The possibilities will take your breath away: breath analysis for assessing environmental exposure

In Vivo Solid-Phase Microextraction and Applications in Environmental Sciences

Solid-phase microextraction (SPME) is a well-established sample-preparation technique for environmental studies. The application of SPME has extended from the headspace extraction of volatile compounds to the capture of active components in living organisms via the direct immersion of SPME probes into the tissue (in vivo SPME). The development of biocompatible coatings and the availability of different calibration approaches enable the in vivo sampling of exogenous and endogenous compounds from the living plants and animals without the need for tissue collection. In addition, new geometries such as thin-film coatings, needle-trap devices, recession needles, coated tips, and blades have increased the sensitivity and robustness of in vivo sampling. In this paper, we detail the fundamentals of in vivo SPME, including the various extraction modes, coating geometries, calibration methods, and data analysis methods that are commonly employed. We also discuss recent applications of in vivo SPME in environmental studies and in the analysis of pollutants in plant and animal tissues, as well as in human saliva, breath, and skin analysis. As we show, in vivo SPME has tremendous potential for the targeted and untargeted screening of small molecules in living organisms for environmental monitoring applications.

A headspace collection chamber for whole body volatilomics

The human body secretes a complex blend of volatile organic compounds (VOCs) via the skin, breath and bodily fluids. In this study, we have developed a headspace collection chamber for whole body volatilome profiling.

Rats Sniff Off Toxic Air

Breathing air is a fundamental human need, yet its safety, when challenged by various harmful or lethal substances, is often not properly guarded. For example, air toxicity is currently monitored only for a single or a limited number of known toxicants, thus failing to warn against possible hazardous air fully. Here, we discovered that, within minutes, living rats emitted distinctive profiles of volatile organic compounds (VOCs) via breath when exposed to various airborne toxicants such as endotoxin, O₃, ricin, and CO₂. Compared to background indoor air, when exposed to ricin or endotoxin aerosols, breath-borne VOC levels, especially that of carbon disulfide, were shown to decrease, while their elevated levels were observed for exposure to O₃ and CO₂. A clear contrast in breath-borne VOC profiles of rats exposed to different toxicants was observed with a statistical significance. Differences in microRNA regulations such as miR-33, miR-146a, and miR-155 from rats' blood samples revealed different mechanisms used by rats in combating different air toxicant challenges. Similar to dogs, rats were found here to be able to sniff off toxic air by releasing a specific breath-borne VOC profile. The discovered science opens a new arena for online monitoring of air toxicity and health effects of pollutants.

Human respiratory system as sink for volatile organic compounds: Evidence from field measurements

Human exposure to volatile organic compounds (VOCs) via inhalation might increase the risk of specific diseases. Human breath has been widely investigated as a source of VOCs. However, the role of the human respiratory system as a sink for VOCs is much less studied. In this observational study, the VOC concentrations in inhaled and exhaled air in different environmental conditions were investigated. A total of 98 healthy non-smoking subjects who were exposed to a wide variation in levels of VOCs participated in this study. Individual and statistical results show that human breath could serve as a source for some VOCs and a sink for others, and even when human breath serves as a sink, not all VOCs were 100% absorbed. Interestingly, an increase in inhaled concentrations of toluene was observed to convert human breath from being a source to being a sink. Attention could be given to those VOCs for which humans act as a strong sink.

Automated in Vivo Nanosensing of Breath-Borne Protein Biomarkers

Toxicology and bedside medical condition monitoring is often desired to be both ultrasensitive and noninvasive. However, current biomarker analyses for these purposes are mostly offline and fail to detect low marker quantities. Here, we report a system called dLABer (detection of living animal's exhaled breath biomarker) that integrates living rats, breath sampling, microfluidics, and biosensors for the automated tracking of breath-borne biomarkers. Our data show that dLABer could selectively detect (online) and report differences (of up to 10³-fold) in the levels of inflammation agent interleukin-6 (IL-6) exhaled by rats injected with different ambient particulate matter (PM). The dLABer system was further shown to have an up to 10⁴ higher signal-to-noise ratio than that of the enzyme-linked immunosorbent assay (ELISA) when analyzing the same breath samples. In addition, both blood-borne IL-6 levels analyzed via ELISA in rats injected with different PM extracts and PM toxicity determined by a dithiothreitol (DTT) assay agreed well with those determined by the dLABer system. Video recordings further verified that rats exposed to PM with higher toxicity (according to a DTT assay and as revealed by dLABer) appeared to be less physically active. All the data presented here suggest that the dLABer system is capable of real-time, noninvasive monitoring of breath-borne biomarkers with ultrasensitivity. The dLABer system is expected to revolutionize pollutant health effect studies and bedside disease diagnosis as well as physiological condition monitoring at the single-protein level.

Factors that influence the volatile organic compound content in human breath

BACKGROUND

Thousands of endogenous and exogenous volatile organic compounds (VOCs) are excreted in each breath. Inflammatory and deviant metabolic processes affect the level of endogeneous VOCs, which can serve as specific biomarkers for clinical diagnosis and disease monitoring. Important issues that still need to be tackled are related to potential confounding factors like gender and age and endogenous and exogenous factors, like f.i. smoking.

METHODS

The aim of this study was to systematically access the effect of endogenous and exogenous factors on VOC composition of exhaled breath. In the current study breath samples from 1417 adult participants from the LifeLines cohort, a general population cohort in the Netherlands, were collected and the total content of VOCs was measured using gas chromatography-time-of-flight-mass spectrometry. Breath samples were collected in Groningen and transferred to carbon tubes immediately. These samples were then shipped to Maastricht and measured in batches. VOCs profiles were correlated to 14 relevant characteristics of all participants including age, BMI, smoking and blood cell counts and metabolic parameters as well as to 16 classes of medications.

RESULTS

VOCs profiles were shown to be significantly influenced by smoking behavior and to a lesser extent by age, BMI and gender. These factors need to be controlled for in breath analysis studies. We found no evidence whatsoever in this 1417 subjects' cohort that white blood cell counts, cholesterol or triglycerides levels have an influence on the VOC profile. Thus they may not have to be controlled for in exhaled breath studies.

CONCLUSION

The large cohort of volunteers used here represents a unique opportunity to gauge the factors influencing VOCs profiles in a general population i.e. the most clinically relevant population. Classical clinical parameters and smoking habits clearly influence breath content and should therefore be accounted for in future clinical studies involving breath analysis.

Detection of volatile organic compounds (VOCs) from exhaled breath as noninvasive methods for cancer diagnosis

The detection of cancer at an early stage is often significant in the successful treatment of the disease. Tumor cells have been reported to generate unique cancer volatile organic compound (VOC) profiles which can reflect the disease conditions. The detection and analysis of VOC biomarkers from exhaled breath has been recognized as a new frontier in cancer diagnostics and health inspections owing to its potential in developing rapid, noninvasive, and inexpensive cancer screening tools. To detect specific VOCs of low concentrations from exhaled breath, and to enhance the accuracy of early diagnosis, many breath collection and analysis approaches have been developed. This paper will summarize and critically review the exhaled-breath VOC-related sampling, collection, detection, and analytical methods, especially the recent development in VOC sensors. VOC sensors are commonly inexpensive, portable, programmable, easy to use, and can obtain data in real time with high sensitivities. Therefore, many sensor-based VOC detection techniques have huge potential in clinical point-of-care use.

Breath analysis: technical developments and challenges in the monitoring of human exposure to volatile organic compounds

At present, there is a growing concern about human quality of life. In particular, there is an awareness of the impact of volatile organic compounds (VOCs) on the environment and human health, so the monitoring of human exposure to VOCs is an increasingly urgent need. Biomonitoring is theoretically more accurate compared with traditional ambient air monitoring, and it plays an essential role in human environmental exposure assessment. Breath analysis is a biomonitoring method with many advantages, which is applicable to assessments of human exposure to a large number of VOCs. Techniques are being developed to improve the sensitivity and precision of breath analysis based on in-direct and direct measurements which will be reviewed in this paper. This paper briefly reviews the frequently used methods in both of these categories, specifically highlighting some promising new techniques. Furthermore, this review also provides theoretical background knowledge about the use of breath analysis as a biomonitoring tool for human exposure assessment. A review of the application of breath analysis to human exposure monitoring during last two decades is also provided according to occupational/non-occupational exposure. Obstacles and potential challenges in this field are also summarized. Based on the gradual improvements in the theoretical basis and technology reviewed in this paper, breath analysis is an enormous potential approach for the monitoring of human exposure to VOCs.

A rapid method for the chromatographic analysis of volatile organic compounds in exhaled breath of tobacco cigarette and electronic cigarette smokers

A method for the rapid analysis of volatile organic compounds (VOCs) in smoke from tobacco and electronic cigarettes and in exhaled breath of users of these smoking systems has been developed. Both disposable and rechargeable e-cigarettes were considered. Smoke or breath were collected in Bio-VOCs. VOCs were then desorbed in Tenax cartridges which were subsequently analyzed by thermal desorption coupled to gas chromatography-mass spectrometry. The method provides consistent results when comparing the VOC compositions from cigarette smoke and the equivalent exhaled breath of the smokers. The differences in composition of these two sample types are useful to ascertain which compounds are retained in the respiratory system after tobacco cigarette or e-cigarette smoking. Strong differences were observed in the VOC composition of tobacco cigarette smoke and exhaled breath when comparing with those of e-cigarette smoking. The former involved transfers of a much larger burden of organic compounds into smokers, including benzene, toluene, naphthalene and other pollutants of general concern. e-Cigarettes led to strong absorptions of propylene glycol and glycerin in the users of these systems. Tobacco cigarettes were also those showing highest concentration differences between nicotine concentrations in smoke and exhaled breath. The results from disposable e-cigarettes were very similar to those from rechargeable e-cigarettes.

Technologies for Clinical Diagnosis Using Expired Human Breath Analysis

This review elucidates the technologies in the field of exhaled breath analysis. Exhaled breath gas analysis offers an inexpensive, noninvasive and rapid method for detecting a large number of compounds under various conditions for health and disease states. There are various techniques to analyze some exhaled breath gases, including spectrometry, gas chromatography and spectroscopy. This review places emphasis on some of the critical biomarkers present in exhaled human breath, and its related effects. Additionally, various medical monitoring techniques used for breath analysis have been discussed. It also includes the current scenario of breath analysis with nanotechnology-oriented techniques.

Clinical application of volatile organic compound analysis for detecting infectious diseases

This review article introduces the significance of testing of volatile organic compounds (VOCs) in clinical samples and summarizes important features of some of the technologies. Compared to other human diseases such as cancer, studies on VOC analysis in cases of infectious diseases are limited. Here, we have described results of studies which have used some of the appropriate technologies to evaluate VOC biomarkers and biomarker profiles associated with infections. The publications reviewed include important infections of the respiratory tract, gastrointestinal tract, urinary tract, and nasal cavity. The results highlight the use of VOC biomarker profiles resulting from certain infectious diseases in discriminating between infected and healthy subjects. Infection-related VOC profiles measured in exhaled breath as well as from headspaces of feces or urine samples are a source of information with respect to disease detection. The volatiles emitted in clinical matrices may on the one hand represent metabolites of the infecting pathogen or on the other hand reflect pathogen-induced host responses or, indeed, a combination of both. Because exhaled-breath samples are easy to collect and online instruments are commercially available, VOC analysis in exhaled breath appears to be a promising tool for noninvasive detection and monitoring of infectious diseases.

Environmental mass spectrometry

Environmental mass spectrometry is an important branch of science because it provides many of the data that underlie policy decisions that can directly influence the health of people and ecosystems. Environmental mass spectrometry is currently undergoing rapid development. Among the most relevant directions are a significant broadening of the lists of formally targeted compounds; a parallel interest in nontarget chemicals; an increase in the reliability of analyses involving accurate mass measurements, tandem mass spectrometry, and isotopically labeled standards; and a shift toward faster high-throughput analysis, with minimal sample preparation, involving various approaches, including ambient ionization techniques and miniature instruments. A real revolution in analytical chemistry could be triggered with the appearance of robust, simple, and sensitive portable mass spectrometers that can utilize ambient ionization techniques. If the cost of such instruments is reduced to a reasonable level, mass spectrometers could become valuable household devices.

Molecular and microscopic analysis of bacteria and viruses in exhaled breath collected using a simple impaction and condensing method

Exhaled breath condensate (EBC) is increasingly being used as a non-invasive method for disease diagnosis and environmental exposure assessment. By using hydrophobic surface, ice, and droplet scavenging, a simple impaction and condensing based collection method is reported here. Human subjects were recruited to exhale toward the device for 1, 2, 3, and 4 min. The exhaled breath quickly formed into tiny droplets on the hydrophobic surface, which were subsequently scavenged into a 10 µL rolling deionized water droplet. The collected EBC was further analyzed using culturing, DNA stain, Scanning Electron Microscope (SEM), polymerase chain reaction (PCR) and colorimetry (VITEK 2) for bacteria and viruses.Experimental data revealed that bacteria and viruses in EBC can be rapidly collected using the method developed here, with an observed efficiency of 100 µL EBC within 1 min. Culturing, DNA stain, SEM, and qPCR methods all detected high bacterial concentrations up to 7000 CFU/m(3) in exhaled breath, including both viable and dead cells of various types. Sphingomonas paucimobilis and Kocuria variants were found dominant in EBC samples using VITEK 2 system. SEM images revealed that most bacteria in exhaled breath are detected in the size range of 0.5-1.0 µm, which is able to enable them to remain airborne for a longer time, thus presenting a risk for airborne transmission of potential diseases. Using qPCR, influenza A H3N2 viruses were also detected in one EBC sample. Different from other devices restricted solely to condensation, the developed method can be easily achieved both by impaction and condensation in a laboratory and could impact current practice of EBC collection. Nonetheless, the reported work is a proof-of-concept demonstration, and its performance in non-invasive disease diagnosis such as bacterimia and virus infections needs to be further validated including effects of its influencing matrix.

Simultaneous indoor and outdoor on-line hourly monitoring of atmospheric volatile organic compounds in an urban building. The role of inside and outside sources

Indoor air quality (IAQ) has become a very important issue in recent years. As in developed countries people spend more than 90% of their time indoors, besides outdoor pollution assessment, the indoor one is also required. IAQ is not only affected by indoor sources linked to indoor activities, outdoor sources such as road or street traffic and industrial and commercial activities have their role too. Volatile organic compounds (VOCs) frequently show higher indoor mixing ratios with respect to the outdoor ones, and monitoring is required to report their indoor mixing ratios. Many studies have reported average indoor VOCs' mixing ratios in different environments, but their temporal variability has not been well documented. The main objective of this work was to simultaneously measure VOCs' indoor and outdoor mixing ratios with high time-resolution in order to assess the effect of sources inside and outside the building upon indoor mixing ratios of individual VOCs. Simultaneous hourly, continuous, and on-line measurements of C(2)-C(11) VOCs were performed inside and outside the School of Engineering of Bilbao (ETSI) building, located in the city center of Bilbao, an urban area in Northern Spain. The analysis of simultaneous data allowed the classification of VOCs based on their main sources. Some VOCs were mainly emitted by indoor sources (1-pentene, 2-methylpentane, n-hexane, methylcyclopentane, benzene, 1-heptene+2,2,4-trimethylbenzene, and tetrachloroethylene) or by outdoor sources (n-heptane, C(8) alkanes except trimethylpentanes and C(9) aromatics). Other VOCs, such as toluene, were emitted by both indoor and outdoor sources. The isoprene indoor pattern indicated that its main indoor source could be the air exhaled by people occupying the building. Some halocarbons, such as trichloroethylene, tetrachloroethylene, and carbon tetrachloride may be generated from the use inside the building of chlorine bleach containing products.