1
|
Xie Z, Morris JD, Pan J, Cooke EA, Sutaria SR, Balcom D, Marimuthu S, Parrish LW, Aliesky H, Huang JJ, Rai SN, Arnold FW, Huang J, Nantz MH, Fu XA. Detection of COVID-19 by quantitative analysis of carbonyl compounds in exhaled breath. Sci Rep 2024; 14:14568. [PMID: 38914586 PMCID: PMC11196736 DOI: 10.1038/s41598-024-61735-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/09/2024] [Indexed: 06/26/2024] Open
Abstract
COVID-19 has caused a worldwide pandemic, creating an urgent need for early detection methods. Breath analysis has shown great potential as a non-invasive and rapid means for COVID-19 detection. The objective of this study is to detect patients infected with SARS-CoV-2 and even the possibility to screen between different SARS-CoV-2 variants by analysis of carbonyl compounds in breath. Carbonyl compounds in exhaled breath are metabolites related to inflammation and oxidative stress induced by diseases. This study included a cohort of COVID-19 positive and negative subjects confirmed by reverse transcription polymerase chain reaction between March and December 2021. Carbonyl compounds in exhaled breath were captured using a microfabricated silicon microreactor and analyzed by ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). A total of 321 subjects were enrolled in this study. Of these, 141 (85 males, 60.3%) (mean ± SD age: 52 ± 15 years) were COVID-19 (55 during the alpha wave and 86 during the delta wave) positive and 180 (90 males, 50%) (mean ± SD age: 45 ± 15 years) were negative. Panels of a total of 34 ketones and aldehydes in all breath samples were identified for detection of COVID-19 positive patients. Logistic regression models indicated high accuracy/sensitivity/specificity for alpha wave (98.4%/96.4%/100%), for delta wave (88.3%/93.0%/84.6%) and for all COVID-19 positive patients (94.7%/90.1%/98.3%). The results indicate that COVID-19 positive patients can be detected by analysis of carbonyl compounds in exhaled breath. The technology for analysis of carbonyl compounds in exhaled breath has great potential for rapid screening and detection of COVID-19 and for other infectious respiratory diseases in future pandemics.
Collapse
Affiliation(s)
- Zhenzhen Xie
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA
| | - James D Morris
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA
| | - Jianmin Pan
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- The Cancer Data Science Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Elizabeth A Cooke
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Saurin R Sutaria
- Department of Chemistry, University of Louisville, Louisville, KY, USA
| | - Dawn Balcom
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Subathra Marimuthu
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Leslie W Parrish
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Holly Aliesky
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | | | - Shesh N Rai
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- The Cancer Data Science Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Forest W Arnold
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA.
| | - Michael H Nantz
- Department of Chemistry, University of Louisville, Louisville, KY, USA.
| | - Xiao-An Fu
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA.
| |
Collapse
|
2
|
Yazicioglu O, Ucuncu MK, Guven K. Ingredients in Commercially Available Mouthwashes. Int Dent J 2024; 74:223-241. [PMID: 37709645 PMCID: PMC10988267 DOI: 10.1016/j.identj.2023.08.004] [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: 06/28/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Mouthwashes, a cornerstone of oral and dental hygiene, play a pivotal role in combating the formation of dental plaque, a leading cause of periodontal disease and dental caries. This study aimed to review the composition of mouthwashes found on retail shelves in Turkey and evaluate their prevalence and side effects, if any. METHODS The mouthwashes examined were sourced from the 5 largest chain stores in each district of Istanbul. A comprehensive list of the constituents was meticulously recorded. The research was supported by an extensive compilation of references from scholarly databases such as Google Scholar, PubMed, and ScienceDirect. Through rigorous analysis, the relative proportions of mouthwash ingredients and components were determined. RESULTS A total of 45 distinctive variations of mouthwashes, representing 17 prominent brands, were identified. Amongst the 116 ingredients discovered, 70 were evaluated for potential adverse effects and undesirable side effects. The aroma of the mouthwash (n = 45; 100%), as welll as their sodium fluoride (n = 28; 62.22%), sodium saccharin (n = 29; 64.44%), sorbitol (n = 21; 46.6%), and propylene glycol (n = 28; 62.22%) content were the main undesireable features. CONCLUSIONS The limited array of mouthwashes found on store shelves poses a concern for both oral and public health. Furthermore, the intricate composition of these products, consisting of numerous ingredients with the potential for adverse effects, warrants serious attention. Both clinicians and patients should acknowledge the importance and unwarranted side effects of the compnents of the mouthwashes.
Collapse
Affiliation(s)
- Oktay Yazicioglu
- Istanbul University, Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey
| | - Musa Kazim Ucuncu
- Altinbas University, Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey.
| | | |
Collapse
|
3
|
Taylor MJ, Chitwood CP, Xie Z, Miller HA, van Berkel VH, Fu XA, Frieboes HB, Suliman SA. Disease diagnosis and severity classification in pulmonary fibrosis using carbonyl volatile organic compounds in exhaled breath. Respir Med 2024; 222:107534. [PMID: 38244700 DOI: 10.1016/j.rmed.2024.107534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Pathophysiological conditions underlying pulmonary fibrosis remain poorly understood. Exhaled breath volatile organic compounds (VOCs) have shown promise for lung disease diagnosis and classification. In particular, carbonyls are a byproduct of oxidative stress, associated with fibrosis in the lungs. To explore the potential of exhaled carbonyl VOCs to reflect underlying pathophysiological conditions in pulmonary fibrosis, this proof-of-concept study tested the hypothesis that volatile and low abundance carbonyl compounds could be linked to diagnosis and associated disease severity. METHODS Exhaled breath samples were collected from outpatients with a diagnosis of Idiopathic Pulmonary Fibrosis (IPF) or Connective Tissue related Interstitial Lung Disease (CTD-ILD) with stable lung function for 3 months before enrollment, as measured by pulmonary function testing (PFT) DLCO (%), FVC (%) and FEV1 (%). A novel microreactor was used to capture carbonyl compounds in the breath as direct output products. A machine learning workflow was implemented with the captured carbonyl compounds as input features for classification of diagnosis and disease severity based on PFT (DLCO and FVC normal/mild vs. moderate/severe; FEV1 normal/mild/moderate vs. moderately severe/severe). RESULTS The proposed approach classified diagnosis with AUROC=0.877 ± 0.047 in the validation subsets. The AUROC was 0.820 ± 0.064, 0.898 ± 0.040, and 0.873 ± 0.051 for disease severity based on DLCO, FEV1, and FVC measurements, respectively. Eleven key carbonyl VOCs were identified with the potential to differentiate diagnosis and to classify severity. CONCLUSIONS Exhaled breath carbonyl compounds can be linked to pulmonary function and fibrotic ILD diagnosis, moving towards improved pathophysiological understanding of pulmonary fibrosis.
Collapse
Affiliation(s)
- Matthew J Taylor
- Division of Pulmonary Medicine, University of Louisville, Louisville, KY, USA
| | - Corey P Chitwood
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Zhenzhen Xie
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA
| | - Hunter A Miller
- Department of Bioengineering, University of Louisville, Louisville, KY, USA
| | - Victor H van Berkel
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY, USA
| | - Xiao-An Fu
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA.
| | - Hermann B Frieboes
- Department of Bioengineering, University of Louisville, Louisville, KY, USA; Department of Pharmacology/Toxicology, University of Louisville, Louisville, KY, USA; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY, USA.
| | - Sally A Suliman
- Banner University Medical Center, Phoenix, AZ, USA; Formerly at: Division of Pulmonary Medicine, University of Louisville, Louisville, KY, USA.
| |
Collapse
|
4
|
Maruo YY, Kawamura N, Abe N. Development of an analytical chip for colorimetric detection of medium-chain aldehydes by reaction with pararosaniline in porous glass. Talanta 2023; 257:124382. [PMID: 36821963 DOI: 10.1016/j.talanta.2023.124382] [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: 12/27/2022] [Revised: 01/28/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
Medium-chain aldehydes are common human biogases that can be detected in the breath of patients with lung diseases. As such, the measurement of medium-chain aldehyde gases in human breath can provide significant, noninvasive, and diagnostic information related to the potential presence of such diseases. In this study, an analytical chip is developed for the detection of medium-chain aldehydes without interference from short-chain aldehydes. This analytical chip is composed of porous glass impregnated with pararosaniline and an acid (i.e., acetic acid with small amount of phosphoric acid). After exposure to medium-chain aldehydes, the red analytical chip became violet in color, and an absorption peak was observed at 620 nm. It was found that a non-reversible reaction occurred in the porous glass, therefore, the analytical chip functions in a cumulative manner. A linear relationship was determined between the absorbance change of the analytical chip at 620 nm and the nonanal exposure concentration. Importantly, the developed analytical chip successfully detected nonanal at concentrations of 8-270 ppb as calculated from the absorbance change at 620 nm after a 24 h exposure time. In addition, nonanal concentration was estimated using the change in the R value of the analytical chip photograph. This method is suitable for point-of-care breath analysis. Finally, the analytical chip was also found to be active toward octanal and decanal with a relative sensitivity of 0.7 compared to that of nonanal; it was not active toward short-chain aldehydes.
Collapse
Affiliation(s)
- Yasuko Y Maruo
- Tohoku Institute of Technology, 35-1 Yagiyama Kasumi-cho, Taihakuku, Sendai, Miyagi, 982-8577, Japan.
| | - Naoto Kawamura
- Tohoku Institute of Technology, 35-1 Yagiyama Kasumi-cho, Taihakuku, Sendai, Miyagi, 982-8577, Japan
| | - Natsumi Abe
- Tohoku Institute of Technology, 35-1 Yagiyama Kasumi-cho, Taihakuku, Sendai, Miyagi, 982-8577, Japan
| |
Collapse
|
5
|
Xie Z, Morris JD, Mattingly SJ, Sutaria SR, Huang J, Nantz MH, Fu XA. Analysis of a Broad Range of Carbonyl Metabolites in Exhaled Breath by UHPLC-MS. Anal Chem 2023; 95:4344-4352. [PMID: 36815760 PMCID: PMC10521381 DOI: 10.1021/acs.analchem.2c04604] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Analysis of volatile organic compounds (VOCs) in exhaled breath (EB) has shown great potential for disease detection including lung cancer, infectious respiratory diseases, and chronic obstructive pulmonary disease. Although many breath sample collection and analytical methods have been developed for breath analysis, analysis of metabolic VOCs in exhaled breath is still a challenge for clinical application. Many carbonyl compounds in exhaled breath are related to the metabolic processes of diseases. This work reports a method of ultrahigh-performance liquid chromatography coupled with high-resolution mass spectrometry (UHPLC-MS) for the analysis of a broad range of carbonyl metabolites in exhaled breath. Carbonyl compounds in the exhaled breath were captured by a fabricated silicon microreactor with a micropillar array coated with 2-(aminooxy)ethyl-N,N,N-trimethylammonium (ATM) triflate. A total of six subgroups consisting of saturated aldehydes and ketones, hydroxy-aldehydes, and hydroxy-ketones, unsaturated 2-alkenals, and 4-hydroxy-2-alkenals were identified in the exhaled breath. The combination of a silicon microreactor for the selective capture of carbonyl compounds with UHPLC-MS analysis may provide a quantitative method for the analysis of carbonyls to identify disease markers in exhaled breath.
Collapse
Affiliation(s)
- Zhenzhen Xie
- Department of Chemical Engineering, University of Louisville, Louisville, KY 40292, United States
| | - James D. Morris
- Department of Chemical Engineering, University of Louisville, Louisville, KY 40292, United States
| | | | - Saurin R. Sutaria
- Department of Chemistry, University of Louisville, Louisville, KY 40292, United States
| | - Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY 40292, United States
| | - Michael H. Nantz
- Department of Chemistry, University of Louisville, Louisville, KY 40292, United States
| | - Xiao-An Fu
- Department of Chemical Engineering, University of Louisville, Louisville, KY 40292, United States
| |
Collapse
|
6
|
Exhaled Aldehydes as Biomarkers for Lung Diseases: A Narrative Review. Molecules 2022; 27:molecules27165258. [PMID: 36014494 PMCID: PMC9415864 DOI: 10.3390/molecules27165258] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Breath analysis provides great potential as a fast and non-invasive diagnostic tool for several diseases. Straight-chain aliphatic aldehydes were repeatedly detected in the breath of patients suffering from lung diseases using a variety of methods, such as mass spectrometry, ion mobility spectrometry, or electro-chemical sensors. Several studies found increased concentrations of exhaled aldehydes in patients suffering from lung cancer, inflammatory and infectious lung diseases, and mechanical lung injury. This article reviews the origin of exhaled straight-chain aliphatic aldehydes, available detection methods, and studies that found increased aldehyde exhalation in lung diseases.
Collapse
|
7
|
Jeerage KM, Berry J, Murray J, Goodman C, Piotrowski P, Jones C, Cecelski CE, Carney J, Lippa K, Lovestead T. The need for multicomponent gas standards for breath biomarker analysis. J Breath Res 2022; 16. [PMID: 35584612 DOI: 10.1088/1752-7163/ac70ef] [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: 01/18/2022] [Accepted: 05/18/2022] [Indexed: 11/11/2022]
Abstract
Exhaled breath is a non-invasive, information-rich matrix with the potential to diagnose or monitor disease, including infectious disease. Despite significant effort dedicated to biomarker identification in case control studies, very few breath tests are established in practice. In this topical review, we identify how gas standards support breath analysis today and what is needed to support further expansion and translation to practice. We examine forensic and clinical breath tests and discuss how confidence has been built through unambiguous biomarker identification and quantitation supported by gas calibration standards. Based on this discussion, we identify a need for multicomponent gas standards with part-per-trillion to part-per-million concentrations. We highlight National Institute of Standards and Technology (NIST) gas standards developed for atmospheric measurements that are also relevant to breath analysis and describe investigations of long-term stability, chemical reactions, and interactions with gas cylinder wall treatments. An overview of emerging online instruments and their need for gas standards is also presented. This review concludes with a discussion of our ongoing research to examine the feasibility of producing multicomponent gas standards at breath-relevant concentrations. Such standards could be used to investigate interference from ubiquitous endogenous compounds and as a starting point for standards tailored to specific breath tests.
Collapse
Affiliation(s)
- Kavita M Jeerage
- Applied Chemicals and Materials Division, National Institute of Standards and Technology, 325 Broadway, MS 647.07, Boulder, Colorado, 80305, UNITED STATES
| | - Jennifer Berry
- Applied Chemicals and Materials Division, National Institute of Standards and Technology, 325 Broadway, Boulder, Colorado, 80305, UNITED STATES
| | - Jacolin Murray
- Chemical Sciences Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland, 20899, UNITED STATES
| | - Cassie Goodman
- Chemical Sciences Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland, 20899, UNITED STATES
| | - Paulina Piotrowski
- Chemical Sciences Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland, 20899, UNITED STATES
| | - Christina Jones
- Office of Advanced Manufacturing, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland, 20899, UNITED STATES
| | - Christina Elena Cecelski
- Chemical Sciences Division, National Institute of Standards and Technology, Gaithersburg, Maryland, UNITED STATES
| | - Jennifer Carney
- Chemical Sciences Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland, 20899, UNITED STATES
| | - Katrice Lippa
- Office of Weights and Measures, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland, 20899, UNITED STATES
| | - Tara Lovestead
- Applied Chemicals and Materials Division, National Institute of Standards and Technology, 325 Broadway, MS 647.07, Boulder, Colorado, 80305, UNITED STATES
| |
Collapse
|
8
|
Chew B, Pimentel Contreras R, McCartney MM, Borras E, Kenyon NJ, Davis CE. A low cost, easy-to-assemble, open-source modular mobile sampler design for thermal desorption analysis of breath and environmental VOCs. J Breath Res 2022; 16. [PMID: 35508102 DOI: 10.1088/1752-7163/ac6c9f] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/04/2022] [Indexed: 11/12/2022]
Abstract
Exhaled breath vapor contains hundreds of volatile organic compounds (VOCs), which are the byproducts of health and disease metabolism, and they have clinical and diagnostic potential. Simultaneous collection of breath VOCs and background environmental VOCs is important to ensure analyses eliminate exogenous compounds from clinical studies. We present a mobile sampling system to extract gaseous VOCs onto commercially available sorbent-packed thermal desorption tubes. The sampler can be connected to a number of commonly available disposable and reusable sampling bags, in the case of this study, a Tedlar bag containing a breath sample. Alternatively, the inlet can be left open to directly sample room or environmental air when obtaining a background VOC sample. The system contains a screen for the operator to input a desired sample volume. A needle valve allows the operator to control the sample flow rate, which operates with an accuracy of -1.52 ± 0.63% of the desired rate, and consistently generated that rate with 0.12 ± 0.06% error across repeated measures. A flow pump, flow sensor and microcontroller allow volumetric sampling, as opposed to timed sampling, with 0.06 ± 0.06% accuracy in the volume extracted. Four samplers were compared by sampling a standard chemical mixture, which resulted in 6.4 ± 4.7% error across all four replicate modular samplers to extract a given VOC. The samplers were deployed in a clinical setting to collect breath and background/environmental samples, including patients with active SARS-CoV-2 infections, and the device could easily move between rooms and can undergo required disinfection protocols to prevent transmission of pathogens on the case exterior. All components required for assembly are detailed and are made publicly available for non-commercial use, including the microcontroller software. We demonstrate the device collects volatile compounds, including use of chemical standards, and background and breath samples in real use conditions.
Collapse
Affiliation(s)
- Bradley Chew
- Department of Mechanical and Aerospace Engineering, University of California - Davis, Davis, USA, Davis, California, 95616, UNITED STATES
| | - Raquel Pimentel Contreras
- Department of Mechanical and Aerospace Engineering, University of California - Davis, Davis, USA, Davis, California, 95616, UNITED STATES
| | - Mitchell M McCartney
- Mechanical and Aerospace Engineering, University of California - Davis, One Shields Avenue, Davis, California, 95616, UNITED STATES
| | - Eva Borras
- Department of Mechanical and Aerospace Engineering, University of California, Davis, One Shields Avenue, Davis, California, 95616, UNITED STATES
| | - Nicholas J Kenyon
- Sacramento Medical Center, UC Davis Health System, Sacramento, CA 795187, USA, Sacramento, California, 95616, UNITED STATES
| | - Cristina E Davis
- Department of Mechanical and Aerospace Engineering, University of California - Davis, Davis, USA, Davis, California, 95616, UNITED STATES
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
Quantification of Volatile Aldehydes Deriving from In Vitro Lipid Peroxidation in the Breath of Ventilated Patients. Molecules 2021; 26:molecules26113089. [PMID: 34064214 PMCID: PMC8196825 DOI: 10.3390/molecules26113089] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 01/18/2023] Open
Abstract
Exhaled aliphatic aldehydes were proposed as non-invasive biomarkers to detect increased lipid peroxidation in various diseases. As a prelude to clinical application of the multicapillary column–ion mobility spectrometry for the evaluation of aldehyde exhalation, we, therefore: (1) identified the most abundant volatile aliphatic aldehydes originating from in vitro oxidation of various polyunsaturated fatty acids; (2) evaluated emittance of aldehydes from plastic parts of the breathing circuit; (3) conducted a pilot study for in vivo quantification of exhaled aldehydes in mechanically ventilated patients. Pentanal, hexanal, heptanal, and nonanal were quantifiable in the headspace of oxidizing polyunsaturated fatty acids, with pentanal and hexanal predominating. Plastic parts of the breathing circuit emitted hexanal, octanal, nonanal, and decanal, whereby nonanal and decanal were ubiquitous and pentanal or heptanal not being detected. Only pentanal was quantifiable in breath of mechanically ventilated surgical patients with a mean exhaled concentration of 13 ± 5 ppb. An explorative analysis suggested that pentanal exhalation is associated with mechanical power—a measure for the invasiveness of mechanical ventilation. In conclusion, exhaled pentanal is a promising non-invasive biomarker for lipid peroxidation inducing pathologies, and should be evaluated in future clinical studies, particularly for detection of lung injury.
Collapse
|
11
|
Changes of Exhaled Volatile Organic Compounds in Postoperative Patients Undergoing Analgesic Treatment: A Prospective Observational Study. Metabolites 2020; 10:metabo10080321. [PMID: 32784730 PMCID: PMC7463857 DOI: 10.3390/metabo10080321] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/30/2020] [Accepted: 08/05/2020] [Indexed: 12/26/2022] Open
Abstract
Assessment and treatment of postoperative pain can be challenging as objective examination techniques to detect and quantify pain are lacking. We aimed to investigate changes of exhaled volatile organic compounds (VOCs) in patients with postoperative pain before and after treatment with opioid analgesics. In an observational study in 20 postoperative patients, we monitored for postoperative pain, hemodynamic parameters, and catecholamines before and during treatment. VOCs in the patients were determined by direct real-time proton transfer reaction time-of-flight mass spectrometry prior (0 min) and after piritramide application (15 min as well as 30 min). Cardiovascular variables changed and norepinephrine levels decreased during treatment. The VOCs acetonitrile (<0.001), acetaldehyde (p = 0.002), benzopyran (p = 0.004), benzene (p < 0.001), hexenal (p = < 0.001), 1-butanethiol (p = 0.004), methanethiol (p < 0.001), ethanol (p = 0.003), and propanol (p = < 0.001) changed significantly over time. Patients with Numeric Rating Scale (NRS) < 4 showed a significantly lower concentration of hexenal compared to patients with NRS > 4 at the time points 15 min (45.0 vs. 385.3 ncps, p = 0.047) and 30 min (38.3 vs. 334.6 ncps, p = 0.039). Breath analysis can provide additional information for noninvasive monitoring for analgesic treatment in postoperative patients.
Collapse
|