Breath acetone change during aerobic exercise is moderated by cardiorespiratory fitness

A solid state electrolyte based enzymatic acetone sensor

This paper introduces a novel solid-state electrolyte-based enzymatic sensor designed for the detection of acetone, along with an examination of its performance under various surface modifications aimed at optimizing its sensing capabilities. To measure acetone concentrations in both liquid and vapor states, cyclic voltammetry and amperometry techniques were employed, utilizing disposable screen-printed electrodes consisting of a platinum working electrode, a platinum counter electrode, and a silver reference electrode. Four different surface modifications, involving different combinations of Nafion (N) and enzyme (E) layers (N + E; N + E + N; N + N + E; N + N + E + N), were tested to identify the most effective configuration for a sensor that can be used for breath acetone detection. The sensor's essential characteristics, including linearity, sensitivity, reproducibility, and limit of detection, were thoroughly evaluated through a range of experiments spanning concentrations from 1 µM to 25 mM. Changes in acetone concentration were monitored by comparing currents readings at different acetone concentrations. The sensor exhibited high sensitivity, and a linear response to acetone concentration in both liquid and gas phases within the specified concentration range, with correlation coefficients ranging from 0.92 to 0.98. Furthermore, the sensor achieved a rapid response time of 30-50 s and an impressive detection limit as low as 0.03 µM. The results indicated that the sensor exhibited the best linearity, sensitivity, and limit of detection when four layers were employed (N + N + E + N).

Metabolic insights at the finish line: deciphering physiological changes in ultramarathon runners through breath VOC analysis

Exhaustive exercise can induce unique physiological responses in the lungs and other parts of the human body. The volatile organic compounds (VOCs) in exhaled breath are ideal for studying the effects of exhaustive exercise on the lungs due to the proximity of the breath matrix to the respiratory tract. As breath VOCs can originate from the bloodstream, changes in abundance should also indicate broader physiological effects of exhaustive exercise on the body. Currently, there is limited published data on the effects of exhaustive exercise on breath VOCs. Breath has great potential for biomarker analysis as it can be collected non-invasively, and capture real-time metabolic changes to better understand the effects of exhaustive exercise. In this study, we collected breath samples from a small group of elite runners participating in the 2019 Ultra-Trail du Mont Blanc ultra-marathon. The final analysis included matched paired samples collected before and after the race from 24 subjects. All 48 samples were analyzed using the Breath Biopsy Platform with GC-Orbitrap™ via thermal desorption gas chromatography-mass spectrometry. The Wilcoxon signed-rank test was used to determine whether VOC abundances differed between pre- and post-race breath samples (adjustedP-value < .05). We identified a total of 793 VOCs in the breath samples of elite runners. Of these, 63 showed significant differences between pre- and post-race samples after correction for multiple testing (12 decreased, 51 increased). The specific VOCs identified suggest the involvement of fatty acid oxidation, inflammation, and possible altered gut microbiome activity in response to exhaustive exercise. This study demonstrates significant changes in VOC abundance resulting from exhaustive exercise. Further investigation of VOC changes along with other physiological measurements can help improve our understanding of the effect of exhaustive exercise on the body and subsequent differences in VOCs in exhaled breath.

Breath analysis combined with cardiopulmonary exercise testing and echocardiography for monitoring heart failure patients: the AEOLUS protocol

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.

Handheld device quantifies breath acetone for real-life metabolic health monitoring

Non-invasive breath analysis with mobile health devices bears tremendous potential to guide therapeutic treatment and personalize lifestyle changes. Of particular interest is the breath volatile acetone, a biomarker for fat burning, that could help in understanding and treating metabolic diseases. Here, we report a hand-held (6 × 10 × 19.5 cm³), light-weight (490 g), and simple device for rapid acetone detection in breath. It comprises a tailor-made end-tidal breath sampling unit, connected to a sensor and a pump for on-demand breath sampling, all operated using a Raspberry Pi microcontroller connected with a HDMI touchscreen. Accurate acetone detection is enabled by introducing a catalytic filter and a separation column, which remove and separate undesired interferents from acetone upstream of the sensor. This way, acetone is detected selectively even in complex gas mixtures containing highly concentrated interferents. This device accurately tracks breath acetone concentrations in the exhaled breath of five volunteers during a ketogenic diet, being as high as 26.3 ppm. Most importantly, it can differentiate small acetone changes during a baseline visit as well as before and after an exercise stimulus, being as low as 0.5 ppm. It is stable for at least four months (122 days), and features excellent bias and precision of 0.03 and 0.6 ppm at concentrations below 5 ppm, as validated by proton-transfer-reaction time-of-flight mass spectrometry (PTR-ToF-MS). Hence, this detector is highly promising for simple-in-use, non-invasive, and routine monitoring of acetone to guide therapeutic treatment and track lifestyle changes.

Mixed effects of moderate exercise and subsequent various food ingestion on breath acetone

Acetone, which is exhaled with breath, is a by-product of lipolysis and could be used as a simple, useful indicator of lipolysis in the body because, unlike blood sampling, it can be measured non-invasively and repeatedly. Breath acetone concentration, however, is known to be affected by several factors such as exercise and food. We designed the experiments to evaluate the mixed effect on breath acetone of exercise and food ingestion in order to enhance the usefulness of breath acetone for monitoring fat loss. Seven healthy males performed moderate exercise for twice of 45 min with an interval of 15 min then rested for 4 h. Exhaled air was sampled every 15 min throughout the experiment. The subjects took one of four types, sugar-rich, balanced, protein-rich and fat-rich, of food for lunch one hour after the exercises or kept fasting. In the case of fasting, breath acetone kept increasing significantly (p < 0.05) compared with the rest value after the exercises until the end of the experiment. In contrast, in the case of taking any type of food, the change in breath acetone varied according to the food type. In the case of taking sugar-rich food, breath acetone significantly decreased (p < 0.05) compared with the fasting case. This decrease might be due to a suppression of acetone production when carbohydrates such as sugar are supplied to a body in the fasting condition. In contrast, in the case of taking fat-rich food, breath acetone showed the higher level than the fasting case. This additional increase might be attributable to the promotion of ketone bodies production, including acetone, due to the ingestion of medium chain triglycerides contained in the fat-rich food. We should therefore consider exercise and food ingestion in using breath acetone as a non-invasive indicator of lipolysis.

Variation of volatile organic compound levels within ambient room air and its impact upon the standardisation of breath sampling

The interest around analysis of volatile organic compounds (VOCs) within breath has increased in the last two decades. Uncertainty remains around standardisation of sampling and whether VOCs within room air can influence breath VOC profiles. To assess the abundance of VOCs within room air in common breath sampling locations within a hospital setting and whether this influences the composition of breath. A secondary objective is to investigate diurnal variation in room air VOCs. Room air was collected using a sampling pump and thermal desorption (TD) tubes in the morning and afternoon from five locations. Breath samples were collected in the morning only. TD tubes were analysed using gas chromatography coupled with time-of-flight mass spectrometry (GC-TOF-MS). A total of 113 VOCs were identified from the collected samples. Multivariate analysis demonstrated clear separation between breath and room air. Room air composition changed throughout the day and different locations were characterized by specific VOCs, which were not influencing breath profiles. Breath did not demonstrate separation based on location, suggesting that sampling can be performed across different locations without affecting results.

Acetone sensing in liquid and gas phases using cyclic voltammetry

This paper presents the use of cyclic voltammetry to measure acetone concentration in liquid and vapor forms at disposable screen-printed electrodes of platinum working electrode, platinum counter electrode, and silver/silver chloride reference electrode. The main characteristics of the acetone sensor including its linearity, sensitivity, reproducibility, and limit of detection (LOD) were studied by doing different experiments to test both liquid and vapor samples in the physiological range of 1 µM to 10 mM. The change in acetone concentration was monitored by comparing the lineshape of butterfly region before and after injecting the acetone sample in the baseline solution that contains 0.5 M H₂SO₄. The sensor was shown to have a good sensitivity, reproducibility, and a linear response with respect to the acetone concentration in both liquid and gas phases over a range of 1 µM to 10 mM with R² > 0.97 and LOD of 0.1 µM. The system stability was improved by building a closed glass system to reduce the exchange of acetone with the surrounding air in an open environment. The closed system was tested using vapor samples and the error bars in the calibration curve were reduced to more than half of their values before using the closed system. The new system will be used extensively in future for an enzyme-based acetone sensor that will be used for diabetes monitoring.

The need for multicomponent gas standards for breath biomarker analysis

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.

Acetone Sensing and Catalytic Conversion by Pd-Loaded SnO2

Noble metal additives are widely used to improve the performance of metal oxide gas sensors, most prominently with palladium on tin oxide. Here, we photodeposit different quantities of Pd (0–3 mol%) onto nanostructured SnO₂ and determine their effect on sensing acetone, a critical tracer of lipolysis by breath analysis. We focus on understanding the effect of operating temperature on acetone sensing performance (sensitivity and response/recovery times) and its relationship to catalytic oxidation of acetone through a packed bed of such Pd-loaded SnO₂. The addition of Pd can either boost or deteriorate the sensing performance, depending on its loading and operating temperature. The sensor performance is optimal at Pd loadings of less than 0.2 mol% and operating temperatures of 200–262.5 °C, where acetone conversion is around 50%.

Room-Temperature Catalyst Enables Selective Acetone Sensing

Catalytic packed bed filters ahead of gas sensors can drastically improve their selectivity, a key challenge in medical, food and environmental applications. Yet, such filters require high operation temperatures (usually some hundreds °C) impeding their integration into low-power (e.g., battery-driven) devices. Here, we reveal room-temperature catalytic filters that facilitate highly selective acetone sensing, a breath marker for body fat burn monitoring. Varying the Pt content between 0-10 mol% during flame spray pyrolysis resulted in Al2O3 nanoparticles decorated with Pt/PtOx clusters with predominantly 5-6 nm size, as revealed by X-ray diffraction and electron microscopy. Most importantly, Pt contents above 3 mol% removed up to 100 ppm methanol, isoprene and ethanol completely already at 40 °C and high relative humidity, while acetone was mostly preserved, as confirmed by mass spectrometry. When combined with an inexpensive, chemo-resistive sensor of flame-made Si/WO3, acetone was detected with high selectivity (≥225) over these interferants next to H2, CO, form-/acetaldehyde and 2-propanol. Such catalytic filters do not require additional heating anymore, and thus are attractive for integration into mobile health care devices to monitor, for instance, lifestyle changes in gyms, hospitals or at home.