Every breath you take: The value of the electronic nose (e-nose) technology in the early detection of lung cancer

Nanoporous MoS2 Field-Effect Transistor Based Artificial Olfaction: Achieving Enhanced Volatile Organic Compound Detection Inspired by the Drosophila Olfactory System

Olfaction, a primal and effective sense, profoundly impacts our emotions and instincts. This sensory system plays a crucial role in detecting volatile organic compounds (VOCs) and realizing the chemical environment. Animals possess superior olfactory systems compared to humans. Thus, taking inspiration from nature, artificial olfaction aims to achieve a similar level of excellence in VOC detection. In this study, we present the development of an artificial olfaction sensor utilizing a nanostructured bio-field-effect transistor (bio-FET) based on transition metal dichalcogenides and the Drosophila odor-binding protein LUSH. To create an effective sensing platform, we prepared a hexagonal nanoporous structure of molybdenum disulfide (MoS2) using block copolymer lithography and selective etching techniques. This structure provides plenty of active sites for the integration of the LUSH protein, enabling enhanced binding with ethanol (EtOH) for detection purposes. The coupling of the biomolecule with EtOH influences the bio-FETs potential, which generates indicative electrical signals. By mimicking the sniffing techniques observed in Drosophila, these bio-FETs exhibit an impressive limit of detection of 10-6% for EtOH, with high selectivity, sensitivity, and detection ability even in realistic environments. This bioelectric sensor demonstrates substantial potential in the field of artificial olfaction, offering advancements in VOC detection.

Does the last 20 years paradigm of clinical research using volatile organic compounds to non-invasively diagnose cancer need to change? Challenges and future direction

PURPOSE

Volatile organic compounds (VOCs) have shown great potential as novel biomarkers for cancer detection; however, comprehensive quantitative analysis is lacking. In this study, we performed a bibliometric analysis of non-invasive cancer diagnosis using VOCs to better characterise international trends and to predict future hotspots in this field, and then we focussed on human studies to analyse clinical characteristics for presenting the current controversies and future perspectives of further clinical work.

METHODS

Publications, from 2002 to 2022, were retrieved from the Web of Science Core Collection database. CiteSpace and VOSviewer were used to generate network maps and identify the annual publications, top countries, authors, institutions, journals, references, and keywords. Then, we further screened clinical trials, and the key information was extracted into Microsoft Excel for further systematical analysis.

RESULTS

Six hundred and forty-one articles were identified to evaluate research trends, of which 301 clinical trials were selected for further systematical analysis. Overall, the annual publications in this area increased, with an overall upward trend, while the quality of clinical research remains remarkably uneven.

CONCLUSION

The study of non-invasive cancer diagnosis using VOCs would continue to be an active field. However, without stringent clinical design criteria, most suitable acquisition and analysis devices and statistical approaches, a list of exclusive, specific, reliable and reproducible VOCs to identify a disease and these VOCs appearing in a breath at detectable levels at early stage disease, the clinical utility of VOC tests will be difficult to have any breakthroughs.

Breath Testing in the Surgical Setting: Applications, Challenges, and Future Perspectives

BACKGROUND

The potential for exhaled breath to be a valuable diagnostic tool is often overlooked as it can be difficult to imagine how a barely visible sample of breath could hold such a rich source of information about the state of our health. However, technological advances over the last 50 years have enabled us to detect volatile organic compounds (VOCs) present in exhaled breath, and this provides the key to understanding the wealth of information contained within these readily available samples.

SUMMARY

VOCs are produced as a by-product of metabolism; hence, changes in the underlying physiological processes will be reflected in the exact composition of VOCs in exhaled breath. It has been shown that characteristic changes occur in the breath VOC profile associated with certain diseases including cancer, which may enable the non-invasive detection of cancer at primary care level for patients with vague symptoms. The use of breath testing as a diagnostic tool has many advantages. It is non-invasive and quick, and the test is widely accepted by patients and clinicians. However, breath samples provide a snapshot of the VOCs present in a particular patient at a given point in time, so this can be heavily influenced by external factors such as diet, smoking, and the environment. These must all be accounted for when attempting to draw conclusions about disease status. This review focuses on the current applications for breath testing in the field of surgery, as well as discussing the challenges encountered with developing a breath test in a clinical environment. The future of breath testing in the surgical setting is also discussed, including the translation of breath research into clinical practice.

KEY MESSAGES

Analysis of VOCs in exhaled breath can identify the presence of underlying disease including cancer as well as other infectious or inflammatory conditions. Despite the patient factors, environmental factors, storage, and transport considerations that must be accounted for, breath testing demonstrates ideal characteristics for a triage test, being non-invasive, simple, and universally acceptable to patients and clinicians. Many novel biomarkers and diagnostic tests fail to translate into clinical practice because their potential clinical application does not align with the requirements and unmet needs of the healthcare sector. Non-invasive breath testing, however, has the great potential to revolutionise the early detection of diseases, such as cancer, in the surgical setting for patients with vague symptoms.

Exhaled breath analysis using GC-MS and an electronic nose for lung cancer diagnostics

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.

Recent Trends in Exhaled Breath Diagnosis Using an Artificial Olfactory System

Artificial olfactory systems are needed in various fields that require real-time monitoring, such as healthcare. This review introduces cases of detection of specific volatile organic compounds (VOCs) in a patient's exhaled breath and discusses trends in disease diagnosis technology development using artificial olfactory technology that analyzes exhaled human breath. We briefly introduce algorithms that classify patterns of odors (VOC profiles) and describe artificial olfactory systems based on nanosensors. On the basis of recently published research results, we describe the development trend of artificial olfactory systems based on the pattern-recognition gas sensor array technology and the prospects of application of this technology to disease diagnostic devices. Medical technologies that enable early monitoring of health conditions and early diagnosis of diseases are crucial in modern healthcare. By regularly monitoring health status, diseases can be prevented or treated at an early stage, thus increasing the human survival rate and reducing the overall treatment costs. This review introduces several promising technical fields with the aim of developing technologies that can monitor health conditions and diagnose diseases early by analyzing exhaled human breath in real time.

Opto-Electronic Nose Coupled to a Silicon Micro Pre-Concentrator Device for Selective Sensing of Flavored Waters

Headspace analysis of highly humid samples remains a challenge for artificial olfaction. Based on surface plasmon resonance imaging and bio-based sensors, the NeOse Pro olfactive analyzer yields multivariate data and enhances the statistical discrimination capacity of odor patterns. However, the presence of a high background signal, such as water vapor from aqueous samples, may deteriorate its discriminant ability. Recently, miniaturized pre-concentrators packed with hydrophobic adsorbent have been developed to improve the detection limit of gas analysis methods and to enhance their selectivity by reducing the water’s background signal. This work presents, for the first time, the coupling of a miniaturized silicon micro pre-concentration unit (µPC) to a bio-based opto-electronic nose (NeOse Pro). The results showed that the coupling of a silicon µPC with the NeOse Pro led to an improvement in the detection limit of n-nonane by at least a factor of 125. Additionally, principal component analysis (PCA) of eight different flavored waters showed an enhanced discrimination ability of the coupled set-up in highly humid conditions.

A review of breath analysis techniques in head and neck cancer

Cancers of the head and neck region are a severely disabling group of diseases with no method for early detection. Analysis of exhaled breath volatile organic compounds shows promise as biomarkers for early detection and disease monitoring. This article reviews breath analysis in the setting of head and neck cancer, with a practical focus on breath sampling techniques, detection technologies and valid data analysis methods. Title and abstract keyword searches were conducted on PubMed and Embase databases to identify English language studies without a time-period limitation. The main inclusion criteria were human studies comparing head and neck cancer patients to healthy controls using exhaled breath analysis. Multiple breath collection techniques, three major detection technologies and multiple data analysis methods were identified. However, the variability in techniques and lack of methodological standardization does not allow for adequate study replication or data pooling. Twenty-two volatile organic compounds identified in five studies have been reported to discriminate head and neck cancer patients from healthy controls. Breath analysis for detection of head and neck cancer shows promise as a non-invasive detection tool. However, methodological standardization is paramount for future research study design to provide the potential for translating these techniques into routine clinical use.

A Novel Subspace Alignment-Based Interference Suppression Method for the Transfer Caused by Different Sample Carriers in Electronic Nose

A medical electronic nose (e-nose) with 31 gas sensors is used for wound infection detection by analyzing the bacterial metabolites. In practical applications, the prediction accuracy drops dramatically when the prediction model established by laboratory data is directly used in human clinical samples. This is a key issue for medical e-nose which should be more worthy of attention. The host (carrier) of bacteria can be the culture solution, the animal wound, or the human wound. As well, the bacterial culture solution or animals (such as: mice, rabbits, etc.) obtained easily are usually used as experimental subjects to collect sufficient sensor array data to establish the robust predictive model, but it brings another serious interference problem at the same time. Different carriers have different background interferences, therefore the distribution of data collected under different carriers is different, which will make a certain impact on the recognition accuracy in the detection of human wound infection. This type of interference problem is called "transfer caused by different sample carriers". In this paper, a novel subspace alignment-based interference suppression (SAIS) method with domain correction capability is proposed to solve this interference problem. The subspace is the part of space whose dimension is smaller than the whole space, and it has some specific properties. In this method, first the subspaces of different data domains are gotten, and then one subspace is aligned to another subspace, thereby the problem of different distributions between two domains is solved. From experimental results, it can be found that the recognition accuracy of the infected rat samples increases from 29.18% (there is no interference suppression) to 82.55% (interference suppress by SAIS).

Protein- and Peptide-Based Biosensors in Artificial Olfaction

Animals' olfactory systems rely on proteins, olfactory receptors (ORs) and odorant-binding proteins (OBPs), as their native sensing units to detect odours. Recent advances demonstrate that these proteins can also be employed as molecular recognition units in gas-phase biosensors. In addition, the interactions between odorant molecules and ORs or OBPs are a source of inspiration for designing peptides with tunable odorant selectivity. We review recent progress in gas biosensors employing biological units (ORs, OBPs, and peptides) in light of future developments in artificial olfaction, emphasizing examples where biological components have been employed to detect gas-phase analytes.