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Gouzi F, Ayache D, Hédon C, Molinari N, Vicet A. Breath acetone concentration: too heterogeneous to constitute a diagnosis or prognosis biomarker in heart failure? A systematic review and meta-analysis. J Breath Res 2021; 16. [PMID: 34727537 DOI: 10.1088/1752-7163/ac356d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 11/02/2021] [Indexed: 12/19/2022]
Abstract
Introduction. Exhaled breath acetone (ExA) has been investigated as a biomarker for heart failure (HF). Yet, barriers to its use in the clinical field have not been identified. The aim of this systematic review and meta-analysis was to assess the ExA heterogeneity and factors of variability in healthy controls (HC), to identify its relations with HF diagnosis and prognostic factors and to assess its diagnosis and prognosis accuracy in HF patients.Methods. A systematic search was conducted in PUBMED and Web of Science database. All studies with HC and HF patients with a measured ExA were included and studies providing ExA's diagnosis and prognosis accuracy were identified.Results. Out of 971 identified studies, 18 studies involving 833 HC and 1009 HF patients were included in the meta-analysis. In HC, ExA showed an important heterogeneity (I2= 99%). Variability factors were fasting state, sampling type and analytical method. The mean ExA was 1.89 times higher in HF patients vs. HC (782 [531-1032] vs. 413 [347-478] ppbv;p< 0.001). One study showed excellent diagnosis accuracy, and one showed a good prognosis value. ExA correlated with New York Heart Association (NYHA) dyspnea (p< 0.001) and plasma brain natriuretic peptide (p< 0.001). Studies showed a poor definition and reporting of included subjects.Discussion. Despite the between-study heterogeneity in HC, the evidence of an excellent diagnosis and prognosis value of ExA in HF from single studies can be extended to clinical populations worldwide. Factors of variability (ExA procedure and breath sampling) could further improve the diagnosis and prognosis values of this biomarker in HF patients.
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Affiliation(s)
- Fares Gouzi
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Diba Ayache
- IES, Montpellier University, CNRS, F-34000 Montpellier, France
| | - Christophe Hédon
- PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France
| | - Nicolas Molinari
- IDESP, INSERM, Montpellier University, Montpellier University Hospital, Montpellier, France
| | - Aurore Vicet
- IES, Montpellier University, CNRS, F-34000 Montpellier, France
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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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Meidert AS, Choukèr A, Praun S, Schelling G, Dolch ME. Exhaled Breath and Oxygenator Sweep Gas Propionaldehyde in Acute Respiratory Distress Syndrome. Molecules 2020; 26:molecules26010145. [PMID: 33396196 PMCID: PMC7796205 DOI: 10.3390/molecules26010145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Oxidative stress-induced lipid peroxidation (LPO) due to neutrophil-derived reactive oxygen species plays a key role in the early stage of the acute respiratory distress syndrome (ARDS). Monitoring of oxidative stress in this patient population is of great interest, and, ideally, this can be done noninvasively. Recently, propionaldehyde, a volatile chemical compound (VOC) released during LPO, was identified in the breath of lung transplant recipients as a marker of oxidative stress. The aim of the present study was to identify if markers of oxidative stress appear in the oxygenator outflow gas of patients with severe ARDS treated with veno-venous extracorporeal membrane oxygenation (ECMO). Methods: The present study included patients with severe ARDS treated with veno-venous ECMO. Concentrations of acetone, isoprene, and propionaldehyde were measured in inspiratory air, exhaled breath, and oxygenator inflow and outflow gas at corresponding time points. Ion-molecule reaction mass spectrometry was used to measure VOCs in a sequential order within the first 24 h and on day three after ECMO initiation. Results: Nine patients (5 female, 4 male; age = 42.1 ± 12.2 year) with ARDS and already established ECMO therapy (pre-ECMO PaO2/FiO2 = 44.0 ± 11.5 mmHg) were included into analysis. VOCs appeared in comparable amounts in breath and oxygenator outflow gas (acetone: 838 (422–7632) vs. 1114 (501–4916) ppbv; isoprene: 53.7 (19.5–244) vs. 48.7 (37.9–108) ppbv; propionaldehyde: 53.7 (32.1–82.2) vs. 42.9 (24.8–122) ppbv). Concentrations of acetone, isoprene, and propionaldehyde in breath and oxygenator outflow gas showed a parallel course with time. Conclusions: Acetone, isoprene, and propionaldehyde appear in breath and oxygenator outflow gas in comparable amounts. This allows for the measurement of these VOCs in a critically ill patient population via the ECMO oxygenator outflow gas without the need of ventilator circuit manipulation.
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Affiliation(s)
- Agnes S. Meidert
- Department of Anesthesiology, University Hospital of Munich—Campus Großhadern, Ludwig-Maximilians-University of Munich, 81366 Munich, Germany; (A.S.M.); (A.C.); (G.S.)
| | - Alexander Choukèr
- Department of Anesthesiology, University Hospital of Munich—Campus Großhadern, Ludwig-Maximilians-University of Munich, 81366 Munich, Germany; (A.S.M.); (A.C.); (G.S.)
| | - Siegfried Praun
- V&F Analyse-und Messtechnik GmbH, Andreas Hofer Strasse 15, 6067 Absam, Austria;
| | - Gustav Schelling
- Department of Anesthesiology, University Hospital of Munich—Campus Großhadern, Ludwig-Maximilians-University of Munich, 81366 Munich, Germany; (A.S.M.); (A.C.); (G.S.)
| | - Michael E. Dolch
- Department of Anesthesiology, University Hospital of Munich—Campus Großhadern, Ludwig-Maximilians-University of Munich, 81366 Munich, Germany; (A.S.M.); (A.C.); (G.S.)
- Department of Anesthesiology & Intensive Care Medicine, InnKlinikum Altötting, Vinzenz-von-Paul-Str. 10, 84503 Altötting, Germany
- Correspondence:
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Zeng N, Long Z, Wang Y, Sun J, Ouyang J, Na N. An Acetone Sensor Based on Plasma-Assisted Cataluminescence and Mechanism Studies by Online Ionizations. Anal Chem 2019; 91:15763-15768. [DOI: 10.1021/acs.analchem.9b04023] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Ni Zeng
- Key Laboratory of Theoretical and Computational Photochemistry, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Zi Long
- Key Laboratory of Theoretical and Computational Photochemistry, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Yan Wang
- Key Laboratory of Theoretical and Computational Photochemistry, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Jianghui Sun
- Key Laboratory of Theoretical and Computational Photochemistry, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Jin Ouyang
- Key Laboratory of Theoretical and Computational Photochemistry, College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Na Na
- Key Laboratory of Theoretical and Computational Photochemistry, College of Chemistry, Beijing Normal University, Beijing 100875, China
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Wang C, Ke H, Xu X, Chen J, Sun D, Ji F. Protective effect of nicorandil on collapse‑induced lung injury in rabbits by inhibiting apoptosis. Int J Mol Med 2019; 44:725-736. [PMID: 31173181 DOI: 10.3892/ijmm.2019.4236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 05/24/2019] [Indexed: 11/06/2022] Open
Abstract
The one‑lung ventilation (OLV) technique is vital in thoracic surgery. However, it can result in severe lung injury, which is difficult to manage. The main solution at present is the use of ventilation strategies, including continuous positive oxygen pressure, low tidal volume and high frequency ventilation, and the administering of drugs, including phenylephrine, dexmedetomidine and morphine. However, the protective effect of these methods on the lungs is not sufficient to improve the prognosis of patients. Therefore, how to develop a novel protective drug remains an open question. Nicorandil, a mitochondrial (mito)KATP‑specific opener, serves an important role in cardioprotection, although its effect on lung injury remains unclear. The present study examined the protective role of nicorandil against collapse‑induced lung injury in rabbits undergoing OLV. Changes in arterial oxygen saturation (SaO2), arterial partial pressure for oxygen (PaO2), wet/dry weight ratio, and the microstructure of tissues and cells were observed. Enzyme‑linked immunosorbent assays were used to determine the concentrations of malondialdehyde (MDA) and tumor necrosis factor (TNF)‑α, and the activity of superoxide dismutase (SOD) in rabbits treated with nicorandil. Terminal deoxynucleotidyl transferase transfer‑mediated dUTP nick end‑labeling was used to detect apoptosis and western blotting was used to analyze the relative proteins involved in apoptosis. Western blotting and reverse transcription‑quantitative polymerase chain reaction analysis were used to examine the expression of hypoxia inducible factor 1α (HIF‑1α), phosphatidylinositol‑3‑kinase (PI3K), protein kinase B (Akt) and nuclear factor (NF)‑κB in the lungs of rabbits treated with nicorandil. The SaO2 and PaO2 in the high‑dose group were significantly higher than those in the control group in the process of OLV. The wet/dry weight ratio, and the concentrations of MDA and TNF‑α in the collapsed lung of the high‑dose group were significantly lower than those in the control group. The activity of SOD in the high‑dose group was significantly higher than that in the control group. The lung had improved microstructure and less apoptosis, which was determined by the Bax/Bcl2 ratio in the high‑dose group. The expression levels of PI3K, phosphorylated Akt and HIF‑1α were upregulated, whereas the expression of NF‑κB was downregulated. In conclusion, nicorandil had a protective effect via inhibiting apoptosis in non‑ventilated lung collapsed and re‑expansion during OLV in the rabbit. It acted on mitoKATP through the PI3K/Akt signaling pathway.
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Affiliation(s)
- Chunguang Wang
- Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Honggang Ke
- Department of Cardiothoracic Surgery, The Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Xingguo Xu
- Department of Anesthesiology, The Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Junjie Chen
- Department of Anesthesiology, The Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Dongyun Sun
- Department of Ophthalmic Operating Room, The Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Fuhai Ji
- Department of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
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Lin H, Duan Y, Yan S, Wang Z, Zareef M. Quantitative analysis of volatile organic compound using novel chemoselective response dye based on Vis-NIRS coupled Si-PLS. Microchem J 2019. [DOI: 10.1016/j.microc.2018.12.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Küppers L, Holz O, Schuchardt S, Gottlieb J, Fuge J, Greer M, Hohlfeld JM. Breath volatile organic compounds of lung transplant recipients with and without chronic lung allograft dysfunction. J Breath Res 2018; 12:036023. [PMID: 29771243 DOI: 10.1088/1752-7163/aac5af] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Chronic lung allograft dysfunction with its clinical correlative of bronchiolitis obliterans syndrome (BOS) remains the major limiting factor for long-term graft survival. Currently there are no established methods for the early diagnosis or prediction of BOS. To assess the feasibility of breath collection as a non-invasive tool and the potential of breath volatile organic compounds (VOC) for the early detection of BOS, we compared the breath VOC composition between transplant patients without and different stages of BOS. METHODS 75 outpatients (25 BOS stage 0, 25 BOS stage 1 + 2, 25 BOS stage 3) after bilateral lung transplantation were included. Exclusion criteria were active smoking, oxygen therapy and acute infection. Patients inhaled room air through a VOC and sterile filter and exhaled into an aluminum reservoir tube. Breath was loaded directly onto Tenax® TA adsorption tubes and was subsequently analyzed by gas-chromatography/mass-spectrometry. RESULTS The three groups were age and gender matched, but differed with respect to time since transplantation, the spectrum of underlying disease, and treatment regimes. Relative to patients without BOS, BOS stage 3 patients showed a larger number of different VOCs, and more pronounced differences in the level of VOCs as compared to BOS stage 1 + 2 patients. Logistic regression analysis found no differences between controls and BOS 1 + 2, but four VOCs (heptane, isopropyl-myristate, ethyl-acetate, ionone) with a significant contribution to the discrimination between controls and BOS stage 3. A combination of these four VOCs separated these groups with an area under the curve of 0.87. CONCLUSION Breath sample collection using our reservoir sampler in the clinical environment was feasible. Our results suggest that breath VOCs can discriminate severe BOS. However, convincing evidence for VOCs with a potential to detect early onset BOS is lacking.
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Affiliation(s)
- L Küppers
- Fraunhofer ITEM, Clinical Airway Research-Hannover, Germany
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Variation in Exhaled Acetone and Other Ketones in Patients Undergoing Bariatric Surgery: a Prospective Cross-sectional Study. Obes Surg 2018. [DOI: 10.1007/s11695-018-3180-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Hüppe T, Lorenz D, Maurer F, Albrecht FW, Schnauber K, Wolf B, Sessler DI, Volk T, Fink T, Kreuer S. Exhalation of volatile organic compounds during hemorrhagic shock and reperfusion in rats: an exploratory trial. J Breath Res 2016; 10:016016. [DOI: 10.1088/1752-7155/10/1/016016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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