, etc.
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Affiliation(s)
- Xiaoping Zhang
- Jiangxi Key Laboratory for Mass Spectrometry and Instrumentation, East China University of Technology, Nanchang, 330013, P. R. China.
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16
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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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17
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Paleczek A, Grochala D, Rydosz A. Artificial Breath Classification Using XGBoost Algorithm for Diabetes Detection. SENSORS 2021; 21:s21124187. [PMID: 34207196 PMCID: PMC8234852 DOI: 10.3390/s21124187] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/13/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022]
Abstract
Exhaled breath analysis has become more and more popular as a supplementary tool for medical diagnosis. However, the number of variables that have to be taken into account forces researchers to develop novel algorithms for proper data interpretation. This paper presents a system for analyzing exhaled air with the use of various sensors. Breath simulations with acetone as a diabetes biomarker were performed using the proposed e-nose system. The XGBoost algorithm for diabetes detection based on artificial breath analysis is presented. The results have shown that the designed system based on the XGBoost algorithm is highly selective for acetone, even at low concentrations. Moreover, in comparison with other commonly used algorithms, it was shown that XGBoost exhibits the highest performance and recall.
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18
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Sibul F, Burkhardt T, Kachhadia A, Pilz F, Scherer G, Scherer M, Pluym N. Identification of biomarkers specific to five different nicotine product user groups: Study protocol of a controlled clinical trial. Contemp Clin Trials Commun 2021; 22:100794. [PMID: 34189337 PMCID: PMC8219643 DOI: 10.1016/j.conctc.2021.100794] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/09/2021] [Accepted: 05/23/2021] [Indexed: 01/03/2023] Open
Abstract
Background Assessing biomarker profiles in various body fluids is of large value to discern between the sole use of nicotine products. In particular, the assessment of the product compliance is required for long-term clinical studies. The objective of this study was the identification of biomarkers and biomarker patterns in body fluids, to distinguish between combustibles, heated tobacco products, electronic cigarettes, oral tobacco and oral/dermal nicotine products used for nicotine replacement therapy (NRT), as well as a control group of non-users. Methods A controlled, single-center study was conducted with 60 healthy subjects, divided into 6 groups (5 nicotine product user groups and one non-user group) based on their sole use of the products of choice. The subjects were confined for 76 h, during which, free and uncontrolled use of the products was provided. Sample collections were performed according to the study time schedule provided in Table 2. The primary outcome will be validated through analysis of the collected biospecimens (urine, blood, saliva, exhaled breath and exhaled breath condensate) by means of untargeted omics approaches (i.e. exposomics, breathomics and adductomics). Secondary outcome will include established biomarker quantification methods to allow for the identification of typical biomarker patterns. Statistical analysis tools will be used to specifically discriminate different product use categories. Results/Conclusions The clinical trial was successfully completed in May 2020, resulting in sample management and preparations for the quantitative and qualitative analyses. This work will serve as a solid basis to discern between biomarker profiles of different nicotine product user groups. The knowledge collected during this research will be required to develop prototype diagnostic tools that can reliably assess the differences and evaluate possible health risks of various nicotine products.
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Affiliation(s)
- Filip Sibul
- Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152 Planegg, Germany
| | - Therese Burkhardt
- Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152 Planegg, Germany
| | - Alpeshkumar Kachhadia
- Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152 Planegg, Germany
| | - Fabian Pilz
- Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152 Planegg, Germany
| | - Gerhard Scherer
- Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152 Planegg, Germany
| | - Max Scherer
- Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152 Planegg, Germany
| | - Nikola Pluym
- Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152 Planegg, Germany
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19
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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: 86] [Impact Index Per Article: 28.7] [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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20
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Guo W, Surya SG, Babar V, Ming F, Sharma S, Alshareef HN, Schwingenschlögl U, Salama KN. Selective Toluene Detection with Mo 2CT x MXene at Room Temperature. ACS APPLIED MATERIALS & INTERFACES 2020; 12:57218-57227. [PMID: 33289555 DOI: 10.1021/acsami.0c16302] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
MXenes are a promising class of two-dimensional materials with several potential applications, including energy storage, catalysis, electromagnetic interference shielding, transparent electronics, and sensors. Here, we report a novel Mo2CTx MXene sensor for the successful detection of volatile organic compounds (VOCs). The proposed sensor is a chemiresistive device fabricated on a Si/SiO2 substrate using photolithography. The impact of various MXene process conditions on the performance of the sensor is evaluated. The VOCs, such as toluene, benzene, ethanol, methanol, and acetone, are studied at room temperature with varying concentrations. Under optimized conditions, the sensor demonstrates a detection limit of 220 ppb and a sensitivity of 0.0366 Ω/ppm at a toluene concentration of 140 ppm. It exhibits an excellent selectivity toward toluene against the other VOCs. Ab initio simulations demonstrate selectivity toward toluene in line with the experimental results.
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Affiliation(s)
- Wenzhe Guo
- Sensors Lab, Advanced Membranes & Porous Materials Center (AMPMC), CEMSE, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Sandeep G Surya
- Sensors Lab, Advanced Membranes & Porous Materials Center (AMPMC), CEMSE, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Vasudeo Babar
- Computational Physics & Materials Science Lab, Physical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Fangwang Ming
- Functional Nanomaterials & Devices Lab, Materials Science and Engineering, Physical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Sitansh Sharma
- Computational Physics & Materials Science Lab, Physical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Husam N Alshareef
- Functional Nanomaterials & Devices Lab, Materials Science and Engineering, Physical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Udo Schwingenschlögl
- Computational Physics & Materials Science Lab, Physical Sciences and Engineering Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - Khaled N Salama
- Sensors Lab, Advanced Membranes & Porous Materials Center (AMPMC), CEMSE, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
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21
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Data preprocessing workflow for exhaled breath analysis by GC/MS using open sources. Sci Rep 2020; 10:22008. [PMID: 33319832 PMCID: PMC7738550 DOI: 10.1038/s41598-020-79014-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/03/2020] [Indexed: 12/24/2022] Open
Abstract
The noninvasive diagnosis and monitoring of high prevalence diseases such as cardiovascular diseases, cancers and chronic respiratory diseases are currently priority objectives in the area of health. In this regard, the analysis of volatile organic compounds (VOCs) has been identified as a potential noninvasive tool for the diagnosis and surveillance of several diseases. Despite the advantages of this strategy, it is not yet a routine clinical tool. The lack of reproducible protocols for each step of the biomarker discovery phase is an obstacle of the current state. Specifically, this issue is present at the data preprocessing step. Thus, an open source workflow for preprocessing the data obtained by the analysis of exhaled breath samples using gas chromatography coupled with single quadrupole mass spectrometry (GC/MS) is presented in this paper. This workflow is based on the connection of two approaches to transform raw data into a useful matrix for statistical analysis. Moreover, this workflow includes matching compounds from breath samples with a spectral library. Three free packages (xcms, cliqueMS and eRah) written in the language R are used for this purpose. Furthermore, this paper presents a suitable protocol for exhaled breath sample collection from infants under 2 years of age for GC/MS.
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22
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Kim U, Karthikraj R. Solid‐phase microextraction for the human biomonitoring of environmental chemicals: Current applications and future perspectives. J Sep Sci 2020; 44:247-273. [DOI: 10.1002/jssc.202000830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/18/2020] [Accepted: 11/13/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Un‐Jung Kim
- Department of Earth & Environmental Sciences University of Texas at Arlington Arlington Texas USA
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23
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Pauwels CGGM, Hintzen KFH, Talhout R, Cremers HWJM, Pennings JLA, Smolinska A, Opperhuizen A, Van Schooten FJ, Boots AW. Smoking regular and low-nicotine cigarettes results in comparable levels of volatile organic compounds in blood and exhaled breath. J Breath Res 2020; 15:016010. [PMID: 33027777 DOI: 10.1088/1752-7163/abbf38] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Smokers are exposed to more than 6000 (toxic) smoke components including volatile organic compounds (VOCs). In this study VOCs levels in headspace of blood and exhaled breath, in the mainstream smoke of three types of cigarettes of one brand varying in declared tar, nicotine and carbon monoxide (TNCO) yields are investigated. The objective was to identify whether VOC levels correlate with TNCO yields of cigarettes smoked according to ISO 3308. Our data show that smoking regular and low-TNCO cigarettes result in comparable levels of VOCs in blood and exhaled breath. Hence, declared TNCO-yields as determined with the ISO 3308 machine smoking protocol are irrelevant for predicting VOC exposure upon human smoking. Venous blood and exhaled breath were sampled from 12 male volunteers directly before and 10 min after smoking cigarettes on 3 d (day 1 Marlboro Red (regular), day 2 Marlboro Prime (highly ventilated, low-TNCO), day 3 Marlboro Prime with blocked filter ventilation (taped)). Upon smoking, the levels of toluene, ethylbenzene, m/p-xylene, o-xylene, and 2,5-dimethylfuran in both headspace of venous blood and exhaled breath increase within the same range for all three cigarette types smoked. However, no strong correlation was found between VOC levels in exhaled breath and VOC levels in headspace of blood because of variations between the individual smoking volunteers. More research is required in order to use exhaled breath sampling as a non-invasive quantitative marker for volatile toxicants from cigarette smoke exposure of different brands.
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Affiliation(s)
- Charlotte G G M Pauwels
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Maastricht, The Netherlands
| | - Kim F H Hintzen
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Reinskje Talhout
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Maastricht, The Netherlands
| | - Hans W J M Cremers
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Maastricht, The Netherlands
| | - Jeroen L A Pennings
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Maastricht, The Netherlands
| | - Agnieszka Smolinska
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Antoon Opperhuizen
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Office of Risk Assessment and Research, Netherlands Food and Consumer Product Safety Authority (NVWA), Maastricht, The Netherlands
| | - Frederik J Van Schooten
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Agnes W Boots
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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24
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Papaefstathiou E, Stylianou M, Andreou C, Agapiou A. Breath analysis of smokers, non-smokers, and e-cigarette users. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1160:122349. [PMID: 32920481 DOI: 10.1016/j.jchromb.2020.122349] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/17/2020] [Accepted: 08/25/2020] [Indexed: 12/18/2022]
Abstract
Solid phase micro extraction-Gas Chromatography/Mass Spectrometry (SPME-GC/MS) analysis was performed in exhaled breath samples of 48 healthy volunteers: 20 non-smokers, 10 smokers and 18 e-cigarette (EC, vape) users. Each volunteer provided 1 L of exhaled breath in a pre-cleaned Tedlar bag, in which an SPME fiber was exposed to absorb the emitted breath volatile organic compounds (VOCs). The acquired data were processed using multivariate data analysis (MDA) methods in order to identify the characteristic chemicals of the three groups. The results revealed that the breath of non-smokers demonstrated inverse correlation with a variety of molecules related to the breath from smokers including furan, toluene, 2-butanone and other organic substances. Vapers were distinguished from smokers by the chemical speciation of the e-liquids, such as that of esters (e.g. ethyl acetate), terpenes (e.g. α-pinene, β-pinene, d-limonene, p-cymene, etc.) and oxygenated compounds (e.g. 3-hexen-1-ol, benzaldehyde, hexanal, decanal, etc). Two classification models were developed (a) using principal component analysis (PCA) with hierarchical cluster analysis (HCA) and (b) using partial least squares-discriminant analysis (PLS-DA). Both models were validated using 8 new samples (4 vapers and 4 smokers), collected in addition to the 48 samples of the calibration set. The combination of GC/MS breath analysis and MDA contributed successfully in classifying the volunteers into their respective groups and highlighted the relevant characteristic VOCs. The respective dynamic combination (SPME-GC/MS and MDA) provides a means for long term non-invasive monitoring of the population's health status for early detection purposes.
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Affiliation(s)
- E Papaefstathiou
- Department of Chemistry, University of Cyprus, P.O.Box 20537, 1678 Nicosia, Cyprus
| | - M Stylianou
- Department of Chemistry, University of Cyprus, P.O.Box 20537, 1678 Nicosia, Cyprus
| | - C Andreou
- Department of Electrical and Computer Engineering, University of Cyprus, 1678 Nicosia, Cyprus
| | - A Agapiou
- Department of Chemistry, University of Cyprus, P.O.Box 20537, 1678 Nicosia, Cyprus.
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25
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Koureas M, Kirgou P, Amoutzias G, Hadjichristodoulou C, Gourgoulianis K, Tsakalof A. Target Analysis of Volatile Organic Compounds in Exhaled Breath for Lung Cancer Discrimination from Other Pulmonary Diseases and Healthy Persons. Metabolites 2020; 10:metabo10080317. [PMID: 32756521 PMCID: PMC7464039 DOI: 10.3390/metabo10080317] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of the present study was to investigate the ability of breath analysis to distinguish lung cancer (LC) patients from patients with other respiratory diseases and healthy people. The population sample consisted of 51 patients with confirmed LC, 38 patients with pathological computed tomography (CT) findings not diagnosed with LC, and 53 healthy controls. The concentrations of 19 volatile organic compounds (VOCs) were quantified in the exhaled breath of study participants by solid phase microextraction (SPME) of the VOCs and subsequent gas chromatography-mass spectrometry (GC-MS) analysis. Kruskal-Wallis and Mann-Whitney tests were used to identify significant differences between subgroups. Machine learning methods were used to determine the discriminant power of the method. Several compounds were found to differ significantly between LC patients and healthy controls. Strong associations were identified for 2-propanol, 1-propanol, toluene, ethylbenzene, and styrene (p-values < 0.001-0.006). These associations remained significant when ambient air concentrations were subtracted from breath concentrations. VOC levels were found to be affected by ambient air concentrations and a few by smoking status. The random forest machine learning algorithm achieved a correct classification of patients of 88.5% (area under the curve-AUC 0.94). However, none of the methods used achieved adequate discrimination between LC patients and patients with abnormal computed tomography (CT) findings. Biomarker sets, consisting mainly of the exogenous monoaromatic compounds and 1- and 2- propanol, adequately discriminated LC patients from healthy controls. The breath concentrations of these compounds may reflect the alterations in patient's physiological and biochemical status and perhaps can be used as probes for the investigation of these statuses or normalization of patient-related factors in breath analysis.
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Affiliation(s)
- Michalis Koureas
- Department of Hygiene and Epidemiology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (M.K.); (C.H.)
| | - Paraskevi Kirgou
- Respiratory Medicine Department, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (P.K.); (K.G.)
| | - Grigoris Amoutzias
- Bioinformatics Laboratory, Department of Biochemistry and Biotechnology, University of Thessaly, 41500 Larissa, Greece;
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (M.K.); (C.H.)
| | - Konstantinos Gourgoulianis
- Respiratory Medicine Department, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (P.K.); (K.G.)
| | - Andreas Tsakalof
- Department of Hygiene and Epidemiology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (M.K.); (C.H.)
- Department of Biochemistry, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
- Correspondence: ; Tel.: +30-2410685580
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26
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Töreyin ZN, Ghosh M, Göksel Ö, Göksel T, Godderis L. Exhaled Breath Analysis in Diagnosis of Malignant Pleural Mesothelioma: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1110. [PMID: 32050546 PMCID: PMC7036862 DOI: 10.3390/ijerph17031110] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 12/12/2022]
Abstract
Malignant pleural mesothelioma (MPM) is mainly related to previous asbestos exposure. There is still dearth of information on non-invasive biomarkers to detect MPM at early stages. Human studies on exhaled breath biomarkers of cancer and asbestos-related diseases show encouraging results. The aim of this systematic review was to provide an overview on the current knowledge about exhaled breath analysis in MPM diagnosis. A systematic review was conducted on MEDLINE (PubMed), EMBASE and Web of Science databases to identify relevant studies. Quality assessment was done by the Newcastle-Ottawa Scale. Six studies were identified, all of which showed fair quality and explored volatile organic compounds (VOC) based breath profile using Gas Chromatography Coupled to Mass Spectrometry (GC-MS), Ion Mobility Spectrometry Coupled to Multi-capillary Columns (IMS-MCC) or pattern-recognition technologies. Sample sizes varied between 39 and 330. Some compounds (i.e, cyclohexane, P3, P5, P50, P71, diethyl ether, limonene, nonanal, VOC IK 1287) that can be indicative of MPM development in asbestos exposed population were identified with high diagnostic accuracy rates. E-nose studies reported breathprints being able to distinguish MPM from asbestos exposed individuals with high sensitivity and a negative predictive value. Small sample sizes and methodological diversities among studies limit the translation of results into clinical practice. More prospective studies with standardized methodologies should be conducted on larger populations.
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Affiliation(s)
- Zehra Nur Töreyin
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
| | - Manosij Ghosh
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
| | - Özlem Göksel
- Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Laboratory of Occupational and Environmental Respiratory Diseases, Bornova, 35100 Izmir, Turkey;
| | - Tuncay Göksel
- Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Bornova, 35100 Izmir, Turkey;
| | - Lode Godderis
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
- Idewe, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
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27
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Swanson B, Fogg L, Julion W, Arrieta MT. Electronic Nose Analysis of Exhaled Breath Volatiles to Identify Lung Cancer Cases: A Systematic Review. J Assoc Nurses AIDS Care 2020; 31:71-79. [PMID: 31860595 DOI: 10.1097/jnc.0000000000000146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of our review was to analyze evidence of the validity of electronic noses to discriminate persons with lung cancer from healthy control subjects and to advance implications for this technology in the care of people living with HIV. A computerized database search of the literature (published 1946-2018) was conducted to identify studies that used electronic nose-generated smellprints to discriminate persons with lung cancer from healthy control subjects. Fifteen articles met the sampling criteria. In 14 studies, mean sensitivity and specificity values from a single training sample were 84.1% and 80.9%, respectively. Five studies applied the prediction model obtained from the training sample to a separate validation sample; mean sensitivity was 88.2%, and mean specificity was 70.2%. Findings suggest that breath smellprints are valid markers of lung cancer and may be useful screening measures for cancer. No studies included people living with HIV; additional studies are needed to assess generalizability to this population.
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28
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Ghosh C, Singh V, Grandy J, Pawliszyn J. Recent advances in breath analysis to track human health by new enrichment technologies. J Sep Sci 2019; 43:226-240. [PMID: 31826324 DOI: 10.1002/jssc.201900769] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/31/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022]
Abstract
Detection of biomarkers in exhaled breath has been gaining increasing attention as a tool for diagnosis of specific diseases. However, rapid and accurate quantification of biomarkers associated with specific diseases requires the use of analytical methods capable of fast sampling and preconcentration from breath matrix. In this regard, solid phase microextraction and needle trap technology are becoming increasingly popular in the field of breath analysis due to the unique benefits imparted by such methods, such as the integration of sampling, extraction, and preconcentration in a single step. This review discusses recent advances in breath analysis using these sample preparation techniques, providing a summary of recent developments of analytical methods based on breath volatile organic compounds analysis, including the successful identification of various biomarkers related to human diseases.
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Affiliation(s)
- Chiranjit Ghosh
- Department of Chemistry, 200 University Avenue West, University of Waterloo, Ontario, Canada
| | - Varoon Singh
- Department of Chemistry, 200 University Avenue West, University of Waterloo, Ontario, Canada
| | - Jonathan Grandy
- Department of Chemistry, 200 University Avenue West, University of Waterloo, Ontario, Canada
| | - Janusz Pawliszyn
- Department of Chemistry, 200 University Avenue West, University of Waterloo, Ontario, Canada
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29
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Longo V, Forleo A, Capone S, Scoditti E, Carluccio MA, Siciliano P, Massaro M. In vitro profiling of endothelial volatile organic compounds under resting and pro-inflammatory conditions. Metabolomics 2019; 15:132. [PMID: 31583479 DOI: 10.1007/s11306-019-1602-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/27/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The evaluation of volatile organic compounds(VOCs) emitted by human body offers a unique tool to set up new non-invasive devices for early diagnosis and long-lasting monitoring of most human diseases. However, their cellular origin and metabolic fate have not been completely elucidated yet, thus limiting their clinical application. Endothelium acts as an interface between blood and surrounding tissues. As such, it adapts its physiology in response to different environmental modifications thus playing a role in the pathogenesis of many metabolic and inflammatory diseases. OBJECTIVES Since endothelium specifically reshapes its physiologic functions upon environmental changes the objective of this study was to evaluate if and how pro-inflammatory stimuli affect VOC metabolism in endothelial cell in culture. METHODS Gas chromatography with mass spectrometric detection was applied to profile VOCs in the headspace of cultured endothelial cells (EC) in the absence or presence of the pro-inflammatory stimulus lipopolysaccharide (LPS). RESULTS We observed that, under resting conditions, EC affected the amount of 58 VOCs belonging to aldehyde, alkane and ketone families. Among these, LPS significantly altered the amount of 15 VOCs. ROC curves show a perfect performance (AUC = 1) for 10 metabolites including 1-butanol, 3-methyl-1-butanol and 2-ethyl-1-hexanol. DISCUSSION The emission and uptake of the aforementioned VOCs disclose potential unexplored metabolic pathways for EC that deserve to be investigated. Overall, we identified new candidate VOC potentially exploitable, upon experimental confirm in in vivo model of disease, as potential biomarkers of sepsis and pro-inflammatory clinical settings.
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Affiliation(s)
- V Longo
- National Research Council of Italy, Institute for Microelectronics and Microsystems, Lecce, Italy.
| | - A Forleo
- National Research Council of Italy, Institute for Microelectronics and Microsystems, Lecce, Italy
| | - S Capone
- National Research Council of Italy, Institute for Microelectronics and Microsystems, Lecce, Italy
| | - E Scoditti
- National Research Council of Italy, Institute of Clinical Physiology, Lecce, Italy
| | - M A Carluccio
- National Research Council of Italy, Institute of Clinical Physiology, Lecce, Italy
| | - P Siciliano
- National Research Council of Italy, Institute for Microelectronics and Microsystems, Lecce, Italy
| | - M Massaro
- National Research Council of Italy, Institute of Clinical Physiology, Lecce, Italy.
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30
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Exogenous factors of influence on exhaled breath analysis by ion-mobility spectrometry (MCC/IMS). ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s12127-019-00247-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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31
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Longo V, Forleo A, Provenzano SP, Coppola L, Zara V, Ferramosca A, Siciliano P, Capone S. HS-SPME-GC-MS metabolomics approach for sperm quality evaluation by semen volatile organic compounds (VOCs) analysis. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aaeb07] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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32
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Gasparri R, Sedda G, Spaggiari L. The Electronic Nose's Emerging Role in Respiratory Medicine. SENSORS 2018; 18:s18093029. [PMID: 30201931 PMCID: PMC6163163 DOI: 10.3390/s18093029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 08/27/2018] [Accepted: 09/08/2018] [Indexed: 01/04/2023]
Abstract
New interest has grown in the respiratory disorder diagnosis and monitoring, throughout electronic nose technologies. This technology has several advantages compared to classic approach. In this short letter, we aim to emphasize electronic nose role in respiratory medicine.
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Affiliation(s)
- Roberto Gasparri
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy.
| | - Giulia Sedda
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy.
| | - Lorenzo Spaggiari
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy.
- Department of Oncology and Hemato-oncology, University of Milan, 20122 Milan, Italy.
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