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GAN L, ZHOU Y, FANG Q, XU J, CHEN S, ZHU Y, NI C. [Determination of organic acids and anions in exhaled breath by condensation collection-ion chromatography]. Se Pu 2024; 42:275-281. [PMID: 38503704 PMCID: PMC10951814 DOI: 10.3724/sp.j.1123.2023.07016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Indexed: 03/21/2024] Open
Abstract
A non-invasive condensation collection-ion chromatography method was established for the determination of organic acids and anions including lactic acid, formic acid, acetic acid, pyruvic acid, chloride, nitrate, nitrite, and sulfate in the exhaled breath of humans. The breath exhaled was condensed and collected using a home-made exhaled breath condensation equipment. This equipment included a disposable mouthpiece as a blow-off port, one-way valve and flow meter, cold trap, disposable condensate collection tube placed in the cold trap, and gas outlet. A standard sampling procedure was used. Before collection, the collection temperature and sampling volume were set on the instrument control panel, and sampling was started when the cold-trap temperature dropped to the set value, while maintaining the balance. Subjects were required to gargle with pure water before sampling. During the sampling process, the subjects were required to inhale deeply until the lungs were full of gas and then exhale evenly through the air outlet. When the set volume was collected, the instrument made a prompt sound; then, the collection was immediately ended, the expiration time was recorded, and the average collection flow was calculated according to the expiration time and sampling volume. After collection, the disposable condensation collection tube was immediately taken out, sealed, and stored in the refrigerator at -20 ℃ away from light, and immediately used for further testing. The organic acids and anions in exhaled breath condensation (EBC) were filtered through a 0.22 μm membrane filter before injection and detected by ion chromatography with conductivity detection. Factors such as collection temperature and collection flow rate during condensation collection were optimized. The optimal cooling temperature was set at -15 ℃, and the optimal exhaled breath flow rate was set at 15 L/min. The mobile phase consisted of a mixture of sodium carbonate (1.5 mmol/L) and sodium bicarbonate (3 mmol/L). The flow rate was 0.8 mL/min, and the injection volume was 100 μL. An IC-SA3 column (250 mm×4.0 mm) was used, and the temperature was set at 45 ℃. An ICDS-40A electrodialysis suppressor was used, and the current was set at 150 mA. The linear ranges of the eight organic acids and anions were 0.1-10.0 mg/L; their correlation coefficients (r) were ≥0.9993. The limits of detection (LODs) for the eight organic acids and anions were 0.0017-0.0150 mg/L based on a signal-to-noise ratio of 3, and the limits of quantification (LOQs) were 0.0057-0.0500 mg/L based on a signal-to-noise ratio of 10. The intra-day precisions were 5.06%-6.33% (n=5), and the inter-day precisions were 5.37%-7.50% (n=5). This method was used to detect organic acids and anions in the exhaled breath of five healthy subjects. The contents of organic acids and anions in the exhaled breath were calculated. The content of lactic acid was relatively high, at 1.13-42.3 ng/L, and the contents of other seven organic acids and anions were 0.18-11.0 ng/L. During a 10 km-long run, the majority of organic acids and anions in the exhaled breath of five subjects first increased and then decreased. However, due to abnormal metabolism, the content changes of lactic acid, acetic acid, pyruvic acid and chloride in one subject were obviously different from others during exercise, showing a continuous rise. This method has the advantages of involving a simple sampling process and exhibiting good precision, few side effects, and no obvious discomfort or risk to the subjects. This study provides experimental ideas and a theoretical basis for future research on human metabolites.
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Ghumra D, Shetty N, McBrearty KR, Puthussery JV, Sumlin BJ, Gardiner WD, Doherty BM, Magrecki JP, Brody DL, Esparza TJ, O’Halloran JA, Presti RM, Bricker TL, Boon ACM, Yuede CM, Cirrito JR, Chakrabarty RK. Rapid Direct Detection of SARS-CoV-2 Aerosols in Exhaled Breath at the Point of Care. ACS Sens 2023; 8:3023-3031. [PMID: 37498298 PMCID: PMC10463275 DOI: 10.1021/acssensors.3c00512] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
Airborne transmission via virus-laden aerosols is a dominant route for the transmission of respiratory diseases, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Direct, non-invasive screening of respiratory virus aerosols in patients has been a long-standing technical challenge. Here, we introduce a point-of-care testing platform that directly detects SARS-CoV-2 aerosols in as little as two exhaled breaths of patients and provides results in under 60 s. It integrates a hand-held breath aerosol collector and a llama-derived, SARS-CoV-2 spike-protein specific nanobody bound to an ultrasensitive micro-immunoelectrode biosensor, which detects the oxidation of tyrosine amino acids present in SARS-CoV-2 viral particles. Laboratory and clinical trial results were within 20% of those obtained using standard testing methods. Importantly, the electrochemical biosensor directly detects the virus itself, as opposed to a surrogate or signature of the virus, and is sensitive to as little as 10 viral particles in a sample. Our platform holds the potential to be adapted for multiplexed detection of different respiratory viruses. It provides a rapid and non-invasive alternative to conventional viral diagnostics.
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Affiliation(s)
- Dishit
P. Ghumra
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Nishit Shetty
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Kevin R. McBrearty
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - Joseph V. Puthussery
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Benjamin J. Sumlin
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
| | - Woodrow D. Gardiner
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - Brookelyn M. Doherty
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - Jordan P. Magrecki
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - David L. Brody
- National
Institute of Neurological Disorders and Stroke, Bethesda, Maryland 20892, United States
- Department
of Neurology, Uniformed Services University
of the Health Sciences, Bethesda, Maryland 20814, United States
| | - Thomas J. Esparza
- National
Institute of Neurological Disorders and Stroke, Bethesda, Maryland 20892, United States
| | - Jane A. O’Halloran
- Department
of Medicine, Washington University, St. Louis, Missouri 63110, United States
| | - Rachel M. Presti
- Department
of Medicine, Washington University, St. Louis, Missouri 63110, United States
| | - Traci L. Bricker
- Department
of Medicine, Washington University, St. Louis, Missouri 63110, United States
- Departments
Molecular Microbiology, and Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri 63110, United States
| | - Adrianus C. M. Boon
- Department
of Medicine, Washington University, St. Louis, Missouri 63110, United States
- Departments
Molecular Microbiology, and Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri 63110, United States
| | - Carla M. Yuede
- Department
of Psychiatry, Washington University School
of Medicine, Campus Box
8134, 660 South Euclid Avenue, St. Louis, Missouri 63110, United States
| | - John R. Cirrito
- Department
of Neurology, Hope Center for Neurological Disease, Knight Alzheimer’s
Disease Research Center, Washington University, St. Louis, Missouri 63110, United States
| | - Rajan K. Chakrabarty
- Center
for Aerosol Science and Engineering, Department of Energy, Environmental
and Chemical Engineering, Washington University
in St. Louis, St. Louis, Missouri 63130, United States
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Exhaled breath condensate as bioanalyte: from collection considerations to biomarker sensing. Anal Bioanal Chem 2023; 415:27-34. [PMID: 36396732 PMCID: PMC9672542 DOI: 10.1007/s00216-022-04433-5] [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: 10/17/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 11/19/2022]
Abstract
Since the SARS-CoV-2 pandemic, the potential of exhaled breath (EB) to provide valuable information and insight into the health status of a person has been revisited. Mass spectrometry (MS) has gained increasing attention as a powerful analytical tool for clinical diagnostics of exhaled breath aerosols (EBA) and exhaled breath condensates (EBC) due to its high sensitivity and specificity. Although MS will continue to play an important role in biomarker discovery in EB, its use in clinical setting is rather limited. EB analysis is moving toward online sampling with portable, room temperature operable, and inexpensive point-of-care devices capable of real-time measurements. This transition is happening due to the availability of highly performing biosensors and the use of wearable EB collection tools, mostly in the form of face masks. This feature article will outline the last developments in the field, notably the novel ways of EBA and EBC collection and the analytical aspects of the collected samples. The inherit non-invasive character of the sample collection approach might open new doors for efficient ways for a fast, non-invasive, and better diagnosis.
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Riccò M, Zaniboni A, Satta E, Ranzieri S, Marchesi F. Potential Use of Exhaled Breath Condensate for Diagnosis of SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12092245. [PMID: 36140647 PMCID: PMC9497929 DOI: 10.3390/diagnostics12092245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/31/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Reverse-transcriptase polymerase chain reaction (RT-qPCR) assays performed on respiratory samples collected through nasal swabs still represent the gold standard for COVID-19 diagnosis. Alternative methods to this invasive and time-consuming options are still being inquired, including the collection of airways lining fluids through exhaled breath condensate (EBC). Materials and Methods. We performed a systematic review and meta-analysis in order to explore the reliability of EBC as a way to collect respiratory specimens for RT-qPCR for diagnosis of COVID-19. Results. A total of 4 studies (205 specimens), were ultimately collected, with a pooled sensitivity of 69.5% (95%CI 26.8–93.4), and a pooled specificity of 98.3% (95%CI 87.8–99.8), associated with high heterogeneity and scarce diagnostic agreement with the gold standard represented by nasal swabs (Cohen’s kappa = 0.585). Discussion. Even though non-invasive options for diagnosis of COVID-19 are still necessary, EBC-based RT-qPCR showed scarce diagnostic performances, ultimately impairing its implementation in real-world settings. However, as few studies have been carried out to date, and the studies included in the present review are characterized by low numbers and low sample power, further research are requested to fully characterize the actual reliability of EBC-based RT-qPCR in the diagnosis of COVID-19.
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Affiliation(s)
- Matteo Riccò
- Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS di Reggio Emilia, Via Amendola n.2, I-42122 Reggio Emilia, Italy
- Correspondence: ; Tel.: +39-339-2994-343
| | - Alessandro Zaniboni
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy
| | - Elia Satta
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy
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Molecular detection of SARS-COV-2 in exhaled breath at the point-of-need. Biosens Bioelectron 2022; 217:114663. [PMID: 36150327 PMCID: PMC9424122 DOI: 10.1016/j.bios.2022.114663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/17/2022] [Accepted: 08/24/2022] [Indexed: 12/19/2022]
Abstract
The SARS-CoV-2 pandemic has highlighted the need for improved technologies to help control the spread of contagious pathogens. While rapid point-of-need testing plays a key role in strategies to rapidly identify and isolate infectious patients, current test approaches have significant shortcomings related to assay limitations and sample type. Direct quantification of viral shedding in exhaled particles may offer a better rapid testing approach, since SARS-CoV-2 is believed to spread mainly by aerosols. It assesses contagiousness directly, the sample is easy and comfortable to obtain, sampling can be standardized, and the limited sample volume lends itself to a fast and sensitive analysis. In view of these benefits, we developed and tested an approach where exhaled particles are efficiently sampled using inertial impaction in a micromachined silicon chip, followed by an RT-qPCR molecular assay to detect SARS-CoV-2 shedding. Our portable, silicon impactor allowed for the efficient capture (>85%) of respiratory particles down to 300 nm without the need for additional equipment. We demonstrate using both conventional off-chip and in-situ PCR directly on the silicon chip that sampling subjects’ breath in less than a minute yields sufficient viral RNA to detect infections as early as standard sampling methods. A longitudinal study revealed clear differences in the temporal dynamics of viral load for nasopharyngeal swab, saliva, breath, and antigen tests. Overall, after an infection, the breath-based test remains positive during the first week but is the first to consistently report a negative result, putatively signalling the end of contagiousness and further emphasizing the potential of this tool to help manage the spread of airborne respiratory infections.
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