Isotope-specific breath analysis to track the end-stage renal disease during hemodialysis

Oxygen-18 and Carbon-13 isotopes in eCO2and erythrocytes carbonic anhydrase activity of Finnish prediabetic population

Complex human physiological processes create the stable isotopic composition of exhaled carbon dioxide (eCO2), measurable with noninvasive breath tests. Recently, isotope-selective breath tests utilizing natural fluctuation in 18O/16O isotope ratio in eCO2 have been proposed for screening prediabetic (PD) individuals. It has been suggested that 18O/16O fractionation patterns reflect shifts in the activity of carbonic anhydrase (CA), an enzyme involved in the metabolic changes in the PD state. To evaluate the applicability of the breath sampling method in Finnish PD individuals, breath delta values (BDVs, ‰) of 18O/16O (δ18O) were monitored for 120 min in real-time with a high-precision optical isotope ratio spectrometer, both in the fasting state and during a 2-hour oral glucose tolerance test (2h OGTT) with non-labelled glucose. In addition, the BDV of 13C/12C (δ13C) was measured, and total erythrocyte CA activity was determined. δ18O and CA did not demonstrate any statistically significant differences between PD and non-diabetic control (NDC) participants. Instead, δ13C was significantly lower in PD patients in comparison to NDCs in the fasting state and at time points 90 and 120 min of the 2h OGTT, thus indicating slightly better potential in identifying Finnish PD individuals. However, overlapping values were measured in PD participants and NDCs, and therefore, δ13C cannot be applied as a sole measure in screening prediabetes at an individual level. Thus, because the combination of environmental and lifestyle factors and anthropometric parameters has a greater effect on glucose metabolism and CA activity in comparison to the PD state, 18O/16O and 13C/12C fractionations or CA activity did not prove to be reliable biomarkers for impaired glucose tolerance in Finnish subjects. This study was conducted under the clinicaltrials.gov ID NCT03156478.

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

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