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Wei S, Li Z, Murugappan K, Li Z, Lysevych M, Vora K, Tan HH, Jagadish C, Karawdeniya BI, Nolan CJ, Tricoli A, Fu L. Nanowire Array Breath Acetone Sensor for Diabetes Monitoring. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2309481. [PMID: 38477429 PMCID: PMC11109654 DOI: 10.1002/advs.202309481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/18/2024] [Indexed: 03/14/2024]
Abstract
Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes characterized by the accumulation of ketone bodies in the blood. Breath acetone, a ketone, directly correlates with blood ketones. Therefore, monitoring breath acetone can significantly enhance the safety and efficacy of diabetes care. In this work, the design and fabrication of an InP/Pt/chitosan nanowire array-based chemiresistive acetone sensor is reported. By incorporation of chitosan as a surface-functional layer and a Pt Schottky contact for efficient charge transfer processes and photovoltaic effect, self-powered, highly selective acetone sensing is achieved. The sensor has exhibited an ultra-wide acetone detection range from sub-ppb to >100 000 ppm level at room temperature, covering those in the exhaled breath from healthy individuals (300-800 ppb) to people at high risk of DKA (>75 ppm). The nanowire sensor has also been successfully integrated into a handheld breath testing prototype, the Ketowhistle, which can successfully detect different ranges of acetone concentrations in simulated breath samples. The Ketowhistle demonstrates the immediate potential for non-invasive ketone monitoring for people living with diabetes, in particular for DKA prevention.
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Affiliation(s)
- Shiyu Wei
- Australian Research Council Centre of Excellence for Transformative Meta‐Optical SystemsDepartment of Electronic Materials EngineeringResearch School of PhysicsThe Australian National UniversityCanberraACT2600Australia
| | - Zhe Li
- Australian Research Council Centre of Excellence for Transformative Meta‐Optical SystemsDepartment of Electronic Materials EngineeringResearch School of PhysicsThe Australian National UniversityCanberraACT2600Australia
| | - Krishnan Murugappan
- Commonwealth Scientific and Industrial Research Organisation (CSIRO)Mineral ResourcesPrivate Bag 10Clayton SouthVIC3169Australia
- Nanotechnology Research LaboratoryResearch School of ChemistryCollege of ScienceThe Australian National UniversityCanberraACT2600Australia
| | - Ziyuan Li
- Australian Research Council Centre of Excellence for Transformative Meta‐Optical SystemsDepartment of Electronic Materials EngineeringResearch School of PhysicsThe Australian National UniversityCanberraACT2600Australia
| | - Mykhaylo Lysevych
- Australian National Fabrication FacilityThe Australian National UniversityCanberraACT2600Australia
| | - Kaushal Vora
- Australian National Fabrication FacilityThe Australian National UniversityCanberraACT2600Australia
| | - Hark Hoe Tan
- Australian Research Council Centre of Excellence for Transformative Meta‐Optical SystemsDepartment of Electronic Materials EngineeringResearch School of PhysicsThe Australian National UniversityCanberraACT2600Australia
| | - Chennupati Jagadish
- Australian Research Council Centre of Excellence for Transformative Meta‐Optical SystemsDepartment of Electronic Materials EngineeringResearch School of PhysicsThe Australian National UniversityCanberraACT2600Australia
| | - Buddini I Karawdeniya
- Australian Research Council Centre of Excellence for Transformative Meta‐Optical SystemsDepartment of Electronic Materials EngineeringResearch School of PhysicsThe Australian National UniversityCanberraACT2600Australia
| | - Christopher J Nolan
- School of Medicine and PsychologyCollege of Health and MedicineThe Australian National UniversityCanberraACT2600Australia
- Department of Diabetes and EndocrinologyThe Canberra HospitalGarranACT2605Australia
| | - Antonio Tricoli
- Nanotechnology Research LaboratoryResearch School of ChemistryCollege of ScienceThe Australian National UniversityCanberraACT2600Australia
- Nanotechnology Research LaboratoryFaculty of EngineeringThe University of SydneyCamperdown2006Australia
| | - Lan Fu
- Australian Research Council Centre of Excellence for Transformative Meta‐Optical SystemsDepartment of Electronic Materials EngineeringResearch School of PhysicsThe Australian National UniversityCanberraACT2600Australia
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2
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Bourgin M, Durand S, Kroemer G. Diagnostic, Prognostic and Mechanistic Biomarkers of COVID-19 Identified by Mass Spectrometric Metabolomics. Metabolites 2023; 13:metabo13030342. [PMID: 36984782 PMCID: PMC10056171 DOI: 10.3390/metabo13030342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
A number of studies have assessed the impact of SARS-CoV-2 infection and COVID-19 severity on the metabolome of exhaled air, saliva, plasma, and urine to identify diagnostic and prognostic biomarkers. In spite of the richness of the literature, there is no consensus about the utility of metabolomic analyses for the management of COVID-19, calling for a critical assessment of the literature. We identified mass spectrometric metabolomic studies on specimens from SARS-CoV2-infected patients and subjected them to a cross-study comparison. We compared the clinical design, technical aspects, and statistical analyses of published studies with the purpose to identify the most relevant biomarkers. Several among the metabolites that are under- or overrepresented in the plasma from patients with COVID-19 may directly contribute to excessive inflammatory reactions and deficient immune control of SARS-CoV2, hence unraveling important mechanistic connections between whole-body metabolism and the course of the disease. Altogether, it appears that mass spectrometric approaches have a high potential for biomarker discovery, especially if they are subjected to methodological standardization.
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Affiliation(s)
- Mélanie Bourgin
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, 94805 Villejuif, France
- Centre de Recherche des Cordeliers, Equipe Labellisée par la Ligue Contre le Cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Institut Universitaire de France, 75005 Paris, France
- Correspondence:
| | - Sylvère Durand
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, 94805 Villejuif, France
- Centre de Recherche des Cordeliers, Equipe Labellisée par la Ligue Contre le Cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Institut Universitaire de France, 75005 Paris, France
| | - Guido Kroemer
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, 94805 Villejuif, France
- Centre de Recherche des Cordeliers, Equipe Labellisée par la Ligue Contre le Cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Institut Universitaire de France, 75005 Paris, France
- Institut du Cancer Paris CARPEM, Department of Biology, Hôpital Européen Georges Pompidou, AP-HP, 75610 Paris, France
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3
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Breath Analysis in Children with Ketogenic Glycogen Storage Diseases. LIVERS 2022. [DOI: 10.3390/livers2040025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
(1) Background: The treatment goal of ketogenic glycogen storage diseases (GSDs) is appropriate control of hypoglycemia and other disturbances such as dyslipidemia. Monitoring and treatment of ketosis are known to improve outcomes. We used breath analysis to identify volatile organic compounds (VOCs) that correlate with serum ketones in order to provide a non-invasive method of monitoring ketosis. (2) Methods: Consecutive children with ketogenic GSDs were recruited from a single center during routine admission to monitor serum glucose and ketone levels. Five breath samples were collected from every patient at the same time of blood draws. SIFT-mass spectrometry was used to analyze breath samples. Univariate linear mixed-effects regression models for 22 known VOCs and either serum ketones or glucose were performed. (3) Results: Our cohort included 20 patients aged 5–15 years with a mean BMI of 20 kg/m2 (72% tile). Most patients had GSD type 0 (35%), while 25% had type IX. VOCs that showed a significant correlation with serum ketone levels included acetone (p < 0.0001), trimethylamine (p < 0.0001), pentane (p = 0.0001), 3-methylhexane (p = 0.0047), and carbon disulfide (p = 0.0499). No correlation was found between serum glucose and any VOC. (4) Conclusions: Breath analysis is a promising noninvasive tool that can be used to predict ketone serum levels in patients with GSD.
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Computational Design of MOF-Based Electronic Noses for Dilute Gas Species Detection: Application to Kidney Disease Detection. ACS Sens 2021; 6:4425-4434. [PMID: 34855364 DOI: 10.1021/acssensors.1c01808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The diverse chemical composition of exhaled human breath contains a vast amount of information about the health of the body, and yet this is seldom taken advantage of for diagnostic purposes due to the lack of appropriate gas-sensing technologies. In this work, we apply computational methods to design mass-based gas sensor arrays, often called electronic noses, that are optimized for detecting kidney disease from breath, for which ammonia is a known biomarker. We define combined linear adsorption coefficients (CLACs), which are closely related to Henry's law coefficients, for calculating gas adsorption in metal-organic frameworks (MOFs) of gases commonly found in breath (i.e., carbon dioxide, argon, and ammonia). These CLACs were determined computationally using classical atomistic molecular simulation techniques and subsequently used to design and evaluate gas sensor arrays. We also describe a novel numerical algorithm for determining the composition of a breath sample given a set of sensor outputs and a library of CLACs. After identifying an optimal array of five MOFs, we screened a set of 100 simplified computer-generated, water-free breath samples for kidney disease and were able to successfully quantify the amount of ammonia in all samples within the tolerances needed to classify them as either healthy or diseased, demonstrating the promise of such devices for disease detection applications.
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Gould O, Drabińska N, Ratcliffe N, de Lacy Costello B. Hyphenated Mass Spectrometry versus Real-Time Mass Spectrometry Techniques for the Detection of Volatile Compounds from the Human Body. Molecules 2021; 26:molecules26237185. [PMID: 34885767 PMCID: PMC8659178 DOI: 10.3390/molecules26237185] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 01/16/2023] Open
Abstract
Mass spectrometry (MS) is an analytical technique that can be used for various applications in a number of scientific areas including environmental, security, forensic science, space exploration, agri-food, and numerous others. MS is also continuing to offer new insights into the proteomic and metabolomic fields. MS techniques are frequently used for the analysis of volatile compounds (VCs). The detection of VCs from human samples has the potential to aid in the diagnosis of diseases, in monitoring drug metabolites, and in providing insight into metabolic processes. The broad usage of MS has resulted in numerous variations of the technique being developed over the years, which can be divided into hyphenated and real-time MS techniques. Hyphenated chromatographic techniques coupled with MS offer unparalleled qualitative analysis and high accuracy and sensitivity, even when analysing complex matrices (breath, urine, stool, etc.). However, these benefits are traded for a significantly longer analysis time and a greater need for sample preparation and method development. On the other hand, real-time MS techniques offer highly sensitive quantitative data. Additionally, real-time techniques can provide results in a matter of minutes or even seconds, without altering the sample in any way. However, real-time MS can only offer tentative qualitative data and suffers from molecular weight overlap in complex matrices. This review compares hyphenated and real-time MS methods and provides examples of applications for each technique for the detection of VCs from humans.
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Affiliation(s)
- Oliver Gould
- Centre for Research in Biosciences, Frenchay Campus, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK; (N.R.); (B.d.L.C.)
- Correspondence: (O.G.); (N.D.)
| | - Natalia Drabińska
- Department of Chemistry and Biodynamics of Food, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
- Food Volatilomics and Sensomics Group, Faculty of Food Science and Nutrition, Poznan University of Life Sciences, 60-637 Poznan, Poland
- Correspondence: (O.G.); (N.D.)
| | - Norman Ratcliffe
- Centre for Research in Biosciences, Frenchay Campus, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK; (N.R.); (B.d.L.C.)
| | - Ben de Lacy Costello
- Centre for Research in Biosciences, Frenchay Campus, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK; (N.R.); (B.d.L.C.)
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Pham YL, Beauchamp J. Breath Biomarkers in Diagnostic Applications. Molecules 2021; 26:molecules26185514. [PMID: 34576985 PMCID: PMC8468811 DOI: 10.3390/molecules26185514] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
The detection of chemical compounds in exhaled human breath presents an opportunity to determine physiological state, diagnose disease or assess environmental exposure. Recent advancements in metabolomics research have led to improved capabilities to explore human metabolic profiles in breath. Despite some notable challenges in sampling and analysis, exhaled breath represents a desirable medium for metabolomics applications, foremost due to its non-invasive, convenient and practically limitless availability. Several breath-based tests that target either endogenous or exogenous gas-phase compounds are currently established and are in practical and/or clinical use. This review outlines the concept of breath analysis in the context of these unique tests and their applications. The respective breath biomarkers targeted in each test are discussed in relation to their physiological production in the human body and the development and implementation of the associated tests. The paper concludes with a brief insight into prospective tests and an outlook of the future direction of breath research.
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Affiliation(s)
- Y Lan Pham
- Department of Sensory Analytics and Technologies, Fraunhofer Institute for Process Engineering and Packaging IVV, Giggenhauser Straße 35, 85354 Freising, Germany;
- Department of Chemistry and Pharmacy, Chair of Aroma and Smell Research, Friedrich-Alexander-Universität Erlangen-Nürnberg, Henkestraße 9, 91054 Erlangen, Germany
| | - Jonathan Beauchamp
- Department of Sensory Analytics and Technologies, Fraunhofer Institute for Process Engineering and Packaging IVV, Giggenhauser Straße 35, 85354 Freising, Germany;
- Correspondence:
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Statistical Evaluation of Total Expiratory Breath Samples Collected throughout a Year: Reproducibility and Applicability toward Olfactory Sensor-Based Breath Diagnostics. SENSORS 2021; 21:s21144742. [PMID: 34300482 PMCID: PMC8309533 DOI: 10.3390/s21144742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/22/2022]
Abstract
The endogenous volatile organic compounds (VOCs) in exhaled breath can be promising biomarkers for various diseases including cancers. An olfactory sensor has a possibility for extracting a specific feature from collective variations of the related VOCs with a certain health condition. For this approach, it is important to establish a feasible protocol for sampling exhaled breath in practical conditions to provide reproducible signal features. Here we report a robust protocol for the breath analysis, focusing on total expiratory breath measured by a Membrane-type Surface stress Sensor (MSS), which possesses practical characteristics for artificial olfactory systems. To assess its reproducibility, 83 exhaled breath samples were collected from one subject throughout more than a year. It has been confirmed that the reduction of humidity effects on the sensing signals either by controlling the humidity of purging room air or by normalizing the signal intensities leads to reasonable reproducibility verified by statistical analyses. We have also demonstrated the applicability of the protocol for detecting a target material by discriminating exhaled breaths collected from different subjects with pre- and post-alcohol ingestion on different occasions. This simple yet reproducible protocol based on the total expiratory breath measured by the MSS olfactory sensors will contribute to exploring the possibilities of clinical applications of breath diagnostics.
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8
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Navaneethan U, Spencer C, Zhu X, Vargo JJ, Grove D, Dweik RA. Volatile organic compounds in bile can distinguish pancreatic cancer from chronic pancreatitis: a prospective observational study. Endoscopy 2021; 53:732-736. [PMID: 32894868 DOI: 10.1055/a-1255-9169] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Early and accurate diagnosis of pancreatic cancer is important. Our aim was to identify potential volatile organic compounds (VOCs) in the bile that can help distinguish pancreatic cancer from chronic pancreatitis. METHODS In this prospective observational study, bile was aspirated from patients undergoing endoscopic retrograde cholangiopancreatography for chronic pancreatitis and pancreatic cancer, and the gaseous headspace was analyzed using mass spectrometry. RESULTS The study included a discovery cohort of 57 patients (46 pancreatic cancer, 11 chronic pancreatitis) and a validation cohort of 31 patients (19 and 12, respectively). Using logistic regression analysis, the model [0.158 × age + 9.747 × log (ammonia) - 3.994 × log (acetonitrile) + 5.044 × log (trimethylamine) - 30.23] successfully identified patients with pancreatic cancer with a sensitivity of 93.5 % and specificity of 100 % (likelihood ratio 40.9, area under the curve 0.98, 95 % confidence interval 0.95 - 1.00). The diagnostic accuracy of this model was confirmed in the second independent validation cohort. CONCLUSION The measurement of VOCs in bile helped to accurately distinguish pancreatic cancer from chronic pancreatitis.
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Affiliation(s)
| | - Chad Spencer
- Department of Gastroenterology and Hepatology, University of South Alabama College of Medicine, Mobile, Alabama, United States
| | - Xiang Zhu
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, United States
| | - John J Vargo
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, United States
| | - David Grove
- Pathobiology, Lerners Research Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Raed A Dweik
- Pathobiology, Lerners Research Institute, Cleveland Clinic, Cleveland, Ohio, United States
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9
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Silva LG, Bueno SCE, da Silva MG, Mota L, Sthel MS, de Castro MPP, Santiago Neto RM, Kuba VM. Photoacoustic detection of ammonia exhaled by individuals with chronic kidney disease. Lasers Med Sci 2021; 37:983-991. [PMID: 34050494 DOI: 10.1007/s10103-021-03342-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
Ammonia (NH3) has been reported as a breath biomarker for chronic kidney disease (CKD) usually detected at concentrations greater than 0.25 parts per million by volume (ppmV). NH3 was detected in breath of individuals with CKD through gaseous photoacoustic spectroscopy (PAS). The efficiency of hemodialysis (HD) was demonstrated. Eight volunteers aged between 20 and 60 years and without previous respiratory disease were eligible, among which six were control volunteers (CV) and two volunteers with advanced CKD, named CKDV1 and CKDV2. The presence of CKD was confirmed by the calculation of creatinine clearance (CC) according to the Cockcroft-Gault equation. Before HD, the mean NH3 concentration exhaled by CKDV1 was 0.9 ± 0.1 ppmV and after HD was 0.20 ± 0.03 ppmV, which demonstrated an efficiency of 76% NH3 reduction in breath. The CKDV2 exhaled 1.27 ± 0.03 ppmV of NH3 pre-HD and 0.42 ± 0.08 ppmV post-HD, which resulted in efficiency of about 67%. It was not possible to quantify NH3 from CV, what led us to infer that all of them exhaled amounts below the detection limit, i.e., 0.20 ppmV. This assumption is underpinned by CC, whose values hovered at 90 ≤ CC ≤ 120 mL/ min, confirming normal renal function.
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Affiliation(s)
- Liana Genuncio Silva
- Centro de Ciência e Tecnologia Laboratório de Ciências Físicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Avenida Alberto Lamego, 2000, Campos dos Goytacazes, Rio de Janeiro, 28013-602, Brazil
| | - Sâmylla Cristina Espécie Bueno
- Centro de Ciência e Tecnologia Laboratório de Ciências Físicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Avenida Alberto Lamego, 2000, Campos dos Goytacazes, Rio de Janeiro, 28013-602, Brazil
| | - Marcelo Gomes da Silva
- Centro de Ciência e Tecnologia Laboratório de Ciências Físicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Avenida Alberto Lamego, 2000, Campos dos Goytacazes, Rio de Janeiro, 28013-602, Brazil
| | - Leonardo Mota
- Centro de Ciência e Tecnologia Laboratório de Ciências Físicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Avenida Alberto Lamego, 2000, Campos dos Goytacazes, Rio de Janeiro, 28013-602, Brazil
| | - Marcelo Silva Sthel
- Centro de Ciência e Tecnologia Laboratório de Ciências Físicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Avenida Alberto Lamego, 2000, Campos dos Goytacazes, Rio de Janeiro, 28013-602, Brazil
| | - Maria Priscila Pessanha de Castro
- Centro de Ciência e Tecnologia Laboratório de Ciências Físicas, Universidade Estadual do Norte Fluminense Darcy Ribeiro, Avenida Alberto Lamego, 2000, Campos dos Goytacazes, Rio de Janeiro, 28013-602, Brazil.
| | | | - Valeska Mansur Kuba
- Faculdade de Medicina de Campos, Avenida Alberto Torres, 217, Campos dos Goytacazes, Rio de Janeiro, 28035-581, Brazil
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10
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Wang D, Zhang F, Prabhakar A, Qin X, Forzani ES, Tao N. Colorimetric Sensor for Online Accurate Detection of Breath Acetone. ACS Sens 2021; 6:450-453. [PMID: 33210907 DOI: 10.1021/acssensors.0c02025] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Breath acetone (BrAce) is a validated biomarker of lipid oxidation and has been extensively studied for many applications, such as monitoring ketoacidosis in diabetes, guiding ketogenic diet, and measuring fat burning during exercise. Although many sensors have been reported for BrAce measurement, most of the contributions tested only synthetic or spiked breath samples, because of the complex components of human breath. Here, we show that online accurate detection of BrAce can be achieved using a colorimetric sensor. The high selectivity is enabled by the specific reaction between acetone and hydroxylamine sulfate, and the sensor has a high agreement with a reference instrument in ketosis monitoring. We anticipate that the colorimetric acetone sensor can be applied to various health-related applications.
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Affiliation(s)
- Di Wang
- Research Center for Intelligent Sensing, Zhejiang Lab, Hangzhou 310000, China
- Biodesign Center for Bioelectronics and Biosensors, Arizona State University, Tempe, Arizona 85287, United States
| | - Fenni Zhang
- Biodesign Center for Bioelectronics and Biosensors, Arizona State University, Tempe, Arizona 85287, United States
| | - Amlendu Prabhakar
- Biodesign Center for Bioelectronics and Biosensors, Arizona State University, Tempe, Arizona 85287, United States
| | - Xingcai Qin
- School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, Jiangsu 210023, China
| | - Erica S. Forzani
- Biodesign Center for Bioelectronics and Biosensors, Arizona State University, Tempe, Arizona 85287, United States
| | - Nongjian Tao
- Biodesign Center for Bioelectronics and Biosensors, Arizona State University, Tempe, Arizona 85287, United States
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11
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Lan H, Hartonen K, Riekkola ML. Miniaturised air sampling techniques for analysis of volatile organic compounds in air. Trends Analyt Chem 2020. [DOI: 10.1016/j.trac.2020.115873] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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12
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Ratiu IA, Bocos-Bintintan V, Monedeiro F, Milanowski M, Ligor T, Buszewski B. An Optimistic Vision of Future: Diagnosis of Bacterial Infections by Sensing Their Associated Volatile Organic Compounds. Crit Rev Anal Chem 2019; 50:501-512. [PMID: 31514505 DOI: 10.1080/10408347.2019.1663147] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Simple tests using sniff analysis that have the ability of diagnosing and rapidly distinguishing between infections due to different bacteria are urgently required by medical community worldwide. Professionals interested in this topic wish for these tests to be simultaneously cheap, fast, easily applicable, non-invasive, robust, reliable, and sensitive. Current analytical instrumentation has already the ability for performing real time (minutes or a few dozens of minutes) analysis of volatile bacterial biomarkers (the VOCs emitted by bacteria). Although many articles are available, a review displaying an objective evaluation of the current status in the field is still needed. This review tries to present an overview regarding the bacterial biomarkers released from in vitro cultivation of various bacterial strains and also from different biological matrices investigated, over the last 10 years. We have described results of relevant studies, which used modern analytical techniques to evaluate specific biomarker profiles associated with bacterial infections. Our purpose was to present a comprehensive view of available possibilities for detection of emitted bacterial VOCs from different matrices. We intend that this review to be of general interest for both medical doctors and for all researchers preoccupied with bacterial infectious diseases and their rapid diagnosis using analytical instrumentation.
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Affiliation(s)
- Ileana-Andreea Ratiu
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, Toruń, Poland.,Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, Toruń, Poland.,Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Victor Bocos-Bintintan
- Faculty of Environmental Science and Engineering, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Fernanda Monedeiro
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, Toruń, Poland.,Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, Toruń, Poland.,Department of Chemistry, Faculty of Philosophy, Science and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, CEP, Brazil
| | - Maciej Milanowski
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, Toruń, Poland.,Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, Toruń, Poland
| | - Tomasz Ligor
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, Toruń, Poland.,Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, Toruń, Poland
| | - Bogusław Buszewski
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University, Toruń, Poland.,Interdisciplinary Centre of Modern Technologies, Nicolaus Copernicus University, Toruń, Poland
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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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14
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Singh KD, Del Miguel GV, Gaugg MT, Ibañez AJ, Zenobi R, Kohler M, Frey U, Sinues PML. Translating secondary electrospray ionization-high-resolution mass spectrometry to the clinical environment. J Breath Res 2018; 12:027113. [PMID: 29411710 DOI: 10.1088/1752-7163/aa9ee3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
While there has been progress in making use of breath tests to guide clinical decision making, the full potential of exhaled breath analysis still remains to be exploited. Here we summarize some of the reasons why this is the case, what we have done so far to overcome some of the existing obstacles, and our vision of how we think breath analysis will play a more prominent role in the coming years. In particular, we envision that real-time high-resolution mass spectrometry will provide valuable information in biomarker discovery studies. However, this can only be achieved by a coordinated effort, using standardized equipment and methods in multi-center studies to eventually deliver tangible advances in the field of breath analysis in a clinical setting. Concrete aspects such as sample integrity, compound identification, quantification and standardization are discussed. Novel secondary electrospray ionization developments with the aim of facilitating inter-groups comparisons and biomarker validation studies are also presented.
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Affiliation(s)
- Kapil Dev Singh
- University of Basel Children's Hospital, Basel, Switzerland. Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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15
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Abstract
INTRODUCTION Human breath can contain thousands of volatile organic compounds (VOCs) and semi-volatile compounds that are related to metabolism and other biochemical processes. The presence of cancer cells can affect the identity and abundances of chemicals in breath when compared to those in healthy control subjects, which can be used to indicate the likelihood of a patient having cancer. Recently, the chemical analysis of exhaled breath from patients has been shown to be promising for diagnosing many different types of cancers, including lung, breast, colon, head, neck, and prostate, along with pre-cancerous conditions (dysplasia). AREAS COVERED Here, we reviewed the sampling, analytical and data analysis methods reported in the recent patent literature related to cancer breath testing (2014-2017). In addition, the different types of cancer biomarkers that were disclosed are discussed. EXPERT OPINION The major advantages of breath testing compared to conventional X-ray and imaging based methods includes simplicity of use, non-invasiveness, and the potential to detect cancer at a relatively early stage. Such methods are also suitable to perform population screening because of their non-invasiveness. However, the establishment of standard sampling, detection and quantification methods for breath testing is required before the methods can be employed for clinical diagnosis.
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Affiliation(s)
- K M Mohibul Kabir
- a School of Chemistry , University of New South Wales, NSW , Sydney , Australia
| | - William A Donald
- a School of Chemistry , University of New South Wales, NSW , Sydney , Australia
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16
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Winters BR, Pleil JD, Angrish MM, Stiegel MA, Risby TH, Madden MC. Standardization of the collection of exhaled breath condensate and exhaled breath aerosol using a feedback regulated sampling device. J Breath Res 2017; 11:047107. [PMID: 28894051 DOI: 10.1088/1752-7163/aa8bbc] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Exhaled breath condensate (EBC) and associated exhaled breath aerosols (EBA) are valuable non-invasive biological media used for the quantification of biomarkers. EBC contains exhaled water vapor, soluble gas-phase (polar) organic compounds, ionic species, plus other species including semi- and non-volatile organic compounds, proteins, cell fragments, DNA, dissolved inorganic compounds, ions, and microbiota (bacteria and viruses) dissolved in the co-collected EBA. EBC is collected from subjects who breathe 'normally' through a chilled tube assembly for approximately 10 min and is then harvested into small vials for analysis. Aerosol filters without the chilled tube assembly are also used to separately collect EBA. Unlike typical gas-phase breath samples used for environmental and clinical applications, the constituents of EBC and EBA are not easily characterized by total volume or carbon dioxide (CO2) concentration, because the gas-phase is vented. Furthermore, EBC and associated EBA are greatly affected by breathing protocol, more specifically, depth of inhalation and expelled breath velocity. We have tested a new instrument developed by Loccioni Gruppa Humancare (Ancona, Italy) for implementation of EBC collection from human subjects to assess EBC collection parameters. The instrument is the first EBC collection device that provides instantaneous visual feedback to the subjects to control breathing patterns. In this report we describe the operation of the instrument, and present an overview of performance and analytical applications.
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Affiliation(s)
- Brett R Winters
- Curriculum in Toxicology, University of North Carolina, Chapel Hill, NC, United States of America
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17
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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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18
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Staerz A, Weimar U, Barsan N. Understanding the Potential of WO₃ Based Sensors for Breath Analysis. SENSORS 2016; 16:s16111815. [PMID: 27801881 PMCID: PMC5134474 DOI: 10.3390/s16111815] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 10/24/2016] [Accepted: 10/26/2016] [Indexed: 11/29/2022]
Abstract
Tungsten trioxide is the second most commonly used semiconducting metal oxide in gas sensors. Semiconducting metal oxide (SMOX)-based sensors are small, robust, inexpensive and sensitive, making them highly attractive for handheld portable medical diagnostic detectors. WO3 is reported to show high sensor responses to several biomarkers found in breath, e.g., acetone, ammonia, carbon monoxide, hydrogen sulfide, toluene, and nitric oxide. Modern material science allows WO3 samples to be tailored to address certain sensing needs. Utilizing recent advances in breath sampling it will be possible in the future to test WO3-based sensors in application conditions and to compare the sensing results to those obtained using more expensive analytical methods.
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Affiliation(s)
- Anna Staerz
- Institute of Physical and Theoretical Chemistry (IPTC), University of Tuebingen, Auf der Morgenstelle 15, D-72076 Tuebingen, Germany.
- Center for Light-Matter Interaction, Sensors & Analytics (LISA+), University of Tuebingen, Auf der Morgenstelle 15, D-72076 Tuebingen, Germany.
| | - Udo Weimar
- Institute of Physical and Theoretical Chemistry (IPTC), University of Tuebingen, Auf der Morgenstelle 15, D-72076 Tuebingen, Germany.
- Center for Light-Matter Interaction, Sensors & Analytics (LISA+), University of Tuebingen, Auf der Morgenstelle 15, D-72076 Tuebingen, Germany.
| | - Nicolae Barsan
- Institute of Physical and Theoretical Chemistry (IPTC), University of Tuebingen, Auf der Morgenstelle 15, D-72076 Tuebingen, Germany.
- Center for Light-Matter Interaction, Sensors & Analytics (LISA+), University of Tuebingen, Auf der Morgenstelle 15, D-72076 Tuebingen, Germany.
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19
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Bhatt A, Parsi MA, Stevens T, Gabbard S, Kumaravel A, Jang S, Grove D, Lopez R, Murthy S, Vargo JJ, Dweik R. Volatile organic compounds in plasma for the diagnosis of esophageal adenocarcinoma: a pilot study. Gastrointest Endosc 2016; 84:597-603. [PMID: 26646671 DOI: 10.1016/j.gie.2015.11.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/20/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS A noninvasive screening test that can detect esophageal adenocarcinoma (EAC) at an earlier stage could improve the prognosis associated with EAC. The role of plasma volatile organic compounds (VOCs) for the diagnosis of EAC has not been previously studied. METHODS Plasma samples were collected from subjects with EAC and GERD before endoscopy. Twenty-two preselected VOCs were analyzed with selected ion flow tube mass spectrometry. RESULTS The headspaces from 39 plasma samples (20 EAC, 19 GERD) were analyzed. The levels of 9 VOCs (acetonitrile, acrylonitrile, carbon disulfide, isoprene, 1-heptene, 3-methylhexane, [E]-2-nonene, hydrogen sulfide, and triethylamine) were significantly altered in EAC patients compared with GERD patients. A multivariable logistic regression analysis was performed to build a model for the prediction of EAC. The model identified patients with EAC with an area under the curve of 0.83 (95% confidence interval, 0.67-0.98). CONCLUSIONS Plasma VOCs may be useful in diagnosing EAC. Larger studies are needed to confirm our pilot study observations.
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Affiliation(s)
- Amit Bhatt
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Mansour A Parsi
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Tyler Stevens
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Scott Gabbard
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Arthi Kumaravel
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sunguk Jang
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - David Grove
- Department of Pathobiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rocio Lopez
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sudish Murthy
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - John J Vargo
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Raed Dweik
- Department of Pathobiology, Cleveland Clinic, Cleveland, Ohio, USA
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20
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Alkhouri N, Feldstein AE. Noninvasive diagnosis of nonalcoholic fatty liver disease: Are we there yet? Metabolism 2016; 65:1087-95. [PMID: 26972222 PMCID: PMC4931968 DOI: 10.1016/j.metabol.2016.01.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/22/2015] [Accepted: 01/07/2016] [Indexed: 12/15/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) has rapidly become the most common form of chronic liver disease in the United States affecting approximately 80-100 million Americans. NAFLD includes a spectrum of diseases ranging from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) to fibrosis and eventually cirrhosis. Patients with NASH and significant fibrosis on liver biopsy have an increased risk for liver-related morbidity and mortality compared to those with NAFL. Due to the high prevalence of NAFLD and its progressive nature, there has been an urgent need to develop reliable noninvasive tests that can accurately predict the presence of advanced disease without the need for liver biopsy. These tests can be divided into those that predict the presence of NASH and those that predict the presence of fibrosis. In this review, we provide a concise overview of different noninvasive methods for staging the severity of NAFLD.
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Affiliation(s)
- Naim Alkhouri
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA; Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ariel E Feldstein
- Department of Pediatrics, University of California San Diego (UCSD), CA, USA.
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21
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Hicks LC, Huang J, Kumar S, Powles ST, Orchard TR, Hanna GB, Williams HRT. Analysis of Exhaled Breath Volatile Organic Compounds in Inflammatory Bowel Disease: A Pilot Study. J Crohns Colitis 2015; 9:731-7. [PMID: 26071410 DOI: 10.1093/ecco-jcc/jjv102] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/01/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Distinguishing between the inflammatory bowel diseases [IBD], Crohn's disease [CD] and ulcerative colitis [UC], is important for determining management and prognosis. Selected ion flow tube mass spectrometry [SIFT-MS] may be used to analyse volatile organic compounds [VOCs] in exhaled breath: these may be altered in disease states, and distinguishing breath VOC profiles can be identified. The aim of this pilot study was to identify, quantify, and analyse VOCs present in the breath of IBD patients and controls, potentially providing insights into disease pathogenesis and complementing current diagnostic algorithms. METHODS SIFT-MS breath profiling of 56 individuals [20 UC, 18 CD, and 18 healthy controls] was undertaken. Multivariate analysis included principal components analysis and partial least squares discriminant analysis with orthogonal signal correction [OSC-PLS-DA]. Receiver operating characteristic [ROC] analysis was performed for each comparative analysis using statistically significant VOCs. RESULTS OSC-PLS-DA modelling was able to distinguish both CD and UC from healthy controls and from one other with good sensitivity and specificity. ROC analysis using combinations of statistically significant VOCs [dimethyl sulphide, hydrogen sulphide, hydrogen cyanide, ammonia, butanal, and nonanal] gave integrated areas under the curve of 0.86 [CD vs healthy controls], 0.74 [UC vs healthy controls], and 0.83 [CD vs UC]. CONCLUSIONS Exhaled breath VOC profiling was able to distinguish IBD patients from controls, as well as to separate UC from CD, using both multivariate and univariate statistical techniques.
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Affiliation(s)
- Lucy C Hicks
- Gastroenterology & Hepatology Section, Department of Medicine, Imperial College London, London UK
| | - Juzheng Huang
- Department of Surgery and Cancer, Imperial College London, London UK
| | - Sacheen Kumar
- Department of Surgery and Cancer, Imperial College London, London UK
| | - Sam T Powles
- Gastroenterology & Hepatology Section, Department of Medicine, Imperial College London, London UK
| | - Timothy R Orchard
- Gastroenterology & Hepatology Section, Department of Medicine, Imperial College London, London UK
| | - George B Hanna
- Department of Surgery and Cancer, Imperial College London, London UK
| | - Horace R T Williams
- Gastroenterology & Hepatology Section, Department of Medicine, Imperial College London, London UK
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22
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Kurada S, Alkhouri N, Fiocchi C, Dweik R, Rieder F. Review article: breath analysis in inflammatory bowel diseases. Aliment Pharmacol Ther 2015; 41:329-41. [PMID: 25523187 DOI: 10.1111/apt.13050] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 05/15/2014] [Accepted: 11/21/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is an urgent need for cheap, reproducible, easy to perform and specific biomarkers for diagnosis, differentiation and stratification of inflammatory bowel disease (IBD) patients. Technical advances allow for the determination of volatile organic compounds in the human breath to differentiate between health and disease. AIM Review and discuss medical literature on volatile organic compounds in exhaled human breath in GI disorders, focusing on diagnosis and differentiation of IBD. METHODS A systematic search in PubMed, Ovid Medline and Scopus was completed using appropriate keywords. In addition, a bibliography search of each article was performed. RESULTS Mean breath pentane, ethane, propane, 1-octene, 3-methylhexane, 1-decene and NO levels were elevated (P < 0.05 to P < 10(-7)) and mean breath 1-nonene, (E)-2-nonene, hydrogen sulphide and methane were decreased in IBD compared to healthy controls (P = 0.003 to P < 0.001). A combined panel of 3 volatile organic compounds (octene, (E)-2-nonene and decene) showed the best discrimination between paediatric IBD and controls (AUC 0.96). Breath condensate cytokines were higher in IBD compared to healthy individuals (P < 0.008). Breath pentane, ethane, propane, isoprene and NO levels correlated with disease activity in IBD patients. Breath condensate interleukin-1β showed an inverse relation with clinical disease activity. CONCLUSIONS Breath analysis in IBD is a promising approach that is not yet ready for routine clinical use, but data from other gastrointestinal diseases suggest the feasibility for use of this technology in clinical practice. Well-designed future trials, incorporating the latest breath detection techniques, need to determine the exact breath metabolome pattern linked to diagnosis and phenotype of IBD.
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Affiliation(s)
- S Kurada
- Department of Hospital Medicine, Medicine Institute, Cleveland, OH, USA
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23
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Alkhouri N, Eng K, Cikach F, Patel N, Yan C, Brindle A, Rome E, Hanouneh I, Grove D, Lopez R, Hazen SL, Dweik R. Breathprints of childhood obesity: changes in volatile organic compounds in obese children compared with lean controls. Pediatr Obes 2015; 10:23-9. [PMID: 24677760 PMCID: PMC4177515 DOI: 10.1111/j.2047-6310.2014.221.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 12/31/2013] [Accepted: 01/31/2014] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The objective of this study was to investigate changes in volatile organic compounds (VOCs) in exhaled breath in overweight/obese children compared with their lean counterparts. STUDY DESIGN Single exhaled breath was collected and analyzed per protocol using selective ion flow tube mass spectrometry (SIFT-MS). RESULTS Sixty overweight/obese children and 55 lean controls were included. Compared with the lean group, the obese group was significantly older (14.1 ± 2.8 vs. 12.1 ± 3.0 years), taller (164.8 ± 10.9 vs. 153.3 ± 17.1 cm) and more likely to be Caucasian (60% vs. 35.2%); P < 0.05 for all. A comparison of the SIFT-MS results of the obese group with the lean group revealed differences in concentration of more than 50 compounds. A panel of four VOCs can identify the presence of overweight/obesity with excellent accuracy. Further analysis revealed that breath isoprene, 1-decene, 1-octene, ammonia and hydrogen sulfide were significantly higher in the obese group compared with the lean group (P value < 0.01 for all). CONCLUSION Obese children have a unique pattern of exhaled VOCs. Changes in VOCs observed in this study may help to gain insight into pathophysiological processes and pathways leading to the development of childhood obesity.
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Affiliation(s)
- Naim Alkhouri
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH,Digestive Disease Institute, Cleveland Clinic, Cleveland, OH,Center for Cardiovascular Diagnostics and Prevention, Cleveland Clinic, Cleveland, OH
| | - Katharine Eng
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH
| | - Frank Cikach
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH,Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Nisha Patel
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH
| | - Chen Yan
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH
| | - Alison Brindle
- Department of General Pediatrics, Cleveland Clinic, Cleveland, OH
| | - Ellen Rome
- Department of General Pediatrics, Cleveland Clinic, Cleveland, OH
| | | | - David Grove
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH,Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Rocio Lopez
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - Stanley L Hazen
- Department of Cell Biology Lerner Research Institute Cleveland Clinic College of Medicine of CWRU, Cleveland Clinic, Cleveland, OH,Center for Cardiovascular Diagnostics and Prevention, Cleveland Clinic, Cleveland, OH,Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH
| | - Raed Dweik
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH,Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
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24
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Navaneethan U, Parsi MA, Gutierrez NG, Bhatt A, Venkatesh PGK, Lourdusamy D, Grove D, Hammel JP, Jang S, Sanaka MR, Stevens T, Vargo JJ, Dweik RA. Volatile organic compounds in bile can diagnose malignant biliary strictures in the setting of pancreatic cancer: a preliminary observation. Gastrointest Endosc 2014; 80:1038-45. [PMID: 24929484 DOI: 10.1016/j.gie.2014.04.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 04/02/2014] [Indexed: 01/28/2023]
Abstract
BACKGROUND Ascertaining the nature of biliary strictures is challenging. The role of volatile organic compounds (VOCs) in bile in determining the cause of biliary strictures is not known. OBJECTIVE To identify potential VOCs in the headspaces (gas above the sample) of bile in patients with malignant biliary strictures from pancreatic cancer. DESIGN Prospective cross-sectional study. SETTING Referral center. PATIENTS Prospective study in which bile was aspirated in 96 patients undergoing ERCP for benign and malignant conditions. MAIN OUTCOME MEASUREMENTS Selected ion flow tube mass spectrometry (VOICE200R SIFT-MS instrument; Syft Technologies Ltd, Christchurch, New Zealand) was used to analyze the headspace and to build a predictive model for pancreatic cancer. RESULTS The headspaces from 96 bile samples were analyzed, including 24 from patients with pancreatic cancer and 72 from patients with benign biliary conditions. The concentrations of 6 compounds (acetaldehyde, acetone, benzene, carbon disulfide, pentane, and trimethylamine [TMA]) were increased in patients with pancreatic cancer compared with controls (P < .05). By using receiver-operating characteristic curve analysis, we developed a model for the diagnosis of pancreatic cancer based on the levels of TMA, acetone, isoprene, dimethyl sulfide, and acetaldehyde. The model [10.94 + 1.8229* log (acetaldehyde) + 0.7600* log (acetone) - 1.1746* log (dimethyl sulfide) + 1.0901* log (isoprene) - 2.1401 * log (trimethylamine) ≥ 10] identified the patients with pancreatic cancer (area under the curve = 0.85), with 83.3% sensitivity and 81.9% specificity. LIMITATIONS Sample size. CONCLUSIONS The measurement of biliary fluid VOCs may help to distinguish malignant from benign biliary strictures. Further studies are warranted to validate these observations. (Clinical Trial Registration Number NCT01565460.).
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Affiliation(s)
- Udayakumar Navaneethan
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Mansour A Parsi
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Norma G Gutierrez
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Amit Bhatt
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Preethi G K Venkatesh
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Dennisdhilak Lourdusamy
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - David Grove
- Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jeffrey P Hammel
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Sunguk Jang
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Madhusudhan R Sanaka
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Tyler Stevens
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - John J Vargo
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland, Ohio, USA
| | - Raed A Dweik
- Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland Clinic, Cleveland, Ohio, USA
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25
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Patel N, Alkhouri N, Eng K, Cikach F, Mahajan L, Yan C, Grove D, Rome ES, Lopez R, Dweik RA. Metabolomic analysis of breath volatile organic compounds reveals unique breathprints in children with inflammatory bowel disease: a pilot study. Aliment Pharmacol Ther 2014; 40:498-507. [PMID: 25041596 PMCID: PMC4127094 DOI: 10.1111/apt.12861] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 02/26/2014] [Accepted: 06/14/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Breath testing is becoming an important diagnostic method to evaluate many disease states. In the light of rising healthcare costs, is important to develop a simple non-invasive tool to potentially identify paediatric patients who need endoscopy for suspected inflammatory bowel disease (IBD). AIM To analyse exhaled volatile organic compounds (VOCs) and investigate the presence of a unique breath patterns to differentiate paediatric patients with (IBD) from healthy controls. METHODS A cross-sectional, single-centre study included paediatric IBD patients and healthy controls (age range, 5-21 years). The diagnosis of IBD was confirmed by endoscopic, histological and radiographic data. Exhaled breath was collected and analysed using a selective ion flow tube mass spectroscopy (SIFT-MS) to identify new markers or patterns of IBD. RESULTS One hundred and seventeen patients (62 with IBD and 55 healthy controls) were included in the study. Linear discriminant analysis and principle component analysis of mass scanning ion peak data demonstrated 21 pre-selected VOCs correctly classify patients with IBD or as healthy controls; P < 0.0001. Multivariable logistic regression analysis further showed three specific VOCs (1-octene, 1-decene, (E)-2-nonene) had excellent accuracy for predicting the presence of IBD with an area under the curve (AUC) of 0.96 (95% CI: 0.93-0.99). No significant difference in VOCs was found between patients with Crohn's disease or ulcerative colitis, and no significant correlation was seen with disease activity. CONCLUSION These pilot data support the hypothesis that a unique breathprint potentially exists for paediatric IBD in the exhaled metabolome.
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Affiliation(s)
- Nisha Patel
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Naim Alkhouri
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Katharine Eng
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Frank Cikach
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Lori Mahajan
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Chen Yan
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, 44195
| | - David Grove
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Ellen S. Rome
- Department of General Pediatrics, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Rocio Lopez
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Raed A. Dweik
- Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, 44195,Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, 44195
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Cikach FS, Tonelli AR, Barnes J, Paschke K, Newman J, Grove D, Dababneh L, Wang S, Dweik RA. Breath analysis in pulmonary arterial hypertension. Chest 2014; 145:551-558. [PMID: 24091389 DOI: 10.1378/chest.13-1363] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is a progressive and devastating condition characterized by vascular cell proliferation and is associated with several metabolic derangements. We hypothesized that metabolic derangements in PAH can be detected by measuring metabolic by-products in exhaled breath. METHODS We collected breath and blood samples from patients with PAH at the time of right-sided heart catheterization (n=31) and from healthy control subjects (n=34). Breath was analyzed by selected ion flow tube-mass spectrometry in predetermined training and validation cohorts. RESULTS Patients with PAH were 51.5±14 years old, and 27 were women (85%). Control subjects were 38±13 years old, and 22 were women (65%). Discriminant analysis in the training set identified three ion peaks (H3O+29+, NO+56+, and O2+98+) and the variable age that correctly classified 88.9% of the individuals. In an independent validation cohort, 82.8% of the individuals were classified correctly. The concentrations of the volatile organic compounds 2-propanol, acetaldehyde, ammonia, ethanol, pentane, 1-decene, 1-octene, and 2-nonene were different in patients with PAH compared with control subjects. Exhaled ammonia was higher in patients with PAH (median [interquartile range]: 94.7 parts per billion (ppb) [70-129 ppb] vs 60.9 ppb [46-77 ppb], P<.001) and was associated with right atrial pressure (ρ=0.57, P<.001), mean pulmonary artery pressure (ρ=0.43, P=.015), cardiac index by thermodilution (ρ=-0.39, P=.03), pulmonary vascular resistance (ρ=0.40, P=.04), mixed venous oxygen (ρ=-0.59, P<.001), and right ventricular dilation (ρ=0.42, P=.03). CONCLUSIONS Breathprint is different between patients with PAH and healthy control subjects. Several specific compounds, including ammonia, were elevated in the breath of patients with PAH. Exhaled ammonia levels correlated with severity of disease.
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Affiliation(s)
- Frank S Cikach
- Pathobiology Department, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Adriano R Tonelli
- Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Jarrod Barnes
- Pathobiology Department, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Kelly Paschke
- Pathobiology Department, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Jennie Newman
- Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - David Grove
- Pathobiology Department, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Luma Dababneh
- Pathobiology Department, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Sihe Wang
- Department of Clinical Pathology, Cleveland Clinic, Cleveland, OH
| | - Raed A Dweik
- Pathobiology Department, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.
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Hanouneh IA, Zein NN, Cikach F, Dababneh L, Grove D, Alkhouri N, Lopez R, Dweik RA. The breathprints in patients with liver disease identify novel breath biomarkers in alcoholic hepatitis. Clin Gastroenterol Hepatol 2014; 12:516-23. [PMID: 24036050 PMCID: PMC3971429 DOI: 10.1016/j.cgh.2013.08.048] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 08/20/2013] [Accepted: 08/21/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Selected-ion flow-tube mass spectrometry can precisely identify trace gases in the human breath, in the parts-per-billion range. We investigated whether concentrations of volatile compounds in breath samples correlate with the diagnosis of alcoholic hepatitis (AH) and the severity of liver disease in patients with AH. METHODS We recruited patients with liver disease from a single tertiary care center. The study population was divided between those with AH with cirrhosis (n = 40) and those with cirrhosis with acute decompensation from etiologies other than alcohol (n = 40); individuals without liver disease served as control subjects (n = 43). We used selected-ion flow-tube mass spectrometry to identify and measure 14 volatile compounds in breath samples from fasted subjects. We used various statistical analyses to compare clinical characteristics and breath levels of compounds among groups and to test the correlation between levels of compounds and severity of liver disease. Logistic regression analysis was performed to build a predictive model for AH. RESULTS We identified 6 compounds (2-propanol, acetaldehyde, acetone, ethanol, pentane, and trimethylamine [TMA]) whose levels were increased in patients with liver disease compared with control subjects. Mean concentrations of TMA and pentane (TAP) were particularly high in breath samples from patients with AH, compared with those with acute decompensation or control subjects (for both, P < .001). Using receiver operating characteristic curve analysis, we developed a model for the diagnosis of AH based on breath levels of TAP. TAP scores of 36 or higher identified the patients with AH (area under the receiver operating characteristic curves = 0.92) with 90% sensitivity and 80% specificity. The levels of exhaled TMA had a low level of correlation with the severity of AH based on model for end-stage liver disease score (r = 0.38; 95% confidence interval, 0.07-0.69; P = .018). CONCLUSIONS Based on levels of volatile compounds in breath samples, we can identify patients with AH vs patients with acute decompensation or individuals without liver disease. Levels of exhaled TMA moderately correlate with the severity of AH. These findings might be used in diagnosis of AH or in determining patient prognosis.
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Affiliation(s)
- Ibrahim A Hanouneh
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio
| | - Nizar N Zein
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio
| | - Frank Cikach
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Luma Dababneh
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - David Grove
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Naim Alkhouri
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio
| | - Rocio Lopez
- Department of Quantitative Health Science, Cleveland Clinic, Cleveland, Ohio
| | - Raed A Dweik
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
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Hanouneh IA, Zein NN, Cikach F, Dababneh L, Grove D, Alkhouri N, Lopez R, Dweik RA. The breathprints in patients with liver disease identify novel breath biomarkers in alcoholic hepatitis. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY : THE OFFICIAL CLINICAL PRACTICE JOURNAL OF THE AMERICAN GASTROENTEROLOGICAL ASSOCIATION 2014. [PMID: 24036050 DOI: 10.1016/j.cgh.2013.08.048]24036050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Selected-ion flow-tube mass spectrometry can precisely identify trace gases in the human breath, in the parts-per-billion range. We investigated whether concentrations of volatile compounds in breath samples correlate with the diagnosis of alcoholic hepatitis (AH) and the severity of liver disease in patients with AH. METHODS We recruited patients with liver disease from a single tertiary care center. The study population was divided between those with AH with cirrhosis (n = 40) and those with cirrhosis with acute decompensation from etiologies other than alcohol (n = 40); individuals without liver disease served as control subjects (n = 43). We used selected-ion flow-tube mass spectrometry to identify and measure 14 volatile compounds in breath samples from fasted subjects. We used various statistical analyses to compare clinical characteristics and breath levels of compounds among groups and to test the correlation between levels of compounds and severity of liver disease. Logistic regression analysis was performed to build a predictive model for AH. RESULTS We identified 6 compounds (2-propanol, acetaldehyde, acetone, ethanol, pentane, and trimethylamine [TMA]) whose levels were increased in patients with liver disease compared with control subjects. Mean concentrations of TMA and pentane (TAP) were particularly high in breath samples from patients with AH, compared with those with acute decompensation or control subjects (for both, P < .001). Using receiver operating characteristic curve analysis, we developed a model for the diagnosis of AH based on breath levels of TAP. TAP scores of 36 or higher identified the patients with AH (area under the receiver operating characteristic curves = 0.92) with 90% sensitivity and 80% specificity. The levels of exhaled TMA had a low level of correlation with the severity of AH based on model for end-stage liver disease score (r = 0.38; 95% confidence interval, 0.07-0.69; P = .018). CONCLUSIONS Based on levels of volatile compounds in breath samples, we can identify patients with AH vs patients with acute decompensation or individuals without liver disease. Levels of exhaled TMA moderately correlate with the severity of AH. These findings might be used in diagnosis of AH or in determining patient prognosis.
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Affiliation(s)
- Ibrahim A Hanouneh
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio
| | - Nizar N Zein
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio
| | - Frank Cikach
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Luma Dababneh
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - David Grove
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Naim Alkhouri
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio
| | - Rocio Lopez
- Department of Quantitative Health Science, Cleveland Clinic, Cleveland, Ohio
| | - Raed A Dweik
- Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
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29
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Zhang L, Tian G, Li J, Yu B. Applications of absorption spectroscopy using quantum cascade lasers. APPLIED SPECTROSCOPY 2014; 68:1095-1107. [PMID: 25239063 DOI: 10.1366/14-00001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Infrared laser absorption spectroscopy (LAS) is a promising modern technique for sensing trace gases with high sensitivity, selectivity, and high time resolution. Mid-infrared quantum cascade lasers, operating in a pulsed or continuous wave mode, have potential as spectroscopic sources because of their narrow linewidths, single mode operation, tunability, high output power, reliability, low power consumption, and compactness. This paper reviews some important developments in modern laser absorption spectroscopy based on the use of quantum cascade laser (QCL) sources. Among the various laser spectroscopic methods, this review is focused on selected absorption spectroscopy applications of QCLs, with particular emphasis on molecular spectroscopy, industrial process control, combustion diagnostics, and medical breath analysis.
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Affiliation(s)
- Lizhu Zhang
- School of Science, Tianjin University of Technology and Education, Tianjin 300220, China
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30
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Abstract
Breath tests (BTs) have been investigated as diagnostic tools to phenotype drug disposition in cancer patients in the pursuit to individualize drug treatment. The choice of the right phenotype probe is crucial and depends on the metabolic pathway of the anticancer agent of interest. BTs using orally or intravenously administered selective non-radioactive (13)C-labeled probes to non-invasively evaluate dihydropyrimidine dehydrogenase, cytochrome P450 (CYP) 3A4, and CYP2D6 enzyme activity have been published. Clinically, a (13)C-dextromethorphan BT to predict endoxifen levels in breast cancer patients and a (13)C-uracil BT to predict fluoropyrimidine toxicity in colorectal cancer patients are most promising. However, the clinical benefit and cost effectiveness of these phenotype BTs need to be determined in order to make the transition from an experimental setting to clinical practice as companion diagnostic tests.
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31
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Wang AA, Paige KN, Gaskins HR, Teran-Garcia M. An Improved Method for Collecting Breath From 3- to 7-Year-Old Children. JPEN J Parenter Enteral Nutr 2013; 38:507-9. [DOI: 10.1177/0148607113483178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - H. Rex Gaskins
- Division of Nutritional Sciences
- Department of Animal Sciences
- Institute for Genomic Biology
- Department of Pathobiology
- University of Illinois Cancer Center
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL
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32
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Abstract
With each breath that we exhale, thousands of molecules are expelled in our breath, giving individuals a "breath-print" that can tell a lot about them and their state of health. Breath analysis is rapidly evolving as the new frontier in medical testing. The end of the 20th century and the beginning of the 21st century have arguably witnessed a revolution in our understanding of the constituents of exhaled breath and the development of the field of breath analysis and testing. Thanks to major breakthroughs in new technologies (infrared, electrochemical, chemiluminescence, and others) and the availability of mass spectrometers, the field of breath analysis has made considerable advances in the 21st century. Several methods are now in clinical use or nearly ready to enter that arena. Breath analysis has the potential to offer relatively inexpensive, rapid, noninvasive methods for detecting and/or monitoring a variety of diseases. Breath analysis also has applications in fields beyond medicine, including environmental monitoring, security, and others. This review will focus on exhaled breath as a potential source of biomarkers for medical applications with specific attention to applications (and potential applications) in cardiovascular disease.
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Affiliation(s)
- Frank S Cikach
- Department of Pathobiology/Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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33
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Minh TDC, Blake DR, Galassetti PR. The clinical potential of exhaled breath analysis for diabetes mellitus. Diabetes Res Clin Pract 2012; 97:195-205. [PMID: 22410396 PMCID: PMC3384765 DOI: 10.1016/j.diabres.2012.02.006] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 02/02/2012] [Accepted: 02/12/2012] [Indexed: 01/15/2023]
Abstract
Various compounds in present human breath have long been loosely associated with pathological states (including acetone smell in uncontrolled diabetes). Only recently, however, the precise measurement of exhaled volatile organic compounds (VOCs) and aerosolized particles was made possible at extremely low concentrations by advances in several analytical methodologies, described in detail in the international literature and each suitable for specific subsets of exhaled compounds. Exhaled gases may be generated endogenously (in the pulmonary tract, blood, or peripheral tissues), as metabolic by-products of human cells or colonizing micro-organisms, or may be inhaled as atmospheric pollutants; growing evidence indicates that several of these molecules have distinct cell-to-cell signaling functions. Independent of origin and physiological role, exhaled VOCs are attractive candidates as biomarkers of cellular activity/metabolism, and could be incorporated in future non-invasive clinical testing devices. Indeed, several recent studies reported altered exhaled gas profiles in dysmetabolic conditions and relatively accurate predictions of glucose concentrations, at least in controlled experimental conditions, for healthy and diabetic subjects over a broad range of glycemic values. Optimization of this methodology and validation in large-scale trials under a wider range of conditions is needed to determine its true potential to transition into practical clinical use.
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Affiliation(s)
- Timothy Do Chau Minh
- Department of Pharmacology, University of California, Irvine, Irvine, CA 92697-1385, United States.
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34
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Abstract
With each breath that we exhale, thousands of molecules are expelled in our breath, giving individuals a "breath-print" that can tell a lot about them and their state of health. Breath analysis is rapidly evolving as the new frontier in medical testing. The end of the 20th century and the beginning of the 21st century have arguably witnessed a revolution in our understanding of the constituents of exhaled breath and the development of the field of breath analysis and testing. Thanks to major breakthroughs in new technologies (infrared, electrochemical, chemiluminescence, and others) and the availability of mass spectrometers, the field of breath analysis has made considerable advances in the 21st century. Several methods are now in clinical use or nearly ready to enter that arena. Breath analysis has the potential to offer relatively inexpensive, rapid, noninvasive methods for detecting and/or monitoring a variety of diseases. Breath analysis also has applications in fields beyond medicine, including environmental monitoring, security, and others. This review will focus on exhaled breath as a potential source of biomarkers for medical applications with specific attention to applications (and potential applications) in cardiovascular disease.
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Affiliation(s)
- Frank S. Cikach
- Department of Pathobiology / Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, 44195
| | - Raed A. Dweik
- Department of Pathobiology / Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, 44195
- Department of Pulmonary and Critical Care Medicine / Respiratory Institute Cleveland Clinic, Cleveland, Ohio, 44195
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35
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Dweik RA. The great challenge for exhaled breath analysis: embracing complexity, delivering simplicity. J Breath Res 2011; 5:030201. [PMID: 21900732 DOI: 10.1088/1752-7155/5/3/030201] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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