A fully integrated standalone portable cavity ringdown breath acetone analyzer

Breath-based biosensors and system development for noninvasive detection of diabetes: A review

BACKGROUND AND AIMS

In recent years, noninvasive techniques are becoming conspicuous for diabetes detection. Sweat, tear, saliva, urine and breath-based methods showing prominent results in breath acetone detection which is considered as a biomarker of diabetes. A concrete relationship between breath acetone and BG helps in the development of devices for diabetes detection.

METHODS

The primary source for this study includes scholarly publications that primarily focus on the development of biosensors and systems for diabetes detection using acetone present in breath. Articles were analysed to examine various types of biosensors with their sensing materials to provide acetone detection limits. Recent noninvasive systems and products have been investigated and determine the relationship between breath acetone and BG levels.

RESULTS

Breath-based biosensor technologies are capable for diabetes detection. The acetone biosensor detection ranges from 100 ppb to 100 ppm, and it can applicable from room temperature to 400 °C. In healthy volunteers, acetone level ranges from 0.32 to 2.19 ppm, while patients with diabetes exhibit a wider range of 0.22-21 ppm depending on the biosensor, detection method, and clinical circumstances of patients and lab conditions.

CONCLUSION

This manuscript presents an extensive analysis of breath-based biosensors and their potential for detection of diabetes. Acetone detection methods are promising but unable to provide concrete correlation between breath acetone and blood glucose levels. The present study motivates the continued research and development of biosensors, and electronic devices to provide linear relationship of breath acetone and BG for noninvasive diabetes detection applications.

A combined screening study for evaluating the potential of exhaled acetone, isoprene, and nitric oxide as biomarkers of lung cancer

Background: the early lung cancer (LC) screening strategy significantly reduces LC mortality. According to previous studies, lung cancer can be effectively diagnosed by analyzing the concentration of volatile organic compounds (VOCs) in human exhaled breath and establishing a diagnosis model based on the different VOCs. This method, called breath analysis, has the advantage of being rapid and non-invasive. To develop a non-invasive, portable breath detection instrument based on cavity ring-down spectroscopy (CRDS), we explored the feasibility of establishing a model with acetone, isoprene, and nitric oxide (NO) exhaled through human breath, which can be detected on the CRDS instrument. Methods: a total of 511 participants were recruited from the Cancer Institute and Hospital, Tianjin Medical University as the discovery set and randomly split (2 : 1) into training set and internal validation set with stratification. For external validation, 51 participants were recruited from the General Hospital, Tianjin Medical University. Acetone and isoprene from exhaled breath were detected by proton-transfer-reaction time-of-flight mass spectrometry (PTR-TOF-MS), and NO was measured using CRDS. The model was constructed using the ensemble learning method that set eXtreme gradient boosting and logistic regression as the basis model and logistic regression as the senior model. The model was evaluated based on accuracy, sensitivity, and specificity. Results: the model achieved an accuracy of 78.8%, sensitivity of 81.0%, specificity of 70.0%, and area under the receiver operating curve (ROC, AUC) of 0.8341 (95% CI from 0.8055 to 0.8852) in the internal validation set. Furthermore, it attained an accuracy of 66.7%, sensitivity of 68.2%, specificity of 65.5%, and AUC of 0.6834 (95% CI from 0.5259 to 0.7956) in the external validation set. Conclusion: the model, established with acetone, isoprene, and NO as predictors, possesses the ability to identify LC patients from healthy control (HC) participants. The CRDS instrument, which simultaneously detects acetone, isoprene, and NO, is expected to be a non-invasive, rapid, portable, and accurate device for early screening of LC.

A sub-ppbv-level Acetone and Ethanol Quantum Cascade Laser Based Photoacoustic Sensor - Characterization and Multi-Component Spectra Recording in Synthetic Breath

Trace gas analysis in breath is challenging due to the vast number of different components. We present a highly sensitive quantum cascade laser based photoacoustic setup for breath analysis. Scanning the range between 8263 and 8270 nm with a spectral resolution of 48 pm, we are able to quantify acetone and ethanol within a typical breath matrix containing water and CO2. We photoacoustically acquired spectra within this region of mid-infra-red light and prove that those spectra do not suffer from non-spectral interferences. The purely additive behavior of a breath sample spectrum was verified by comparing it with the independently acquired single component spectra using Pearson and Spearman correlation coefficients. A previously presented simulation approach is improved and an error attribution study is presented. With a 3σ detection limit of 6.5 ppbv in terms of ethanol and 250 pptv regarding acetone, our system is among the best performing presented so far.

Acetone sensing in liquid and gas phases using cyclic voltammetry

This paper presents the use of cyclic voltammetry to measure acetone concentration in liquid and vapor forms at disposable screen-printed electrodes of platinum working electrode, platinum counter electrode, and silver/silver chloride reference electrode. The main characteristics of the acetone sensor including its linearity, sensitivity, reproducibility, and limit of detection (LOD) were studied by doing different experiments to test both liquid and vapor samples in the physiological range of 1 µM to 10 mM. The change in acetone concentration was monitored by comparing the lineshape of butterfly region before and after injecting the acetone sample in the baseline solution that contains 0.5 M H₂SO₄. The sensor was shown to have a good sensitivity, reproducibility, and a linear response with respect to the acetone concentration in both liquid and gas phases over a range of 1 µM to 10 mM with R² > 0.97 and LOD of 0.1 µM. The system stability was improved by building a closed glass system to reduce the exchange of acetone with the surrounding air in an open environment. The closed system was tested using vapor samples and the error bars in the calibration curve were reduced to more than half of their values before using the closed system. The new system will be used extensively in future for an enzyme-based acetone sensor that will be used for diabetes monitoring.

Breath acetone concentration: too heterogeneous to constitute a diagnosis or prognosis biomarker in heart failure? A systematic review and meta-analysis

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.

Vacuum Ultraviolet Absorption Spectroscopy Analysis of Breath Acetone Using a Hollow Optical Fiber Gas Cell

Human breath is a biomarker of body fat metabolism and can be used to diagnose various diseases, such as diabetes. As such, in this paper, a vacuum ultraviolet (VUV) spectroscopy system is proposed to measure the acetone in exhaled human breath. A strong absorption acetone peak at 195 nm is detected using a simple system consisting of a deuterium lamp source, a hollow-core fiber gas cell, and a fiber-coupled compact spectrometer corresponding to the VUV region. The hollow-core fiber functions both as a long-path and an extremely small-volume gas cell; it enables us to sensitively measure the trace components of exhaled breath. For breath analysis, we apply multiple regression analysis using the absorption spectra of oxygen, water, and acetone standard gas as explanatory variables to quantitate the concentration of acetone in breath. Based on human breath, we apply the standard addition method to obtain the measurement accuracy. The results suggest that the standard deviation is 0.074 ppm for healthy human breath with an acetone concentration of around 0.8 ppm and a precision of 0.026 ppm. We also monitor body fat burn based on breath acetone and confirm that breath acetone increases after exercise because it is a volatile byproduct of lipolysis.

Exhaled breath analysis using cavity-enhanced optical techniques: a review

Cavity-enhanced absorption spectroscopies (CEAS) have gained importance in a wide range of applications in molecular spectroscopy. The development of optical sensors based on the CEAS techniques coupled with the continuous wave or pulsed laser sources operating in the mid-infrared or near-infrared spectral regime uniquely offers molecularly selective and ultra-sensitive detection of trace species in complex matrices including exhaled human breath. In this review, we discussed recent applications of CEAS for analyzing trace constituents within the exhaled breath matrix facilitating the non-invasive assessment of human health status. Next to a brief discussion on the mechanisms of formation of trace components found in the exhaled breath matrix related to particular disease states, existing challenges in CEAS and future development towards non-invasive clinical diagnostics will be discussed.

On-Line Analysis of Exhaled Breath Focus Review

On-line analysis of exhaled breath offers insight into a person's metabolism without the need for sample preparation or sample collection. Due to its noninvasive nature and the possibility to sample continuously, the analysis of breath has great clinical potential. The unique features of this technology make it an attractive candidate for applications in medicine, beyond the task of diagnosis. We review the current methodologies for on-line breath analysis, discuss current and future applications, and critically evaluate challenges and pitfalls such as the need for standardization. Special emphasis is given to the use of the technology in diagnosing respiratory diseases, potential niche applications, and the promise of breath analysis for personalized medicine. The analytical methodologies used range from very small and low-cost chemical sensors, which are ideal for continuous monitoring of disease status, to optical spectroscopy and state-of-the-art, high-resolution mass spectrometry. The latter can be utilized for untargeted analysis of exhaled breath, with the capability to identify hitherto unknown molecules. The interpretation of the resulting big data sets is complex and often constrained due to a limited number of participants. Even larger data sets will be needed for assessing reproducibility and for validation of biomarker candidates. In addition, molecular structures and quantification of compounds are generally not easily available from on-line measurements and require complementary measurements, for example, a separation method coupled to mass spectrometry. Furthermore, a lack of standardization still hampers the application of the technique to screen larger cohorts of patients. This review summarizes the present status and continuous improvements of the principal on-line breath analysis methods and evaluates obstacles for their wider application.

Nanostructured P3HT as a Promising SensingElement for Real-Time, Dynamic Detection ofGaseous Acetone

The dynamic response of gas sensors based on poly(3-hexylthiophene) (P3HT) nanofibers (NFs) to gaseous acetone was assessed using a setup based on flow-injection analysis, aimed at emulating actual breath exhalation. The setup was validated by using a commercially available sensor. The P3HT NFs sensors tested in dynamic flow conditions showed satisfactory reproducibility down to about 3.5 ppm acetone concentration, a linear response over a clinically relevant concentration range (3.5-35 ppm), excellent baseline recovery and reversibility upon repeated exposures to the analyte, short pulse rise and fall times (less than 1 s and about 2 s, respectively) and low power consumption (few nW), with no relevant response to water. Comparable responses’ decay times under either nitrogen or dry air suggest that the mechanisms at work is mainly attributable to specific analyte-semiconducting polymer interactions. These results open the way to the use of P3HT NFs-based sensing elements for the realization of portable, real-time electronic noses for on-the-fly exhaled breath analysis.

Evolution of clinical and environmental health applications of exhaled breath research: Review of methods and instrumentation for gas-phase, condensate, and aerosols

Human breath, along with urine and blood, has long been one of the three major biological media for assessing human health and environmental exposure. In fact, the detection of odor on human breath, as described by Hippocrates in 400 BC, is considered the first analytical health assessment tool. Although less common in comparison to contemporary bio-fluids analyses, breath has become an attractive diagnostic medium as sampling is non-invasive, unlimited in timing and volume, and does not require clinical personnel. Exhaled breath, exhaled breath condensate (EBC), and exhaled breath aerosol (EBA) are different types of breath matrices used to assess human health and disease state. Over the past 20 years, breath research has made many advances in assessing health state, overcoming many of its initial challenges related to sampling and analysis. The wide variety of sampling techniques and collection devices that have been developed for these media are discussed herein. The different types of sensors and mass spectrometry instruments currently available for breath analysis are evaluated as well as emerging breath research topics, such as cytokines, security and airport surveillance, cellular respiration, and canine olfaction.

Real-Time Analysis of Isoprene in Breath by Using Ultraviolet-Absorption Spectroscopy with a Hollow Optical Fiber Gas Cell

A breath analysis system based on ultraviolet-absorption spectroscopy was developed by using a hollow optical fiber as a gas cell for real-time monitoring of isoprene in breath. The hollow optical fiber functions as an ultra-small-volume gas cell with a long path. The measurement sensitivity of the system was evaluated by using nitric-oxide gas as a gas sample. The evaluation result showed that the developed system, using a laser-driven, high-intensity light source and a 3-m-long, aluminum-coated hollow optical fiber, could successfully measure nitric-oxide gas with a 50 ppb concentration. An absorption spectrum of a breath sample in the wavelength region of around 200–300 nm was measured, and the measured spectrum revealed the main absorbing components in breath as water vapor, isoprene, and ozone converted from oxygen by radiation of ultraviolet light. The concentration of isoprene in breath was estimated by multiple linear regression. The regression analysis results showed that the proposed analysis system enables real-time monitoring of isoprene during the exhaling of breath. Accordingly, it is suitable for measuring the circadian variation of isoprene.

Portable Device for Measuring Breath Acetone Based on Sample Preconcentration and Cavity Enhanced Spectroscopy

A portable and compact device is demonstrated for measuring acetone in breath samples. The device features a 7 cm long high finesse optical cavity as an optical sensor that is coupled to a miniature adsorption preconcentrator containing 0.5 g of polymer material. Acetone is trapped out of breath and released into the optical cavity where it is probed by a near-infrared diode laser operating at ∼1670 nm. With an optical cavity mirror reflectivity of 99.994%, a limit of detection of 159 ppbv (1σ) is demonstrated on samples from breath bags. Initial results on direct breath sampling are presented with a precision of 100 ppbv. The method is validated with measurements made using an ion-molecule reaction mass spectrometer. Data are presented on elevated breath acetone from two individuals following an overnight fast and exercise, and from a third individual during several days of routine behavior.