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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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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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Sport in Town: The Smart Healthy ENV Project, a Pilot Study of Physical Activity with Multiparametric Monitoring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052432. [PMID: 33801395 PMCID: PMC7967572 DOI: 10.3390/ijerph18052432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/19/2021] [Accepted: 02/26/2021] [Indexed: 11/17/2022]
Abstract
Background: Increasing evidence links meteorological characteristics and air pollution to physiological responses during sports activities in urban areas with different traffic levels. Objective: The main objective of the Smart Healthy ENV (SHE, “Smart Monitoring Integrated System For A Healthy Urban Environment In Smart Cities”) project was to identify the specific responses of a group of volunteers during physical activity, by monitoring their heart rates and collecting breath samples, combined with data on meteorological determinants and pollution substances obtained through fixed sensor nodes placed along city routes and remotely connected to a dedicated data acquisition server. Methods: Monitoring stations were placed along two urban routes in Pisa, each two km long, with one located within the park beside the Arno river (green route) and the other in a crowded traffic zone (red route). Our sample participants were engaged in sports activities (N = 15, with different levels of ability) and were monitored through wearable sensors. They were first asked to walk back and forth (4 km) and then to run the same route. The experimental sessions were conducted over one day per route. A breath sample was also collected before each test. A questionnaire concerning temperature and fatigue perception was administered for all of the steps of the study over the two days. Results: The heart rates of the participants were monitored in the baseline condition, during walking, and while running, and were correlated with meteorological and pollutant data and with breath composition. Changes in the heart rates and breath composition were detected during the experimental sessions. These variations were related to the physical activity and to the meteorological conditions and air pollution levels. Conclusions: The SHE project can be considered a proof-of-concept study aimed at monitoring physiological and environmental variables during physical activity in urban areas, and can be used in future studies to provide useful information to those involved in sports and the broader community.
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Bellagambi FG, Lomonaco T, Ghimenti S, Biagini D, Fuoco R, Di Francesco F. Determination of peppermint compounds in breath by needle trap micro-extraction coupled with gas chromatography-tandem mass spectrometry. J Breath Res 2020; 15. [PMID: 33238253 DOI: 10.1088/1752-7163/abcdec] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 11/25/2020] [Indexed: 01/26/2023]
Abstract
Breath analysis is an alternative approach for disease diagnosis and for monitoring therapy. The lack of standardized procedures for collecting and analysing breath samples currently limits its use in clinical practice. In order to overcome this limitation, the "Peppermint Consortium" was established within the breath community to carry out breath wash-out experiments and define reference values for a panel of compounds contained in the peppermint oil capsule. Here, we present a needle trap micro-extraction technique coupled with gas chromatography and tandem mass spectrometry for a rapid and accurate determination of alpha-pinene, beta-pinene, limonene, eucalyptol, menthofuran, menthone, menthol and menthyl acetate in mixed breath samples. Detection limits between 1 and 20 pptv were observed when 25 mL of a humidified standard gas mixture were loaded into a needle trap device at a flow rate of 10 mL/min. Inter- and intra-day precisions were lower than 15%, thus confirming the reliability of the assay. Our procedure was used to analyse breath samples taken from a nominally healthy volunteer who were invited to swallow a 200 mg capsule of peppermint oil. Six samples were collected at various times within six hours of ingestion. Analyte concentrations were not affected by the sampling mode (i.e. mixed vs. end-tidal fraction), whereas respiratory rate and exhalation flow rate values slightly influenced the concentration of the target compounds in breath samples.
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Affiliation(s)
- Francesca G Bellagambi
- Institut des Sciences Analytiques, Université Claude Bernard Lyon 1, 5, rue de la Doua, Villeurbanne, FRANCE, 69100, FRANCE
| | - 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
| | - Silvia Ghimenti
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Toscana, ITALY
| | - Denise Biagini
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Toscana, ITALY
| | - Roger Fuoco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Toscana, ITALY
| | - Fabio Di Francesco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Pisa, Toscana, ITALY
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Lomonaco T, Salvo P, Ghimenti S, Biagini D, Antoni S, Bellagambi FG, Di Francesco F, Fuoco R. A sampler prototype for the simultaneous collection of exhaled air and breath condensate. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:2226-2229. [PMID: 31946343 DOI: 10.1109/embc.2019.8856302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Exhaled air and breath condensate contain a large number of health biomarkers, such as volatile and semi-volatile organic compounds, proteins and lipids. Nowadays, the collection of breath samples is carried out by commercial or lab-made sampling systems that collect only one type of sample (e.g. gaseous or condensate phase), thus limiting the diagnostic capability of breath tests. This work presents a portable prototype optimized for the simultaneous collection of gaseous exhaled breath and exhaled breath condensate within five minutes. The system is fully portable and has a total weight of about 1 Kg. An illustrative determination of ethanol, isoprene, acetone, isopropyl alcohol, 1-propanol, 2-butanone, 2-pentanone, toluene and xylenes in breath, and cortisol and 8-iso-prostaglandin F2α in breath condensate is discussed.
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7
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Using labelled internal standards to improve needle trap micro-extraction technique prior to gas chromatography/mass spectrometry. Talanta 2019; 200:145-155. [DOI: 10.1016/j.talanta.2019.03.046] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 12/18/2022]
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Tejero Rioseras A, Singh KD, Nowak N, Gaugg MT, Bruderer T, Zenobi R, Sinues PML. Real-Time Monitoring of Tricarboxylic Acid Metabolites in Exhaled Breath. Anal Chem 2018; 90:6453-6460. [DOI: 10.1021/acs.analchem.7b04600] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Alberto Tejero Rioseras
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
- SEADM, S.L., 28036 Madrid, Spain
- Department of Analytical Chemistry, University of Cordoba, 14005 Cordoba, Spain
| | - Kapil Dev Singh
- University Children’s Hospital Basel, University of Basel, 4056 Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Nora Nowak
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | - Martin T. Gaugg
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | - Tobias Bruderer
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | - Renato Zenobi
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | - Pablo M.-L. Sinues
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
- University Children’s Hospital Basel, University of Basel, 4056 Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
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Stach R, Haas J, Tütüncü E, Daboss S, Kranz C, Mizaikoff B. polyHWG: 3D Printed Substrate-Integrated Hollow Waveguides for Mid-Infrared Gas Sensing. ACS Sens 2017; 2:1700-1705. [PMID: 29090579 DOI: 10.1021/acssensors.7b00649] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Gas analysis via mid-infrared (MIR) spectroscopic techniques has gained significance due to its inherent molecular selectivity and sensitivity probing pronounced vibrational, rotational, and roto-vibrational modes. In addition, MIR gas sensors are suitable for real-time monitoring in a wide variety of sensing scenarios. Our research team has recently introduced so-called substrate-integrated hollow waveguides (iHWGs) fabricated by precision milling, which have been demonstrated to be useful in online process monitoring, environmental sensing, and exhaled breath analysis especially if low sample volumes (i.e., few hundreds of microliters) are probed with rapid signal transients. A logical next step is to establish ultralightweight, potentially disposable, and low-cost substrate-integrated hollow waveguides, which may be readily customized and tailored to specific applications using 3D printing techniques. 3D printing provides access to an unprecedented variety of thermoplastic materials including biocompatible polylactides, readily etchable styrene copolymers, and magnetic or conductive materials. Thus, the properties of the waveguide may be adapted to suit its designated application, e.g., drone-mounted ultralightweight waveguides for environmental monitoring or biocompatible disposable sensor interfaces in medical/clinical applications.
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Affiliation(s)
- Robert Stach
- Institute of Analytical and
Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Julian Haas
- Institute of Analytical and
Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Erhan Tütüncü
- Institute of Analytical and
Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Sven Daboss
- Institute of Analytical and
Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Christine Kranz
- Institute of Analytical and
Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Boris Mizaikoff
- Institute of Analytical and
Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
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