Improved pre-concentration and detection methods for volatile sulphur breath constituents

Preservation of exhaled breath samples for analysis by off-line SESI-HRMS: proof-of-concept study

Secondary electrospray ionization-high resolution mass spectrometry (SESI-HRMS) is an established technique in the field of breath analysis characterized by its short analysis time, as well as high levels of sensitivity and selectivity. Traditionally, SESI-HRMS has been used for real-time breath analysis, which requires subjects to be at the location of the analytical platform. Therefore, it limits the possibilities for an introduction of this methodology in day-to-day clinical practice. However, recent methodological developments have shown feasibility on the remote sampling of exhaled breath in Nalophan® bags prior to measurement using SESI-HRMS. To further explore the range of applications of this method, we conducted a proof-of-concept study to assess the impact of the storage time of exhaled breath in Nalophan® bags at different temperatures (room temperature and dry ice) on the relative intensities of the compounds. In addition, we performed a detailed study of the storage effect of 27 aldehydes related to oxidative stress. After 2 h of storage, the mean of intensity of allm/zsignals relative to the samples analyzed without prior storage remained above 80% at both room temperature and dry ice. For the 27 aldehydes, the mean relative intensity losses were lower than 20% at 24 h of storage, remaining practically stable since the first hour of storage following sample collection. Furthermore, the mean relative intensity of most aldehydes in samples stored at room temperature was higher than those stored in dry ice, which could be related to water vapor condensation issues. These findings indicate that the exhaled breath samples could be preserved for hours with a low percentage of mean relative intensity loss, thereby allowing more flexibility in the logistics of off-line SESI-HRMS studies.

Common Strategies and Factors Affecting Off-Line Breath Sampling and Volatile Organic Compounds Analysis Using Thermal Desorption-Gas Chromatography-Mass Spectrometry (TD-GC-MS)

An analysis of exhaled breath enables specialists to noninvasively monitor biochemical processes and to determine any pathological state in the human body. Breath analysis holds the greatest potential to remold and personalize diagnostics; however, it requires a multidisciplinary approach and collaboration of many specialists. Despite the fact that breath is considered to be a less complex matrix than blood, it is not commonly used as a diagnostic and prognostic tool for early detection of disordered conditions due to its problematic sampling, analysis, and storage. This review is intended to determine, standardize, and marshal experimental strategies for successful, reliable, and especially, reproducible breath analysis.

Trends in the Development of Electronic Noses Based on Carbon Nanotubes Chemiresistors for Breathomics

The remarkable potential of breath analysis in medical care and diagnosis, and the consequent development of electronic noses, is currently attracting the interest of the research community. This is mainly due to the possibility of applying the technique for early diagnosis, screening campaigns, or tracking the effectiveness of treatment. Carbon nanotubes (CNTs) are known to be good candidates for gas sensing, and they have been recently considered for the development of electronic noses. The present work has the aim of reviewing the available literature on the development of CNTs-based electronic noses for breath analysis applications, detailing the functionalization procedure used to prepare the sensors, the breath sampling techniques, the statistical analysis methods, the diseases under investigation, and the population studied. The review is divided in two main sections: one focusing on the e-noses completely based on CNTs and one reporting on the e-noses that feature sensors based on CNTs, along with sensors based on other materials. Finally, a classification is presented among studies that report on the e-nose capability to discriminate biomarkers, simulated breath, and animal or human breath.

Rapid and accurate determination of trace volatile sulfur compounds in human halitosis by an adaptable active sampling system coupling with gas chromatography

Halitosis with the main components of trace volatile sulfur compounds widely affects the quality of life. In this study, an adaptable active sampling system with two sample-collection modes of direct injection and solid-phase microextraction was developed for the rapid and precise determination of trace volatile sulfur compounds in human halitosis coupled with gas chromatography-flame photometric detection. The active sampling system was well designed and produced for efficiently sampling and precisely determining trace volatile targets in halitosis under the optimized sampling and detection conditions. The analytical method established was successfully applied for the determination of trace targets in halitosis. The limits of detection of H₂ S, CH₃ SH, and CH₃ SCH₃ by direct injection were 0.0140-23.0 μg/L with good recoveries ranging from 82.2 to 118% and satisfactory relative standard deviations of 0.4-9.5% (n = 3), respectively. The limit of detections of CH₃ SH and CH₃ SCH₃ by solid-phase microextraction were 2.03 and 0.186 × 10^-3  μg/L with good recoveries ranging from 98.3 to 108% and relative standard deviations of 5.9-9.0% (n = 3). Trace volatile targets in positive real samples could be actually found and quantified by combination of direct injection and solid-phase microextraction. This method was reliable and efficient for the determination of trace volatile sulfur compounds in halitosis.

Stability control for breath analysis using GC-MS

Gas chromatography mass spectrometry (GC-MS) instruments provide researchers and clinicians with a vast amount of information on sample composition, thus these instruments are seen as gold standard in breath analysis research. However, there are many factors that can confound the data measured by GC-MS instruments. These factors will make interpretation of GC-MS data unreliable for breath analysis research. We present in this paper detailed studies of two of these factors: instrument variation over time and chemical degradation of known biomarkers during storage in sorbent tubes. We found that a single quadrupole MS showed larger variability in measurements than a quadrupole time-of-flight MS when the same mixture of chemical standards was analysed for a period of up to 8 weeks. We recommend procedures of normalising the data. Moreover, the stability studies of breath biomarkers like thioethers, previously found indicative of malaria, showed that there is a need to store the samples in sorbent tubes at low temperature, 6 °C, for no more than 20 days to avoid the total decay of the chemicals.

Temperature-programmed multicapillary gas chromatograph microcolumn for the analysis of odorous sulfur pollutants

We report the fabrication and performance of a silicon-on-glass micro gas chromatography eight-capillary column based on microelectromechanical systems technology that is 50 cm long, 30 μm wide, and 300 μm deep. According to the theory of a gas chromatography column, an even gas flow among different capillaries play a vital role in the peak broadening. Thus, a flow splitter structure is designed by the finite element method through the comparison of the velocity distributions of the eight-capillary columns with and without splitter as well as an open tubular column. The simulation results reveal that eight-capillary column with flow splitters can receive more uniform flow velocity in different capillaries, hence decreases the peak broadening and in turn increases the separation efficiency. The separation experiment results show that the separation efficiency of about 22 000 plates/m is achieved with the chip column temperature programmed for analysis of odorous sulfur pollutants. This figure is nearly two times higher than that of the commercial capillary column coated the similar stationary phase. And the separation time of all the components in the microcolumn is less than 3.8 min, which is faster than the commercial capillary column.

The Different Sensitive Behaviors of a Hydrogen-Bond Acidic Polymer-Coated SAW Sensor for Chemical Warfare Agents and Their Simulants

A linear hydrogen-bond acidic (HBA) linear functionalized polymer (PLF), was deposited onto a bare surface acoustic wave (SAW) device to fabricate a chemical sensor. Real-time responses of the sensor to a series of compounds including sarin (GB), dimethyl methylphosphonate (DMMP), mustard gas (HD), chloroethyl ethyl sulphide (2-CEES), 1,5-dichloropentane (DCP) and some organic solvents were studied. The results show that the sensor is highly sensitive to GB and DMMP, and has low sensitivity to HD and DCP, as expected. However, the sensor possesses an unexpected high sensitivity toward 2-CEES. This good sensing performance can’t be solely or mainly attributed to the dipole-dipole interaction since the sensor is not sensitive to some high polarity solvents. We believe the lone pair electrons around the sulphur atom of 2-CEES provide an electron-rich site, which facilitates the formation of hydrogen bonding between PLF and 2-CEES. On the contrary, the electron cloud on the sulphur atom of the HD molecule is offset or depleted by its two neighbouring strong electron-withdrawing groups, hence, hydrogen bonding can hardly be formed.

Hydrogen sulphide in human nasal air quantified using thermal desorption and selected ion flow tube mass spectrometry

The discovery that hydrogen sulphide (H2S) acts as a gasotransmitter when present at very low concentrations (sub-parts per billion (ppbv)) has resulted in the need to quickly quantify trace amounts of the gas in complex biological samples. Selected ion flow tube mass spectrometry (SIFT-MS) is capable of real-time quantification of H2S but many SIFT-MS instruments lack sufficient sensitivity for this application. In this study we investigate the utility of combining thermal desorption with SIFT-MS for quantifying H2S in the 0.1-1 ppbv concentration range. Human orally or nasally derived breath, and background ambient air, were collected in sampling bags and dried by passing through CaCl2 and H2S pre-concentrated using a sorbent trap optimised for the capture of this gas. The absorbed H2S was then thermally desorbed and quantified by SIFT-MS. H2S concentrations in ambient air, nasal breath and oral breath collected from 10 healthy volunteers were 0.12  ±  0.02 (mean ± SD), 0.40  ±  0.11 and 3.1  ±  2.5 ppbv respectively, and in the oral cavity H2S, quantified by SIFT-MS without pre-concentration, was present at 13.5  ±  8.6 ppbv. The oral cavity H2S correlates well with oral breath H2S but not with nasal breath H2S, suggesting that oral breath H2S derives mainly from the oral cavity but nasal breath is likely pulmonary in origin. The successful quantification of such low concentrations of H2S in nasal air using a rapid analytical procedure paves the way for the straightforward analysis of H2S in breath and may assist in elucidating the role that H2S plays in biological systems.

Breath volatile organic compounds for the gut-fatty liver axis: Promise, peril, and path forward

The worldwide interest in the gut microbiome and its impact on the upstream liver highlight a critical upside to breath research: it can uniquely measure otherwise unmeasurable biology. Bacteria make gases [volatile organic compounds (VOCs)] that are directly relevant to pathophysiology of the fatty liver and associated conditions, including obesity. Measurement of these VOCs and their metabolites in the exhaled breath, therefore, present an opportunity to safely and easily evaluate, on both a personal and a population level, some of our most pressing public health threats. This is an opportunity that must be pursued. To date, however, breath analysis remains a slowly evolving field which only occasionally impacts clinical research or patient care. One major obstacle to progress is that breath analysis is inherently and emphatically mutli-disciplinary: it connects engineering, chemistry, breath mechanics, biology and medicine. Unbalanced or incomplete teams may produce inconsistent and often unsatisfactory results. A second impediment is the lack of a well-known stepwise structure for the development of non-invasive diagnostics. As a result, the breath research landscape is replete with orphaned single-center pilot studies. Often, important hypotheses and key observations have not been pursued to maturation. This paper reviews the rationale and requirements for breath VOC research applied to the gut-fatty liver axis and offers some suggestions for future development.

The human volatilome: volatile organic compounds (VOCs) in exhaled breath, skin emanations, urine, feces and saliva

Breath analysis is a young field of research with its roots in antiquity. Antoine Lavoisier discovered carbon dioxide in exhaled breath during the period 1777-1783, Wilhelm (Vilém) Petters discovered acetone in breath in 1857 and Johannes Müller reported the first quantitative measurements of acetone in 1898. A recent review reported 1765 volatile compounds appearing in exhaled breath, skin emanations, urine, saliva, human breast milk, blood and feces. For a large number of compounds, real-time analysis of exhaled breath or skin emanations has been performed, e.g., during exertion of effort on a stationary bicycle or during sleep. Volatile compounds in exhaled breath, which record historical exposure, are called the 'exposome'. Changes in biogenic volatile organic compound concentrations can be used to mirror metabolic or (patho)physiological processes in the whole body or blood concentrations of drugs (e.g. propofol) in clinical settings-even during artificial ventilation or during surgery. Also compounds released by bacterial strains like Pseudomonas aeruginosa or Streptococcus pneumonia could be very interesting. Methyl methacrylate (CAS 80-62-6), for example, was observed in the headspace of Streptococcus pneumonia in concentrations up to 1420 ppb. Fecal volatiles have been implicated in differentiating certain infectious bowel diseases such as Clostridium difficile, Campylobacter, Salmonella and Cholera. They have also been used to differentiate other non-infectious conditions such as irritable bowel syndrome and inflammatory bowel disease. In addition, alterations in urine volatiles have been used to detect urinary tract infections, bladder, prostate and other cancers. Peroxidation of lipids and other biomolecules by reactive oxygen species produce volatile compounds like ethane and 1-pentane. Noninvasive detection and therapeutic monitoring of oxidative stress would be highly desirable in autoimmunological, neurological, inflammatory diseases and cancer, but also during surgery and in intensive care units. The investigation of cell cultures opens up new possibilities for elucidation of the biochemical background of volatile compounds. In future studies, combined investigations of a particular compound with regard to human matrices such as breath, urine, saliva and cell culture investigations will lead to novel scientific progress in the field.

Comparative analyses of volatile organic compounds (VOCs) from patients, tumors and transformed cell lines for the validation of lung cancer-derived breath markers

Breath analysis for the purpose of non-invasive diagnosis of lung cancer has yielded numerous candidate compounds with still questionable clinical relevance. To arrive at suitable volatile organic compounds our approach combined the analysis of different sources: isolated tumor samples compared to healthy lung tissues, and exhaled breath from lung cancer patients and healthy controls. Candidate compounds were further compared to substances previously identified in the comparison of transformed and normal lung epithelial cell lines. For human studies, a breath sampling device was developed enabling automated and CO2-controlled collection of the end-tidal air. All samples were first preconcentrated on multibed sorption tubes and analyzed with gas chromatography mass spectrometry (GC-MS). Significantly (p < 0.05) higher concentrations in all three types of cancer samples studied were observed for ethanol and n-octane. Additional metabolites (inter alia 2-methylpentane, n-hexane) significantly released by lung cancer cells were observed at higher levels in cancer lung tissues and breath samples (compared to respective healthy controls) with statistical significance (p < 0.05) only in breath samples. The results obtained confirmed the cancer-related origin of volatile metabolites, e.g. ethanol and octane that were both detected at significantly (p < 0.05) elevated concentrations in all three kinds of cancer samples studied. This work is an important step towards identification of volatile breath markers of lung cancer through the demonstration of cancer-related origin of certain volatile metabolites.

Assessment, origin, and implementation of breath volatile cancer markers

A new non-invasive and potentially inexpensive frontier in the diagnosis of cancer relies on the detection of volatile organic compounds (VOCs) in exhaled breath samples. Breath can be sampled and analyzed in real-time, leading to fascinating and cost-effective clinical diagnostic procedures. Nevertheless, breath analysis is a very young field of research and faces challenges, mainly because the biochemical mechanisms behind the cancer-related VOCs are largely unknown. In this review, we present a list of 115 validated cancer-related VOCs published in the literature during the past decade, and classify them with respect to their "fat-to-blood" and "blood-to-air" partition coefficients. These partition coefficients provide an estimation of the relative concentrations of VOCs in alveolar breath, in blood and in the fat compartments of the human body. Additionally, we try to clarify controversial issues concerning possible experimental malpractice in the field, and propose ways to translate the basic science results as well as the mechanistic understanding to tools (sensors) that could serve as point-of-care diagnostics of cancer. We end this review with a conclusion and a future perspective.

Evaluation of septa quality for automatic SPME-GC-MS trace analysis

The vials used for the preparation of breath samples for automated solid-phase microextraction-gas chromatography-mass spectrometry analysis are crimped with septa. These septa often emit specific volatile organic compounds (VOCs) confounding the measurement results of breath samples. In the current paper, 14 different brands of magnetic caps with silicone-polytetrafluoroethylene (PTFE), butyl-PTFE, or butyl rubber septa were tested. The total emission of septa over a 4 h period was also evaluated. The tested septa emitted 39 different compounds, which are mainly hydrocarbons, alcohols, and ketones. Acetone and toluene are the most abundant out-gassing products. The concentration of acetone was in the range from 55 to 694 ppb for butyl-PTFE septum (brand 14) and butyl rubber (brand 10), respectively. The measured toluene amount was 69-1323 ppb for the septum brand 14 and brand 8 (silicone-PTFE), respectively. Generally, the butyl rubber septa released higher amounts of contaminants in comparison to the silicone ones.

Application of GC-MS with a SPME and thermal desorption technique for determination of dimethylamine and trimethylamine in gaseous samples for medical diagnostic purposes

Biogenic amines are interesting compounds which may be of use for medical diagnosis or therapeutic monitoring. The present paper deals with the problems that occur with concentration determination of dimethylamine (DMA) and trimethylamine (TMA). These occur in the breath of people suffering from renal disease. The measurement of amines present in trace concentrations requires the application of suitable analytical methods during sampling, storage and preconcentration. This is particularly so due to their polar and basic properties. In this paper, the application of solid phase microextraction (SPME) and thermal desorption (TD) with subsequent measurement by GC-MS for the determination of amines is discussed. For DMA, preconcentration by SPME did not give satisfactory results. TMA may be analysed using SPME preconcentration with an LOD of 1.5 ppb. Thermal desorption with Tenax as the adsorbing material allows reliable concentration determination for TMA (LOD = 0.5 ppb) and DMA (LOD = 4.6 ppb). DMA cannot be stored reliably in Tedlar bags and longer storage on Tenax (with subsequent TD) does not give good repeatability of results. For TMA, storage can be done on Tenax or in bags, the best results for the latter being achieved with Flex Foil bags.