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Shen Q, Liu Y, Li G, An T. A review of disrupted biological response associated with volatile organic compound exposure: Insight into identification of biomarkers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 948:174924. [PMID: 39047835 DOI: 10.1016/j.scitotenv.2024.174924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/09/2024] [Accepted: 07/19/2024] [Indexed: 07/27/2024]
Abstract
Volatile organic compounds (VOCs) are widespread harmful atmospheric pollutants, which have long been concerned and elucidated to be one of the risks of acute and chronic diseases for human, such as leukemia and cancer. Although numerous scientific studies have documented the potential adverse outcomes caused by VOC exposure, the mechanisms which biological response pathways of these VOC disruption remain poorly understood. Therefore, the identification of biochemical markers associated with metabolism, health effects and diseases orientation can be an effective means of screening biological targets for VOC exposure, which provide evidences to the toxicity assessment of compounds. The current review aims to understand the mechanisms underlying VOCs-elicited adverse outcomes by charactering various types of biomarkers. VOCs-related biomarkers from three aspects were summarized through in vitro, animal and epidemiological studies. i) Unmetabolized and metabolized VOC biomarkers in human samples for assessing exposure characteristics in different communities; ii) Adverse endpoint effects related biomarkers, mainly including (anti)oxidative stress, inflammation response and DNA damage; iii) Omics-based molecular biomarkers alteration in gene, protein, lipid and metabolite aspects associated with biological signaling pathway disorders response to VOC exposure. Further research, advanced machine learning and bioinformation approaches combined with experimental results are urgently needed to ascertain the selection of biomarkers and further illuminate toxic mechanisms of VOC exposure. Finally, VOCs-induced disease causes can be predicted with proven results.
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Affiliation(s)
- Qianyong Shen
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China; Guangdong Engineering Technology Research Center for Photocatalytic Technology Integration and Equipment, Guangzhou Key Laboratory of Environmental Catalysis and Pollution Control, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
| | - Yalin Liu
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China; Guangdong Engineering Technology Research Center for Photocatalytic Technology Integration and Equipment, Guangzhou Key Laboratory of Environmental Catalysis and Pollution Control, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
| | - Guiying Li
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China; Guangdong Engineering Technology Research Center for Photocatalytic Technology Integration and Equipment, Guangzhou Key Laboratory of Environmental Catalysis and Pollution Control, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China
| | - Taicheng An
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China; Guangdong Engineering Technology Research Center for Photocatalytic Technology Integration and Equipment, Guangzhou Key Laboratory of Environmental Catalysis and Pollution Control, School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou 510006, China.
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Sharma A, Kumar R, Varadwaj P. Smelling the Disease: Diagnostic Potential of Breath Analysis. Mol Diagn Ther 2023; 27:321-347. [PMID: 36729362 PMCID: PMC9893210 DOI: 10.1007/s40291-023-00640-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/03/2023]
Abstract
Breath analysis is a relatively recent field of research with much promise in scientific and clinical studies. Breath contains endogenously produced volatile organic components (VOCs) resulting from metabolites of ingested precursors, gut and air-passage bacteria, environmental contacts, etc. Numerous recent studies have suggested changes in breath composition during the course of many diseases, and breath analysis may lead to the diagnosis of such diseases. Therefore, it is important to identify the disease-specific variations in the concentration of breath to diagnose the diseases. In this review, we explore methods that are used to detect VOCs in laboratory settings, VOC constituents in exhaled air and other body fluids (e.g., sweat, saliva, skin, urine, blood, fecal matter, vaginal secretions, etc.), VOC identification in various diseases, and recently developed electronic (E)-nose-based sensors to detect VOCs. Identifying such VOCs and applying them as disease-specific biomarkers to obtain accurate, reproducible, and fast disease diagnosis could serve as an alternative to traditional invasive diagnosis methods. However, the success of VOC-based identification of diseases is limited to laboratory settings. Large-scale clinical data are warranted for establishing the robustness of disease diagnosis. Also, to identify specific VOCs associated with illness states, extensive clinical trials must be performed using both analytical instruments and electronic noses equipped with stable and precise sensors.
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Affiliation(s)
- Anju Sharma
- Systems Biology Lab, Indian Institute of Information Technology, Allahabad, Uttar Pradesh, India
| | - Rajnish Kumar
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Uttar Pradesh, Lucknow Campus, Lucknow, India
| | - Pritish Varadwaj
- Systems Biology Lab, Indian Institute of Information Technology, Allahabad, Uttar Pradesh, India.
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3
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Mochalski P, King J, Mayhew CA, Unterkofler K. Modelling of Breath and Various Blood Volatilomic Profiles—Implications for Breath Volatile Analysis. Molecules 2022; 27:molecules27082381. [PMID: 35458579 PMCID: PMC9028376 DOI: 10.3390/molecules27082381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 12/04/2022] Open
Abstract
Researchers looking for biomarkers from different sources, such as breath, urine, or blood, frequently search for specific patterns of volatile organic compounds (VOCs), often using pattern recognition or machine learning techniques. However, they are not generally aware that these patterns change depending on the source they use. Therefore, we have created a simple model to demonstrate that the distribution patterns of VOCs in fat, mixed venous blood, alveolar air, and end-tidal breath are different. Our approach follows well-established models for the description of dynamic real-time breath concentration profiles. We start with a uniform distribution of end-tidal concentrations of selected VOCs and calculate the corresponding target concentrations. For this, we only need partition coefficients, mass balance, and the assumption of an equilibrium state, which avoids the need to know the volatiles’ metabolic rates and production rates within the different compartments.
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Affiliation(s)
- Paweł Mochalski
- Institute for Breath Research, Leopold-Franzens-Universität, Innrain 66, A-6020 Innsbruck, Austria; (P.M.); (J.K.); (C.A.M.)
- Institute of Chemistry, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Julian King
- Institute for Breath Research, Leopold-Franzens-Universität, Innrain 66, A-6020 Innsbruck, Austria; (P.M.); (J.K.); (C.A.M.)
| | - Chris A. Mayhew
- Institute for Breath Research, Leopold-Franzens-Universität, Innrain 66, A-6020 Innsbruck, Austria; (P.M.); (J.K.); (C.A.M.)
- Tiroler Krebsforschungsinstitut (TKFI), Innrain 66, A-6020 Innsbruck, Austria
| | - Karl Unterkofler
- Institute for Breath Research, Leopold-Franzens-Universität, Innrain 66, A-6020 Innsbruck, Austria; (P.M.); (J.K.); (C.A.M.)
- Research Center BI, University of Applied Sciences Vorarlberg, Hochschulstraße 1, A-6850 Dornbirn, Austria
- Correspondence:
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4
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Issitt T, Wiggins L, Veysey M, Sweeney S, Brackenbury W, Redeker K. Volatile compounds in human breath: critical review and meta-analysis. J Breath Res 2022; 16. [PMID: 35120340 DOI: 10.1088/1752-7163/ac5230] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/04/2022] [Indexed: 11/12/2022]
Abstract
Volatile compounds contained in human breath reflect the inner workings of the body. A large number of studies have been published that link individual components of breath to disease, but diagnostic applications remain limited, in part due to inconsistent and conflicting identification of breath biomarkers. New approaches are therefore required to identify effective biomarker targets. Here, volatile organic compounds have been identified in the literature from four metabolically and physiologically distinct diseases and grouped into chemical functional groups (e.g. - methylated hydrocarbons or aldehydes; based on known metabolic and enzymatic pathways) to support biomarker discovery and provide new insight on existing data. Using this functional grouping approach, principal component analysis doubled explanatory capacity from 19.1% to 38% relative to single individual compound approaches. Random forest and linear discriminant analysis reveal 93% classification accuracy for cancer. This review and meta-analysis provides insight for future research design by identifying volatile functional groups associated with disease. By incorporating our understanding of the complexities of the human body, along with accounting for variability in methodological and analytical approaches, this work demonstrates that a suite of targeted, functional volatile biomarkers, rather than individual biomarker compounds, will improve accuracy and success in diagnostic research and application.
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Affiliation(s)
- Theo Issitt
- Biology, University of York, University of York, York, York, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Laura Wiggins
- Biology, University of York, University of York, York, York, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Martin Veysey
- The University of Newcastle, School of Medicine & Public Health, Callaghan, New South Wales, 2308, AUSTRALIA
| | - Sean Sweeney
- Biology, University of York, University of York, York, York, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - William Brackenbury
- Biology, University of York, University of York, York, York, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Kelly Redeker
- Biology, University of York, Biology Dept. University of York, York, York, North Yorkshire, YO10 5DD, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
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5
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Xiang L, Wu S, Hua Q, Bao C, Liu H. Volatile Organic Compounds in Human Exhaled Breath to Diagnose Gastrointestinal Cancer: A Meta-Analysis. Front Oncol 2021; 11:606915. [PMID: 33747921 PMCID: PMC7970758 DOI: 10.3389/fonc.2021.606915] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/21/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction Human exhaled volatile organic compounds (VOCs) are being extensively studied for the purposes of noninvasive cancer diagnoses. This article was primarily to assess the feasibility of utilizing exhaled VOCs analysis for gastrointestinal cancer (GIC) diagnosis. Methods PRISMA-based system searches were conducted for related studies of exhaled VOCs in GIC diagnosis based on predetermined criteria. Relevant articles on colorectal cancer and gastroesophageal cancer were summarized, and meta analysis was performed on articles providing sensitivity and specificity data. Results From 2,227 articles, 14 were found to meet inclusion criteria, six of which were on colorectal cancer (CRC) and eight on Gastroesophageal cancer(GEC). Five articles could provide specific data of sensitivity and specificity in GEC, which were used for meta-analysis. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated based on the combination of these data, and were 85.0% [95% confidence interval (CI): 79.0%-90.0%], 89.0% (95%CI: 86.0%-91.0%), 41.30 (21.56-79.10), and 0.93, respectively. Conclusion VOCs can distinguish gastrointestinal cancers from other gastrointestinal diseases, opening up a new avenue for the diagnosis and identification of gastrointestinal cancers, and the analysis of VOCs in exhaled breath has potential clinical application in screening. VOCs are promising tumor biomarkers for GIC diagnosis. Furthermore, limitations like the heterogeneity of diagnostic VOCs between studies should be minded.
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Affiliation(s)
- Lijuan Xiang
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Sihan Wu
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Oncology, Affiliated Provincial Hospital of Anhui Medical University, Hefei, China
| | - Qingling Hua
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, China
| | - Chuyang Bao
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hu Liu
- Department of Tumor Biotherapy (5th Ward of the Department of Oncology), Anhui Provincial Cancer Hospital, West District of The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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6
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Bellagambi FG, Lomonaco T, Ghimenti S, Biagini D, Fuoco R, Di Francesco F. Determination of peppermint compounds in breath by needle trap micro-extraction coupled with gas chromatography-tandem mass spectrometry. J Breath Res 2020; 15. [PMID: 33238253 DOI: 10.1088/1752-7163/abcdec] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 11/25/2020] [Indexed: 01/26/2023]
Abstract
Breath analysis is an alternative approach for disease diagnosis and for monitoring therapy. The lack of standardized procedures for collecting and analysing breath samples currently limits its use in clinical practice. In order to overcome this limitation, the "Peppermint Consortium" was established within the breath community to carry out breath wash-out experiments and define reference values for a panel of compounds contained in the peppermint oil capsule. Here, we present a needle trap micro-extraction technique coupled with gas chromatography and tandem mass spectrometry for a rapid and accurate determination of alpha-pinene, beta-pinene, limonene, eucalyptol, menthofuran, menthone, menthol and menthyl acetate in mixed breath samples. Detection limits between 1 and 20 pptv were observed when 25 mL of a humidified standard gas mixture were loaded into a needle trap device at a flow rate of 10 mL/min. Inter- and intra-day precisions were lower than 15%, thus confirming the reliability of the assay. Our procedure was used to analyse breath samples taken from a nominally healthy volunteer who were invited to swallow a 200 mg capsule of peppermint oil. Six samples were collected at various times within six hours of ingestion. Analyte concentrations were not affected by the sampling mode (i.e. mixed vs. end-tidal fraction), whereas respiratory rate and exhalation flow rate values slightly influenced the concentration of the target compounds in breath samples.
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Affiliation(s)
- Francesca G Bellagambi
- Institut des Sciences Analytiques, Université Claude Bernard Lyon 1, 5, rue de la Doua, Villeurbanne, FRANCE, 69100, FRANCE
| | - Tommaso Lomonaco
- Department of Chemistry and Industrial Chemistry, Universita degli Studi di Pisa Dipartimento di Chimica e Chimica Industriale, Via G. Moruzzi, 13, Pisa, Tuscany, 56124, ITALY
| | - Silvia Ghimenti
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Toscana, ITALY
| | - Denise Biagini
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Toscana, ITALY
| | - Roger Fuoco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Toscana, ITALY
| | - Fabio Di Francesco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Toscana, ITALY
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7
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Ager C, Mochalski P, King J, Mayhew CA, Unterkofler K. Effect of inhaled acetone concentrations on exhaled breath acetone concentrations at rest and during exercise. J Breath Res 2020; 14:026010. [PMID: 31829984 DOI: 10.1088/1752-7163/ab613a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Real-time measurements of the differences in inhaled and exhaled, unlabeled and fully deuterated acetone concentration levels, at rest and during exercise, have been conducted using proton transfer reaction mass spectrometry. A novel approach to continuously differentiate between the inhaled and exhaled breath acetone concentration signals is used. This leads to unprecedented fine grained data of inhaled and exhaled concentrations. The experimental results obtained are compared with those predicted using a simple three compartment model that theoretically describes the influence of inhaled concentrations on exhaled breath concentrations for volatile organic compounds with high blood:air partition coefficients, and hence is appropriate for acetone. An agreement between the predicted and observed concentrations is obtained. Our results highlight that the influence of the upper airways cannot be neglected for volatiles with high blood:air partition coefficients, i.e. highly water soluble volatiles.
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Affiliation(s)
- Clemens Ager
- Institute for Breath Research, Leopold-Franzens-Universität Innsbruck, Rathausplatz 4, A-6850 Dornbirn, Austria. Univ.-Clinic for Anesthesia and Intensive Care, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck, Austria
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8
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Azim A, Barber C, Dennison P, Riley J, Howarth P. Exhaled volatile organic compounds in adult asthma: a systematic review. Eur Respir J 2019; 54:13993003.00056-2019. [PMID: 31273044 DOI: 10.1183/13993003.00056-2019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022]
Abstract
The search for biomarkers that can guide precision medicine in asthma, particularly those that can be translated to the clinic, has seen recent interest in exhaled volatile organic compounds (VOCs). Given the number of studies reporting "breathomics" findings and its growing integration in clinical trials, we performed a systematic review of the literature to summarise current evidence and understanding of breathomics technology in asthma.A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-oriented systematic search was performed (CRD42017084145) of MEDLINE, Embase and the Cochrane databases to search for any reports that assessed exhaled VOCs in adult asthma patients, using the following terms (asthma AND (volatile organic compounds AND exhaled) OR breathomics).Two authors independently determined the eligibility of 2957 unique records, of which 66 underwent full-text review. Data extraction and risk of bias assessment was performed on the 22 studies deemed to fulfil the search criteria. The studies are described in terms of methodology and the evidence narratively summarised under the following clinical headings: diagnostics, phenotyping, treatment stratification, treatment monitoring and exacerbation prediction/assessment.Our review found that most studies were designed to assess diagnostic potential rather than focus on underlying biology or treatable traits. Results are generally limited by a lack of methodological standardisation and external validation and by insufficiently powered studies, but there is consistency across the literature that exhaled VOCs are sensitive to underlying inflammation. Modern studies are applying robust breath analysis workflows to large multi-centre study designs, which should unlock the full potential of measurement of exhaled volatile organic compounds in airways diseases such as asthma.
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Affiliation(s)
- Adnan Azim
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK .,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Clair Barber
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Paddy Dennison
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - John Riley
- Galaxy Asthma, GSK, Medicines Research Centre, Stevenage, UK
| | - Peter Howarth
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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9
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Španěl P, Smith D. What is the real utility of breath ammonia concentration measurements in medicine and physiology? J Breath Res 2018; 12:027102. [PMID: 28972201 DOI: 10.1088/1752-7163/aa907f] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Much effort continues to be devoted to the development of devices to analyse breath ammonia with the anticipation that breath ammonia analyses will be useful in clinical practice. In this perspective we refer to the analytical techniques that have been used to measure breath ammonia, focusing on selected ion flow tube mass spectrometry, SIFT-MS, of which we have special knowledge and understanding. From the collected data obtained using the different techniques, we exam the origins of mouth- and nose-exhaled ammonia and conclude that mouth-exhaled ammonia is always elevated above a concentration that would be equilibrated with blood ammonia and is largely produced by the action of enzymes on salivary urea. Support to this conclusion is given by the reasonable correlation between blood urea concentration and mouth-exhaled ammonia concentration. Further, it is discussed that nose-exhaled ammonia largely originates at the alveolar interface and so its concentration more closely relates to the expected alveolar blood ammonia concentration. Ingestion of proteins results in increased blood/saliva urea and ultimately mouth-exhaled ammonia as does the generation of urease by H. pylori infection. It is also concluded that when mouth-exhaled ammonia is elevated then it may be due to either abnormally high blood urea, a high pH of the saliva/mouth/airways mucosa, poor oral hygiene or a combinations of these.
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Affiliation(s)
- Patrik Španěl
- J. Heyrovský Institute of Physical Chemistry, Academy of Sciences of the Czech Republic, v.v.i., Dolejškova 3, 182 23 Prague 8, Czechia
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10
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Neerincx AH, Vijverberg SJH, Bos LDJ, Brinkman P, van der Schee MP, de Vries R, Sterk PJ, Maitland-van der Zee AH. Breathomics from exhaled volatile organic compounds in pediatric asthma. Pediatr Pulmonol 2017; 52:1616-1627. [PMID: 29082668 DOI: 10.1002/ppul.23785] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 07/21/2017] [Indexed: 12/19/2022]
Abstract
Asthma is the most common chronic disease in children, and is characterized by airway inflammation, bronchial hyperresponsiveness, and airflow obstruction. Asthma diagnosis, phenotyping, and monitoring are still challenging with currently available methods, such as spirometry, FE NO or sputum analysis. The analysis of volatile organic compounds (VOCs) in exhaled breath could be an interesting non-invasive approach, but has not yet reached clinical practice. This review describes the current status of breath analysis in the diagnosis and monitoring of pediatric asthma. Furthermore, features of an ideal breath test, different breath analysis techniques, and important methodological issues are discussed. Although only a (small) number of studies have been performed in pediatric asthma, of which the majority is focusing on asthma diagnosis, these studies show moderate to good prediction accuracy (80-100%, with models including 6-28 VOCs), thereby qualifying breathomics for future application. However, standardization of procedures, longitudinal studies, as well as external validation are needed in order to further develop breathomics into clinical tools. Such a non-invasive tool may be the next step toward stratified and personalized medicine in pediatric respiratory disease.
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Affiliation(s)
- Anne H Neerincx
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Susanne J H Vijverberg
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Lieuwe D J Bos
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.,Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Paul Brinkman
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Marc P van der Schee
- Department of Paediatric Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Rianne de Vries
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Peter J Sterk
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
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11
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Horváth I, Barnes PJ, Loukides S, Sterk PJ, Högman M, Olin AC, Amann A, Antus B, Baraldi E, Bikov A, Boots AW, Bos LD, Brinkman P, Bucca C, Carpagnano GE, Corradi M, Cristescu S, de Jongste JC, Dinh-Xuan AT, Dompeling E, Fens N, Fowler S, Hohlfeld JM, Holz O, Jöbsis Q, Van De Kant K, Knobel HH, Kostikas K, Lehtimäki L, Lundberg J, Montuschi P, Van Muylem A, Pennazza G, Reinhold P, Ricciardolo FLM, Rosias P, Santonico M, van der Schee MP, van Schooten FJ, Spanevello A, Tonia T, Vink TJ. A European Respiratory Society technical standard: exhaled biomarkers in lung disease. Eur Respir J 2017; 49:49/4/1600965. [PMID: 28446552 DOI: 10.1183/13993003.00965-2016] [Citation(s) in RCA: 375] [Impact Index Per Article: 53.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 01/09/2017] [Indexed: 12/19/2022]
Abstract
Breath tests cover the fraction of nitric oxide in expired gas (FeNO), volatile organic compounds (VOCs), variables in exhaled breath condensate (EBC) and other measurements. For EBC and for FeNO, official recommendations for standardised procedures are more than 10 years old and there is none for exhaled VOCs and particles. The aim of this document is to provide technical standards and recommendations for sample collection and analytic approaches and to highlight future research priorities in the field. For EBC and FeNO, new developments and advances in technology have been evaluated in the current document. This report is not intended to provide clinical guidance on disease diagnosis and management.Clinicians and researchers with expertise in exhaled biomarkers were invited to participate. Published studies regarding methodology of breath tests were selected, discussed and evaluated in a consensus-based manner by the Task Force members.Recommendations for standardisation of sampling, analysing and reporting of data and suggestions for research to cover gaps in the evidence have been created and summarised.Application of breath biomarker measurement in a standardised manner will provide comparable results, thereby facilitating the potential use of these biomarkers in clinical practice.
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Affiliation(s)
- Ildiko Horváth
- Dept of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Peter J Barnes
- National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, UK
| | | | - Peter J Sterk
- Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieann Högman
- Centre for Research & Development, Uppsala University/Gävleborg County Council, Gävle, Sweden
| | - Anna-Carin Olin
- Occupational and Environmental Medicine, Sahlgrenska Academy and University Hospital, Goteborg, Sweden
| | - Anton Amann
- Innsbruck Medical University, Innsbruck, Austria
| | - Balazs Antus
- Dept of Pathophysiology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | - Andras Bikov
- Dept of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Agnes W Boots
- Dept of Pharmacology and Toxicology, University of Maastricht, Maastricht, The Netherlands
| | - Lieuwe D Bos
- Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Paul Brinkman
- Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Caterina Bucca
- Biomedical Sciences and Human Oncology, Universita' di Torino, Turin, Italy
| | | | | | - Simona Cristescu
- Dept of Molecular and Laser Physics, Institute for Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Johan C de Jongste
- Dept of Pediatrics/Respiratory Medicine, Erasmus MC-Sophia Childrens' Hospital, Rotterdam, The Netherlands
| | | | - Edward Dompeling
- Dept of Paediatrics/Family Medicine Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Niki Fens
- Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Stephen Fowler
- Respiratory Research Group, University of Manchester Wythenshawe Hospital, Manchester, UK
| | - Jens M Hohlfeld
- Clinical Airway Research, Fraunhofer Institute of Toxicology and Experimental Medicine (ITEM), Hannover, Germany.,Medizinische Hochschule Hannover, Hannover, Germany
| | - Olaf Holz
- Clinical Airway Research, Fraunhofer Institute of Toxicology and Experimental Medicine (ITEM), Hannover, Germany
| | - Quirijn Jöbsis
- Department of Paediatric Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Kim Van De Kant
- Dept of Paediatrics/Family Medicine Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Hugo H Knobel
- Philips Research, High Tech Campus 11, Eindhoven, The Netherlands
| | | | | | - Jon Lundberg
- Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Montuschi
- Pharmacology, Catholic University of the Sacred Heart, Rome, Italy
| | - Alain Van Muylem
- Hopital Erasme Cliniques Universitaires de Bruxelles, Bruxelles, Belgium
| | - Giorgio Pennazza
- Faculty of Engineering, University Campus Bio-Medico, Rome, Italy
| | - Petra Reinhold
- Institute of Molecular Pathogenesis, Friedrich Loeffler Institut, Jena, Germany
| | - Fabio L M Ricciardolo
- Clinic of Respiratory Disease, Dept of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Philippe Rosias
- Dept of Paediatrics/Family Medicine Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands.,Dept of Pediatrics, Maasland Hospital, Sittard, The Netherlands
| | - Marco Santonico
- Faculty of Engineering, University Campus Bio-Medico, Rome, Italy
| | - Marc P van der Schee
- Dept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Thomy Tonia
- European Respiratory Society, Lausanne, Switzerland
| | - Teunis J Vink
- Philips Research, High Tech Campus 11, Eindhoven, The Netherlands
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12
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Doping-assisted low-pressure photoionization mass spectrometry for the real-time detection of lung cancer-related volatile organic compounds. Talanta 2016; 165:98-106. [PMID: 28153325 DOI: 10.1016/j.talanta.2016.12.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/16/2016] [Accepted: 12/18/2016] [Indexed: 01/15/2023]
Abstract
Real-time detection of lung cancer-related volatile organic compounds (VOCs) is a promising, non-intrusive technique for lung cancer (LC) prescreening. In this study, a novel method was designed to enhance the detection selectivity and sensitivity of LC-related polar VOCs by dichloromethane (CH2Cl2) doping-assisted low-pressure photoionization mass spectrometry (LPPI-MS). Compared with conventional LPPI-MS, CH2Cl2 doping-assisted LPPI-MS boosted the peak intensities of n-propanol, n-pentanal, acetone, and butyl acetate in nitrogen specifically by 53, 18, 16, and 43 times, respectively. The signal intensities of their daughter ions were inhibited or reduced. At relative humidity (RH) of 20%, the sensitivities of n-propanol, n-pentanal, acetone, and butyl acetate detection ranged from 116 to 452 counts/ppbv with a detection time of 10s and R2 >0.99 for the linear calibration curves. The method was also applicable under higher RH levels of 50% and 90%. Breath samples obtained from 10 volunteers and spiked samples were investigated. Eight-fold enhancements in the signal intensities of polar VOCs were observed in the normal and spiked samples. These preliminary results demonstrate the efficacy of the dichloromethane doping-assisted LPPI technique for the detection of LC-related polar VOCs. Further studies are indispensible to illustrating the detailed mechanism and applying the technique to breath diagnosis.
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13
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Recent analytical approaches to detect exhaled breath ammonia with special reference to renal patients. Anal Bioanal Chem 2016; 409:21-31. [PMID: 27595582 DOI: 10.1007/s00216-016-9903-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/10/2016] [Accepted: 08/24/2016] [Indexed: 12/15/2022]
Abstract
The ammonia odor from the exhaled breath of renal patients is associated with high levels of blood urea nitrogen. Typically, in the liver, ammonia and ammonium ions are converted into urea through the urea cycle. In the case of renal dysfunction, urea is unable to be removed and that causes a buildup of excessive ammonia. As small molecules, ammonia and ammonium ions can be forced into the blood-lung barrier and occur in exhaled breath. Therefore, people with renal failure have an ammonia (fishy) odor in their exhaled breath. Thus, exhaled breath ammonia can be a potential biomarker for monitoring renal diseases during hemodialyis. In this review, we have summarized the source of ammonia in the breath of end-stage renal disease patient, cause of renal disorders, exhaled breath condensate, and breath sampling. Further, various biosensor approaches to detect exhaled ammonia from renal patients and other ammonia systems are also discussed. We conclude with future perspectives, namely colorimetric-based real-time breathing diagnosis of renal failure, which might be useful for prospective studies.
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14
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FEV manoeuvre induced changes in breath VOC compositions: an unconventional view on lung function tests. Sci Rep 2016; 6:28029. [PMID: 27311826 PMCID: PMC4911606 DOI: 10.1038/srep28029] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/27/2016] [Indexed: 12/23/2022] Open
Abstract
Breath volatile organic compound (VOC) analysis can open a non-invasive window onto pathological and metabolic processes in the body. Decades of clinical breath-gas analysis have revealed that changes in exhaled VOC concentrations are important rather than disease specific biomarkers. As physiological parameters, such as respiratory rate or cardiac output, have profound effects on exhaled VOCs, here we investigated VOC exhalation under respiratory manoeuvres. Breath VOCs were monitored by means of real-time mass-spectrometry during conventional FEV manoeuvres in 50 healthy humans. Simultaneously, we measured respiratory and hemodynamic parameters noninvasively. Tidal volume and minute ventilation increased by 292 and 171% during the manoeuvre. FEV manoeuvre induced substance specific changes in VOC concentrations. pET-CO2 and alveolar isoprene increased by 6 and 21% during maximum exhalation. Then they decreased by 18 and 37% at forced expiration mirroring cardiac output. Acetone concentrations rose by 4.5% despite increasing minute ventilation. Blood-borne furan and dimethyl-sulphide mimicked isoprene profile. Exogenous acetonitrile, sulphides, and most aliphatic and aromatic VOCs changed minimally. Reliable breath tests must avoid forced breathing. As isoprene exhalations mirrored FEV performances, endogenous VOCs might assure quality of lung function tests. Analysis of exhaled VOC concentrations can provide additional information on physiology of respiration and gas exchange.
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15
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Bigazzi AY, Figliozzi MA, Luo W, Pankow JF. Breath Biomarkers to Measure Uptake of Volatile Organic Compounds by Bicyclists. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2016; 50:5357-5363. [PMID: 27097118 DOI: 10.1021/acs.est.6b01159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Breath biomarkers were used to study uptake of traffic-related volatile organic compounds (VOCs) from urban bicycling. Breath analysis was selected because it is one of the least invasive methods to assess urban traveler exposure. Research hurdles that were overcome included considering that factors other than on-road exposure can influence concentrations in the body, and absorbed doses during a trip can be small compared to baseline body burdens. Pre-trip, on-road, and post-trip breath concentrations and ambient air concentrations were determined for 26 VOCs for bicyclists traveling on different path types. Statistical analyses of the concentration data identified eight monoaromatic hydrocarbons potentially useful as breath biomarkers to compare differences in body levels brought about by urban travel choices. Breath concentrations of the biomarker compounds were significantly higher than background levels after riding on high-traffic arterial streets and on a path through a high-exposure industrial area, but not after riding on low-traffic local streets or on other off-street paths. Modeled effects of high-traffic streets on ambient concentrations were 100-200% larger than those of low-traffic streets; modeled effects of high-traffic streets on breath concentrations were 40-100% larger than those of low-traffic streets. Similar percentage increases in breath concentrations are expected for bicyclists in other cities.
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Affiliation(s)
- Alexander Y Bigazzi
- Department of Civil Engineering and ‡School of Community and Regional Planning, The University of British Columbia , Vancouver, British Columbia V6T 1Z4, Canada
- Department of Civil and Environmental Engineering and ∥Department of Chemistry, Portland State University , Portland, Oregon 97207, United States
| | - Miguel A Figliozzi
- Department of Civil Engineering and ‡School of Community and Regional Planning, The University of British Columbia , Vancouver, British Columbia V6T 1Z4, Canada
- Department of Civil and Environmental Engineering and ∥Department of Chemistry, Portland State University , Portland, Oregon 97207, United States
| | - Wentai Luo
- Department of Civil Engineering and ‡School of Community and Regional Planning, The University of British Columbia , Vancouver, British Columbia V6T 1Z4, Canada
- Department of Civil and Environmental Engineering and ∥Department of Chemistry, Portland State University , Portland, Oregon 97207, United States
| | - James F Pankow
- Department of Civil Engineering and ‡School of Community and Regional Planning, The University of British Columbia , Vancouver, British Columbia V6T 1Z4, Canada
- Department of Civil and Environmental Engineering and ∥Department of Chemistry, Portland State University , Portland, Oregon 97207, United States
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16
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Kramer C, Mochalski P, Unterkofler K, Agapiou A, Ruzsanyi V, Liedl KR. Prediction of blood:air and fat:air partition coefficients of volatile organic compounds for the interpretation of data in breath gas analysis. J Breath Res 2016; 10:017103. [PMID: 26815030 PMCID: PMC4957668 DOI: 10.1088/1752-7155/10/1/017103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In this article, a database of blood:air and fat:air partition coefficients (λ b:a and λ f:a) is reported for estimating 1678 volatile organic compounds recently reported to appear in the volatilome of the healthy human. For this purpose, a quantitative structure-property relationship (QSPR) approach was applied and a novel method for Henry's law constants prediction developed. A random forest model based on Molecular Operating Environment 2D (MOE2D) descriptors based on 2619 literature-reported Henry's constant values was built. The calculated Henry's law constants correlate very well (R(2) test = 0.967) with the available experimental data. Blood:air and fat:air partition coefficients were calculated according to the method proposed by Poulin and Krishnan using the estimated Henry's constant values. The obtained values correlate reasonably well with the experimentally determined ones for a test set of 90 VOCs (R(2) = 0.95). The provided data aim to fill in the literature data gap and further assist the interpretation of results in studies of the human volatilome.
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Affiliation(s)
- Christian Kramer
- Institute of General, Inorganic and Theoretical Chemistry, University of Innsbruck, Innrain 82, A-6020 Innsbruck, Austria. Present address: Fa. Hoffmann-La Roche Ltd, Pharma Research and Early Development, Therapeutic Modalities, Roche Innovation Center Basel, Grenzacherstrasse 124, CH-4070 Basel, Switzerland
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17
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Vishinkin R, Haick H. Nanoscale Sensor Technologies for Disease Detection via Volatolomics. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2015; 11:6142-64. [PMID: 26448487 DOI: 10.1002/smll.201501904] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 07/19/2015] [Indexed: 05/07/2023]
Abstract
The detection of many diseases is missed because of delayed diagnoses or the low efficacy of some treatments. This emphasizes the urgent need for inexpensive and minimally invasive technologies that would allow efficient early detection, stratifying the population for personalized therapy, and improving the efficacy of rapid bed-side assessment of treatment. An emerging approach that has a high potential to fulfill these needs is based on so-called "volatolomics", namely, chemical processes involving profiles of highly volatile organic compounds (VOCs) emitted from body fluids, including breath, skin, urine and blood. This article presents a didactic review of some of the main advances related to the use of nanomaterial-based solid-state and flexible sensors, and related artificially intelligent sensing arrays for the detection and monitoring of disease with volatolomics. The article attempts to review the technological gaps and confounding factors related to VOC testing. Different ways to choose nanomaterial-based sensors are discussed, while considering the profiles of targeted volatile markers and possible limitations of applying the sensing approach. Perspectives for taking volatolomics to a new level in the field of diagnostics are highlighted.
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Affiliation(s)
- Rotem Vishinkin
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
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18
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Sukul P, Trefz P, Kamysek S, Schubert JK, Miekisch W. Instant effects of changing body positions on compositions of exhaled breath. J Breath Res 2015; 9:047105. [PMID: 26582820 DOI: 10.1088/1752-7155/9/4/047105] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Concentrations of exhaled volatile organic compounds (VOCs) may depend not only on biochemical or pathologic processes but also on physiological parameters. As breath sampling may be done in different body positions, effects of the sampling position on exhaled VOC concentrations were investigated by means of real-time mass spectrometry. Breaths from 15 healthy volunteers were analyzed in real-time by PTR-ToF-MS-8000 during paced breathing (12/min) in a continuous side-stream mode. We applied two series of body positions (setup 1: sitting, standing, supine, and sitting; setup 2: supine, left lateral, right lateral, prone, and supine). Each position was held for 2 min. Breath VOCs were quantified in inspired and alveolar air by means of a custom-made algorithm. Parallel monitoring of hemodynamics and capnometry was performed noninvasively. In setup 1, when compared to the initial sitting position, normalized mean concentrations of isoprene, furan, and acetonitrile decreased by 24%, 26%, and 9%, respectively, during standing and increased by 63%, 36%, and 10% during lying mirroring time profiles of stroke volume and pET-CO2. In contrast, acetone and H2S concentrations remained almost constant. In setup 2, when compared to the initial supine position, mean alveolar concentrations of isoprene and furan increased significantly up to 29% and 16%, respectively, when position was changed from lying on the right side to the prone position. As cardiac output and stroke volume decreased at that time, the reasons for the observed concentrations changes have to be linked to the ventilation/perfusion ratio or compartmental distribution rather than to perfusion alone. During final postures, all VOC concentrations, hemodynamics, and pET-CO2 returned to baseline. Exhaled blood-borne VOC profiles changed due to body postures. Changes depended on cardiac stroke volume, origin, compartmental distribution and physico-chemical properties of the substances. Patients' positions and cardiac output have to be controlled when concentrations of breath VOCs are to be interpreted in terms of biomarkers.
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Affiliation(s)
- Pritam Sukul
- Department of Anesthesiology and Intensive Care Medicine, Rostock Medical Breath Research Analytics and Technologies (ROMBAT), University Medicine Rostock, Schillingallee 35, D-18057 Rostock, Germany
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19
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Unterkofler K, King J, Mochalski P, Jandacka M, Koc H, Teschl S, Amann A, Teschl G. Modeling-based determination of physiological parameters of systemic VOCs by breath gas analysis: a pilot study. J Breath Res 2015; 9:036002. [PMID: 25972041 DOI: 10.1088/1752-7155/9/3/036002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In this paper we develop a simple two compartment model which extends the Farhi equation to the case when the inhaled concentration of a volatile organic compound (VOC) is not zero. The model connects the exhaled breath concentration of systemic VOCs with physiological parameters such as endogenous production rates and metabolic rates. Its validity is tested with data obtained for isoprene and inhaled deuterated isoprene-D5.
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Affiliation(s)
- Karl Unterkofler
- Breath Research Institute, University of Innsbruck, Rathausplatz 4, A-6850 Dornbirn, Austria. University of Applied Sciences Vorarlberg, Hochschulstr. 1, A-6850 Dornbirn, Austria
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20
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Mochalski P, Unterkofler K, Teschl G, Amann A. Potential of volatile organic compounds as markers of entrapped humans for use in urban search-and-rescue operations. Trends Analyt Chem 2015. [DOI: 10.1016/j.trac.2015.02.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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21
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Advances in electronic-nose technologies for the detection of volatile biomarker metabolites in the human breath. Metabolites 2015; 5:140-63. [PMID: 25738426 PMCID: PMC4381294 DOI: 10.3390/metabo5010140] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 02/11/2015] [Accepted: 02/23/2015] [Indexed: 11/16/2022] Open
Abstract
Recent advancements in the use of electronic-nose (e-nose) devices to analyze human breath profiles for the presence of specific volatile metabolites, known as biomarkers or chemical bio-indicators of specific human diseases, metabolic disorders and the overall health status of individuals, are providing the potential for new noninvasive tools and techniques useful to point-of-care clinical disease diagnoses. This exciting new area of electronic disease detection and diagnosis promises to yield much faster and earlier detection of human diseases and disorders, allowing earlier, more effective treatments, resulting in more rapid patient recovery from various afflictions. E-nose devices are particularly suited for the field of disease diagnostics, because they are sensitive to a wide range of volatile organic compounds (VOCs) and can effectively distinguish between different complex gaseous mixtures via analysis of electronic aroma sensor-array output profiles of volatile metabolites present in the human breath. This review provides a summary of some recent developments of electronic-nose technologies, particularly involving breath analysis, with the potential for providing many new diagnostic applications for the detection of specific human diseases associated with different organs in the body, detectable from e-nose analyses of aberrant disease-associated VOCs present in air expired from the lungs.
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22
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Trace detection of endogenous human volatile organic compounds for search, rescue and emergency applications. Trends Analyt Chem 2015. [DOI: 10.1016/j.trac.2014.11.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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23
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Sukul P, Trefz P, Schubert JK, Miekisch W. Immediate effects of breath holding maneuvers onto composition of exhaled breath. J Breath Res 2014; 8:037102. [DOI: 10.1088/1752-7155/8/3/037102] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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24
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Lourenço C, Turner C. Breath analysis in disease diagnosis: methodological considerations and applications. Metabolites 2014; 4:465-98. [PMID: 24957037 PMCID: PMC4101517 DOI: 10.3390/metabo4020465] [Citation(s) in RCA: 141] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 06/02/2014] [Accepted: 06/09/2014] [Indexed: 02/07/2023] Open
Abstract
Breath analysis is a promising field with great potential for non-invasive diagnosis of a number of disease states. Analysis of the concentrations of volatile organic compounds (VOCs) in breath with an acceptable accuracy are assessed by means of using analytical techniques with high sensitivity, accuracy, precision, low response time, and low detection limit, which are desirable characteristics for the detection of VOCs in human breath. "Breath fingerprinting", indicative of a specific clinical status, relies on the use of multivariate statistics methods with powerful in-built algorithms. The need for standardisation of sample collection and analysis is the main issue concerning breath analysis, blocking the introduction of breath tests into clinical practice. This review describes recent scientific developments in basic research and clinical applications, namely issues concerning sampling and biochemistry, highlighting the diagnostic potential of breath analysis for disease diagnosis. Several considerations that need to be taken into account in breath analysis are documented here, including the growing need for metabolomics to deal with breath profiles.
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Affiliation(s)
- Célia Lourenço
- Department of Life, Health & Chemical Sciences, Chemistry and Analytical Sciences, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK.
| | - Claire Turner
- Department of Life, Health & Chemical Sciences, Chemistry and Analytical Sciences, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK.
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25
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Amann A, Costello BDL, Miekisch W, Schubert J, Buszewski B, Pleil J, Ratcliffe N, Risby T. The human volatilome: volatile organic compounds (VOCs) in exhaled breath, skin emanations, urine, feces and saliva. J Breath Res 2014; 8:034001. [PMID: 24946087 DOI: 10.1088/1752-7155/8/3/034001] [Citation(s) in RCA: 361] [Impact Index Per Article: 36.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Breath analysis is a young field of research with its roots in antiquity. Antoine Lavoisier discovered carbon dioxide in exhaled breath during the period 1777-1783, Wilhelm (Vilém) Petters discovered acetone in breath in 1857 and Johannes Müller reported the first quantitative measurements of acetone in 1898. A recent review reported 1765 volatile compounds appearing in exhaled breath, skin emanations, urine, saliva, human breast milk, blood and feces. For a large number of compounds, real-time analysis of exhaled breath or skin emanations has been performed, e.g., during exertion of effort on a stationary bicycle or during sleep. Volatile compounds in exhaled breath, which record historical exposure, are called the 'exposome'. Changes in biogenic volatile organic compound concentrations can be used to mirror metabolic or (patho)physiological processes in the whole body or blood concentrations of drugs (e.g. propofol) in clinical settings-even during artificial ventilation or during surgery. Also compounds released by bacterial strains like Pseudomonas aeruginosa or Streptococcus pneumonia could be very interesting. Methyl methacrylate (CAS 80-62-6), for example, was observed in the headspace of Streptococcus pneumonia in concentrations up to 1420 ppb. Fecal volatiles have been implicated in differentiating certain infectious bowel diseases such as Clostridium difficile, Campylobacter, Salmonella and Cholera. They have also been used to differentiate other non-infectious conditions such as irritable bowel syndrome and inflammatory bowel disease. In addition, alterations in urine volatiles have been used to detect urinary tract infections, bladder, prostate and other cancers. Peroxidation of lipids and other biomolecules by reactive oxygen species produce volatile compounds like ethane and 1-pentane. Noninvasive detection and therapeutic monitoring of oxidative stress would be highly desirable in autoimmunological, neurological, inflammatory diseases and cancer, but also during surgery and in intensive care units. The investigation of cell cultures opens up new possibilities for elucidation of the biochemical background of volatile compounds. In future studies, combined investigations of a particular compound with regard to human matrices such as breath, urine, saliva and cell culture investigations will lead to novel scientific progress in the field.
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Affiliation(s)
- Anton Amann
- Univ-Clinic for Anesthesia and Intensive Care, Innsbruck Medical University, Anichstr, 35, A-6020 Innsbruck, Austria. Breath Research Institute of the University of Innsbruck, Rathausplatz 4, A-6850 Dornbirn, Austria
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26
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Emission rates of selected volatile organic compounds from skin of healthy volunteers. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 959:62-70. [PMID: 24768920 PMCID: PMC4013926 DOI: 10.1016/j.jchromb.2014.04.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 03/31/2014] [Accepted: 04/03/2014] [Indexed: 12/23/2022]
Abstract
Quantification of volatiles emitted by human skin by SPME-GCMS. Determination of emission rates of 64 skin-borne species. Selection of potential skin-borne markers of human presence for rescue applications.
Gas chromatography with mass spectrometric detection (GC–MS) coupled with solid phase micro-extraction as pre-concentration method (SPME) was applied to identify and quantify volatile organic compounds (VOCs) emitted by human skin. A total of 64 C4-C10 compounds were quantified in skin emanation of 31 healthy volunteers. Amongst them aldehydes and hydrocarbons were the predominant chemical families with eighteen and seventeen species, respectively. Apart from these, there were eight ketones, six heterocyclic compounds, six terpenes, four esters, two alcohols, two volatile sulphur compounds, and one nitrile. The observed median emission rates ranged from 0.55 to 4790 fmol cm−2 min−1. Within this set of analytes three volatiles; acetone, 6-methyl-5-hepten-2-one, and acetaldehyde exhibited especially high emission rates exceeding 100 fmol cm−2 min−1. Thirty-three volatiles were highly present in skin emanation with incidence rates over 80%. These species can be considered as potential markers of human presence, which could be used for early location of entrapped victims during Urban Search and Rescue Operations (USaR).
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27
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Smith D, Španěl P, Herbig J, Beauchamp J. Mass spectrometry for real-time quantitative breath analysis. J Breath Res 2014; 8:027101. [PMID: 24682047 DOI: 10.1088/1752-7155/8/2/027101] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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28
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Amann A, Mochalski P, Ruzsanyi V, Broza YY, Haick H. Assessment of the exhalation kinetics of volatile cancer biomarkers based on their physicochemical properties. J Breath Res 2014; 8:016003. [PMID: 24566039 DOI: 10.1088/1752-7155/8/1/016003] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The current review provides an assessment of the exhalation kinetics of volatile organic compounds (VOCs) that have been linked with cancer. Towards this end, we evaluate various physicochemical properties, such as 'breath:air' and 'blood:fat' partition coefficients, of 112 VOCs that have been suggested over the past decade as potential markers of cancer. With these data, we show that the cancer VOC concentrations in the blood and in the fat span over 12 and 8 orders of magnitude, respectively, in order to provide a specific counterpart concentration in the exhaled breath (e.g., 1 ppb). This finding suggests that these 112 different compounds have different storage compartments in the body and that their exhalation kinetics depends on one or a combination of the following factors: (i) the VOC concentrations in different parts of the body; (ii) the VOC synthesis and metabolism rates; (iii) the partition coefficients between tissue(s), blood and air; and (iv) the VOCs' diffusion constants. Based on this analysis, we discuss how this knowledge allows modeling and simulating the behavior of a specific VOC under different sampling protocols (with and without exertion of effort). We end this review by a brief discussion on the potential role of these scenarios in screening and therapeutic monitoring of cancer.
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Affiliation(s)
- Anton Amann
- Breath Research Institute, Leopold-Franzens University of Innsbruck, 6850 Dornbirn, Austria. Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, 6020 Innsbruck, Austria
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29
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Fu XA, Li M, Knipp RJ, Nantz MH, Bousamra M. Noninvasive detection of lung cancer using exhaled breath. Cancer Med 2014; 3:174-81. [PMID: 24402867 PMCID: PMC3930402 DOI: 10.1002/cam4.162] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 09/27/2013] [Accepted: 10/11/2013] [Indexed: 12/11/2022] Open
Abstract
Early detection of lung cancer is a key factor for increasing the survival rates of lung cancer patients. The analysis of exhaled breath is promising as a noninvasive diagnostic tool for diagnosis of lung cancer. We demonstrate the quantitative analysis of carbonyl volatile organic compounds (VOCs) and identification of lung cancer VOC markers in exhaled breath using unique silicon microreactor technology. The microreactor consists of thousands of micropillars coated with an ammonium aminooxy salt for capture of carbonyl VOCs in exhaled breath by means of oximation reactions. Captured aminooxy-VOC adducts are analyzed by nanoelectrospray Fourier transform-ion cyclotron resonance (FT-ICR) mass spectrometry (MS). The concentrations of 2-butanone, 2-hydroxyacetaldehyde, 3-hydroxy-2-butanone, and 4-hydroxyhexenal (4-HHE) in the exhaled breath of lung cancer patients (n = 97) were significantly higher than in the exhaled breath of healthy smoker and nonsmoker controls (n = 88) and patients with benign pulmonary nodules (n = 32). The concentration of 2-butanone in exhaled breath of patients (n = 51) with stages II though IV non-small cell lung cancer (NSCLC) was significantly higher than in exhaled breath of patients with stage I (n = 34). The carbonyl VOC profile in exhaled breath determined using this new silicon microreactor technology provides for the noninvasive detection of lung cancer.
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Affiliation(s)
- Xiao-An Fu
- Department of Chemical Engineering, University of LouisvilleLouisville, Kentucky, 40208
| | - Mingxiao Li
- Department of Chemical Engineering, University of LouisvilleLouisville, Kentucky, 40208
| | - Ralph J Knipp
- Department of Chemistry, University of LouisvilleLouisville, Kentucky, 40208
| | - Michael H Nantz
- Department of Chemistry, University of LouisvilleLouisville, Kentucky, 40208
| | - Michael Bousamra
- Department of Surgery, University of LouisvilleLouisville, Kentucky, 40208
- James Graham Brown Cancer Center, University of LouisvilleLouisville, Kentucky, 40208
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30
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Amann A, Miekisch W, Schubert J, Buszewski B, Ligor T, Jezierski T, Pleil J, Risby T. Analysis of exhaled breath for disease detection. ANNUAL REVIEW OF ANALYTICAL CHEMISTRY (PALO ALTO, CALIF.) 2014; 7:455-482. [PMID: 25014347 DOI: 10.1146/annurev-anchem-071213-020043] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.
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Affiliation(s)
- Anton Amann
- Breath Research Institute of the University of Innsbruck, A-6850 Dornbirn, Austria;
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31
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Haick H, Broza YY, Mochalski P, Ruzsanyi V, Amann A. Assessment, origin, and implementation of breath volatile cancer markers. Chem Soc Rev 2013; 43:1423-49. [PMID: 24305596 DOI: 10.1039/c3cs60329f] [Citation(s) in RCA: 351] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A new non-invasive and potentially inexpensive frontier in the diagnosis of cancer relies on the detection of volatile organic compounds (VOCs) in exhaled breath samples. Breath can be sampled and analyzed in real-time, leading to fascinating and cost-effective clinical diagnostic procedures. Nevertheless, breath analysis is a very young field of research and faces challenges, mainly because the biochemical mechanisms behind the cancer-related VOCs are largely unknown. In this review, we present a list of 115 validated cancer-related VOCs published in the literature during the past decade, and classify them with respect to their "fat-to-blood" and "blood-to-air" partition coefficients. These partition coefficients provide an estimation of the relative concentrations of VOCs in alveolar breath, in blood and in the fat compartments of the human body. Additionally, we try to clarify controversial issues concerning possible experimental malpractice in the field, and propose ways to translate the basic science results as well as the mechanistic understanding to tools (sensors) that could serve as point-of-care diagnostics of cancer. We end this review with a conclusion and a future perspective.
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Affiliation(s)
- Hossam Haick
- The Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa 3200003, Israel.
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32
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Abstract
Breath analysis is an attractive non-invasive method for diagnosis and therapeutic monitoring. It uses endogenously produced compounds and metabolites of isotopically labeled precursors. In order to make such tests clinically useful, it is important to have relatively small portable instruments detecting volatile compounds within short time. A particularly promising analytical technique is ion mobility spectrometry (IMS) coupled to a multi capillary column (MCC). This paper focuses on demonstrating the suitability of breath analysis for pharmacokinetic applications using MCC-IMS with respect to practicability and reproducibility testing the model substrate eucalyptol. Validation of the MCC-IMS measurements were performed using proton transfer reaction mass spectrometry (PTR-MS) and resulted in an excellent correspondence of the time-dependent concentrations presented by the two different analytical techniques. Moreover, the good accordance in variance of kinetic parameters with repeated measures, and the determined inter-subject differences indicate the eligibility of the analysis method.
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Affiliation(s)
- V Ruzsanyi
- Breath Research Institute of the Austrian Academy of Sciences, Rathausplatz 4, A-6850 Dornbirn, Austria. Department of Anesthesia and Intensive Care, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck, Austria
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33
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Mochalski P, King J, Unterkofler K, Amann A. Stability of selected volatile breath constituents in Tedlar, Kynar and Flexfilm sampling bags. Analyst 2013; 138:1405-18. [PMID: 23323261 DOI: 10.1039/c2an36193k] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The stability of 41 selected breath constituents in three types of polymer sampling bags, Tedlar, Kynar, and Flexfilm, was investigated using solid phase microextraction and gas chromatography mass spectrometry. The tested molecular species belong to different chemical classes (hydrocarbons, ketones, aldehydes, aromatics, sulphurs, esters, terpenes, etc.) and exhibit close-to-breath low ppb levels (3-12 ppb) with the exception of isoprene, acetone and acetonitrile (106 ppb, 760 ppb, 42 ppb respectively). Stability tests comprised the background emission of contaminants, recovery from dry samples, recovery from humid samples (RH 80% at 37 °C), influence of the bag's filling degree, and reusability. Findings yield evidence of the superiority of Tedlar bags over remaining polymers in terms of background emission, species stability (up to 7 days for dry samples), and reusability. Recoveries of species under study suffered from the presence of high amounts of water (losses up to 10%). However, only heavier volatiles, with molecular masses higher than 90, exhibited more pronounced losses (20-40%). The sample size (the degree of bag filling) was found to be one of the most important factors affecting the sample integrity. To sum up, it is recommended to store breath samples in pre-conditioned Tedlar bags up to 6 hours at the maximum possible filling volume. Among the remaining films, Kynar can be considered as an alternative to Tedlar; however, higher losses of compounds should be expected even within the first hours of storage. Due to the high background emission Flexfilm is not suitable for sampling and storage of samples for analyses aiming at volatiles at a low ppb level.
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Affiliation(s)
- Paweł Mochalski
- Breath Research Institute, Austrian Academy of Sciences, Rathausplatz 4, A-6850 Dornbirn, Austria.
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34
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Trefz P, Schmidt M, Oertel P, Obermeier J, Brock B, Kamysek S, Dunkl J, Zimmermann R, Schubert JK, Miekisch W. Continuous Real Time Breath Gas Monitoring in the Clinical Environment by Proton-Transfer-Reaction-Time-of-Flight-Mass Spectrometry. Anal Chem 2013; 85:10321-9. [DOI: 10.1021/ac402298v] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Phillip Trefz
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Markus Schmidt
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Peter Oertel
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Juliane Obermeier
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Beate Brock
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Svend Kamysek
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Jürgen Dunkl
- Ionicon Analytik GmbH, Eduard-Bodem-Gasse 3, A-6020 Innsbruck, Austria
| | - Ralf Zimmermann
- Joint Mass Spectrometry
Centre, Chair of Analytical Chemistry, University of Rostock, Dr. Lorenz Weg
1, 18059 Rostock, Germany and Joint Mass Spectrometry Centre, Cooperation Group “Comprehensive
Molecular Analytics”, Helmholtz Zentrum München, D-85764 Neuherberg, Germany
| | - Jochen K. Schubert
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Wolfram Miekisch
- Department of Anaesthesia
and Intensive Care, University Medical Center Rostock, Schillingallee 35, 18057 Rostock, Germany
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Ruzsanyi V, Fischer L, Herbig J, Ager C, Amann A. Multi-capillary-column proton-transfer-reaction time-of-flight mass spectrometry. J Chromatogr A 2013; 1316:112-8. [PMID: 24119758 PMCID: PMC3810645 DOI: 10.1016/j.chroma.2013.09.072] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 09/17/2013] [Accepted: 09/22/2013] [Indexed: 01/11/2023]
Abstract
Proton-transfer-reaction time-of-flight mass-spectrometry (PTR-TOFMS) exhibits high selectivity with a resolution of around 5000 m/Δm. While isobars can be separated with this resolution, discrimination of isomeric compounds is usually not possible. The coupling of a multi-capillary column (MCC) with a PTR-TOFMS overcomes these problems as demonstrated in this paper for the ketone isomers 3-heptanone and 2-methyl-3-hexanone and for different aldehydes. Moreover, fragmentation of compounds can be studied in detail which might even improve the identification. LODs for compounds tested are in the range of low ppbv and peak positions of the respective separated substances show good repeatability (RSD of the peak positions <3.2%). Due to its special characteristics, such as isothermal operation, compact size, the MCC setup is suitable to be installed inside the instrument and the overall retention time for a complete spectrum is only a few minutes: this allows near real-time measurements in the optional MCC mode. In contrast to other methods that yield additional separation, such as the use of pre-cursor ions other than H3O(+), this method yields additional information without increasing complexity.
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Affiliation(s)
- Veronika Ruzsanyi
- Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria; Breath Research Institute, Austrian Academy of Sciences, Austria.
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36
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Mochalski P, Rudnicka J, Agapiou A, Statheropoulos M, Amann A, Buszewski B. Near real-time VOCs analysis using an aspiration ion mobility spectrometer. J Breath Res 2013; 7:026002. [DOI: 10.1088/1752-7155/7/2/026002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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37
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Spaněl P, Dryahina K, Smith D. A quantitative study of the influence of inhaled compounds on their concentrations in exhaled breath. J Breath Res 2013; 7:017106. [PMID: 23445832 DOI: 10.1088/1752-7155/7/1/017106] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Throughout the development of breath analysis research, there has been interest in how the concentrations of trace compounds in exhaled breath are related to their concentrations in the ambient inhaled air. In considering this, Phillips introduced the concept of 'alveolar gradient' and judged that the measured exhaled concentrations of volatile organic compounds should be diminished by an amount equal to their concentrations in the inhaled ambient air. The objective of the work described in this paper was to investigate this relationship quantitatively. Thus, experiments have been carried out in which inhaled air was polluted by seven compounds of interest in breath research, as given below, and exhaled breath has been analysed by SIFT-MS as the concentrations of these compounds in the inhaled air were reduced. The interesting result obtained is that all the exogenous compounds are partially retained in the exhaled breath and there are close linear relationships between the exhaled and inhaled air concentrations for all seven compounds. Thus, retention coefficients, a, have been derived for the following compounds: pentane, 0.76 ± 0.09; isoprene, 0.66 ± 0.04; acetone, 0.17 ± 0.03; ammonia, 0.70 ± 0.13, methanol, 0.29 ± 0.02; formaldehyde, 0.06 ± 0.03; deuterated water (HDO), 0.09 ± 0.02. From these data, correction to breath analyses for inhaled concentration can be described by coefficients specific to each compound, which can be close to 1 for hydrocarbons, as applied by Phillips, or around 0.1, meaning that inhaled concentrations of such compounds can essentially be neglected. A further deduction from the experimental data is that under conditions of the inhalation of clean air, the measured exhaled breath concentrations of those compounds should be increased by a factor of 1/(1 - a) to correspond to gaseous equilibrium with the compounds dissolved in the mixed venous blood entering the alveoli. Thus, for isoprene, this is a factor of 3, which we have confirmed experimentally by re-breathing experiments.
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Affiliation(s)
- Patrik Spaněl
- J Heyrovsky Institute of Physical Chemistry, Academy of Sciences of the Czech Republic, Dolejskova 3, Prague 8, Czech Republic.
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38
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van der Schee MP, Fens N, Brinkman P, Bos LDJ, Angelo MD, Nijsen TME, Raabe R, Knobel HH, Vink TJ, Sterk PJ. Effect of transportation and storage using sorbent tubes of exhaled breath samples on diagnostic accuracy of electronic nose analysis. J Breath Res 2012; 7:016002. [PMID: 23257711 DOI: 10.1088/1752-7155/7/1/016002] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Many (multi-centre) breath-analysis studies require transport and storage of samples. We aimed to test the effect of transportation and storage using sorbent tubes of exhaled breath samples for diagnostic accuracy of eNose and GC-MS analysis. As a reference standard for diagnostic accuracy, breath samples of asthmatic patients and healthy controls were analysed by three eNose devices. Samples were analysed by GC-MS and eNose after 1, 7 and 14 days of transportation and storage using sorbent tubes. The diagnostic accuracy for eNose and GC-MS after storage was compared to the reference standard. As a validation, the stability was assessed of 15 compounds known to be related to asthma, abundant in breath or related to sampling and analysis. The reference test discriminated asthma and healthy controls with a median AUC (range) of 0.77 (0.72-0.76). Similar accuracies were achieved at t1 (AUC eNose 0.78; GC-MS 0.84), t7 (AUC eNose 0.76; GC-MS 0.79) and t14 (AUC eNose 0.83; GC-MS 0.84). The GC-MS analysis of compounds showed an adequate stability for all 15 compounds during the 14 day period. Short-term transportation and storage using sorbent tubes of breath samples does not influence the diagnostic accuracy for discrimination between asthma and health by eNose and GC-MS.
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Affiliation(s)
- M P van der Schee
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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39
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Halbritter S, Fedrigo M, Höllriegl V, Szymczak W, Maier JM, Ziegler AG, Hummel M. Human breath gas analysis in the screening of gestational diabetes mellitus. Diabetes Technol Ther 2012; 14:917-25. [PMID: 22775148 PMCID: PMC3459034 DOI: 10.1089/dia.2012.0076] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND We present a pilot study on the feasibility of the application and advantages of online, noninvasive breath gas analysis (BGA) by proton transfer reaction quadrupole mass spectrometry for the screening of gestational diabetes mellitus (GDM) in 52 pregnant women by means of an oral glucose tolerance test (OGTT). SUBJECTS AND METHODS We collected and identified samples of end-tidal breath gas from patients during OGTT. Time evolution parameters of challenge-responsive volatile organic compounds (VOCs) in human breath gas were estimated. Multivariate analysis of variance and permutation analysis were used to assess feasibility of BGA as a diagnostic tool for GDM. RESULTS Standard OGTT diagnosis identified pregnant women as having GDM (n = 8), impaired glucose tolerance (n = 12), and normal glucose tolerance (n = 32); a part of this latter group was further subdivided into a "marginal" group (n = 9) because of a marginal high 1-h or 2-h OGTT value. We observed that OGTT diagnosis (four metabolic groups) could be mapped into breath gas data. The time evolution of oxidation products of glucose and lipids, acetone metabolites, and thiols in breath gas after a glucose challenge was correlated with GDM diagnosis (P = 0.035). Furthermore, basal (fasting) values of dimethyl sulfide and values of methanol in breath gas were inversely correlated with phenotype characteristics such as homeostasis model assessment of insulin resistance index (R = -0.538; P = 0.0002, P(corrected) = 0.0034) and pregestational body mass index (R = -0.433; P = 0.0013, P(corrected) = 0.022). CONCLUSIONS Noninvasive BGA in challenge response studies was successfully applied to GDM diagnosis and offered an insight into metabolic pathways involved. We propose a new approach to the identification of diagnosis thresholds for GDM screening.
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Affiliation(s)
- Susanne Halbritter
- Research Unit Medical Radiation Physics and Diagnostics, Helmholtz Center Munich, Neuherberg, Germany
| | - Mattia Fedrigo
- Research Unit Medical Radiation Physics and Diagnostics, Helmholtz Center Munich, Neuherberg, Germany
| | - Vera Höllriegl
- Research Unit Medical Radiation Physics and Diagnostics, Helmholtz Center Munich, Neuherberg, Germany
| | - Wilfried Szymczak
- Research Unit Medical Radiation Physics and Diagnostics, Helmholtz Center Munich, Neuherberg, Germany
| | - Joerg M. Maier
- Institute of Diabetes Research, Helmholtz Center Munich, Munich, Germany
- Diabetes Research Group, Hospital Rechts der Isar, Technical University of Munich, Munich, Germany
- Diabetes Research Group e.V., Munich-Neuherberg, Germany
| | - Anette-Gabriele Ziegler
- Institute of Diabetes Research, Helmholtz Center Munich, Munich, Germany
- Diabetes Research Group, Hospital Rechts der Isar, Technical University of Munich, Munich, Germany
- Diabetes Research Group e.V., Munich-Neuherberg, Germany
| | - Michael Hummel
- Diabetes Research Group e.V., Munich-Neuherberg, Germany
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40
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Hakim M, Broza YY, Barash O, Peled N, Phillips M, Amann A, Haick H. Volatile organic compounds of lung cancer and possible biochemical pathways. Chem Rev 2012; 112:5949-66. [PMID: 22991938 DOI: 10.1021/cr300174a] [Citation(s) in RCA: 485] [Impact Index Per Article: 40.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Meggie Hakim
- The Department of Chemical Engineering, Technion-Israel Institute of Technology, Haifa, Israel
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41
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Luque de Castro M, Fernández-Peralbo M. Analytical methods based on exhaled breath for early detection of lung cancer. Trends Analyt Chem 2012. [DOI: 10.1016/j.trac.2012.03.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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42
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Prabhakar A, Iglesias RA, Shan X, Xian X, Zhang L, Tsow F, Forzani ES, Tao N. Online sample conditioning for portable breath analyzers. Anal Chem 2012; 84:7172-8. [PMID: 22812638 DOI: 10.1021/ac301542j] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Various innovative chemical sensors have been developed in recent years to sense dangerous substances in air and trace biomarkers in breath. However, in order to solve real world problems, the sensors must be equipped with efficient sample conditioning that can, e.g., control the humidity, which is discussed much less in the literature. To meet the demand, a miniaturized mouthpiece was developed for personal breath analyzers. A key function of the mouthpiece is to condition the humidity in real breath samples without changing the analyte concentrations and introducing substantial backpressure, which is achieved with optimized packing of desiccant particles. Numerical simulations were carried out to determine the performance of the mouthpiece in terms of various controllable parameters, such as the size, density, and geometry of the packing. Mouthpieces with different configurations were built and tested, and the experimental data validated the simulation findings. A mouthpiece with optimized performance reducing relative humidity from 95% (27,000 ppmV) to 29% (8000 ppmV) whereas retaining 92% nitric oxide (50 ppbV to 46 ppbV) was built and integrated into a hand-held exhaled nitric oxide sensor, and the performance of exhaled nitric oxide measurement was in good agreement with the gold standard chemiluminescence technique. Acetone, carbon dioxide, oxygen, and ammonia samples were also measured after passing through the desiccant mouthpiece using commercial sensors to examine wide applicability of this breath conditioning approach.
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Affiliation(s)
- Amlendu Prabhakar
- Center for Bioelectronics & Biosensors, Biodesign Institute, Arizona State University, Tempe, Arizona 85287, USA
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43
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Tan BK, Davies SJ, Spaněl P, Smith D. Injection of deuterated water into the pulmonary/alveolar circulation; measurement of HDO in exhaled breath and implications to breath analysis. J Breath Res 2012; 6:036005. [PMID: 22824740 DOI: 10.1088/1752-7155/6/3/036005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The results of experiments are described in which a known quantity of sterile deuterated water is injected directly into the pulmonary circulation via the right internal jugular vein of several haemodialysis patients and the deuterium to hydrogen ratio, D/H, in the exhaled lung water was measured using the flowing afterglow mass spectrometry technique. The breath D/H abundance was measured in sequential breath exhalations before and after the injection, providing data that are sufficiently detailed to follow the production and loss rate of D/H in the exhaled breath. Thus, in principle, considering isotope dilution the volume of water in the lungs and pulmonary circulation can be derived. However, it is seen that the maximum abundance that the breath D/H reached was much lower than anticipated by considering the likely volume of blood/water in the pulmonary circulation and so it is deduced that either 'leakage' of the injected deuterated water rapidly occurs from the pulmonary to the systemic circulation and/or isotope exchange of deuterium with hydrogen along the bronchial tree efficiently occurs, thus reducing the D/H in the exhaled breath. This latter phenomenon has important implications to breath analysis in which it is often assumed that so-called alveolar breath concentrations of metabolites reflect blood/systemic levels. Detailed consideration of the breath D/H abundances when the deuterium is equilibrated amongst the total body water, TBW, of the patients, which occurs about 40 min after injection of the deuterated water, allows the TBW of the patients to be estimated.
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Affiliation(s)
- Boon K Tan
- Institute for Science and Technology in Medicine, Keele University, Thornburrow Drive, Hartshill, Stoke on Trent ST4 7QB, UK
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