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Chou H, Godbeer L, Allsworth M, Boyle B, Ball ML. Progress and challenges of developing volatile metabolites from exhaled breath as a biomarker platform. Metabolomics 2024; 20:72. [PMID: 38977623 PMCID: PMC11230972 DOI: 10.1007/s11306-024-02142-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/13/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND The multitude of metabolites generated by physiological processes in the body can serve as valuable biomarkers for many clinical purposes. They can provide a window into relevant metabolic pathways for health and disease, as well as be candidate therapeutic targets. A subset of these metabolites generated in the human body are volatile, known as volatile organic compounds (VOCs), which can be detected in exhaled breath. These can diffuse from their point of origin throughout the body into the bloodstream and exchange into the air in the lungs. For this reason, breath VOC analysis has become a focus of biomedical research hoping to translate new useful biomarkers by taking advantage of the non-invasive nature of breath sampling, as well as the rapid rate of collection over short periods of time that can occur. Despite the promise of breath analysis as an additional platform for metabolomic analysis, no VOC breath biomarkers have successfully been implemented into a clinical setting as of the time of this review. AIM OF REVIEW This review aims to summarize the progress made to address the major methodological challenges, including standardization, that have historically limited the translation of breath VOC biomarkers into the clinic. We highlight what steps can be taken to improve these issues within new and ongoing breath research to promote the successful development of the VOCs in breath as a robust source of candidate biomarkers. We also highlight key recent papers across select fields, critically reviewing the progress made in the past few years to advance breath research. KEY SCIENTIFIC CONCEPTS OF REVIEW VOCs are a set of metabolites that can be sampled in exhaled breath to act as advantageous biomarkers in a variety of clinical contexts.
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Vinhas M, Leitão PM, Raimundo BS, Gil N, Vaz PD, Luis-Ferreira F. AI Applied to Volatile Organic Compound (VOC) Profiles from Exhaled Breath Air for Early Detection of Lung Cancer. Cancers (Basel) 2024; 16:2200. [PMID: 38927906 PMCID: PMC11201396 DOI: 10.3390/cancers16122200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Volatile organic compounds (VOCs) are an increasingly meaningful method for the early detection of various types of cancers, including lung cancer, through non-invasive methods. Traditional cancer detection techniques such as biopsies, imaging, and blood tests, though effective, often involve invasive procedures or are costly, time consuming, and painful. Recent advancements in technology have led to the exploration of VOC detection as a promising non-invasive and comfortable alternative. VOCs are organic chemicals that have a high vapor pressure at room temperature, making them readily detectable in breath, urine, and skin. The present study leverages artificial intelligence (AI) and machine learning algorithms to enhance classification accuracy and efficiency in detecting lung cancer through VOC analysis collected from exhaled breath air. Unlike other studies that primarily focus on identifying specific compounds, this study takes an agnostic approach, maximizing detection efficiency over the identification of specific compounds focusing on the overall compositional profiles and their differences across groups of patients. The results reported hereby uphold the potential of AI-driven techniques in revolutionizing early cancer detection methodologies towards their implementation in a clinical setting.
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Affiliation(s)
- Manuel Vinhas
- Departamento de Engenharia Electrotécnica e de Computadores, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-516 Monte da Caparica, Portugal;
| | - Pedro M. Leitão
- Unidade de Pulmão, Centro Clínico Champalimaud, Fundação Champalimaud, Av. Brasília, 1400-038 Lisbon, Portugal; (P.M.L.); (B.S.R.); (N.G.)
| | - Bernardo S. Raimundo
- Unidade de Pulmão, Centro Clínico Champalimaud, Fundação Champalimaud, Av. Brasília, 1400-038 Lisbon, Portugal; (P.M.L.); (B.S.R.); (N.G.)
| | - Nuno Gil
- Unidade de Pulmão, Centro Clínico Champalimaud, Fundação Champalimaud, Av. Brasília, 1400-038 Lisbon, Portugal; (P.M.L.); (B.S.R.); (N.G.)
| | - Pedro D. Vaz
- Unidade de Pulmão, Centro Clínico Champalimaud, Fundação Champalimaud, Av. Brasília, 1400-038 Lisbon, Portugal; (P.M.L.); (B.S.R.); (N.G.)
| | - Fernando Luis-Ferreira
- Departamento de Engenharia Electrotécnica e de Computadores, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-516 Monte da Caparica, Portugal;
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Schulz E, Woollam M, Vashistha S, Agarwal M. Quantifying exhaled acetone and isoprene through solid phase microextraction and gas chromatography-mass spectrometry. Anal Chim Acta 2024; 1301:342468. [PMID: 38553125 DOI: 10.1016/j.aca.2024.342468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Acetone, isoprene, and other volatile organic compounds (VOCs) in exhaled breath have been shown to be biomarkers for many medical conditions. Researchers use different techniques for VOC detection, including solid phase microextraction (SPME), to preconcentrate volatile analytes prior to instrumental analysis by gas chromatography-mass spectrometry (GC-MS). These techniques include a previously developed method to detect VOCs in breath directly using SPME, but it is uncommon for studies to quantify exhaled volatiles because it can be time consuming due to the need of many external/internal standards, and there is no standardized or widely accepted method. The objective of this study was to develop an accessible method to quantify acetone and isoprene in breath by SPME GC-MS. RESULTS A system was developed to mimic human exhalation and expose VOCs to a SPME fiber in the gas phase at known concentrations. VOCs were bubbled/diluted with dry air at a fixed flow rate, duration, and volume that was comparable to a previously developed breath sampling method. Identification of acetone and isoprene through GC-MS was verified using standards and observing overlaps in chromatographic retention/mass spectral fragmentation. Calibration curves were developed for these two analytes, which showed a high degree of linear correlation. Acetone and isoprene displayed limits of detection/quantification equal to 12 ppb/37 ppb and 73 ppb/222 ppb respectively. Quantification results in healthy breath samples (n = 15) showed acetone concentrations spanned between 71 ppb and 294 ppb, and isoprene varied between 170 ppb and 990 ppb. Both concentration ranges for acetone and isoprene in this study overlap with those reported in existing literature. SIGNIFICANCE Results indicate the development of a system to quantify acetone and isoprene in breath that can be adapted to diverse sampling methods and instrumental analyses beyond SPME GC-MS.
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Affiliation(s)
- Eray Schulz
- Integrated Nanosystems Development Institute, Indiana University-Purdue University, Indianapolis, IN, 46202, USA; Department of Chemistry and Chemical Biology, Indiana University-Purdue University, Indianapolis, IN, 46202, USA
| | - Mark Woollam
- Integrated Nanosystems Development Institute, Indiana University-Purdue University, Indianapolis, IN, 46202, USA; Department of Chemistry and Chemical Biology, Indiana University-Purdue University, Indianapolis, IN, 46202, USA
| | - Sneha Vashistha
- Integrated Nanosystems Development Institute, Indiana University-Purdue University, Indianapolis, IN, 46202, USA
| | - Mangilal Agarwal
- Integrated Nanosystems Development Institute, Indiana University-Purdue University, Indianapolis, IN, 46202, USA; Department of Chemistry and Chemical Biology, Indiana University-Purdue University, Indianapolis, IN, 46202, USA; Department of BioHealth Informatics, Indiana University-Purdue University, Indianapolis, IN, 46202, USA.
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4
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Chou H, Godbeer L, Ball ML. Establishing breath as a biomarker platform-take home messages from the Breath Biopsy Conference 2023. J Breath Res 2024; 18:030401. [PMID: 38631337 DOI: 10.1088/1752-7163/ad3fdf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/17/2024] [Indexed: 04/19/2024]
Abstract
The annual Breath Biopsy Conference hosted by Owlstone Medical gathers together the leading experts, early career researchers, and physicians working with breath as a biomarker platform for clinical purposes. The current topics in breath research are discussed and presented, and an overarching topical theme is identified and discussed as part of an expert panel to close the conference. The profiling of normal breath composition and the establishment of standards for analyzing breath compared to background signal were two important topics that were major focuses of this conference, as well as important innovative progress that has been made since last year, including the development of a non-invasive breath test for lung cancer and liver disease. This meeting report offers an overview of the key take-home messages from the various presentations, posters, and discussions from the conference.
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Affiliation(s)
- Hsuan Chou
- Owlstone Medical Ltd, 183 Cambridge Science Park, Milton Road, Cambridge, CB4 0GJ, United Kingdom
| | - Lucy Godbeer
- Owlstone Medical Ltd, 183 Cambridge Science Park, Milton Road, Cambridge, CB4 0GJ, United Kingdom
| | - Madeleine L Ball
- Owlstone Medical Ltd, 183 Cambridge Science Park, Milton Road, Cambridge, CB4 0GJ, United Kingdom
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Jung AE, Davidson CN, Land CJ, Dash AI, Guess BT, Edmonds HS, Pitsch RL, Harshman SW. Impact of thermal desorption tubes on the variability of exhaled breath data. J Breath Res 2023; 18:016008. [PMID: 38096565 DOI: 10.1088/1752-7163/ad15a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Due to the overall low abundance of volatile compounds in exhaled breath, it is necessary to preconcentrate the sample prior to traditional thermal desorption (TD) gas chromatography mass spectrometry analysis. While certain aspects of TD tubes, such as volatile storage, have been evaluated, many aspects remain uncharacterized. Two common TD tubes, Tenax TA and Biomonitoring 5TD tubes, were evaluated for background content and flow rate variability. The data illustrate that the Biomonitoring 5TD tubes have the highest number (23) and abundance of background contamination greater than 3x the mean noise when compared to Tenax TA (13) and empty tubes (9). Tentative identifications of the compounds in the background contamination experiment show that greater than 59% (16/27) of the compounds identified have been reported in the breath literature. The data illustrate the TD tube background abundance could account for more than 70% of the chromatographic signal from exhaled breath for these select compounds. Flow rate measurements of 200 Tenax TA and 200 Biomonitoring 5TD tubes show a large range in measured flow rates among the TD tubes (Tenax: 252.9-284.0 ml min-1, 5TD: 220.6-255.1 ml min-1). Finally, TD tubes of each type, Tenax TA and Biomonitoring 5TD, previously established to have high, medium, and low flow rates, show insignificant differences (p> 0.05) among the tubes of different flow rates, using both gas standards and an exhaled breath from a peppermint experiment. Collectively, these results establish overall background compounds attributed to each TD tube type tested. Additionally, while measured flow rate variability is present and plausibly impacts exhaled breath results, the data demonstrate no statistically significant difference was observed between tubes showing high, medium, and low flow rates from two separate sample types.
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Affiliation(s)
- Anne E Jung
- UES Inc., Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Christina N Davidson
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Christopher J Land
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Aubrianne I Dash
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Barlow T Guess
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Heidi S Edmonds
- United States Air Force Academy, 2304 Cadet Drive, United States Air Force Academy, CO 80840, United States of America
| | - Rhonda L Pitsch
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Sean W Harshman
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
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Westhoff M, Keßler M, Baumbach JI. Alveolar gradients in breath analysis. A pilot study with comparison of room air and inhaled air by simultaneous measurements using ion mobility spectrometry. J Breath Res 2023; 17:046009. [PMID: 37611565 DOI: 10.1088/1752-7163/acf338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/23/2023] [Indexed: 08/25/2023]
Abstract
Analyzing exhaled breath samples, especially using a highly sensitive method such as MCC/IMS (multi-capillary column/ion mobility spectrometry), may also detect analytes that are derived from exogenous production. In this regard, there is a discussion about the optimal interpretation of exhaled breath, either by considering volatile organic compounds (VOCs) only in exhaled breath or by additionally considering the composition of room air and calculating the alveolar gradients. However, there are no data on whether the composition and concentration of VOCs in room air are identical to those in truly inhaled air directly before analyzing the exhaled breath. The current study aimed to determine whether the VOCs in room air, which are usually used for the calculation of alveolar gradients, are identical to the VOCs in truly inhaled air. For the measurement of inhaled air and room air, two IMS, each coupled with an MCC that provided a pre-separation of the VOCs, were used in parallel. One device was used for sampling room air and the other for sampling inhaled air. Each device was coupled with a newly invented system that cleaned room air and provided a clean carrier gas, whereas formerly synthetic air had to be used as a carrier gas. In this pilot study, a healthy volunteer underwent three subsequent runs of sampling of inhaled air and simultaneous sampling and analysis of room air. Three of the selected 11 peaks (P4-unknown, P5-1-Butanol, and P9-Furan, 2-methyl-) had significantly higher intensities during inspiration than in room air, and four peaks (P1-1-Propanamine, N-(phenylmethylene), P2-2-Nonanone, P3-Benzene, 1,2,4-trimethyl-, and P11-Acetyl valeryl) had higher intensities in room air. Furthermore, four peaks (P6-Benzaldehyde, P7-Pentane, 2-methyl-, P8-Acetone, and P10-2-Propanamine) showed inconsistent differences in peak intensities between inhaled air and room air. To the best of our knowledge, this is the first study to compare simultaneous sampling of room air and inhaled air using MCC/IMS. The simultaneous measurement of inhaled air and room air showed that using room air for the calculation of alveolar gradients in breath analysis resulted in different alveolar gradient values than those obtained by measuring truly inhaled air.
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Affiliation(s)
- M Westhoff
- Department of Pneumology, Sleep and Respiratory Medicine, Hemer Lung Clinic, Theo-Funccius-Str. 1, 58675 Hemer, Germany
- Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany
| | - M Keßler
- University of Applied Sciences Münster, Hüfferstrasse 27, 48149 Münster, Germany
- B. Braun Melsungen AG, Branch Dortmund, Center of Competence Breath Analysis, Otto-Hahn-Str. 15, 44227 Dortmund, Germany
| | - J I Baumbach
- Technical University Dortmund, Faculty Bio- and Chemical Engineering, Emil-Figge-Str. 70, 44227 Dortmund, Germany
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Biagini D, Pugliese NR, Vivaldi FM, Ghimenti S, Lenzi A, De Angelis F, Ripszam M, Bruderer T, Armenia S, Cappeli F, Taddei S, Masi S, Francesco FD, Lomonaco T. Breath analysis combined with cardiopulmonary exercise testing and echocardiography for monitoring heart failure patients: the AEOLUS protocol. J Breath Res 2023; 17:046006. [PMID: 37524075 DOI: 10.1088/1752-7163/acec08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/31/2023] [Indexed: 08/02/2023]
Abstract
This paper describes the AEOLUS pilot study which combines breath analysis with cardiopulmonary exercise testing (CPET) and an echocardiographic examination for monitoring heart failure (HF) patients. Ten consecutive patients with a prior clinical diagnosis of HF with reduced left ventricular ejection fraction were prospectively enrolled together with 15 control patients with cardiovascular risk factors, including hypertension, type II diabetes or chronic ischemic heart disease. Breath samples were collected at rest and during CPET coupled with exercise stress echocardiography (CPET-ESE) protocol by means of needle trap micro-extraction and were analyzed through gas-chromatography coupled with mass spectrometry. The protocol also involved using of a selected ion flow tube mass spectrometer for a breath-by-breath isoprene and acetone analysis during exercise. At rest, HF patients showed increased breath levels of acetone and pentane, which are related to altered oxidation of fatty acids and oxidative stress, respectively. A significant positive correlation was observed between acetone and the gold standard biomarker NT-proBNP in plasma (r= 0.646,p< 0.001), both measured at rest. During exercise, some exhaled volatiles (e.g., isoprene) mirrored ventilatory and/or hemodynamic adaptation, whereas others (e.g., sulfide compounds and 3-hydroxy-2-butanone) depended on their origin. At peak effort, acetone levels in HF patients differed significantly from those of the control group, suggesting an altered myocardial and systemic metabolic adaptation to exercise for HF patients. These preliminary data suggest that concomitant acquisition of CPET-ESE and breath analysis is feasible and might provide additional clinical information on the metabolic maladaptation of HF patients to exercise. Such information may refine the identification of patients at higher risk of disease worsening.
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Affiliation(s)
- Denise Biagini
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
| | - Nicola R Pugliese
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico M Vivaldi
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
| | - Silvia Ghimenti
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
| | - Alessio Lenzi
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
| | - Francesca De Angelis
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
| | - Matyas Ripszam
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
| | - Tobias Bruderer
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
| | - Silvia Armenia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federica Cappeli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefano Masi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Fabio Di Francesco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
| | - Tommaso Lomonaco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Italy
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Shawn ST, Harshman SW, Davidson CN, Lee JH, Jung AE, Parker A, Hawkins MA, Stamps BW, Pitsch RL, Martin JA. Sterilization and reuse of masks for a standardized exhaled breath collection device by autoclaving. J Breath Res 2023; 17:036006. [PMID: 37352843 DOI: 10.1088/1752-7163/ace127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/23/2023] [Indexed: 06/25/2023]
Abstract
Exhaled breath research has been hindered by a lack of standardization in collection and analysis methodologies. Recently, the Respiration Collector forIn VitroAnalysis (ReCIVA) sampling device has illustrated the potential to provide a consistent and convenient method for exhaled breath collection onto adsorbent media. However, the significant costs, compared to exhaled breath bags, associated with the standardized collector is believed to be the reason for limited widespread use by researchers in the exhaled breath field. For example, in addition to the sampling hardware, a single-use disposable silicon mask affixed with a filter is required for each exhaled breath collection. To reduce the financial burden, streamline device upkeep, reduce waste material, and ease the logistical burden associated with the single use masks, it is hypothesized that the consumable masks and filters could be sterilized by autoclaving for reuse. The masks were contaminated, autoclaved, and then tested for any surviving pathogens with spore strip standards and by measuring the optical density of cultures. The compound background collected when using the ReCIVA with new masks was compared to that collected with repeatedly autoclaved masks via thermal desorption gas chromatography mass spectrometry (TD-GC-MS). The capacity to block particulate matter of new filters was tested against that of autoclaved filters by introducing an aerosol and comparing pre-filter and post-filter particle counts. Finally, breath samplings were conducted with new masks and autoclaved masks to test for changes in measurements by TD-GC-MS of exogenous and endogenous compounds. The data illustrate the autoclave cycle sterilizes masks spiked with saliva to background levels (p= 0.2527). The results indicate that background levels of siloxane compounds are increased as masks are repetitively autoclaved. The data show that mask filters have significant breakthrough of 1μm particles after five repetitive autoclaving cycles compared to new filters (p= 0.0219). Finally, exhaled breath results utilizing a peppermint ingestion protocol indicate two compounds associated with peppermint, menthone and 1-Methyl-4-(1-methylethyl)-cyclohexanol, and an endogenous exhaled breath compound, isoprene, show no significant difference if sampled with a new mask or a mask autoclaved five times (p> 0.1063). Collectively, the data indicate that ReCIVA masks and filters can be sterilized via autoclave and reused. The results suggest ReCIVA mask and filter reuse should be limited to three times to limit potentially problematic background contaminants and filter dysfunction.
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Affiliation(s)
- Samuel T Shawn
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Sean W Harshman
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Christina N Davidson
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Jae Hwan Lee
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Anne E Jung
- UES Inc., 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Ariel Parker
- UES Inc., 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - M Aaron Hawkins
- UES Inc., 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Blake W Stamps
- Air Force Research Laboratory, Materials and Manufacturing Directorate, 2977 Hobson Way, Area B, Building 653, Wright- Patterson AFB, OH 45433, United States of America
| | - Rhonda L Pitsch
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright- Patterson AFB, OH 45433, United States of America
| | - Jennifer A Martin
- Air Force Research Laboratory, Materials and Manufacturing Directorate, 2977 Hobson Way, Area B, Building 653, Wright- Patterson AFB, OH 45433, United States of America
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Schulz E, Woollam M, Grocki P, Davis MD, Agarwal M. Methods to Detect Volatile Organic Compounds for Breath Biopsy Using Solid-Phase Microextraction and Gas Chromatography-Mass Spectrometry. Molecules 2023; 28:molecules28114533. [PMID: 37299010 DOI: 10.3390/molecules28114533] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Volatile organic compounds (VOCs) are byproducts from metabolic pathways that can be detected in exhaled breath and have been reported as biomarkers for different diseases. The gold standard for analysis is gas chromatography-mass spectrometry (GC-MS), which can be coupled with various sampling methods. The current study aims to develop and compare different methods for sampling and preconcentrating VOCs using solid-phase microextraction (SPME). An in-house sampling method, direct-breath SPME (DB-SPME), was developed to directly extract VOCs from breath using a SPME fiber. The method was optimized by exploring different SPME types, the overall exhalation volume, and breath fractionation. DB-SPME was quantitatively compared to two alternative methods involving the collection of breath in a Tedlar bag. In one method, VOCs were directly extracted from the Tedlar bag (Tedlar-SPME) and in the other, the VOCs were cryothermally transferred from the Tedlar bag to a headspace vial (cryotransfer). The methods were verified and quantitatively compared using breath samples (n = 15 for each method respectively) analyzed by GC-MS quadrupole time-of-flight (QTOF) for compounds including but not limited to acetone, isoprene, toluene, limonene, and pinene. The cryotransfer method was the most sensitive, demonstrating the strongest signal for the majority of the VOCs detected in the exhaled breath samples. However, VOCs with low molecular weights, including acetone and isoprene, were detected with the highest sensitivity using the Tedlar-SPME. On the other hand, the DB-SPME was less sensitive, although it was rapid and had the lowest background GC-MS signal. Overall, the three breath-sampling methods can detect a wide variety of VOCs in breath. The cryotransfer method may be optimal when collecting a large number of samples using Tedlar bags, as it allows the long-term storage of VOCs at low temperatures (-80 °C), while Tedlar-SPME may be more effective when targeting relatively small VOCs. The DB-SPME method may be the most efficient when more immediate analyses and results are required.
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Affiliation(s)
- Eray Schulz
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University, Indianapolis, IN 46202, USA
- Integrated Nanosystems Development Institute, Indiana University-Purdue University, Indianapolis, IN 46202, USA
| | - Mark Woollam
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University, Indianapolis, IN 46202, USA
- Integrated Nanosystems Development Institute, Indiana University-Purdue University, Indianapolis, IN 46202, USA
| | - Paul Grocki
- Integrated Nanosystems Development Institute, Indiana University-Purdue University, Indianapolis, IN 46202, USA
| | - Michael D Davis
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Mangilal Agarwal
- Department of Chemistry and Chemical Biology, Indiana University-Purdue University, Indianapolis, IN 46202, USA
- Integrated Nanosystems Development Institute, Indiana University-Purdue University, Indianapolis, IN 46202, USA
- Department of Mechanical & Energy Engineering, Indiana University-Purdue University, Indianapolis, IN 46202, USA
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Harshman SW, Jung AE, Strayer KE, Alfred BL, Mattamana J, Veigl AR, Dash AI, Salter CE, Stoner-Dixon MA, Kelly JT, Davidson CN, Pitsch RL, Martin JA. Investigation of an individual with background levels of exhaled isoprene: a case study. J Breath Res 2023; 17. [PMID: 36596256 DOI: 10.1088/1752-7163/acaf98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/03/2023] [Indexed: 01/04/2023]
Abstract
Isoprene is one of the most abundant and most frequently evaluated volatile organic compounds in exhaled breath. Recently, several individuals with background levels of exhaled isoprene have been identified. Here, case study data are provided for an individual, identified from a previous study, with this low prevalence phenotype. It is hypothesized that the individual will illustrate low levels of exhaled isoprene at rest and during exercise. At rest, the subject (7.1 ppb) shows background (μ= 14.2 ± 7.0 ppb) levels of exhaled isoprene while the control group illustrates significantly higher quantities (μ= 266.2 ± 72.3 ppb) via proton transfer reaction mass spectrometry (PTR-MS). The result, background levels of isoprene at rest, is verified by thermal desorption gas chromatography mass spectrometry (TD-GC-MS) collections with the individual showing -3.6 ppb exhaled isoprene while the room background containedμ= -4.1 ± 0.1 ppb isoprene. As isoprene has been shown previously to increase at the initiation of exercise, exercise bike experiments were performed with the individual identified with low isoprene, yielding low and invariant levels of exhaled isoprene (μ= 6.6 ± 0.1 ppb) during the exercise while control subjects illustrated an approximate 2.5-fold increase (preμ= 286.3 ± 43.8 ppb, exerciseμ= 573.0 ± 147.8 ppb) in exhaled isoprene upon exercise start. Additionally, exhaled breath bag data showed a significant decrease in isoprene (delta post/pre, p = 0.0078) of the control group following the exercise regimen. Finally, TD-GC-MS results for exhaled isoprene from the individual's family (mother, father, sister and maternal grandmother) illustrated that the mother and father exhibited isoprene values (28.5 ppb, 77.2 ppb) below control samples 95% confidence interval (μ= 166.8 ± 43.3 ppb) while the individual's sister (182.0 ppb) was within the control range. These data provide evidence for a large dynamic range in exhaled isoprene in this family. Collectively, these results provide additional data surrounding the existence of a small population of individuals with background levels of exhaled isoprene.
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Affiliation(s)
- Sean W Harshman
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Anne E Jung
- UES Inc., Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Kraig E Strayer
- UES Inc., Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Bryan L Alfred
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - John Mattamana
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Alena R Veigl
- UES Inc., Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Aubrianne I Dash
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Charles E Salter
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Madison A Stoner-Dixon
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - John T Kelly
- UES Inc., Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Christina N Davidson
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Rhonda L Pitsch
- Air Force Research Laboratory, 711th Human Performance Wing/RHBBA, 2510 Fifth Street, Area B, Building 840, Wright-Patterson AFB, OH 45433, United States of America
| | - Jennifer A Martin
- Materials and Manufacturing Directorate, Air Force Research Laboratory, 2977 Hobson Way, Area B, Building 653, Wright-Patterson AFB, OH 45433, United States of America
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11
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Xu F, Zhou J, Yang H, Chen L, Zhong J, Peng Y, Wu K, Wang Y, Fan H, Yang X, Zhao Y. Recent advances in exhaled breath sample preparation technologies for drug of abuse detection. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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12
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Pham YL, Beauchamp J, Clement A, Wiegandt F, Holz O. 3D-printed mouthpiece adapter for sampling exhaled breath in medical applications. 3D Print Med 2022; 8:27. [PMID: 35943600 PMCID: PMC9364600 DOI: 10.1186/s41205-022-00150-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
The growing use of 3D printing in the biomedical sciences demonstrates its utility for a wide range of research and healthcare applications, including its potential implementation in the discipline of breath analysis to overcome current limitations and substantial costs of commercial breath sampling interfaces. This technical note reports on the design and construction of a 3D-printed mouthpiece adapter for sampling exhaled breath using the commercial respiration collector for in-vitro analysis (ReCIVA) device. The paper presents the design and digital workflow transition of the adapter and its fabrication from three commercial resins (Surgical Guide, Tough v5, and BioMed Clear) using a Formlabs Form 3B stereolithography (SLA) printer. The use of the mouthpiece adapter in conjunction with a pulmonary function filter is appraised in comparison to the conventional commercial silicon facemask sampling interface. Besides its lower cost - investment cost of the printing equipment notwithstanding - the 3D-printed adapter has several benefits, including ensuring breath sampling via the mouth, reducing the likelihood of direct contact of the patient with the breath sampling tubes, and being autoclaveable to enable the repeated use of a single adapter, thereby reducing waste and associated environmental burden compared to current one-way disposable facemasks. The novel adapter for breath sampling presented in this technical note represents an additional field of application for 3D printing that further demonstrates its widespread applicability in biomedicine.
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Affiliation(s)
- Y Lan Pham
- Fraunhofer Institute for Process Engineering and Packaging IVV, Giggenhauser Straße 35, 85354, Freising, Germany.,Department of Chemistry and Pharmacy, Chair of Aroma and Smell Research, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9, 91054, Erlangen, Germany
| | - Jonathan Beauchamp
- Fraunhofer Institute for Process Engineering and Packaging IVV, Giggenhauser Straße 35, 85354, Freising, Germany
| | - Alexander Clement
- Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Feodor-Lynen-Str. 15, 30625, Hannover, Germany
| | - Felix Wiegandt
- Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Feodor-Lynen-Str. 15, 30625, Hannover, Germany
| | - Olaf Holz
- Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Feodor-Lynen-Str. 15, 30625, Hannover, Germany. .,Member of the German Centre of Lung Research DZL (BREATH), Hannover, Germany.
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Holz O, van Vorstenbosch R, Günther F, Schuchardt S, Trinkmann F, van Schooten FJ, Smolinska A, Hohlfeld J. Changes of breath volatile organic compounds in healthy volunteers following segmental and inhalation endotoxin challenge. J Breath Res 2022; 16. [PMID: 35366648 DOI: 10.1088/1752-7163/ac6359] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/01/2022] [Indexed: 11/11/2022]
Abstract
Background It is still unclear how airway inflammation affects the breath volatile organic compounds (VOC) profile in exhaled air. We therefore analyzed breath following well-defined pulmonary endotoxin (lipopolysaccharide, LPS) challenges. Methods Breath was collected from 10 healthy non-smoking subjects at eight time points before and after segmental and whole lung LPS inhalation challenge. Four Tenax-TA® adsorption tubes were simultaneously loaded from an aluminum reservoir cylinder and independently analyzed by two research groups using gas chromatography - mass spectrometry. Airway inflammation was assessed in bronchoalveolar lavage (BAL) and in sputum after segmental and inhaled LPS challenge, respectively. Results Segmental LPS challenge significantly increased the median (interquartile range, IQR) percentage of neutrophils in BAL from 3.0 (4.2) % to 64.0 (7.3) %. The inhalation challenge increased sputum neutrophils from 33.9 (26.8) % to 78.3 (13.5) %. We observed increases in breath aldehydes at both time points after segmental and inhaled LPS challenge. These results were confirmed by an independent laboratory. The longitudinal breath analysis also revealed distinct VOC patterns related to environmental exposures, clinical procedures, and to metabolic changes after food intake. Conclusions Changes in breath aldehydes suggest a relationship to LPS induced inflammation compatible with lipid peroxidation processes within the lung. Findings from our longitudinal data highlight the need for future studies to better consider the potential impact of the multiple VOCs from detergents, hygiene or lifestyle products a subject is continuously exposed to. We suspect that this very individual "owncloud" exposure is contributing to an increased variability of breath aldehydes, which might limit a use as inflammatory markers in daily clinical practice.
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Affiliation(s)
- Olaf Holz
- Clinical Airway Research, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Feodor-Lynen-Str. 15, Hannover, 30625, GERMANY
| | | | - Frank Günther
- Bio- and Environmental Analytics, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Feodor-Lynen-Str. 15, Hannover, 30625, GERMANY
| | - Sven Schuchardt
- Bio- and Environmental Analytics, Fraunhofer-Institut fur Toxikologie und Experimentelle Medizin, Feodor-Lynen-Str. 15, Hannover, Niedersachsen, 30625, GERMANY
| | - Frederik Trinkmann
- Pneumology and Critical Care Medicine, Thoraxklinik at University Hospital Heidelberg, Röntgenstraße 1, Heidelberg, 69126, GERMANY
| | - Frederik Jan van Schooten
- Department of Toxicology, University of Maastricht, Universiteitssingel 50, THE NETHERLANDS, Maastricht, 6229 ER, NETHERLANDS
| | - Agnieszka Smolinska
- Toxicology Department, Maastricht University, Universiteitssingel 50, Maastricht, 6229 ER, NETHERLANDS
| | - Jens Hohlfeld
- ITEM, Fraunhofer Institute for Toxicology and Experimental Medicine, Nikolai-Fuchs-Str. 1, Hannover, 30625, GERMANY
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14
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Haworth JJ, Pitcher CK, Ferrandino G, Hobson AR, Pappan KL, Lawson JLD. Breathing new life into clinical testing and diagnostics: perspectives on volatile biomarkers from breath. Crit Rev Clin Lab Sci 2022; 59:353-372. [PMID: 35188863 DOI: 10.1080/10408363.2022.2038075] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Human breath offers several benefits for diagnostic applications, including simple, noninvasive collection. Breath is a rich source of clinically-relevant biological information; this includes a volatile fraction, where greater than 1,000 volatile organic compounds (VOCs) have been described so far, and breath aerosols that carry nucleic acids, proteins, signaling molecules, and pathogens. Many of these factors, especially VOCs, are delivered to the lung by the systemic circulation, and diffusion of candidate biomarkers from blood into breath allows systematic profiling of organismal health. Biomarkers on breath offer the capability to advance early detection and precision medicine in areas of global clinical need. Breath tests are noninvasive and can be performed at home or in a primary care setting, which makes them well-suited for the kind of public screening program that could dramatically improve the early detection of conditions such as lung cancer. Since measurements of VOCs on breath largely report on metabolic changes, this too aids in the early detection of a broader range of illnesses and can be used to detect metabolic shifts that could be targeted through precision medicine. Furthermore, the ability to perform frequent sampling has envisioned applications in monitoring treatment responses. Breath has been investigated in respiratory, liver, gut, and neurological diseases and in contexts as diverse as infectious diseases and cancer. Preclinical research studies using breath have been ongoing for some time, yet only a few breath-based diagnostics tests are currently available and in widespread clinical use. Most recently, tests assessing the gut microbiome using hydrogen and methane on breath, in addition to tests using urea to detect Helicobacter pylori infections have been released, yet there are many more applications of breath tests still to be realized. Here, we discuss the strengths of breath as a clinical sampling matrix and the technical challenges to be addressed in developing it for clinical use. Historically, a lack of standardized methodologies has delayed the discovery and validation of biomarker candidates, resulting in a proliferation of early-stage pilot studies. We will explore how advancements in breath collection and analysis are in the process of driving renewed progress in the field, particularly in the context of gastrointestinal and chronic liver disease. Finally, we will provide a forward-looking outlook for developing the next generation of clinically relevant breath tests and how they may emerge into clinical practice.
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15
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Bhavra K, Wilde M, Richardson M, Cordell R, Thomas CLP, Zhao B, Bryant L, Brightling CE, Ibrahim W, Salman D, Siddiqui S, Monks P, Gaillard E. The utility of a standardised breath sampler in school age children within a real-world prospective study. J Breath Res 2022; 16. [PMID: 35168217 DOI: 10.1088/1752-7163/ac5526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/15/2022] [Indexed: 11/12/2022]
Abstract
Clinical assessment of paediatric asthmatics is problematic, and non-invasive biomarkers are needed urgently. Monitoring exhaled volatile organic compounds (VOCs) is an attractive alternative to invasive tests (blood and sputum), and may be used as frequently as required. Standardised reproducible breath-sampling is essential for exhaled-VOC analysis, and although the ReCIVA (Owlstone Medical Limited) breath-sampler was designed to satisfy this requirement, paediatric use was not in the original design brief. The efficacy of the ReCIVA for sampling paediatric-breath has been studied, and 90 breath-samples from 64 children (5-15 years) with, and without asthma (controls), were collected with two different ReCIVA units. Seventy samples (77.8%) contained the specified 1L of sampled-breath. Median sampling times were longer in children with acute asthma (770.2 s, range: 532.2-900.1 s) compared to stable asthma (690.6 s, range: 477.5-900.1 s; p=0.01). The ReCIVA successfully detected operational faults, in 21 samples. A leak, caused by a poor fit of the face mask seal was the most common (15); the others were USB communication-faults (5); and, a single instance of a file-creation error. Paediatric breath-profiles were reliably monitored, however synchronisation of sampling to breathing-phases was sometimes lost, causing some breaths not to be sampled, and some to be sampled continuously. This occurred in 60 (66.7%) of the samples and was a source of variability. Three samples were lost from a combination of factors, however, and importantly, multi-variate modelling of untargeted VOC analysis indicated the absence of significant batch effects for 8 operational variables. The ReCIVA appears suitable for paediatric breath-sampling. Post-processing of breath-sample meta-data is recommended to assess the quality of sample-acquisition. Further, future studies should explore the effect of pump-synchronisation faults on recovered VOC profiles, and mask sizes to fit all ages will reduce the potential for leaks and importantly, provide higher levels of comfort to children with asthma.
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Affiliation(s)
- Kirandeep Bhavra
- Department of Respiratory Sciences, Leicester Royal Infirmary, NIHR Leicester Biomedical Research Centre (Respiratory theme), PO Box 65, Robert Kilpatrick Clinical Sciences Building, Leicester, LE2 7LX, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Michael Wilde
- University of Leicester, Department of Chemistry, Leicester, Leicestershire, LE1 7RH, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Matthew Richardson
- Loughborough University School of Science, Department of Chemistry, Loughborough, Leicestershire, LE11 3TU, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Rebecca Cordell
- University of Leicester Department of Chemistry, University of Leicester, Leicester, Leicester, LE1 7RH, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - C L Paul Thomas
- University of Leicester Department of Respiratory Sciences, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, East Midlands, LE3 9QP, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Bo Zhao
- University of Leicester College of Life Sciences, Leicester NIHR Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Groby Road, Leicester, Leicester, LE3 9QP, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Luke Bryant
- University of Leicester Department of Chemistry, University of Leicester, University Road, Leicester, Leicester, LE1 7RH, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Christopher E Brightling
- Loughborough University School of Science, Department of Chemistry, Loughborough, Leicestershire, LE11 3TU, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Wadah Ibrahim
- Loughborough University School of Science, Department of Chemistry, Loughborough, Leicestershire, LE11 3TU, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Dahlia Salman
- University of Leicester Department of Respiratory Sciences, NIHR Leicester Biomedical Research Centre (Respiratory theme),, Glenfield Hospital, Groby Road, Leicester, East Midlands, LE3 9QP, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Salman Siddiqui
- Loughborough University School of Science, Department of Chemistry, Loughborough, Leicestershire, LE11 3TU, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Paul Monks
- University of Leicester, Department of Chemistry, Leicester, Leicestershire, LE1 7RH, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Erol Gaillard
- Department of Respiratory Sciences, University of Leicester, College of Life Sciences, Leicester, Leicestershire, LE1 7RH, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
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16
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Biagini D, Fusi J, Vezzosi A, Oliveri P, Ghimenti S, Lenzi A, Salvo P, Daniele S, Scarfò G, Vivaldi FM, Bonini A, Martini C, Franzoni F, Di Francesco F, Lomonaco T. Effects of long-term vegan diet on breath composition. J Breath Res 2022; 16. [PMID: 35051905 DOI: 10.1088/1752-7163/ac4d41] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/20/2022] [Indexed: 11/11/2022]
Abstract
The composition of exhaled breath derives from an intricate combination of normal and abnormal physiological processes that are modified by the consumption of food and beverages, circadian rhythms, bacterial infections, and genetics as well as exposure to xenobiotics. This complexity, which results wide intra- and inter-individual variability and is further influenced by sampling conditions, hinders the identification of specific biomarkers and makes it difficult to differentiate between pathological and nominally healthy subjects. The identification of a "normal" breath composition and the relative influence of the aforementioned parameters would make breath analyses much faster for diagnostic applications. We thus compared, for the first time, the breath composition of age-matched volunteers following a vegan and a Mediterranean omnivorous diet in order to evaluate the impact of diet on breath composition. Mixed breath was collected from 38 nominally healthy volunteers who were asked to breathe into a two-liter handmade Nalophan bag. Exhalation flow rate and carbon dioxide values were monitored during breath sampling. An aliquot (100 mL) of breath was loaded into a sorbent tube (250 mg of Tenax GR, 60/80 mesh) before being analyzed by thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS). Breath profiling using TD-GC-MS analysis identified five compounds (methanol, 1-propanol, pentane, hexane, and hexanal), thus enabling differentiation between samples collected from the different group members . Principal component analysis showed a clear separation between groups, suggesting that breath analysis could be used to study the influence of dietary habits in the fields of nutrition and metabolism. Surprisingly, one Italian woman and her brother showed extremely low breath isoprene levels (about 5 ppbv), despite their normal lipidic profile and respiratory data, such as flow rate and pCO2. Further investigations to reveal the reasons behind low isoprene levels in breath would help reveal the origin of isoprene in breath.
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Affiliation(s)
- Denise Biagini
- 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
| | - Jonathan Fusi
- University of Pisa Department of Clinical and Experimental Medicine, Via Roma, 67, Pisa, Toscana, 56126, ITALY
| | - Annasilvia Vezzosi
- 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
| | - Paolo Oliveri
- Department of Drug and Food Chemistry and Technology, University of Genoa, Via Brigata Salerno, 13, Genoa, 16100, ITALY
| | - Silvia Ghimenti
- 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
| | - Alessio Lenzi
- Department of Chemistry and Industrial Chemistry, Universita degli Studi di Pisa Dipartimento di Chimica e Chimica Industriale, Via Moruzzi 13, Pisa, Tuscany, 56124, ITALY
| | - Pietro Salvo
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Via Moruzzi 1, Pisa, 56124, ITALY
| | - Simona Daniele
- University of Pisa Department of Pharmacy, Via Bonanno Pisano, 12, Pisa, Toscana, 56126, ITALY
| | - Giorgia Scarfò
- University of Pisa Department of Clinical and Experimental Medicine, Via Roma, 67, Pisa, Toscana, 56126, ITALY
| | - Federico Maria Vivaldi
- 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
| | - Andrea Bonini
- 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
| | - Claudia Martini
- University of Pisa Department of Pharmacy, Via Bonanno Pisano, 12, Pisa, Toscana, 56126, ITALY
| | - Ferdinando Franzoni
- University of Pisa Department of Clinical and Experimental Medicine, Via Roma, 67, Pisa, Toscana, 56126, ITALY
| | - Fabio Di Francesco
- 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
| | - 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
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17
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Ferrara F, Zoupanou S, Primiceri E, Ali Z, Chiriacò MS. Beyond liquid biopsy: Toward non-invasive assays for distanced cancer diagnostics in pandemics. Biosens Bioelectron 2021; 196:113698. [PMID: 34688113 PMCID: PMC8527216 DOI: 10.1016/j.bios.2021.113698] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/01/2021] [Accepted: 10/07/2021] [Indexed: 12/11/2022]
Abstract
Liquid biopsy technologies have seen a significant improvement in the last decade, offering the possibility of reliable analysis and diagnosis from several biological fluids. The use of these technologies can overcome the limits of standard clinical methods, related to invasiveness and poor patient compliance. Along with this there are now mature examples of lab-on-chips (LOC) which are available and could be an emerging and breakthrough technology for the present and near-future clinical demands that provide sample treatment, reagent addition and analysis in a sample-in/answer-out approach. The possibility of combining non-invasive liquid biopsy and LOC technologies could greatly assist in the current need for minimizing exposure and transmission risks. The recent and ongoing pandemic outbreak of SARS-CoV-2, indeed, has heavily influenced all aspects of life worldwide. Ordinary tasks have been forced to switch from “in presence” to “distanced”, limiting the possibilities for a large number of activities in all fields of life outside of the home. Unfortunately, one of the settings in which physical distancing has assumed noteworthy consequences is the screening, diagnosis and follow-up of diseases. In this review, we analyse biological fluids that are easily collected without the intervention of specialized personnel and the possibility that they may be used -or not-for innovative diagnostic assays. We consider their advantages and limitations, mainly due to stability and storage and their integration into Point-of-Care diagnostics, demonstrating that technologies in some cases are mature enough to meet current clinical needs.
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Affiliation(s)
- Francesco Ferrara
- STMicroelectronics s.r.l., via per Monteroni, 73100, Lecce, Italy; CNR NANOTEC - Institute of Nanotechnology, via per Monteroni, 73100, Lecce, Italy.
| | - Sofia Zoupanou
- CNR NANOTEC - Institute of Nanotechnology, via per Monteroni, 73100, Lecce, Italy; University of Salento, Dept. of Mathematics & Physics E. de Giorgi, Via Arnesano, 73100, Lecce, Italy
| | - Elisabetta Primiceri
- CNR NANOTEC - Institute of Nanotechnology, via per Monteroni, 73100, Lecce, Italy
| | - Zulfiqur Ali
- University of Teesside, School of Health & Life Sciences, Healthcare Innovation Centre, Middlesbrough, TS1 3BX, Tees Valley, England, UK
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18
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Breath Analysis: Comparison among Methodological Approaches for Breath Sampling. Molecules 2020; 25:molecules25245823. [PMID: 33321824 PMCID: PMC7763204 DOI: 10.3390/molecules25245823] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022] Open
Abstract
Despite promising results obtained in the early diagnosis of several pathologies, breath analysis still remains an unused technique in clinical practice due to the lack of breath sampling standardized procedures able to guarantee a good repeatability and comparability of results. The most diffuse on an international scale breath sampling method uses polymeric bags, but, recently, devices named Mistral and ReCIVA, able to directly concentrate volatile organic compounds (VOCs) onto sorbent tubes, have been developed and launched on the market. In order to explore performances of these new automatic devices with respect to sampling in the polymeric bag and to study the differences in VOCs profile when whole or alveolar breath is collected and when pulmonary wash out with clean air is done, a tailored experimental design was developed. Three different breath sampling approaches were compared: (a) whole breath sampling by means of Tedlar bags, (b) the end-tidal breath collection using the Mistral sampler, and (c) the simultaneous collection of the whole and alveolar breath by using the ReCIVA. The obtained results showed that alveolar fraction of breath was relatively less affected by ambient air (AA) contaminants (p-values equal to 0.04 for Mistral and 0.002 for ReCIVA Low) with respect to whole breath (p-values equal to 0.97 for ReCIVA Whole). Compared to Tedlar bags, coherent results were obtained by using Mistral while lower VOCs levels were detected for samples (both breath and AA) collected by ReCIVA, likely due to uncorrected and fluctuating flow rates applied by this device. Finally, the analysis of all data also including data obtained by explorative analysis of the unique lung cancer (LC) breath sample showed that a clean air supply might determine a further confounding factor in breath analysis considering that lung wash-out is species-dependent.
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