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V. R. N, Mohapatra AK, Kartha VB, Chidangil S. Multiwavelength Photoacoustic Breath Analysis Sensor for the Diagnosis of Lung Diseases: COPD and Asthma. ACS Sens 2023; 8:4111-4120. [PMID: 37871260 PMCID: PMC10683506 DOI: 10.1021/acssensors.3c01316] [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: 06/30/2023] [Revised: 10/01/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023]
Abstract
Breath analysis is emerging as a universal diagnostic method for clinical applications. The possibility of breath analysis is being explored vigorously using different analytical techniques. We have designed and assembled a multiwavelength UV photoacoustic spectroscopy (PAS) sensor for the said application. To optimize laser wavelength for sample excitation, photoacoustic signals from disease and normal conditions are recorded with different laser excitations (213, 266, 355, and 532 nm) on exhaled breath samples. Principal component analysis (PCA) of the PA signals has shown that 213, 266, and 355 nm laser excitations are suitable for breath analysis, with reliable descriptive statistics obtained for 266 nm laser. The study has, therefore, been extended for breath samples collected from asthma, chronic obstructive pulmonary disease (COPD), and normal subjects, using 266 nm laser excitation. PCA of the PA data shows good classification among asthma, COPD, and normal subjects. Match/No-match study performed with asthma, COPD, and normal calibration set has demonstrated the potential of using this method for diagnostic application. Sensitivity and specificity are observed as 88 and 89%, respectively. The area under the curve of the ROC curve is found to be 0.948, which justifies the diagnostic capability of the device for lung diseases. The same samples were studied using a commercial E-Nose, and the measurement outcome strongly supports the PAS results.
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Affiliation(s)
- Nidheesh V. R.
- Centre
of Excellence for Biophotonics, Department of Atomic and Molecular
Physics, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Aswini Kumar Mohapatra
- Department
of Respiratory Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Vasudevan Baskaran Kartha
- Centre
of Excellence for Biophotonics, Department of Atomic and Molecular
Physics, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Santhosh Chidangil
- Centre
of Excellence for Biophotonics, Department of Atomic and Molecular
Physics, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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2
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Bratu AM, Bojan M, Banita S, Petrus M, Popa C. NIR and THz spectroscopy: An experimental investigation toward nicotine-related devices. JOURNAL OF BIOPHOTONICS 2023; 16:e202300120. [PMID: 37260323 DOI: 10.1002/jbio.202300120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
This study examined the content of nicotine-delivery products using terahertz time-domain spectroscopy (THz-TDS) and breath ethylene investigated with CO2 laser photoacoustic spectroscopy (CO2 LPAS) system as a biomarker of oxidative stress after smoking. The THz-TDS method provided valuable information on the transmission spectra of tobacco and nicotine in smoking products. From the CO2 LPAS data it was observed that in cigarette (TC) smoking the mean breath ethylene was 687 parts per billion (ppb), while in electronic cigarettes and tobacco heating devices smoking the mean ethylene was 56 ppb and 48 ppb, respectively. The main finding was that TC showed higher transmission in the THz region producing a higher oxidative stress on the body.
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Affiliation(s)
- Ana-Maria Bratu
- National Institute for Laser, Plasma and Radiation Physics, Bucharest, PO, Romania
| | - Mihaela Bojan
- National Institute for Laser, Plasma and Radiation Physics, Bucharest, PO, Romania
| | - Stefan Banita
- National Institute for Laser, Plasma and Radiation Physics, Bucharest, PO, Romania
| | - Mioara Petrus
- National Institute for Laser, Plasma and Radiation Physics, Bucharest, PO, Romania
| | - Cristina Popa
- National Institute for Laser, Plasma and Radiation Physics, Bucharest, PO, Romania
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3
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Jensen KH, Michel BW. Detection of Ethylene with Defined Metal Complexes: Strategies and Recent Advances. ANALYSIS & SENSING 2023; 3:e202200058. [PMID: 37601898 PMCID: PMC10438914 DOI: 10.1002/anse.202200058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Indexed: 08/22/2023]
Abstract
Despite its relative simplicity, ethylene is an interesting molecule with wide-ranging impact in modern chemistry and biology. Stemming from ethylene's role as a critical plant hormone, there has been significant effort to develop selective and sensitive molecular sensors for ethylene. Late transition metal complexes have played an important role in detection strategies due to ethylene's lack of structural complexity and limited reactivity. Two main approaches to ethylene detection are identified: (1) coordination-based sensors, wherein ethylene binds reversibly to a metal center, and (2) activity-based sensors, wherein ethylene undergoes a reaction at a metal center, resulting in the formation and destruction of covalent bonds. Herein, we describe the advantages and disadvantages of various approaches, and the challenges remaining for sensor development.
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Affiliation(s)
- Katrina H Jensen
- School of Natural Sciences, Black Hills State University, 1200 University Street, Spearfish, SD, 57799, United States
| | - Brian W Michel
- Department of Chemistry and Biochemistry, University of Denver, 2101 E. Wesley Ave, Denver, CO, 80210, United States
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4
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Daiber A, Hahad O, Andreadou I, Steven S, Daub S, Münzel T. Redox-related biomarkers in human cardiovascular disease - classical footprints and beyond. Redox Biol 2021; 42:101875. [PMID: 33541847 PMCID: PMC8113038 DOI: 10.1016/j.redox.2021.101875] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 02/07/2023] Open
Abstract
Global epidemiological studies show that chronic non-communicable diseases such as atherosclerosis and metabolic disorders represent the leading cause of premature mortality and morbidity. Cardiovascular disease such as ischemic heart disease is a major contributor to the global burden of disease and the socioeconomic health costs. Clinical and epidemiological data show an association of typical oxidative stress markers such as lipid peroxidation products, 3-nitrotyrosine or oxidized DNA/RNA bases with all major cardiovascular diseases. This supports the concept that the formation of reactive oxygen and nitrogen species by various sources (NADPH oxidases, xanthine oxidase and mitochondrial respiratory chain) represents a hallmark of the leading cardiovascular comorbidities such as hyperlipidemia, hypertension and diabetes. These reactive oxygen and nitrogen species can lead to oxidative damage but also adverse redox signaling at the level of kinases, calcium handling, inflammation, epigenetic control, circadian clock and proteasomal system. The in vivo footprints of these adverse processes (redox biomarkers) are discussed in the present review with focus on their clinical relevance, whereas the details of their mechanisms of formation and technical aspects of their detection are only briefly mentioned. The major categories of redox biomarkers are summarized and explained on the basis of suitable examples. Also the potential prognostic value of redox biomarkers is critically discussed to understand what kind of information they can provide but also what they cannot achieve.
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Affiliation(s)
- Andreas Daiber
- Department of Cardiology, Molecular Cardiology, University Medical Center, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Omar Hahad
- Department of Cardiology, Molecular Cardiology, University Medical Center, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Ioanna Andreadou
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Sebastian Steven
- Department of Cardiology, Molecular Cardiology, University Medical Center, Mainz, Germany
| | - Steffen Daub
- Department of Cardiology, Molecular Cardiology, University Medical Center, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, Molecular Cardiology, University Medical Center, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstr. 1, 55131, Mainz, Germany.
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5
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Banik GD, Mizaikoff B. Exhaled breath analysis using cavity-enhanced optical techniques: a review. J Breath Res 2020; 14:043001. [PMID: 32969348 DOI: 10.1088/1752-7163/abaf07] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cavity-enhanced absorption spectroscopies (CEAS) have gained importance in a wide range of applications in molecular spectroscopy. The development of optical sensors based on the CEAS techniques coupled with the continuous wave or pulsed laser sources operating in the mid-infrared or near-infrared spectral regime uniquely offers molecularly selective and ultra-sensitive detection of trace species in complex matrices including exhaled human breath. In this review, we discussed recent applications of CEAS for analyzing trace constituents within the exhaled breath matrix facilitating the non-invasive assessment of human health status. Next to a brief discussion on the mechanisms of formation of trace components found in the exhaled breath matrix related to particular disease states, existing challenges in CEAS and future development towards non-invasive clinical diagnostics will be discussed.
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Affiliation(s)
- Gourab D Banik
- Institute of Analytical and Bioanalytical Chemistry, Ulm University Albert-Einstein-Allee 11, 89081 Ulm, Germany
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6
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Dumitras DC, Petrus M, Bratu AM, Popa C. Applications of Near Infrared Photoacoustic Spectroscopy for Analysis of Human Respiration: A Review. Molecules 2020; 25:E1728. [PMID: 32283766 PMCID: PMC7180475 DOI: 10.3390/molecules25071728] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
Abstract
In this review, applications of near-infrared photoacoustic spectroscopy are presented as an opportunity to evaluate human respiration because the measurement of breath is fast, intact and simple to implement. Recently, analytical methods for measuring biomarkers in exhaled air have been extensively developed. With laser-based photoacoustic spectroscopy, volatile organic compounds can be identified with high sensitivity, at a high rate, and with very good selectivity. The literature review has shown the applicability of near-infrared photoacoustic spectroscopy to one of the problems of the real world, i.e., human health. In addition, the review will consider and explore different breath sampling methods for human respiration analysis.
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Affiliation(s)
- Dan C. Dumitras
- University “Politehnica” of Bucharest, Physics Department, Faculty of Applied Sciences, University “Politehnica” of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - Mioara Petrus
- National Institute for Laser, Plasma and Radiation Physics, Laser Department, 409 Atomistilor St., PO Box MG 36, 077125 Magurele, Romania; (M.P.); (A.-M.B.); (C.P.)
| | - Ana-Maria Bratu
- National Institute for Laser, Plasma and Radiation Physics, Laser Department, 409 Atomistilor St., PO Box MG 36, 077125 Magurele, Romania; (M.P.); (A.-M.B.); (C.P.)
| | - Cristina Popa
- National Institute for Laser, Plasma and Radiation Physics, Laser Department, 409 Atomistilor St., PO Box MG 36, 077125 Magurele, Romania; (M.P.); (A.-M.B.); (C.P.)
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7
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Iskander-Rizk S, van der Steen AFW, van Soest G. Photoacoustic imaging for guidance of interventions in cardiovascular medicine. Phys Med Biol 2019; 64:16TR01. [PMID: 31048573 DOI: 10.1088/1361-6560/ab1ede] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Imaging guidance is paramount to procedural success in minimally invasive interventions. Catheter-based therapies are the standard of care in the treatment of many cardiac disorders, including coronary artery disease, structural heart disease and electrophysiological conditions. Many of these diseases are caused by, or effect, a change in vasculature or cardiac tissue composition, which can potentially be detected by photoacoustic imaging. This review summarizes the state of the art in photoacoustic imaging approaches that have been proposed for intervention guidance in cardiovascular care. All of these techniques are currently in the preclinical phase. We will conclude with an outlook towards clinical applications.
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Affiliation(s)
- Sophinese Iskander-Rizk
- Department of Cardiology, Biomedical Engineering, Erasmus MC University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
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8
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Standardization procedures for real-time breath analysis by secondary electrospray ionization high-resolution mass spectrometry. Anal Bioanal Chem 2019; 411:4883-4898. [PMID: 30989265 PMCID: PMC6611759 DOI: 10.1007/s00216-019-01764-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/25/2019] [Accepted: 03/06/2019] [Indexed: 01/27/2023]
Abstract
Despite the attractiveness of breath analysis as a non-invasive means to retrieve relevant metabolic information, its introduction into routine clinical practice remains a challenge. Among all the different analytical techniques available to interrogate exhaled breath, secondary electrospray ionization high-resolution mass spectrometry (SESI-HRMS) offers a number of advantages (e.g., real-time, yet wide, metabolome coverage) that makes it ideal for untargeted and targeted studies. However, so far, SESI-HRMS has relied mostly on lab-built prototypes, making it difficult to standardize breath sampling and subsequent analysis, hence preventing further developments such as multi-center clinical studies. To address this issue, we present here a number of new developments. In particular, we have characterized a new SESI interface featuring real-time readout of critical exhalation parameters such as CO2, exhalation flow rate, and exhaled volume. Four healthy subjects provided breath specimens over a period of 1 month to characterize the stability of the SESI-HRMS system. A first assessment of the repeatability of the system using a gas standard revealed a coefficient of variation (CV) of 2.9%. Three classes of aldehydes, namely 4-hydroxy-2-alkenals, 2-alkenals and 4-hydroxy-2,6-alkedienals―hypothesized to be markers of oxidative stress―were chosen as representative metabolites of interest to evaluate the repeatability and reproducibility of this breath analysis analytical platform. Median and interquartile ranges (IQRs) of CVs for CO2, exhalation flow rate, and exhaled volume were 3.2% (1.5%), 3.1% (1.9%), and 5.0% (4.6%), respectively. Despite the high repeatability observed for these parameters, we observed a systematic decay in the signal during repeated measurements for the shorter fatty aldehydes, which eventually reached a steady state after three/four repeated exhalations. In contrast, longer fatty aldehydes showed a steady behavior, independent of the number of repeated exhalation maneuvers. We hypothesize that this highly molecule-specific and individual-independent behavior may be explained by the fact that shorter aldehydes (with higher estimated blood-to-air partition coefficients; approaching 100) mainly get exchanged in the airways of the respiratory system, whereas the longer aldehydes (with smaller estimated blood-to-air partition coefficients; approaching 10) are thought to exchange mostly in the alveoli. Exclusion of the first three exhalations from the analysis led to a median CV (IQR) of 6.7 % (5.5 %) for the said classes of aldehydes. We found that such intra-subject variability is in general much lower than inter-subject variability (median relative differences between subjects 48.2%), suggesting that the system is suitable to capture such differences. No batch effect due to sampling date was observed, overall suggesting that the intra-subject variability measured for these series of aldehydes was biological rather than technical. High correlations found among the series of aldehydes support this notion. Finally, recommendations for breath sampling and analysis for SESI-HRMS users are provided with the aim of harmonizing procedures and improving future inter-laboratory comparisons. Graphical abstract ![]()
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9
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Romano R, Cristescu SM, Risby TH, Marczin N. Lipid peroxidation in cardiac surgery: towards consensus on biomonitoring, diagnostic tools and therapeutic implementation. J Breath Res 2018; 12:027109. [PMID: 29104182 DOI: 10.1088/1752-7163/aa9856] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This review focuses on oxidative stress and more specifically lipid peroxidation in cardiac surgery, one of the fundamental theories of perioperative complications. We present the molecular pathways leading to lipid peroxidation and integrate analytical methods that allow detection of lipid peroxidation markers in the fluid phase with those focusing on volatile compounds in exhaled breath. In order to explore the accumulated data in the literature, we present a systematic review of quantitative analysis of malondialdehyde, a widely used lipid peroxidation product at various stages of cardiac surgery. This exploration reveals major limitations of existing studies in terms of variability of reported values and significant gaps due to discrete and variable sampling times during surgery. We also appraise methodologies that allow real-time and continuous monitoring of oxidative stress. Complimentary techniques highlight that beyond the widely acclaimed contribution of the cardiopulmonary bypass technology and myocardial reperfusion injury, the use of diathermy contributes significantly to intraoperative lipid peroxidation. We conclude that there is an urgent need to implement the theory of oxidative stress towards a paradigm change in the clinical practice. Firstly, we need to acquire definite and irrefutable information on the link between lipid peroxidation and post-operative complications by building international consensus on best analytical approaches towards generating qualitatively and quantitatively comparable datasets in coordinated multicentre studies. Secondly, we should move away from routine low-risk surgeries towards higher risk interventions where there is major unmet clinical need for improving patient journey and outcomes. There is also need for consensus on best therapeutic interventions which could be tested in convincing large scale clinical trials. As future directions, we propose combination of fluid phase platforms and 'metabography', an extended form of capnography-including real-time analysis of lipid peroxidation and volatile footprints of metabolism-for better patient phenotyping prior to and during high risk surgery towards molecular prediction, stratification and monitoring of the patient's journey.
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Affiliation(s)
- Rosalba Romano
- Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
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10
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Metsälä M. Optical techniques for breath analysis: from single to multi-species detection. J Breath Res 2018; 12:027104. [DOI: 10.1088/1752-7163/aa8a31] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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11
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Henderson B, Khodabakhsh A, Metsälä M, Ventrillard I, Schmidt FM, Romanini D, Ritchie GAD, te Lintel Hekkert S, Briot R, Risby T, Marczin N, Harren FJM, Cristescu SM. Laser spectroscopy for breath analysis: towards clinical implementation. APPLIED PHYSICS. B, LASERS AND OPTICS 2018; 124:161. [PMID: 30956412 PMCID: PMC6428385 DOI: 10.1007/s00340-018-7030-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/19/2018] [Indexed: 05/08/2023]
Abstract
Detection and analysis of volatile compounds in exhaled breath represents an attractive tool for monitoring the metabolic status of a patient and disease diagnosis, since it is non-invasive and fast. Numerous studies have already demonstrated the benefit of breath analysis in clinical settings/applications and encouraged multidisciplinary research to reveal new insights regarding the origins, pathways, and pathophysiological roles of breath components. Many breath analysis methods are currently available to help explore these directions, ranging from mass spectrometry to laser-based spectroscopy and sensor arrays. This review presents an update of the current status of optical methods, using near and mid-infrared sources, for clinical breath gas analysis over the last decade and describes recent technological developments and their applications. The review includes: tunable diode laser absorption spectroscopy, cavity ring-down spectroscopy, integrated cavity output spectroscopy, cavity-enhanced absorption spectroscopy, photoacoustic spectroscopy, quartz-enhanced photoacoustic spectroscopy, and optical frequency comb spectroscopy. A SWOT analysis (strengths, weaknesses, opportunities, and threats) is presented that describes the laser-based techniques within the clinical framework of breath research and their appealing features for clinical use.
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Affiliation(s)
- Ben Henderson
- Trace Gas Research Group, Molecular and Laser Physics, IMM, Radboud University, 6525 AJ Nijmegen, The Netherlands
| | - Amir Khodabakhsh
- Trace Gas Research Group, Molecular and Laser Physics, IMM, Radboud University, 6525 AJ Nijmegen, The Netherlands
| | - Markus Metsälä
- Department of Chemistry, University of Helsinki, PO Box 55, 00014 Helsinki, Finland
| | | | - Florian M. Schmidt
- Department of Applied Physics and Electronics, Umeå University, 90187 Umeå, Sweden
| | - Daniele Romanini
- University of Grenoble Alpes, CNRS, LIPhy, 38000 Grenoble, France
| | - Grant A. D. Ritchie
- Department of Chemistry, Physical and Theoretical Chemistry Laboratory, University of Oxford, South Parks Road, Oxford, OX1 3QZ UK
| | | | - Raphaël Briot
- University of Grenoble Alpes, CNRS, TIMC-IMAG, 38000 Grenoble, France
- Emergency Department and Mobile Intensive Care Unit, Grenoble University Hospital, Grenoble, France
| | - Terence Risby
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, USA
| | - Nandor Marczin
- Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Centre of Anaesthesia and Intensive Care, Semmelweis University, Budapest, Hungary
| | - Frans J. M. Harren
- Trace Gas Research Group, Molecular and Laser Physics, IMM, Radboud University, 6525 AJ Nijmegen, The Netherlands
| | - Simona M. Cristescu
- Trace Gas Research Group, Molecular and Laser Physics, IMM, Radboud University, 6525 AJ Nijmegen, The Netherlands
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12
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Bos LDJ. Diagnosis of acute respiratory distress syndrome by exhaled breath analysis. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:33. [PMID: 29430450 DOI: 10.21037/atm.2018.01.17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The acute respiratory distress syndrome (ARDS) is a complication of critical illness that is characterized by acute onset, protein rich, pulmonary edema. There is no treatment for ARDS, other than the reduction of additional ventilator induced lung injury. Prediction or earlier recognition of ARDS could result in preventive measurements and might decrease mortality and morbidity. Exhaled breath contains volatile organic compounds (VOCs), a collection of hundreds of small molecules linked to several physiological and pathophysiological processes. Analysis of exhaled breath through gas-chromatography and mass-spectrometry (GC-MS) has resulted in an accurate diagnosis of ARDS in several studies. Most identified markers are linked to lipid peroxidation. Octane is one of the few markers that was validated as a marker of ARDS and is pathophysiologically likely to be increased in ARDS. None of the currently studied breath analysis methods is directly applicable in clinical practice. Two steps have to be taken before any breath test can be allowed into the intensive care unit. External validation in a multi-center study is a prerequisite for any of the candidate breath markers and the breath test should outperform clinical prediction scores. Second, the technology for breath analysis should be adapted so that it is available at a decentralized lab inside the intensive care unit and can be operated by trained nurses, in order to reduce the analysis time. In conclusion, exhaled analysis might be used for the early diagnosis and prediction of ARDS in the near future but several obstacles have to be taken in the coming years. Most of the candidate markers can be linked to lipid peroxidation. Only octane has been validated in a temporal external validation cohort and is, at this moment, the top-ranking breath biomarker for ARDS.
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Affiliation(s)
- Lieuwe D J Bos
- Department of Respiratory Medicine, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands.,Department of Intensive Care, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
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13
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Paardekooper LM, van den Bogaart G, Kox M, Dingjan I, Neerincx AH, Bendix MB, Beest MT, Harren FJM, Risby T, Pickkers P, Marczin N, Cristescu SM. Ethylene, an early marker of systemic inflammation in humans. Sci Rep 2017; 7:6889. [PMID: 28761087 PMCID: PMC5537290 DOI: 10.1038/s41598-017-05930-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 06/06/2017] [Indexed: 11/09/2022] Open
Abstract
Ethylene is a major plant hormone mediating developmental processes and stress responses to stimuli such as infection. We show here that ethylene is also produced during systemic inflammation in humans and is released in exhaled breath. Traces of ethylene were detected by laser spectroscopy both in vitro in isolated blood leukocytes exposed to bacterial lipopolysaccharide (LPS) as well as in vivo following LPS administration in healthy volunteers. Exposure to LPS triggers formation of ethylene as a product of lipid peroxidation induced by the respiratory burst. In humans, ethylene was detected prior to the increase of blood levels of inflammatory cytokines and stress-related hormones. Our results highlight that ethylene release is an early and integral component of in vivo lipid peroxidation with important clinical implications as a breath biomarker of bacterial infection.
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Affiliation(s)
- Laurent M Paardekooper
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert van den Bogaart
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Matthijs Kox
- Intensive Care Medicine, Nijmegen Institute for Infection, Inflammation and Immunity, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse Dingjan
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne H Neerincx
- Department of Molecular and Laser Physics, Institute of Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Maura B Bendix
- Department of Molecular and Laser Physics, Institute of Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Martin Ter Beest
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frans J M Harren
- Department of Molecular and Laser Physics, Institute of Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Terence Risby
- Department of Environmental Health Sciences, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Peter Pickkers
- Intensive Care Medicine, Nijmegen Institute for Infection, Inflammation and Immunity, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nandor Marczin
- Department of Anaesthesia, Royal Brompton and Harefield NHS Foundation Trust, Harefield, UK
- Section of Anaesthesia, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Simona M Cristescu
- Department of Molecular and Laser Physics, Institute of Molecules and Materials, Radboud University, Nijmegen, The Netherlands.
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14
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Maltesen RG, Rasmussen BS, Pedersen S, Hanifa MA, Kucheryavskiy S, Kristensen SR, Wimmer R. Metabotyping Patients' Journeys Reveals Early Predisposition to Lung Injury after Cardiac Surgery. Sci Rep 2017; 7:40275. [PMID: 28074924 PMCID: PMC5225494 DOI: 10.1038/srep40275] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/05/2016] [Indexed: 12/30/2022] Open
Abstract
Cardiovascular disease is the leading cause of death worldwide and patients with severe symptoms undergo cardiac surgery. Even after uncomplicated surgeries, some patients experience postoperative complications such as lung injury. We hypothesized that the procedure elicits metabolic activity that can be related to the disease progression, which is commonly observed two-three days postoperatively. More than 700 blood samples were collected from 50 patients at nine time points pre-, intra-, and postoperatively. Dramatic metabolite shifts were observed during and immediately after the intervention. Prolonged surgical stress was linked to an augmented anaerobic environment. Time series analysis showed shifts in purine-, nicotinic acid-, tyrosine-, hyaluronic acid-, ketone-, fatty acid, and lipid metabolism. A characteristic 'metabolic biosignature' was identified correlating with the risk of developing postoperative complications two days before the first clinical signs of lung injury. Hence, this study demonstrates the link between intra- and postoperative time-dependent metabolite changes and later postoperative outcome. In addition, the results indicate that metabotyping patients' journeys early, during or just after the end of surgery, may have potential impact in hospitals for the early diagnosis of postoperative lung injury, and for the monitoring of therapeutics targeting disease progression.
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Affiliation(s)
- Raluca Georgiana Maltesen
- Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Denmark
- Department of Chemistry and Bioscience, Aalborg University, Denmark
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark
| | - Bodil Steen Rasmussen
- Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Denmark
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark
| | - Shona Pedersen
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark
- Department of Clinical Biochemistry, Aalborg University Hospital, Denmark
| | - Munsoor Ali Hanifa
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark
| | | | - Søren Risom Kristensen
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark
- Department of Clinical Biochemistry, Aalborg University Hospital, Denmark
| | - Reinhard Wimmer
- Department of Chemistry and Bioscience, Aalborg University, Denmark
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15
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Lazaroid U-74389G for cardioplegia-related ischemia–reperfusion injury: an experimental study. J Surg Res 2017; 207:164-173. [DOI: 10.1016/j.jss.2016.08.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/23/2016] [Accepted: 08/24/2016] [Indexed: 12/27/2022]
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16
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Pleil JD, Beauchamp JD, Miekisch W, Funk WE. Adapting biomarker technologies to adverse outcome pathways (AOPs) research: current thoughts on using
in vivo
discovery for developing
in vitro
target methods. J Breath Res 2015; 9:039001. [DOI: 10.1088/1752-7155/9/3/039001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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