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Capuano R, Ciotti M, Catini A, Bernardini S, Di Natale C. Clinical applications of volatilomic assays. Crit Rev Clin Lab Sci 2024:1-20. [PMID: 39129534 DOI: 10.1080/10408363.2024.2387038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/23/2024] [Accepted: 07/29/2024] [Indexed: 08/13/2024]
Abstract
The study of metabolomics is revealing immense potential for diagnosis, therapy monitoring, and understanding of pathogenesis processes. Volatilomics is a subcategory of metabolomics interested in the detection of molecules that are small enough to be released in the gas phase. Volatile compounds produced by cellular processes are released into the blood and lymph, and can reach the external environment through different pathways, such as the blood-air interface in the lung that are detected in breath, or the blood-water interface in the kidney that leads to volatile compounds detected in urine. Besides breath and urine, additional sources of volatile compounds such as saliva, blood, feces, and skin are available. Volatilomics traces its roots back over fifty years to the pioneering investigations in the 1970s. Despite extensive research, the field remains in its infancy, hindered by a lack of standardization despite ample experimental evidence. The proliferation of analytical instrumentations, sample preparations and methods of volatilome sampling still make it difficult to compare results from different studies and to establish a common standard approach to volatilomics. This review aims to provide an overview of volatilomics' diagnostic potential, focusing on two key technical aspects: sampling and analysis. Sampling poses a challenge due to the susceptibility of human samples to contamination and confounding factors from various sources like the environment and lifestyle. The discussion then delves into targeted and untargeted approaches in volatilomics. Some case studies are presented to exemplify the results obtained so far. Finally, the review concludes with a discussion on the necessary steps to fully integrate volatilomics into clinical practice.
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Affiliation(s)
- Rosamaria Capuano
- Department of Electronic Engineering, University of Rome Tor Vergata, Roma, Italy
- Interdepartmental Center for Volatilomics, "A. D'Amico", University of Rome Tor Vergata, Rome, Italy
| | - Marco Ciotti
- Department of Laboratory Medicine, University Hospital Tor Vergata, Rome, Italy
| | - Alexandro Catini
- Department of Electronic Engineering, University of Rome Tor Vergata, Roma, Italy
- Interdepartmental Center for Volatilomics, "A. D'Amico", University of Rome Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Interdepartmental Center for Volatilomics, "A. D'Amico", University of Rome Tor Vergata, Rome, Italy
- Department of Laboratory Medicine, University Hospital Tor Vergata, Rome, Italy
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Corrado Di Natale
- Department of Electronic Engineering, University of Rome Tor Vergata, Roma, Italy
- Interdepartmental Center for Volatilomics, "A. D'Amico", University of Rome Tor Vergata, Rome, Italy
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2
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Wijsman PC, Goorsenberg AWM, d'Hooghe JNS, Weersink EJM, Fenn DW, Maitland van der Zee AH, Annema JT, Brinkman P, Bonta PI. Exhaled breath analyses for bronchial thermoplasty in severe asthma patients. Respir Med 2024; 225:107583. [PMID: 38447787 DOI: 10.1016/j.rmed.2024.107583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/10/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma. Although multiple trials have demonstrated clinical improvement after BT, optimal patient selection remains a challenge and the mechanism of action is incompletely understood. The aim of this study was to examine whether exhaled breath analysis can contribute to discriminate between BT-responders and non-responders at baseline and to explore pathophysiological insights of BT. METHODS Exhaled breath was collected from patients at baseline and six months post-BT. Patients were defined as responders or non-responders based on a half point increase in asthma quality of life questionnaire scores. Gas chromatography-mass spectrometry was used for volatile organic compounds (VOCs) detection and analyses. Analytical workflow consisted of: 1) detection of VOCs that differentiate between responders and non-responders and those that differ between baseline and six months post-BT, 2) identification of VOCs of interest and 3) explore correlations between clinical biomarkers and VOCs. RESULTS Data was available from 14 patients. Nonanal, 2-ethylhexanol and 3-thujol showed a significant difference in intensity between responders and non-responders at baseline (p = 0.04, p = 0.01 and p = 0.03, respectively). After BT, no difference was found in the compound intensity of these VOCs. A negative correlation was observed between nonanal and IgE and BALF eosinophils (r = -0.68, p < 0.01 and r = -0.61, p = 0.02 respectively) and 3-thujol with BALF neutrophils (r = -0.54, p = 0.04). CONCLUSIONS This explorative study identified discriminative VOCs in exhaled breath between BT responders and non-responders at baseline. Additionally, correlations were found between VOC's and inflammatory BALF cells. Once validated, these findings encourage research in breath analysis as a non-invasive easy to apply technique for identifying airway inflammatory profiles and eligibility for BT or immunotherapies in severe asthma.
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Affiliation(s)
- Pieta C Wijsman
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Annika W M Goorsenberg
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Julia N S d'Hooghe
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Els J M Weersink
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Dominic W Fenn
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | | | - Jouke T Annema
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Paul Brinkman
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Peter I Bonta
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands.
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3
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Kuo PH, Jhong YC, Kuo TC, Hsu YT, Kuo CH, Tseng YJ. A Clinical Breathomics Dataset. Sci Data 2024; 11:203. [PMID: 38355591 PMCID: PMC10866892 DOI: 10.1038/s41597-024-03052-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/07/2024] [Indexed: 02/16/2024] Open
Abstract
This study entailed a comprehensive GC‒MS analysis conducted on 121 patient samples to generate a clinical breathomics dataset. Breath molecules, indicative of diverse conditions such as psychological and pathological states and the microbiome, were of particular interest due to their non-invasive nature. The highlighted noninvasive approach for detecting these breath molecules significantly enhances diagnostic and monitoring capacities. This dataset cataloged volatile organic compounds (VOCs) from the breath of individuals with asthma, bronchiectasis, and chronic obstructive pulmonary disease. Uniform and consistent sample collection protocols were strictly adhered to during the accumulation of this extensive dataset, ensuring its reliability. It encapsulates extensive human clinical breath molecule data pertinent to three specific diseases. This consequential clinical breathomics dataset is a crucial resource for researchers and clinicians in identifying and exploring important compounds within the patient's breath, thereby augmenting future diagnostic and therapeutic initiatives.
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Affiliation(s)
- Ping-Hung Kuo
- National Taiwan University Hospital, No. 1, Changde St., Zhongzheng Dist., Taipei City, 100229, Taiwan
| | - Yue-Chen Jhong
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan
| | - Tien-Chueh Kuo
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan
- The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan
| | - Yu-Ting Hsu
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan
| | - Ching-Hua Kuo
- The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan
- Drug Research Center, College of Pharmacy, College of Medicine, National Taiwan University, No. 33, Linsen S. Road, Taipei, 10055, Taiwan
- Department of Pharmacy, School of Pharmacy, College of Medicine, National Taiwan University, No. 33, Linsen S. Road, Taipei, 10055, Taiwan
| | - Yufeng Jane Tseng
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan.
- Department of Computer Science and Information Engineering, College of Electrical Engineering and Computer Science, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan.
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4
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Bajo-Fernández M, Souza-Silva ÉA, Barbas C, Rey-Stolle MF, García A. GC-MS-based metabolomics of volatile organic compounds in exhaled breath: applications in health and disease. A review. Front Mol Biosci 2024; 10:1295955. [PMID: 38298553 PMCID: PMC10828970 DOI: 10.3389/fmolb.2023.1295955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024] Open
Abstract
Exhaled breath analysis, with particular emphasis on volatile organic compounds, represents a growing area of clinical research due to its obvious advantages over other diagnostic tests. Numerous pathologies have been extensively investigated for the identification of specific biomarkers in exhalates through metabolomics. However, the transference of breath tests to clinics remains limited, mainly due to deficiency in methodological standardization. Critical steps include the selection of breath sample types, collection devices, and enrichment techniques. GC-MS is the reference analytical technique for the analysis of volatile organic compounds in exhalates, especially during the biomarker discovery phase in metabolomics. This review comprehensively examines and compares metabolomic studies focusing on cancer, lung diseases, and infectious diseases. In addition to delving into the experimental designs reported, it also provides a critical discussion of the methodological aspects, ranging from the experimental design and sample collection to the identification of potential pathology-specific biomarkers.
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Affiliation(s)
- María Bajo-Fernández
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Érica A. Souza-Silva
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
- Departmento de Química, Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | - Coral Barbas
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Ma Fernanda Rey-Stolle
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Antonia García
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
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5
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Hart J, Edwards AD, Stainthorpe A. Insights into implementation planning for point-of-care testing to guide treatment of chronic obstructive pulmonary disease exacerbation: a mixed methods feasibility study. FRONTIERS IN HEALTH SERVICES 2024; 3:1302653. [PMID: 38235389 PMCID: PMC10792000 DOI: 10.3389/frhs.2023.1302653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024]
Abstract
The purpose of this mixed methods feasibility study was to gain insights into unmet clinical needs, stakeholder preferences and potential barriers and enablers to adoption for planning the implementation of point-of-care testing for earlier detection and guided treatment of chronic obstructive pulmonary disease (COPD) acute exacerbation in the NHS in England. Exacerbations of COPD cause considerable mortality and morbidity. Earlier identification of exacerbations and guided treatment would lead to reduced exacerbation duration, reduced hospitalizations and mortality, improve health-related quality of life, reduce unnecessary treatments (including inappropriate antibiotic prescribing) which could save the NHS over £400 per patient. During the early stages of product design, we took a multi-disciplinary approach to evidence generation, gaining insights from key stakeholders to test the product concept and inform evidence-based implementation planning. Primary data was collected from 11 health care and service professionals involved in the management of acute COPD exacerbations. Overall, participants agreed that by earlier differentiation of acute exacerbation from stable COPD, patients could be started on appropriate treatment. To implement point-of-care testing into clinical practice, evidence is required to demonstrate the accuracy of differentiating between exacerbation etiologies and to provide information on the beneficial impact to the system in terms of optimized management, reduced long-term side effects, admission avoidance, and cost-effectiveness. This research provides an evidence base for future implementation planning of point-of-care testing for earlier detection and guided treatment of COPD acute exacerbation. Moreover, the technology developers can decide whether to refine the product design and value proposition thereby de-risking product development.
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Affiliation(s)
- Julie Hart
- School of Pharmacy, University of Reading, Reading, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford Academic Health Science Network, Oxford, United Kingdom
| | | | - Andrew Stainthorpe
- Oxford University Hospitals NHS Foundation Trust, Oxford Academic Health Science Network, Oxford, United Kingdom
- Research Health Limited, Corsham, United Kingdom
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Bhatt SP, Agusti A, Bafadhel M, Christenson SA, Bon J, Donaldson GC, Sin DD, Wedzicha JA, Martinez FJ. Phenotypes, Etiotypes, and Endotypes of Exacerbations of Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2023; 208:1026-1041. [PMID: 37560988 PMCID: PMC10867924 DOI: 10.1164/rccm.202209-1748so] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 08/04/2023] [Indexed: 08/11/2023] Open
Abstract
Chronic obstructive pulmonary disease is a major health problem with a high prevalence, a rising incidence, and substantial morbidity and mortality. Its course is punctuated by acute episodes of increased respiratory symptoms, termed exacerbations of chronic obstructive pulmonary disease (ECOPD). ECOPD are important events in the natural history of the disease, as they are associated with lung function decline and prolonged negative effects on quality of life. The present-day therapy for ECOPD with short courses of antibiotics and steroids and escalation of bronchodilators has resulted in only modest improvements in outcomes. Recent data indicate that ECOPD are heterogeneous, raising the need to identify distinct etioendophenotypes, incorporating traits of the acute event and of patients who experience recurrent events, to develop novel and targeted therapies. These characterizations can provide a complete clinical picture, the severity of which will dictate acute pharmacological treatment, and may also indicate whether a change in maintenance therapy is needed to reduce the risk of future exacerbations. In this review we discuss the latest knowledge of ECOPD types on the basis of clinical presentation, etiology, natural history, frequency, severity, and biomarkers in an attempt to characterize these events.
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Affiliation(s)
- Surya P. Bhatt
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alvar Agusti
- Institut Respiratori (Clinic Barcelona), Càtedra Salut Respiratoria (Universitat de Barcelona), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS-Barcelona), Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), España
| | - Mona Bafadhel
- Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Stephanie A. Christenson
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, San Francisco, California
| | - Jessica Bon
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Gavin C. Donaldson
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Don D. Sin
- Centre for Heart Lung Innovation and
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- St. Paul’s Hospital, Vancouver, British Columbia, Canada; and
| | - Jadwiga A. Wedzicha
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
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7
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Shahbazi Khamas S, Alizadeh Bahmani AH, Vijverberg SJ, Brinkman P, Maitland-van der Zee AH. Exhaled volatile organic compounds associated with risk factors for obstructive pulmonary diseases: a systematic review. ERJ Open Res 2023; 9:00143-2023. [PMID: 37650089 PMCID: PMC10463028 DOI: 10.1183/23120541.00143-2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/21/2023] [Indexed: 09/01/2023] Open
Abstract
Background Asthma and COPD are among the most common respiratory diseases. To improve the early detection of exacerbations and the clinical course of asthma and COPD new biomarkers are needed. The development of noninvasive metabolomics of exhaled air into a point-of-care tool is an appealing option. However, risk factors for obstructive pulmonary diseases can potentially introduce confounding markers due to altered volatile organic compound (VOC) patterns being linked to these risk factors instead of the disease. We conducted a systematic review and presented a comprehensive list of VOCs associated with these risk factors. Methods A PRISMA-oriented systematic search was conducted across PubMed, Embase and Cochrane Libraries between 2000 and 2022. Full-length studies evaluating VOCs in exhaled breath were included. A narrative synthesis of the data was conducted, and the Newcastle-Ottawa Scale was used to assess the quality of included studies. Results The search yielded 2209 records and, based on the inclusion/exclusion criteria, 24 articles were included in the qualitative synthesis. In total, 232 individual VOCs associated with risk factors for obstructive pulmonary diseases were found; 58 compounds were reported more than once and 12 were reported as potential markers of asthma and/or COPD in other studies. Critical appraisal found that the identified studies were methodologically heterogeneous and had a variable risk of bias. Conclusion We identified a series of exhaled VOCs associated with risk factors for asthma and/or COPD. Identification of these VOCs is necessary for the further development of exhaled metabolites-based point-of-care tests in these obstructive pulmonary diseases.
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Affiliation(s)
- Shahriyar Shahbazi Khamas
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Amir Hossein Alizadeh Bahmani
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Susanne J.H. Vijverberg
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
| | - Paul Brinkman
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
- These authors contributed equally
| | - Anke H. Maitland-van der Zee
- Department of Pulmonary Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
- Amsterdam Public Health, Amsterdam, the Netherlands
- These authors contributed equally
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8
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Li X, Chen MM, Su HF, Zhang ML, Xie SY, Zheng LS. Real-Time Sniffing Mass Spectrometry Aided by Venturi Self-Pumping Applicable to Gaseous and Solid Surface Analysis. Anal Chem 2022; 94:13719-13727. [PMID: 36173369 DOI: 10.1021/acs.analchem.2c01759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Based on the Venturi self-pumping effect, real-time sniffing with mass spectrometry (R-sniffing MS) is developed as a tool for direct and real-time mass spectrometric analysis of both gaseous and solid samples. It is capable of dual-mode operation in either gaseous or solid phase, with the corresponding techniques termed as Rg-sniffing MS and Rs-sniffing MS, respectively. In its gaseous mode, Rg-sniffing MS is capable of analyzing a gaseous mixture with response time (0.8-2.1 s rise time and 7.3-9.6 s fall time), spatial resolution (<80 μm), three-dimensional diffusion imaging, and aroma distribution imaging of red pepper. In its solid mode, an appropriate solvent droplet desorbs the sample from a solid surface, followed by the aspiration of the mixture using the Venturi self-pumping effect into the mass spectrometer, wherein it is ionized by a standard ion source. Compared with the desorption electrospray ionization (DESI) technique, Rs-sniffing MS demonstrated considerably improved limit of detection (LOD) values for arginine (0.07 μg/cm2 Rs-sniffing vs 1.47 μg/cm2 DESI), thymopentin (0.10 μg/cm2 vs 2.67 μg/cm2), and bacitracin (0.16 μg/cm2 vs 2.28 μg/cm2). Rs-sniffing is applicable for the detection of C60(OCH3)6Cl-, an intermediate in the methoxylation reaction involving C60Cl6 (solid) and methanol (liquid). The convenient and highly sensitive R-sniffing MS has a characteristic separation of desorption from the ionization process, in which the matrix atmosphere of desorption can be interfaced by a pipe channel and self-pumped by the Venturi effect with consequent integration using a standard ion source. The R-sniffing MS operates in a voltage-, heat-, and vibration-free environment, wherein the analyte is ionized by a standard ion source. Consequently, a wide range of samples can be analyzed simultaneously by the R-sniffing MS technique, regardless of their physical state.
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Affiliation(s)
- Xiang Li
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Collaborative Innovation Center of Chemistry for Energy Materials, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
| | - Miao-Miao Chen
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Collaborative Innovation Center of Chemistry for Energy Materials, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
| | - Hai-Feng Su
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Collaborative Innovation Center of Chemistry for Energy Materials, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
| | - Mei-Lin Zhang
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Collaborative Innovation Center of Chemistry for Energy Materials, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
| | - Su-Yuan Xie
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Collaborative Innovation Center of Chemistry for Energy Materials, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
| | - Lan-Sun Zheng
- State Key Laboratory for Physical Chemistry of Solid Surfaces, Collaborative Innovation Center of Chemistry for Energy Materials, Department of Chemistry, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen 361005, China
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9
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Rothbart N, Stanley V, Koczulla R, Jarosch I, Holz O, Schmalz K, Hübers HW. Millimeter-wave gas spectroscopy for breath analysis of COPD patients in comparison to GC-MS. J Breath Res 2022; 16. [PMID: 35688126 DOI: 10.1088/1752-7163/ac77aa] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/10/2022] [Indexed: 01/12/2023]
Abstract
The analysis of human breath is a very active area of research, driven by the vision of a fast, easy, and non-invasive tool for medical diagnoses at the point of care. Millimeter-wave gas spectroscopy (MMWGS) is a novel, well-suited technique for this application as it provides high sensitivity, specificity and selectivity. Most of all, it offers the perspective of compact low-cost systems to be used in doctors' offices or hospitals. In this work, we demonstrate the analysis of breath samples acquired in a medical environment using MMWGS and evaluate validity, reliability, as well as limitations and perspectives of the method. To this end, we investigated 28 duplicate samples from chronic obstructive lung disease patients and compared the results to gas chromatography-mass spectrometry (GC-MS). The quantification of the data was conducted using a calibration-free fit model, which describes the data precisely and delivers absolute quantities. For ethanol, acetone, and acetonitrile, the results agree well with the GC-MS measurements and are as reliable as GC-MS. The duplicate samples deviate from the mean values by only 6% to 18%. Detection limits of MMWGS depend strongly on the molecular species. For example, acetonitrile can be traced down to 1.8 × 10-12mol by the MMWGS system, which is comparable to the GC-MS system. We observed correlations of abundances between formaldehyde and acetaldehyde as well as between acetonitrile and acetaldehyde, which demonstrates the potential of MMWGS for breath research.
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Affiliation(s)
- Nick Rothbart
- Institute of Optical Sensor Systems, German Aerospace Center (DLR), Berlin, Germany.,Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Victoria Stanley
- Institute of Optical Sensor Systems, German Aerospace Center (DLR), Berlin, Germany.,Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rembert Koczulla
- Schön Klinik Berchtesgadener Land, Research Institute for Pulmonary Rehabilitation, Schönau am Königssee, Germany.,Philipps-University of Marburg, Department of Pulmonary Rehabilitation, Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - Inga Jarosch
- Schön Klinik Berchtesgadener Land, Research Institute for Pulmonary Rehabilitation, Schönau am Königssee, Germany.,Philipps-University of Marburg, Department of Pulmonary Rehabilitation, Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - Olaf Holz
- Fraunhofer ITEM, German Center for Lung Research (BREATH, DZL), Clinical Airway Research, Hannover, Germany
| | - Klaus Schmalz
- IHP-Leibniz-Institut für Innovative Mikroelektronik, Frankfurt (Oder), Germany
| | - Heinz-Wilhelm Hübers
- Institute of Optical Sensor Systems, German Aerospace Center (DLR), Berlin, Germany.,Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany
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10
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Predicting Early Hospital Readmissions in COPD Patients Using an Electronic Nose. ARCHIVOS DE BRONCONEUMOLOGÍA 2022; 58:663-665. [DOI: 10.1016/j.arbres.2022.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 11/23/2022]
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11
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Wojnowski W, Kalinowska K. Machine Learning and Electronic Noses for Medical Diagnostics. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
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12
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Salman D, Ibrahim W, Kanabar A, Joyce A, Zhao B, Singapuri A, Wilde M, Cordell RL, McNally T, Ruszkiewicz D, Hadjithekli A, Free R, Greening N, Gaillard EA, Beardsmore C, Monks P, Brightling C, Siddiqui S, Thomas CLP. The variability of volatile organic compounds in the indoor air of clinical environments. J Breath Res 2021; 16. [PMID: 34724656 DOI: 10.1088/1752-7163/ac3565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 11/01/2021] [Indexed: 11/11/2022]
Abstract
The development of clinical breath-analysis is confounded by the variability of background volatile organic compounds (VOCs). Reliable interpretation of clinical breath-analysis at individual, and cohort levels requires characterisation of clinical-VOC levels and exposures. Active-sampling with thermal-desorption/gas chromatography-mass spectrometry recorded and evaluated VOC concentrations in 245 samples of indoor air from three sites in a large National Health Service (NHS) provider trust in the UK over 27 months. Data deconvolution, alignment and clustering isolated 7344 features attributable to VOC and described the variability (composition and concentration) of respirable clinical VOC. 328 VOC were observed in more than 5% of the samples and 68 VOC appeared in more than 30% of samples. Common VOC were associated with exogenous and endogenous sources and 17 VOC were identified as seasonal differentiators. The presence of metabolites from the anaesthetic sevoflurane, and putative-disease biomarkers in room air, indicated that exhaled VOC were a source of background-pollution in clinical breath-testing activity. With the exception of solvents, and waxes associated with personal protective equipment (PPE), exhaled VOC concentrations above 3µg m-3are unlikely to arise from room air contamination, and in the absence of extensive survey-data, this level could be applied as a threshold for inclusion in studies, removing a potential environmental confounding-factor in developing breath-based diagnostics.
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Affiliation(s)
- Dahlia Salman
- Department of Chemistry, Loughborough University, Loughborough LE11 3TU, United Kingdom
| | - Wadah Ibrahim
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom.,Leicester NIHR Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom
| | - Amisha Kanabar
- Department of Chemistry, Loughborough University, Loughborough LE11 3TU, United Kingdom
| | - Abigail Joyce
- Department of Chemistry, Loughborough University, Loughborough LE11 3TU, United Kingdom
| | - Bo Zhao
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom.,Leicester NIHR Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom
| | - Amisha Singapuri
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom.,Leicester NIHR Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom
| | - Michael Wilde
- Department of Chemistry, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom
| | - Rebecca L Cordell
- Department of Chemistry, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom
| | - Teresa McNally
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom
| | - Dorota Ruszkiewicz
- Department of Chemistry, Loughborough University, Loughborough LE11 3TU, United Kingdom
| | - Andria Hadjithekli
- Department of Chemistry, Loughborough University, Loughborough LE11 3TU, United Kingdom
| | - Robert Free
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom.,Leicester NIHR Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom
| | - Neil Greening
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom.,Leicester NIHR Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom
| | - Erol A Gaillard
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom
| | - Caroline Beardsmore
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom
| | - Paul Monks
- Department of Chemistry, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom
| | - Chris Brightling
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom.,Leicester NIHR Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom
| | - Salman Siddiqui
- College of Life Sciences, Department of Respiratory Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom.,Leicester NIHR Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom
| | - C L Paul Thomas
- Department of Chemistry, Loughborough University, Loughborough LE11 3TU, United Kingdom
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13
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van der Sar IG, Wijbenga N, Nakshbandi G, Aerts JGJV, Manintveld OC, Wijsenbeek MS, Hellemons ME, Moor CC. The smell of lung disease: a review of the current status of electronic nose technology. Respir Res 2021; 22:246. [PMID: 34535144 PMCID: PMC8448171 DOI: 10.1186/s12931-021-01835-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/26/2021] [Indexed: 02/08/2023] Open
Abstract
There is a need for timely, accurate diagnosis, and personalised management in lung diseases. Exhaled breath reflects inflammatory and metabolic processes in the human body, especially in the lungs. The analysis of exhaled breath using electronic nose (eNose) technology has gained increasing attention in the past years. This technique has great potential to be used in clinical practice as a real-time non-invasive diagnostic tool, and for monitoring disease course and therapeutic effects. To date, multiple eNoses have been developed and evaluated in clinical studies across a wide spectrum of lung diseases, mainly for diagnostic purposes. Heterogeneity in study design, analysis techniques, and differences between eNose devices currently hamper generalization and comparison of study results. Moreover, many pilot studies have been performed, while validation and implementation studies are scarce. These studies are needed before implementation in clinical practice can be realised. This review summarises the technical aspects of available eNose devices and the available evidence for clinical application of eNose technology in different lung diseases. Furthermore, recommendations for future research to pave the way for clinical implementation of eNose technology are provided.
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Affiliation(s)
- I G van der Sar
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - N Wijbenga
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - G Nakshbandi
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J G J V Aerts
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - O C Manintveld
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M S Wijsenbeek
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M E Hellemons
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - C C Moor
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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14
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Kamal F, Kumar S, Edwards MR, Veselkov K, Belluomo I, Kebadze T, Romano A, Trujillo-Torralbo MB, Shahridan Faiez T, Walton R, Ritchie AI, Wiseman DJ, Laponogov I, Donaldson G, Wedzicha JA, Johnston SL, Singanayagam A, Hanna GB. Virus-induced Volatile Organic Compounds are Detectable in Exhaled Breath During Pulmonary Infection. Am J Respir Crit Care Med 2021; 204:1075-1085. [PMID: 34319857 DOI: 10.1164/rccm.202103-0660oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a condition punctuated by acute exacerbations commonly triggered by viral and/or bacterial infection. Early identification of exacerbation trigger is important to guide appropriate therapy but currently available tests are slow and imprecise. Volatile organic compounds (VOCs) can be detected in exhaled breath and have the potential to be rapid tissue-specific biomarkers of infection aetiology. METHODS We used serial sampling within in vitro and in vivo studies to elucidate the dynamic changes that occur in VOC production during acute respiratory viral infection. Highly sensitive gas-chromatography mass spectrometry (GC-MS) techniques were used to measure VOC production from infected airway epithelial cell cultures and in exhaled breath samples of healthy subjects experimentally challenged with rhinovirus A16 and COPD subjects with naturally-occurring exacerbations. RESULTS We identified a novel VOC signature comprising of decane and other related long chain alkane compounds that is induced during rhinovirus infection of cultured airway epithelial cells and is also increased in the exhaled breath of healthy subjects experimentally challenged with rhinovirus and of COPD patients during naturally-occurring viral exacerbations. These compounds correlated with magnitude of anti-viral immune responses, virus burden and exacerbation severity but were not induced by bacterial infection, suggesting they represent a specific virus-inducible signature. CONCLUSION Our study highlights the potential for measurement of exhaled breath VOCs as rapid, non-invasive biomarkers of viral infection. Further studies are needed to determine whether measurement of these signatures could be used to guide more targeted therapy with antibiotic/antiviral agents for COPD exacerbations.
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Affiliation(s)
- Faisal Kamal
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Sacheen Kumar
- Imperial College, London, Airway Disease Infection Section, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Michael R Edwards
- Imperial College London, Airway Disease Infection, London, United Kingdom of Great Britain and Northern Ireland
| | - Kirill Veselkov
- Imperial College, London, Airway Disease Infection Section, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Ilaria Belluomo
- Imperial College, London, Airway Disease Infection Section, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Tatiana Kebadze
- National Heart & Lung and Wright Felming Institute of Infection & Immunity, Respiratory Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Andrea Romano
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Maria-Belen Trujillo-Torralbo
- Imperial College London, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Tasnim Shahridan Faiez
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Ross Walton
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Andrew I Ritchie
- Imperial College London, Airway Disease Infection, London, United Kingdom of Great Britain and Northern Ireland
| | - Dexter J Wiseman
- Imperial College London, Airway Diseases Section, London, United Kingdom of Great Britain and Northern Ireland
| | - Ivan Laponogov
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland
| | - Gavin Donaldson
- Imperial College London, Airways Disease Section, London, United Kingdom of Great Britain and Northern Ireland
| | - Jadwiga A Wedzicha
- Imperial College London, National Heart and Lung Institute, London, United Kingdom of Great Britain and Northern Ireland
| | - Sebastian L Johnston
- National Heart & Lung and Wright Felming Institute of Infection & Immunity, Respiratory Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Aran Singanayagam
- Imperial College, London, London, United Kingdom of Great Britain and Northern Ireland
| | - George B Hanna
- Imperial College London, 4615, London, United Kingdom of Great Britain and Northern Ireland;
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15
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Ibrahim W, Natarajan S, Wilde M, Cordell R, Monks PS, Greening N, Brightling CE, Evans R, Siddiqui S. A systematic review of the diagnostic accuracy of volatile organic compounds in airway diseases and their relation to markers of type-2 inflammation. ERJ Open Res 2021; 7:00030-2021. [PMID: 34476250 PMCID: PMC8405872 DOI: 10.1183/23120541.00030-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/27/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Asthma and COPD continue to cause considerable diagnostic and treatment stratification challenges. Volatile organic compounds (VOCs) have been proposed as feasible diagnostic and monitoring biomarkers in airway diseases. AIMS To 1) conduct a systematic review evaluating the diagnostic accuracy of VOCs in diagnosing airway diseases; 2) understand the relationship between reported VOCs and biomarkers of type-2 inflammation; 3) assess the standardisation of reporting according to STARD and TRIPOD criteria; 4) review current methods of breath sampling and analysis. METHODS A PRISMA-oriented systematic search was conducted (January 1997 to December 2020). Search terms included: "asthma", "volatile organic compound(s)", "VOC" and "COPD". Two independent reviewers examined the extracted titles against review objectives. RESULTS 44 full-text papers were included; 40/44 studies were cross-sectional and four studies were interventional in design; 17/44 studies used sensor-array technologies (e.g. eNose). Cross-study comparison was not possible across identified studies due to the heterogeneity in design. The commonest airway diseases differentiating VOCs belonged to carbonyl-containing classes (i.e. aldehydes, esters and ketones) and hydrocarbons (i.e. alkanes and alkenes). Although individual markers that are associated with clinical biomarkers of type-2 inflammation were recognised (i.e. ethane and 3,7-dimethylnonane for asthma and α-methylstyrene and decane for COPD), these were not consistently identified across studies. Only 3/44 reported following STARD or TRIPOD criteria for diagnostic accuracy and multivariate reporting, respectively. CONCLUSIONS Breath VOCs show promise as diagnostic biomarkers of airway diseases and for type-2 inflammation profiling. However, future studies should focus on transparent reporting of diagnostic accuracy and multivariate models and continue to focus on chemical identification of volatile metabolites.
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Affiliation(s)
- Wadah Ibrahim
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- These authors contributed equally
| | - Sushiladevi Natarajan
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- These authors contributed equally
| | - Michael Wilde
- Dept of Chemistry, University of Leicester, Leicester, UK
| | | | - Paul S. Monks
- Dept of Chemistry, University of Leicester, Leicester, UK
| | - Neil Greening
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Christopher E. Brightling
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Rachael Evans
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Salman Siddiqui
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- See Acknowledgements for contributors
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16
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Liu L, Li W, He Z, Chen W, Liu H, Chen K, Pi X. Detection of lung cancer with electronic nose using a novel ensemble learning framework. J Breath Res 2021; 15. [PMID: 33578407 DOI: 10.1088/1752-7163/abe5c9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/12/2021] [Indexed: 02/02/2023]
Abstract
Breath analysis based on electronic nose (e-nose) is a promising new technology for the detection of lung cancer that is non-invasive, simple to operate and cost-effective. Lung cancer screening by e-nose relies on predictive models established using machine learning methods. However, using only a single machine learning method to detect lung cancer has some disadvantages, including low detection accuracy and high false negative rate. To address these problems, groups of individual learning models with excellent performance were selected from classic models, including Support Vector Machine, Decision Tree, Random Forest, Logistic Regression and K-nearest neighbor regression, to build an ensemble learning framework (PCA-SVE). The output result of the PCA-SVE framework was obtained by voting. To test this approach, we analyzed 214 breath samples measured by e-nose with 11 gas sensors of four types using the proposed PCA-SVE framework. Experimental results indicated that the accuracy, sensitivity, and specificity of the proposed framework were 95.75%, 94.78%, and 96.96%, respectively. This framework overcomes the disadvantages of a single model, thereby providing an improved, practical alternative for exhaled breath analysis by e-nose.
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Affiliation(s)
- Lei Liu
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, P.R. China, Chongqing, Chongqing, 400044, CHINA
| | - Wang Li
- School of Pharmacy and Bioengineering, Chongqing University of Technology, No.174 Shazhengjie, Shapingba, Chongqing, Chongqing, 400044, CHINA
| | - ZiChun He
- Chongqing Red Cross Hospital (People's Hospital of Jiangbei District), Chongqing Red Cross Hospital, 168 Hai'er Rd, Chongqing, 400020 , CHINA
| | - Weimin Chen
- Kunming University, No.727 South Jingming Rd, Chenggong District, Kunming, Yunnan, 650500, CHINA
| | - Hongying Liu
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, No.174 Shazhengjie, Shapingba, Chongqing, Chongqing, 400044, CHINA
| | - Ke Chen
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, , Chongqing University, No.174 Shazhengjie, Shapingba, Chongqing, Chongqing, 400044, CHINA
| | - Xitian Pi
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, , Chongqing University, No.174 Shazhengjie, Shapingba, Chongqing, Chongqing, 400044, CHINA
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17
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Machine Learning and Electronic Noses for Medical Diagnostics. Artif Intell Med 2021. [DOI: 10.1007/978-3-030-58080-3_329-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Licht JC, Grasemann H. Potential of the Electronic Nose for the Detection of Respiratory Diseases with and without Infection. Int J Mol Sci 2020; 21:E9416. [PMID: 33321951 PMCID: PMC7763696 DOI: 10.3390/ijms21249416] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/16/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023] Open
Abstract
Respiratory tract infections are common, and when affecting the lower airways and lungs, can result in significant morbidity and mortality. There is an unfilled need for simple, non-invasive tools that can be used to screen for such infections at the clinical point of care. The electronic nose (eNose) is a novel technology that detects volatile organic compounds (VOCs). Early studies have shown that certain diseases and infections can result in characteristic changes in VOC profiles in the exhaled breath. This review summarizes current knowledge on breath analysis by the electronic nose and its potential for the detection of respiratory diseases with and without infection.
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Affiliation(s)
- Johann-Christoph Licht
- Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
- Translational Medicine Research Program, Hospital for Sick Children Research Institute, Toronto, ON M5G 1X8, Canada
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Hartmut Grasemann
- Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
- Translational Medicine Research Program, Hospital for Sick Children Research Institute, Toronto, ON M5G 1X8, Canada
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19
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The Role of Electronic Noses in Phenotyping Patients with Chronic Obstructive Pulmonary Disease. BIOSENSORS-BASEL 2020; 10:bios10110171. [PMID: 33187142 PMCID: PMC7697924 DOI: 10.3390/bios10110171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a common progressive disorder of the respiratory system which is currently the third leading cause of death worldwide. Exhaled breath analysis is a non-invasive method to study lung diseases, and electronic noses have been extensively used in breath research. Studies with electronic noses have proved that the pattern of exhaled volatile organic compounds is different in COPD. More recent investigations have reported that electronic noses could potentially distinguish different endotypes (i.e., neutrophilic vs. eosinophilic) and are able to detect microorganisms in the airways responsible for exacerbations. This article will review the published literature on electronic noses and COPD and help in identifying methodological, physiological, and disease-related factors which could affect the results.
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20
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van Bragt JJ, Brinkman P, de Vries R, Vijverberg SJ, Weersink EJ, Haarman EG, de Jongh FH, Kester S, Lucas A, in 't Veen JC, Sterk PJ, Bel EH, Maitland-van der Zee AH. Identification of recent exacerbations in COPD patients by electronic nose. ERJ Open Res 2020; 6:00307-2020. [PMID: 33447611 PMCID: PMC7792783 DOI: 10.1183/23120541.00307-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/28/2020] [Indexed: 12/17/2022] Open
Abstract
Molecular profiling of exhaled breath by electronic nose (eNose) might be suitable as a noninvasive tool that can help in monitoring of clinically unstable COPD patients. However, supporting data are still lacking. Therefore, as a first step, this study aimed to determine the accuracy of exhaled breath analysis by eNose to identify COPD patients who recently exacerbated, defined as an exacerbation in the previous 3 months. Data for this exploratory, cross-sectional study were extracted from the multicentre BreathCloud cohort. Patients with a physician-reported diagnosis of COPD (n=364) on maintenance treatment were included in the analysis. Exacerbations were defined as a worsening of respiratory symptoms requiring treatment with oral corticosteroids, antibiotics or both. Data analysis involved eNose signal processing, ambient air correction and statistics based on principal component (PC) analysis followed by linear discriminant analysis (LDA). Before analysis, patients were randomly divided into a training (n=254) and validation (n=110) set. In the training set, LDA based on PCs 1-4 discriminated between patients with a recent exacerbation or no exacerbation with high accuracy (receiver operating characteristic (ROC)-area under the curve (AUC)=0.98, 95% CI 0.97-1.00). This high accuracy was confirmed in the validation set (AUC=0.98, 95% CI 0.94-1.00). Smoking, health status score, use of inhaled corticosteroids or vital capacity did not influence these results. Exhaled breath analysis by eNose can discriminate with high accuracy between COPD patients who experienced an exacerbation within 3 months prior to measurement and those who did not. This suggests that COPD patients who recently exacerbated have their own exhaled molecular fingerprint that could be valuable for monitoring purposes.
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Affiliation(s)
- Job J.M.H. van Bragt
- Amsterdam UMC, University of Amsterdam, Dept of Respiratory Medicine, Amsterdam, The Netherlands
| | - Paul Brinkman
- Amsterdam UMC, University of Amsterdam, Dept of Respiratory Medicine, Amsterdam, The Netherlands
| | - Rianne de Vries
- Amsterdam UMC, University of Amsterdam, Dept of Respiratory Medicine, Amsterdam, The Netherlands
- Breathomix BV, Leiden, The Netherlands
| | - Susanne J.H. Vijverberg
- Amsterdam UMC, University of Amsterdam, Dept of Respiratory Medicine, Amsterdam, The Netherlands
| | - Els J.M. Weersink
- Amsterdam UMC, University of Amsterdam, Dept of Respiratory Medicine, Amsterdam, The Netherlands
| | - Eric G. Haarman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Dept of Pediatric Respiratory Medicine, Amsterdam, The Netherlands
| | - Frans H.C. de Jongh
- Medisch Spectrum Twente, Dept of Pulmonary Function, Enschede, The Netherlands
| | - Sigrid Kester
- Medisch Centrum Den Bosch Oost, ’s-Hertogenbosch, The Netherlands
| | | | | | - Peter J. Sterk
- Amsterdam UMC, University of Amsterdam, Dept of Respiratory Medicine, Amsterdam, The Netherlands
| | - Elisabeth H.D. Bel
- Amsterdam UMC, University of Amsterdam, Dept of Respiratory Medicine, Amsterdam, The Netherlands
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21
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Mathioudakis AG, Janssens W, Sivapalan P, Singanayagam A, Dransfield MT, Jensen JUS, Vestbo J. Acute exacerbations of chronic obstructive pulmonary disease: in search of diagnostic biomarkers and treatable traits. Thorax 2020; 75:520-527. [PMID: 32217784 PMCID: PMC7279206 DOI: 10.1136/thoraxjnl-2019-214484] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/21/2020] [Accepted: 03/01/2020] [Indexed: 12/12/2022]
Abstract
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with a significant mortality, health and economic burden. Their diagnosis, assessment and management remain suboptimal and unchanged for decades. Recent clinical and translational studies revealed that the significant heterogeneity in mechanisms and outcomes of exacerbations could be resolved by grouping them etiologically. This is anticipated to lead to a better understanding of the biological processes that underlie each type of exacerbation and to allow the introduction of precision medicine interventions that could improve outcomes. This review summarises novel data on the diagnosis, phenotyping, targeted treatment and prevention of COPD exacerbations.
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Affiliation(s)
- Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.,North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - Wim Janssens
- Respiratory Division, Department of Clinical and Experimental Medicine, University Hospital Leuven & KU Leuven, Leuven, Belgium
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Aran Singanayagam
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Mark T Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama School of Medicine, Birmingham, Alabama, USA
| | - Jens-Ulrik Stæhr Jensen
- Section of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark.,PERSIMUNE&CHIP: Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK .,North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
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22
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A Low-Cost Breath Analyzer Module in Domiciliary Non-Invasive Mechanical Ventilation for Remote COPD Patient Monitoring. SENSORS 2020; 20:s20030653. [PMID: 31991608 PMCID: PMC7038329 DOI: 10.3390/s20030653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/14/2020] [Accepted: 01/17/2020] [Indexed: 02/07/2023]
Abstract
Smart Breath Analyzers were developed as sensing terminals of a telemedicine architecture devoted to remote monitoring of patients suffering from Chronic Obstructive Pulmonary Disease (COPD) and home-assisted by non-invasive mechanical ventilation via respiratory face mask. The devices based on different sensors (CO2/O2 and Volatile Organic Compounds (VOCs), relative humidity and temperature (R.H. & T) sensors) monitor the breath air exhaled into the expiratory line of the bi-tube patient breathing circuit during a noninvasive ventilo-therapy session; the sensor raw signals are transmitted pseudonymized to National Health Service units by TCP/IP communication through a cloud remote platform. The work is a proof-of-concept of a sensors-based IoT system with the perspective to check continuously the effectiveness of therapy and/or any state of exacerbation of the disease requiring healthcare. Lab tests in controlled experimental conditions by a gas-mixing bench towards CO2/O2 concentrations and exhaled breath collected in a sampling bag were carried out to test the realized prototypes. The Smart Breath Analyzers were also tested in real conditions both on a healthy volunteer subject and a COPD suffering patient.
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Lu B, Fu L, Nie B, Peng Z, Liu H. A Novel Framework with High Diagnostic Sensitivity for Lung Cancer Detection by Electronic Nose. SENSORS 2019; 19:s19235333. [PMID: 31817006 PMCID: PMC6928832 DOI: 10.3390/s19235333] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 12/11/2022]
Abstract
The electronic nose (e-nose) system is a newly developing detection technology for its advantages of non-invasiveness, simple operation, and low cost. However, lung cancer screening through e-nose requires effective pattern recognition frameworks. Existing frameworks rely heavily on hand-crafted features and have relatively low diagnostic sensitivity. To handle these problems, gated recurrent unit based autoencoder (GRU-AE) is adopted to automatically extract features from temporal and high-dimensional e-nose data. Moreover, we propose a novel margin and sensitivity based ordering ensemble pruning (MSEP) model for effective classification. The proposed heuristic model aims to reduce missed diagnosis rate of lung cancer patients while maintaining a high rate of overall identification. In the experiments, five state-of-the-art classification models and two popular dimensionality reduction methods were involved for comparison to demonstrate the validity of the proposed GRU-AE-MSEP framework, through 214 collected breath samples measured by e-nose. Experimental results indicated that the proposed intelligent framework achieved high sensitivity of 94.22%, accuracy of 93.55%, and specificity of 92.80%, thereby providing a new practical means for wide disease screening by e-nose in medical scenarios.
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Affiliation(s)
- Binchun Lu
- Chongqing University-University of Cincinnati Joint Co-op Institute, Chongqing University, Chongqing 400030, China; (B.L.); (L.F.)
| | - Lidan Fu
- Chongqing University-University of Cincinnati Joint Co-op Institute, Chongqing University, Chongqing 400030, China; (B.L.); (L.F.)
| | - Bo Nie
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China;
| | - Zhiyun Peng
- State Key Laboratory of Power Transmission Equipment & System Security and New Technology, Chongqing University, Chongqing 400030, China;
| | - Hongying Liu
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China;
- Correspondence:
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