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Hintzen KF, Eussen MM, Neutel C, Bouvy ND, van Schooten FJ, Hooijmans CR, Lubbers T. A systematic review on the detection of volatile organic compounds in exhaled breath in experimental animals in the context of gastrointestinal and hepatic diseases. PLoS One 2023; 18:e0291636. [PMID: 37733754 PMCID: PMC10513283 DOI: 10.1371/journal.pone.0291636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/02/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Analysis of volatile organic compounds (VOCs) in exhaled breath has the potential to serve as an accurate diagnostic tool for gastro-intestinal diseases. Animal studies could be instrumental as a preclinical base and subsequent clinical translation to humans, as they are easier to standardize and better equipped to relate specific VOCs to metabolic and pathological processes. This review provides an overview of the study design, characteristics and methodological quality of previously published animal studies on analysis of exhaled breath in gastrointestinal and hepatic diseases. Guidelines are provided for standardization in study design and breath collection methods to improve comparability, avoid duplication of research and reduce discomfort of animals in future studies. METHODS PubMed and Embase database were searched for animal studies using exhaled breath analysis to detect gastro-intestinal diseases. Risk of bias was assessed using the SYRCLE's risk of bias tool for animal studies. Information on study design, standardization methods, animal models, breath collection methods and identified VOCs were extracted from the included studies. RESULTS 10 studies were included (acute liver failure n = 1, non-alcoholic steatohepatitis n = 1, hepatic ischemia n = 2, mesenteric ischemia n = 2, sepsis and peritonitis n = 3, colitis n = 1). Rats were used in most of the studies. Exhaled breath was mostly collected using invasive procedures as tracheal cannulation or tracheostomy. Poor reporting on standardization, breath collection methods, analytical techniques, as well as heterogeneity of the studies, complicate comparison of the different studies. CONCLUSION Poor reporting of essential methodological details impaired comprehensive summarizing the various studies on exhaled breath in gastrointestinal and hepatic diseases. Potential pitfalls in study design, and suggestions for improvement of study design are discussed which, when applied, lead to consistent and generalizable results and a reduction in the use of laboratory animals. Refining the methodological quality of animal studies has the potential to improve subsequent clinical trial design.
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Affiliation(s)
- Kim F.H. Hintzen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Pharmacology and Toxicology, Maastricht University, Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, The Netherlands
| | - Myrthe M.M. Eussen
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Céline Neutel
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Nicole D. Bouvy
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Frederik-Jan van Schooten
- Department of Pharmacology and Toxicology, Maastricht University, Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, The Netherlands
| | - Carlijn R. Hooijmans
- Department of Anesthesiology, Pain and Palliative Care (Meta Research Team), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Tim Lubbers
- Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
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Hintzen K, Smolinska A, Mommers AGR, Bouvy N, van Schooten FJ, Lubbers T. Non-invasive breath collection in murine models using a newly developed sampling device. J Breath Res 2022; 16. [PMID: 35086080 DOI: 10.1088/1752-7163/ac4fae] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/27/2022] [Indexed: 11/11/2022]
Abstract
Volatile organic compounds (VOCs) in exhaled breath have the potential to be used as biomarkers for screening and diagnosis of diseases. Clinical studies are often complicated by both modifiable and non-modifiable factors influencing the composition of VOCs in exhaled breath. Small laboratory animal studies contribute in obtaining fundamental insight in alterations in VOC composition in exhaled breath and thereby facilitate the design and analysis of clinical research. However, long term animal experiments are often limited by invasive breath collection methods and terminal experiments. To overcome this problem, a novel device was developed for non-invasive breath collection in mice using glass nose-only restrainers thereby omitting the need of anesthetics. C57Bl/6J mice were used to test reproducibility and different air sampling settings for air-flow (ml/min) and time (minutes). Exhaled air was collected on desorption tubes and analysed for VOCs by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). In total 27 compounds were putatively identified and used to assess the variability of the VOC measurements in the breath collections. Best reproducibility is obtained when using an air flow of 185 ml/min and a collection time of 20 minutes. Due to the non-invasive nature of breath collections in murine models, this device has the potential to facilitate VOC research in relation to disturbed metabolism and or disease pathways.
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Affiliation(s)
- Kim Hintzen
- Pharmacology & Toxicology, Maastricht University, PO 616, Maastricht, 6200MD, NETHERLANDS
| | - Agnieszka Smolinska
- Pharmacology and Toxicology, Maastricht University, PO 616, Maastricht, Limburg, 6200 MD, NETHERLANDS
| | - Alex G R Mommers
- Pharmacology & Toxicology, Maastricht University, PO 616, Maastricht, 6200MD, NETHERLANDS
| | - Nicole Bouvy
- Surgery, Maastricht University Medical Centre+, PO Box 5800, Maastricht, Limburg, 6202AZ, NETHERLANDS
| | - Frederik Jan van Schooten
- Department of Pharmacology & Toxicology, Maastricht University, Research Institute NUTRIM, Maastricht, Limburg, 6200 MD, NETHERLANDS
| | - Tim Lubbers
- Surgery, Maastricht University Medical Centre+, PO Box 5800, Maastricht, Limburg, 6202AZ, NETHERLANDS
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Faisal H, Ali ST, Xu J, Nisar T, Sabawi M, Salazar E, Masud FN. Carboxyhemoglobinemia in Critically Ill Coronavirus Disease 2019 Patients. J Clin Med 2021; 10:jcm10122731. [PMID: 34205655 PMCID: PMC8234747 DOI: 10.3390/jcm10122731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/02/2021] [Accepted: 06/08/2021] [Indexed: 12/21/2022] Open
Abstract
Carboxyhemoglobinemia is a common but a serious disorder, defined as an increase in carboxyhemoglobin level. Unfortunately, there are few data on carboxyhemoglobinemia in coronavirus disease 2019 (COVID-19) patients. Therefore, our study aimed to evaluate the incidence and etiologies of carboxyhemoglobinemia in COVID-19 patients and determine any association between carboxyhemoglobinemia and novel coronavirus infection. A retrospective chart review was performed at an academic medical center for all inpatient COVID-19 cases with either single or serial carboxyhemoglobin (COHb) levels from March 2020 through August 2020.Our study demonstrates that carboxyhemoglobinemia in COVID-19 patients is due to sepsis, hemolysis, and cytokine storm, triggered by the novel coronavirus infection sequela and is not directly from the virulence of novel coronavirus. Given the coexisting illnesses in critically ill COVID-19 patients, it is impossible to establish if coronavirus virulence was the culprit of elevated COHb levels. Moreover, our study found a high incidence of carboxyhemoglobinemia in critically ill COVID-19 patients. The oxygen saturation measured by pulse oximetry can be inaccurate and unreliable; however, our study could not demonstrate any uniform results on the discrepancy between oxygen saturation measured by pulse oximetry and arterial blood gas. In this study, COHb levels were measured using a CO-oximeter. Therefore, we recommend monitoring the COHb level routinely in critically ill COVID-19 patients to allow more effective and prompt treatment.
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Affiliation(s)
- Hina Faisal
- Department of Surgery, Houston Methodist Hospital, Houston, TX 77030, USA;
- Correspondence: ; Tel.: +1-346-238-0343 or +1-832-954-6079
| | - Syeda T. Ali
- Department of Surgery, Houston Methodist Hospital, Houston, TX 77030, USA;
| | - Jiaqiong Xu
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX 77030, USA; (J.X.); (T.N.)
| | - Tariq Nisar
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX 77030, USA; (J.X.); (T.N.)
| | - Mahmoud Sabawi
- Department of Pharmacy, Houston Methodist Hospital, Houston, TX 77030, USA;
| | - Eric Salazar
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USA;
| | - Faisal N. Masud
- Department of Anesthesia & Critical Care Medicine, Houston Methodist Hospital, Houston, TX 77030, USA;
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Hopper CP, De La Cruz LK, Lyles KV, Wareham LK, Gilbert JA, Eichenbaum Z, Magierowski M, Poole RK, Wollborn J, Wang B. Role of Carbon Monoxide in Host-Gut Microbiome Communication. Chem Rev 2020; 120:13273-13311. [PMID: 33089988 DOI: 10.1021/acs.chemrev.0c00586] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Nature is full of examples of symbiotic relationships. The critical symbiotic relation between host and mutualistic bacteria is attracting increasing attention to the degree that the gut microbiome is proposed by some as a new organ system. The microbiome exerts its systemic effect through a diverse range of metabolites, which include gaseous molecules such as H2, CO2, NH3, CH4, NO, H2S, and CO. In turn, the human host can influence the microbiome through these gaseous molecules as well in a reciprocal manner. Among these gaseous molecules, NO, H2S, and CO occupy a special place because of their widely known physiological functions in the host and their overlap and similarity in both targets and functions. The roles that NO and H2S play have been extensively examined by others. Herein, the roles of CO in host-gut microbiome communication are examined through a discussion of (1) host production and function of CO, (2) available CO donors as research tools, (3) CO production from diet and bacterial sources, (4) effect of CO on bacteria including CO sensing, and (5) gut microbiome production of CO. There is a large amount of literature suggesting the "messenger" role of CO in host-gut microbiome communication. However, much more work is needed to begin achieving a systematic understanding of this issue.
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Affiliation(s)
- Christopher P Hopper
- Institute for Experimental Biomedicine, University Hospital Wuerzburg, Wuerzburg, Bavaria DE 97080, Germany.,Department of Medicinal Chemistry, College of Pharmacy, The University of Florida, Gainesville, Florida 32611, United States
| | - Ladie Kimberly De La Cruz
- Department of Chemistry & Center for Diagnostics and Therapeutics, Georgia State University, Atlanta, Georgia 30303, United States
| | - Kristin V Lyles
- Department of Biology, Georgia State University, Atlanta, Georgia 30303, United States
| | - Lauren K Wareham
- The Vanderbilt Eye Institute and Department of Ophthalmology & Visual Sciences, The Vanderbilt University Medical Center and School of Medicine, Nashville, Tennessee 37232, United States
| | - Jack A Gilbert
- Department of Pediatrics, Scripps Institution of Oceanography, University of California San Diego, La Jolla, California 92093, United States
| | - Zehava Eichenbaum
- Department of Biology, Georgia State University, Atlanta, Georgia 30303, United States
| | - Marcin Magierowski
- Cellular Engineering and Isotope Diagnostics Laboratory, Department of Physiology, Jagiellonian University Medical College, Cracow PL 31-531, Poland
| | - Robert K Poole
- Department of Molecular Biology and Biotechnology, The University of Sheffield, Firth Court, Sheffield S10 2TN, U.K
| | - Jakob Wollborn
- Department of Anesthesiology and Critical Care, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg DE 79085, Germany.,Department of Anesthesiology, Perioperative and Pain Management, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Binghe Wang
- Department of Chemistry & Center for Diagnostics and Therapeutics, Georgia State University, Atlanta, Georgia 30303, United States
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Abstract
One of the most logical applications of modern breath analysis techniques is to provide information on respiratory infections. Ongoing work in various types of pulmonary infections has begun to denote candidate breath biomarkers of bacterial, viral, and fungal lung infections. Groundbreaking studies have been performed in naturally occurring cases with humans and with animal models of the disease. This has been coupled with cell culture work to understand the nature of the origins of breath biomarkers generated from the pathogen itself as it proliferates. Much work remains to be done, and the published studies described in this chapter are helping to set a foundation for this research area.
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Ahmed WM, Lawal O, Nijsen TM, Goodacre R, Fowler SJ. Exhaled Volatile Organic Compounds of Infection: A Systematic Review. ACS Infect Dis 2017; 3:695-710. [PMID: 28870074 DOI: 10.1021/acsinfecdis.7b00088] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
With heightened global concern of microbial drug resistance, advanced methods for early and accurate diagnosis of infection are urgently needed. Analysis of exhaled breath volatile organic compounds (VOCs) toward detecting microbial infection potentially allows a highly informative and noninvasive alternative to current genomics and culture-based methods. We performed a systematic review of research literature reporting human and animal exhaled breath VOCs related to microbial infections. In this Review, we find that a wide range of breath sampling and analysis methods are used by researchers, which significantly affects interstudy method comparability. Studies either perform targeted analysis of known VOCs relating to an infection, or non-targeted analysis to obtain a global profile of volatile metabolites. In general, the field of breath analysis is still relatively immature, and there is much to be understood about the metabolic production of breath VOCs, particularly in a host where both commensal microflora as well as pathogenic microorganisms may be manifested in the airways. We anticipate that measures to standardize high throughput sampling and analysis, together with an increase in large scale collaborative international trials, will bring routine breath VOC analysis to improve diagnosis of infection closer to reality.
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Affiliation(s)
- Waqar M. Ahmed
- Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
- Philips
Research, Royal Philips B.V., High Tech Campus 34, Eindhoven, 5656 AE, The Netherlands
| | - Oluwasola Lawal
- Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
- Philips
Research, Royal Philips B.V., High Tech Campus 34, Eindhoven, 5656 AE, The Netherlands
| | - Tamara M. Nijsen
- Philips
Research, Royal Philips B.V., High Tech Campus 34, Eindhoven, 5656 AE, The Netherlands
| | - Royston Goodacre
- School of
Chemistry, Manchester Institute of Biotechnology, The University of Manchester, 131 Princess Street, Manchester, M1 7DN, United Kingdom
| | - Stephen J. Fowler
- Division of Infection, Immunity & Respiratory Medicine, School of Biological Sciences, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
- Manchester
Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, United Kingdom
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Crowder CD, Ghalyanchi Langeroudi A, Shojaee Estabragh A, Lewis ERG, Marcsisin RA, Barbour AG. Pathogen and Host Response Dynamics in a Mouse Model of Borrelia hermsii Relapsing Fever. Vet Sci 2016; 3:vetsci3030019. [PMID: 29056727 PMCID: PMC5606581 DOI: 10.3390/vetsci3030019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/23/2016] [Accepted: 08/24/2016] [Indexed: 11/23/2022] Open
Abstract
Most Borrelia species that cause tick-borne relapsing fever utilize rodents as their natural reservoirs, and for decades laboratory-bred rodents have served as informative experimental models for the disease. However, while there has much progress in understanding the pathogenetic mechanisms, including antigenic variation, of the pathogen, the host side of the equation has been neglected. Using different approaches, we studied, in immunocompetent inbred mice, the dynamics of infection with and host responses to North American relapsing fever agent B. hermsii. The spirochete’s generation time in blood of infected mice was between 4–5 h and, after a delay, was matched in rate by the increase of specific agglutinating antibodies in response to the infection. After initiating serotype cells were cleared by antibodies, the surviving spirochetes were a different serotype and, as a population, grew more slowly. The retardation was attributable to the host response and not an inherently slower growth rate. The innate responses at infection peak and immediate aftermath were characterized by elevations of both pro-inflammatory and anti-inflammatory cytokines and chemokines. Immunodeficient mice had higher spirochete burdens and severe anemia, which was accounted for by aggregation of erythrocytes by spirochetes and their partially reversible sequestration in greatly enlarged spleens and elsewhere.
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Affiliation(s)
- Christopher D Crowder
- Departments of Microbiology & Molecular Genetics and Medicine, University of California Irvine, Irvine, CA 92697, USA.
| | - Arash Ghalyanchi Langeroudi
- Departments of Microbiology & Molecular Genetics and Medicine, University of California Irvine, Irvine, CA 92697, USA.
| | - Azadeh Shojaee Estabragh
- Departments of Microbiology & Molecular Genetics and Medicine, University of California Irvine, Irvine, CA 92697, USA.
| | - Eric R G Lewis
- Departments of Microbiology & Molecular Genetics and Medicine, University of California Irvine, Irvine, CA 92697, USA.
| | - Renee A Marcsisin
- Departments of Microbiology & Molecular Genetics and Medicine, University of California Irvine, Irvine, CA 92697, USA.
| | - Alan G Barbour
- Departments of Microbiology & Molecular Genetics and Medicine, University of California Irvine, Irvine, CA 92697, USA.
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Langeroudi AG, Hirsch CM, Estabragh AS, Meinardi S, Blake DR, Barbour AG. Elevated carbon monoxide to carbon dioxide ratio in the exhaled breath of mice treated with a single dose of lipopolysaccharide. Open Forum Infect Dis 2014; 1:ofu085. [PMID: 25734151 PMCID: PMC4281777 DOI: 10.1093/ofid/ofu085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 08/04/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Analysis of volatile organic chemicals in breath holds promise for noninvasive diagnosis and monitoring of patients, but investigation of this in experimental mouse models has been limited. Of particular interest is endogenous production of carbon monoxide as a biomarker of inflammation and, more particularly, during sepsis. METHODS Using a nose-only collection procedure for unanesthetized individual adult mice and sensitive gas chromatography of carbon monoxide (CO) and carbon dioxide (CO2) of sampled breath, we investigated the responses of mice to one-time injections with different doses of purified Escherichia coli lipopolysaccharide. Two strains of mice were examined: BALB/c and C3H, including an endotoxin-resistant mutant (HeJ) as well as the wild type (HOuJ). RESULTS The CO to CO2 ratio increased in a dose-responsive manner within hours in treated BALC/c mice but not control mice. The CO/CO2 values declined to the range of control mice within 48-72 h after the injection of lipopolysaccharide. Breath CO/CO2 values correlated with systemic inflammation biomarkers in serum and heme oxygenase-1 gene expression in blood. C3H/HOuJ mice, but not the HeJ mice, had similar increases of the CO/CO2 ratio in response to the endotoxin. CONCLUSIONS Carbon monoxide concentrations in exhaled breath of at least 2 strains of mice increase in response to single injections of endotoxin. The magnitude of increase was similar to what was observed with a bacteremia model. These findings with an experimental model provide a rationale for further studies of normalized CO concentrations in human breath as an informative biomarker for staging and monitoring of sepsis.
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Affiliation(s)
| | | | | | | | | | - Alan G Barbour
- Departments of Medicine ; Microbiology and Molecular Genetics
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Kistler M, Szymczak W, Fedrigo M, Fiamoncini J, Höllriegl V, Hoeschen C, Klingenspor M, Hrabě de Angelis M, Rozman J. Effects of diet-matrix on volatile organic compounds in breath in diet-induced obese mice. J Breath Res 2014; 8:016004. [DOI: 10.1088/1752-7155/8/1/016004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chromosome Sequence of Borrelia miyamotoi, an Uncultivable Tick-Borne Agent of Human Infection. GENOME ANNOUNCEMENTS 2013; 1:1/5/e00713-13. [PMID: 24029760 PMCID: PMC3772144 DOI: 10.1128/genomea.00713-13] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Borrelia miyamotoi is a newly recognized agent of human disease. B. miyamotoi strain LB-2001, an isolate from the tick Ixodes scapularis, was propagated in mice. The sequence of the chromosome was determined by next-generation sequencing of DNA isolated from whole blood. The sequence established that B. miyamotoi is a relapsing fever group species.
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