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de Jong FJM, Lilien TA, Fenn DW, Wingelaar TT, van Ooij PJAM, Maitland-van der Zee AH, Hollmann MW, van Hulst RA, Brinkman P. Volatile Organic Compounds in Cellular Headspace after Hyperbaric Oxygen Exposure: An In Vitro Pilot Study. Metabolites 2024; 14:281. [PMID: 38786758 PMCID: PMC11123173 DOI: 10.3390/metabo14050281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Volatile organic compounds (VOCs) might be associated with pulmonary oxygen toxicity (POT). This pilot study aims to identify VOCs linked to oxidative stress employing an in vitro model of alveolar basal epithelial cells exposed to hyperbaric and hyperoxic conditions. In addition, the feasibility of this in vitro model for POT biomarker research was evaluated. The hyperbaric exposure protocol, similar to the U.S. Navy Treatment Table 6, was conducted on human alveolar basal epithelial cells, and the headspace VOCs were analyzed using gas chromatography-mass spectrometry. Three compounds (nonane [p = 0.005], octanal [p = 0.009], and decane [p = 0.018]), of which nonane and decane were also identified in a previous in vivo study with similar hyperbaric exposure, varied significantly between the intervention group which was exposed to 100% oxygen and the control group which was exposed to compressed air. VOC signal intensities were lower in the intervention group, but cellular stress markers (IL8 and LDH) confirmed increased stress and injury in the intervention group. Despite the observed reductions in compound expression, the model holds promise for POT biomarker exploration, emphasizing the need for further investigation into the complex relationship between VOCs and oxidative stress.
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Affiliation(s)
- Feiko J. M. de Jong
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA Den Helder, The Netherlands
- Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
| | - Thijs A. Lilien
- Department of Pediatric Intensive Care, Amsterdam UMC, Location Emma Children’s Hospital, 1100 DD Amsterdam, The Netherlands
| | - Dominic W. Fenn
- Department of Pulmonology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
| | - Thijs T. Wingelaar
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA Den Helder, The Netherlands
- Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
| | - Pieter-Jan A. M. van Ooij
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA Den Helder, The Netherlands
- Department of Pulmonology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
| | | | - Markus W. Hollmann
- Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
| | - Rob A. van Hulst
- Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
| | - Paul Brinkman
- Department of Pulmonology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
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Lilien TA, Brinkman P, Fenn DW, van Woensel JBM, Bos LDJ, Bem RA. Breath Markers of Oxidative Stress in Children with Severe Viral Lower Respiratory Tract Infection. Am J Respir Cell Mol Biol 2024; 70:392-399. [PMID: 38315815 DOI: 10.1165/rcmb.2023-0349oc] [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: 09/29/2023] [Accepted: 02/05/2024] [Indexed: 02/07/2024] Open
Abstract
Severe viral lower respiratory tract infection (LRTI), resulting in both acute and long-term pulmonary disease, constitutes a substantial burden among young children. Viral LRTI triggers local oxidative stress pathways by infection and inflammation, and supportive care in the pediatric intensive care unit may further aggravate oxidative injury. The main goal of this exploratory study was to identify and monitor breath markers linked to oxidative stress in children over the disease course of severe viral LRTI. Exhaled breath was sampled during invasive ventilation, and volatile organic compounds (VOCs) were analyzed using gas chromatography and mass spectrometry. VOCs were selected in an untargeted principal component analysis and assessed for change over time. In addition, identified VOCs were correlated with clinical parameters. Seventy breath samples from 21 patients were analyzed. A total of 15 VOCs were identified that contributed the most to the explained variance of breath markers. Of these 15 VOCs, 10 were previously linked to pathways of oxidative stress. Eight VOCs, including seven alkanes and methyl alkanes, significantly decreased from the initial phase of ventilation to the day of extubation. No correlation was observed with the administered oxygen dose, whereas six VOCs showed a poor to strong positive correlation with driving pressure. In this prospective study of children with severe viral LRTI, the majority of VOCs that were most important for the explained variance mirrored clinical improvement. These breath markers could potentially help monitor the pulmonary oxidative status in these patients, but further research with other objective measures of pulmonary injury is required.
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Affiliation(s)
- Thijs A Lilien
- Department of Pediatric Intensive Care Medicine, Emma Children's Hospital
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | | | | | - Job B M van Woensel
- Department of Pediatric Intensive Care Medicine, Emma Children's Hospital
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Lieuwe D J Bos
- Department of Pulmonology, and
- Department of Intensive Care Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands; and
| | - Reinout A Bem
- Department of Pediatric Intensive Care Medicine, Emma Children's Hospital
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
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Lilien TA, Fenn DW, Brinkman P, Hagens LA, Smit MR, Heijnen NFL, van Woensel JBM, Bos LDJ, Bem RA. HS-GC-MS analysis of volatile organic compounds after hyperoxia-induced oxidative stress: a validation study. Intensive Care Med Exp 2024; 12:14. [PMID: 38345723 PMCID: PMC10861410 DOI: 10.1186/s40635-024-00600-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Exhaled volatile organic compounds (VOCs), particularly hydrocarbons from oxidative stress-induced lipid peroxidation, are associated with hyperoxia exposure. However, important heterogeneity amongst identified VOCs and concerns about their precise pathophysiological origins warrant translational studies assessing their validity as a marker of hyperoxia-induced oxidative stress. Therefore, this study sought to examine changes in VOCs previously associated with the oxidative stress response in hyperoxia-exposed lung epithelial cells. METHODS A549 alveolar epithelial cells were exposed to hyperoxia for 24 h, or to room air as normoxia controls, or hydrogen peroxide as oxidative-stress positive controls. VOCs were sampled from the headspace, analysed by gas chromatography coupled with mass spectrometry and compared by targeted and untargeted analyses. A secondary analysis of breath samples from a large cohort of critically ill adult patients assessed the association of identified VOCs with clinical oxygen exposure. RESULTS Following cellular hyperoxia exposure, none of the targeted VOCs, previously proposed as breath markers of oxidative stress, were increased, and decane was significantly decreased. Untargeted analysis did not reveal novel identifiable hyperoxia-associated VOCs. Within the clinical cohort, three previously proposed breath markers of oxidative stress, hexane, octane, and decane had no real diagnostic value in discriminating patients exposed to hyperoxia. CONCLUSIONS Hyperoxia exposure of alveolar epithelial cells did not result in an increase in identifiable VOCs, whilst VOCs previously linked to oxidative stress were not associated with oxygen exposure in a cohort of critically ill patients. These findings suggest that the pathophysiological origin of previously proposed breath markers of oxidative stress is more complex than just oxidative stress from hyperoxia at the lung epithelial cellular level.
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Affiliation(s)
- Thijs A Lilien
- Department of Paediatric Intensive Care Medicine, Emma Children's Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Laboratory of Experimental Intensive Care and Anaesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Dominic W Fenn
- Laboratory of Experimental Intensive Care and Anaesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Department of Pulmonary Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Paul Brinkman
- Department of Pulmonary Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Laura A Hagens
- Department of Intensive Care Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Marry R Smit
- Department of Intensive Care Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Nanon F L Heijnen
- Department of Intensive Care Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Job B M van Woensel
- Department of Paediatric Intensive Care Medicine, Emma Children's Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Lieuwe D J Bos
- Laboratory of Experimental Intensive Care and Anaesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Department of Intensive Care Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Reinout A Bem
- Department of Paediatric Intensive Care Medicine, Emma Children's Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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de Jong FJ, Brinkman P, Wingelaar TT, van Ooij PJA, van Hulst RA. Pulmonary oxygen toxicity breath markers after heliox diving to 81 metres. Diving Hyperb Med 2023; 53:340-344. [PMID: 38091594 PMCID: PMC10944665 DOI: 10.28920/dhm53.4.340-344] [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: 07/14/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
Pulmonary oxygen toxicity (POT), an adverse reaction to an elevated partial pressure of oxygen in the lungs, can develop as a result of prolonged hyperbaric hyperoxic conditions. Initially starting with tracheal discomfort, it results in pulmonary symptoms and ultimately lung fibrosis. Previous studies identified several volatile organic compounds (VOCs) in exhaled breath indicative of POT after various wet and dry hyperbaric hypoxic exposures, predominantly in laboratory settings. This study examined VOCs after exposures to 81 metres of seawater by three navy divers during operational heliox diving. Univariate testing did not yield significant results. However, targeted multivariate analysis of POT-associated VOCs identified significant (P = 0.004) changes of dodecane, tetradecane, octane, methylcyclohexane, and butyl acetate during the 4 h post-dive sampling period. No airway symptoms or discomfort were reported. This study demonstrates that breath sampling can be performed in the field, and VOCs indicative of oxygen toxicity are exhaled without clinical symptoms of POT, strengthening the belief that POT develops on a subclinical-to-symptomatic spectrum. However, this study was performed during an actual diving operation and therefore various confounders were introduced, which were excluded in previous laboratory studies. Future studies could focus on optimising sampling protocols for field use to ensure uniformity and reproducibility, and on establishing dose-response relationships.
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Affiliation(s)
- Feiko Jm de Jong
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA, Den Helder, The Netherlands
- Department of Anesthesiology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
- Corresponding author: Feiko JM de Jong, Royal Netherlands Navy Diving and Submarine Medical Centre, Rijkszee-en Marinehaven, Postbus 10.000, 1780 CA, Den Helder, The Netherlands, ORCiD: 0009-0008-9804-8307,
| | - Paul Brinkman
- Department of Pulmonology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
| | - Thijs T Wingelaar
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA, Den Helder, The Netherlands
- Department of Anesthesiology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
| | - Pieter-Jan Am van Ooij
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA, Den Helder, The Netherlands
- Department of Pulmonology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
| | - Robert A van Hulst
- Department of Anesthesiology, Amsterdam University Medical Center, location AMC, 1100 DD, Amsterdam, The Netherlands
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Arieli R. The pulmonary oxygen toxicity index. Respir Physiol Neurobiol 2023; 315:104114. [PMID: 37460079 DOI: 10.1016/j.resp.2023.104114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
Pulmonary oxygen toxicity (POT) is a major risk in diving while breathing hyperoxic gas and is also considered in clinical hyperbaric oxygen treatment. The POTindex calculated by the power equation K = t2 × PO24.57 with the recovery form Ktr = Ke × e - [- 0.42 + 0.384 × (PO2)ex] × tr which are based on chemical and physiological principles, have a better prediction power than other suggested approaches. Reduction of vital capacity as well as incidence of POT are well predicted by the POTindex. Both the cumulative pulmonary toxic effect and concomitant recovery were suggested to operate at the lower toxic range of PO2 used in saturation diving K = t2 × PO24.57 × e-0.0135 × t, and further experimental support is supplied. The recovery time constant for the full range of PO2 is presented. POTindex is suggested to replace the old method of UPTD for safe diving. Many diving clubs and diving institutes already adopted the POTindex.
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Affiliation(s)
- R Arieli
- Israel Naval Medical Institute, Haifa, Israel; Eliachar Research Laboratory, Western Galilee Medical Center, Nahariya, Israel.
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de Jong FJM, Wingelaar TT, van Hulst RA. Pulmonary oxygen toxicity in occupational diving. Occup Med (Lond) 2023; 73:231-232. [PMID: 37364027 PMCID: PMC10292678 DOI: 10.1093/occmed/kqad043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
One of the hazards of occupational diving is pulmonary oxygen toxicity, which can lead to reduced lung diffusion capacity and fibrosis. The current gold standard to determine the ‘safe limits’ for oxygen was developed more than 50 years ago and lacks the accuracy required for occupational specialists. These restrictions may be overcome by new diagnostic methods like exhaled breath analysis, which would allow occupational specialists to accurately monitor pulmonary health in the individual diver, and thus reduce long-term health effects of professional diving.
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Affiliation(s)
- Feiko J M de Jong
- Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA Den Helder, The Netherlands
| | - Thijs T Wingelaar
- Royal Netherlands Navy Diving and Submarine Medical Centre, 1780 CA Den Helder, The Netherlands
- Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
| | - Rob A van Hulst
- Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
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Analysis of Volatile Organic Compounds in Exhaled Breath Following a COMEX-30 Treatment Table. Metabolites 2023; 13:metabo13030316. [PMID: 36984755 PMCID: PMC10056109 DOI: 10.3390/metabo13030316] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
The COMEX-30 hyperbaric treatment table is used to manage decompression sickness in divers but may result in pulmonary oxygen toxicity (POT). Volatile organic compounds (VOCs) in exhaled breath are early markers of hyperoxic stress that may be linked to POT. The present study assessed whether VOCs following COMEX-30 treatment are early markers of hyperoxic stress and/or POT in ten healthy, nonsmoking volunteers. Because more oxygen is inhaled during COMEX-30 treatment than with other treatment tables, this study hypothesized that VOCs exhaled following COMEX-30 treatment are indicators of POT. Breath samples were collected before and 0.5, 2, and 4 h after COMEX-30 treatment. All subjects were followed-up for signs of POT or other symptoms. Nine compounds were identified, with four (nonanal, decanal, ethyl acetate, and tridecane) increasing 33–500% in intensity from before to after COMEX-30 treatment. Seven subjects reported pulmonary symptoms, five reported out-of-proportion tiredness and transient ear fullness, and four had signs of mild dehydration. All VOCs identified following COMEX-30 treatment have been associated with inflammatory responses or pulmonary diseases, such as asthma or lung cancer. Because most subjects reported transient pulmonary symptoms reflecting early-stage POT, the identified VOCs are likely markers of POT, not just hyperbaric hyperoxic exposure.
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Mariotti R, Núñez-Carmona E, Genzardi D, Pandolfi S, Sberveglieri V, Mousavi S. Volatile Olfactory Profiles of Umbrian Extra Virgin Olive Oils and Their Discrimination through MOX Chemical Sensors. SENSORS (BASEL, SWITZERLAND) 2022; 22:7164. [PMID: 36236259 PMCID: PMC9572317 DOI: 10.3390/s22197164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Extra virgin olive oil (EVOO) is the best vegetable oil worldwide but, at the same time, is one of the product victims of fraud in the agri-food sector, and the differences about quality within the extra-virgin olive oil category are often missed. Several scientific techniques were applied in order to guarantee the authenticity and quality of this EVOO. In the present study, the volatile compounds (VOCs) by gas chromatography-mass spectrometry with solid-phase micro-extraction detection (GC-MS SPME), organoleptic analysis by the official Slow Food panel and the detection by a Small Sensor System (S3) were applied. Ten EVOOs from Umbria, a central Italian region, were selected from the 2021 Slow Food Italian extra virgin olive oil official guide, which includes hundreds of high-quality olive oils. The results demonstrated the possibility to discriminate the ten EVOOs, even if they belong to the same Italian region, by all three techniques. The result of GC-MS SPME detection was comparable at the discrimination level to the organoleptic test with few exceptions, while the S3 was able to better separate some EVOOs, which were not discriminated perfectly by the other two methods. The correlation analysis performed among and between the three methodologies allowed us to identify 388 strong associations with a p value less than 0.05. This study has highlighted how much the mix of VOCs was different even among few and localized EVOOs. The correlation with the sensor detection, which is faster and chipper compared to the other two techniques, elucidated the similarities and discrepancies between the applied methods.
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Affiliation(s)
- Roberto Mariotti
- Institute of Biosciences and Bioresources, National Research Council, 06128 Perugia, Italy
| | - Estefanía Núñez-Carmona
- Institute of Biosciences and Bioresources, National Research Council, URT-Reggio Emilia, Via J. F. Kennedy 17/I, 42124 Reggio Emilia, Italy
| | - Dario Genzardi
- Institute of Biosciences and Bioresources, National Research Council, URT-Reggio Emilia, Via J. F. Kennedy 17/I, 42124 Reggio Emilia, Italy
| | - Saverio Pandolfi
- Institute of Biosciences and Bioresources, National Research Council, 06128 Perugia, Italy
| | - Veronica Sberveglieri
- Institute of Biosciences and Bioresources, National Research Council, URT-Reggio Emilia, Via J. F. Kennedy 17/I, 42124 Reggio Emilia, Italy
| | - Soraya Mousavi
- Institute of Biosciences and Bioresources, National Research Council, 06128 Perugia, Italy
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