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Suzukawa M, Ohta K, Sugimoto M, Ohshima N, Kobayashi N, Tashimo H, Tanimoto Y, Itano J, Kimura G, Takata S, Nakano T, Yamashita T, Ikegame S, Hyodo K, Abe M, Chibana K, Kamide Y, Sasaki K, Hashimoto H. Identification of exhaled volatile organic compounds that characterize asthma phenotypes: A J-VOCSA study. Allergol Int 2024:S1323-8930(24)00047-9. [PMID: 38658257 DOI: 10.1016/j.alit.2024.04.003] [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: 09/05/2023] [Revised: 03/23/2024] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Asthma is characterized by phenotypes of different clinical, demographic, and pathological characteristics. Identifying the profile of exhaled volatile organic compounds (VOCs) in asthma phenotypes may facilitate establishing biomarkers and understanding asthma background pathogenesis. This study aimed to identify exhaled VOCs that characterize severe asthma phenotypes among patients with asthma. METHODS This was a multicenter cross-sectional study of patients with severe asthma in Japan. Clinical data were obtained from medical records, and questionnaires were collected. Exhaled breath was sampled and subjected to thermal desorption gas chromatography-mass spectrometry (GC/MS). RESULTS Using the decision tree established in the previous nationwide asthma cohort study, 245 patients with asthma were divided into five phenotypes and subjected to exhaled VOC analysis with 50 healthy controls (HCs). GC/MS detected 243 VOCs in exhaled breath samples, and 142 frequently detected VOCs (50% of all samples) were used for statistical analyses. Cluster analysis assigning the groups with similar VOC profile patterns showed the highest similarities between phenotypes 3 and 4 (early-onset asthma phenotypes), followed by the similarities between phenotypes 1 and 2 (late-onset asthma phenotypes). Comparisons between phenotypes 1-5 and HC revealed 19 VOCs, in which only methanesulfonic anhydride showed p < 0.05 adjusted by false discovery rate (FDR). Comparison of these phenotypes yielded several VOCs showing different trends (p < 0.05); however, no VOCs showed p < 0.05 adjusted by FDR. CONCLUSIONS Exhaled VOC profiles may be useful for distinguishing asthma and asthma phenotypes; however, these findings need to be validated, and their pathological roles should be clarified.
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Affiliation(s)
- Maho Suzukawa
- Clinical Research Center, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.
| | - Ken Ohta
- Clinical Research Center, National Hospital Organization Tokyo National Hospital, Tokyo, Japan; Japan Anti-Tuberculosis Association, JATA Fukujuji Hospital, Tokyo, Japan.
| | - Masahiro Sugimoto
- Institute for Advanced Biosciences, Keio University, Yamagata, Japan; Human Metabolome Technologies, Inc., Yamagata, Japan
| | - Nobuharu Ohshima
- Clinical Research Center, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Nobuyuki Kobayashi
- Clinical Research Center, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Hiroyuki Tashimo
- Clinical Research Center, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Yasushi Tanimoto
- National Hospital Organization Minami-Okayama Medical Center, Okayama, Japan
| | - Junko Itano
- National Hospital Organization Minami-Okayama Medical Center, Okayama, Japan
| | - Goro Kimura
- National Hospital Organization Minami-Okayama Medical Center, Okayama, Japan
| | - Shohei Takata
- National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Takako Nakano
- National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Takafumi Yamashita
- National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Satoshi Ikegame
- National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Kentaro Hyodo
- National Hospital Organization Ibarakihigashi National Hospital, Ibaraki, Japan
| | - Masahiro Abe
- National Hospital Organization Ehime Medical Center, Ehime, Japan
| | - Kenji Chibana
- National Hospital Organization Okinawa National Hospital, Okinawa, Japan
| | - Yosuke Kamide
- National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Kazunori Sasaki
- Institute for Advanced Biosciences, Keio University, Yamagata, Japan; Human Metabolome Technologies, Inc., Yamagata, Japan
| | - Hiroya Hashimoto
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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Wijsman PC, Goorsenberg AWM, d'Hooghe JNS, Weersink EJM, Fenn DW, Maitland van der Zee AH, Annema JT, Brinkman P, Bonta PI. Exhaled breath analyses for bronchial thermoplasty in severe asthma patients. Respir Med 2024; 225:107583. [PMID: 38447787 DOI: 10.1016/j.rmed.2024.107583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/10/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma. Although multiple trials have demonstrated clinical improvement after BT, optimal patient selection remains a challenge and the mechanism of action is incompletely understood. The aim of this study was to examine whether exhaled breath analysis can contribute to discriminate between BT-responders and non-responders at baseline and to explore pathophysiological insights of BT. METHODS Exhaled breath was collected from patients at baseline and six months post-BT. Patients were defined as responders or non-responders based on a half point increase in asthma quality of life questionnaire scores. Gas chromatography-mass spectrometry was used for volatile organic compounds (VOCs) detection and analyses. Analytical workflow consisted of: 1) detection of VOCs that differentiate between responders and non-responders and those that differ between baseline and six months post-BT, 2) identification of VOCs of interest and 3) explore correlations between clinical biomarkers and VOCs. RESULTS Data was available from 14 patients. Nonanal, 2-ethylhexanol and 3-thujol showed a significant difference in intensity between responders and non-responders at baseline (p = 0.04, p = 0.01 and p = 0.03, respectively). After BT, no difference was found in the compound intensity of these VOCs. A negative correlation was observed between nonanal and IgE and BALF eosinophils (r = -0.68, p < 0.01 and r = -0.61, p = 0.02 respectively) and 3-thujol with BALF neutrophils (r = -0.54, p = 0.04). CONCLUSIONS This explorative study identified discriminative VOCs in exhaled breath between BT responders and non-responders at baseline. Additionally, correlations were found between VOC's and inflammatory BALF cells. Once validated, these findings encourage research in breath analysis as a non-invasive easy to apply technique for identifying airway inflammatory profiles and eligibility for BT or immunotherapies in severe asthma.
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Affiliation(s)
- Pieta C Wijsman
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Annika W M Goorsenberg
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Julia N S d'Hooghe
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Els J M Weersink
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Dominic W Fenn
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | | | - Jouke T Annema
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Paul Brinkman
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands
| | - Peter I Bonta
- Amsterdam UMC, University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, Netherlands.
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3
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Moura PC, Raposo M, Vassilenko V. Breath biomarkers in Non-Carcinogenic diseases. Clin Chim Acta 2024; 552:117692. [PMID: 38065379 DOI: 10.1016/j.cca.2023.117692] [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: 11/10/2023] [Revised: 12/02/2023] [Accepted: 12/03/2023] [Indexed: 12/19/2023]
Abstract
The analysis of volatile organic compounds (VOCs) from human matrices like breath, perspiration, and urine has received increasing attention from academic and medical researchers worldwide. These biological-borne VOCs molecules have characteristics that can be directly related to physiologic and pathophysiologic metabolic processes. In this work, gathers a total of 292 analytes that have been identified as potential biomarkers for the diagnosis of various non-carcinogenic diseases. Herein we review the advances in VOCs with a focus on breath biomarkers and their potential role as minimally invasive tools to improve diagnosis prognosis and therapeutic monitoring.
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Affiliation(s)
- Pedro Catalão Moura
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516, Caparica, Portugal.
| | - Maria Raposo
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516, Caparica, Portugal.
| | - Valentina Vassilenko
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516, Caparica, Portugal.
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4
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Sharma A, James A, Kapoor DN, Kaurav H, Sharma AK, Nagraik R. An insight into biosensing platforms used for the diagnosis of various lung diseases: A review. Biotechnol Bioeng 2024; 121:71-81. [PMID: 37661712 DOI: 10.1002/bit.28538] [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: 11/15/2022] [Revised: 07/08/2023] [Accepted: 08/15/2023] [Indexed: 09/05/2023]
Abstract
Many of the infectious diseases are ubiquitous in nature and pose a threat to global and public health. The original cause for such type of serious maladies can be summarized as the scarcity of appropriate analysis and treatment methods. Pulmonary diseases are considered one of the life-threatening lung diseases that affect millions of people globally. It consists of several types, namely, asthma, lung cancer, tuberculosis, chronic obstructive pulmonary disease, and several respiratory-related infections. This is due to the limited access to well-equipped healthcare facilities for early disease diagnosis. This needs the availability of processes and technologies that can help to stop this harmful disease-diagnosing practice. Various approaches for diagnosing various lung diseases have been developed over time, namely, autopsy, chest X-rays, low-dose CT scans, and so forth. The need of the hour is to develop a rapid, simple, portable, and low-cost method for the diagnosis of pulmonary diseases. So nowadays, biosensors have been becoming one of the highest priority research areas as a potentially useful tool for the early diagnosis and detection of many pulmonary lung diseases. In this review article, various types of biosensors and their applications in the diagnosis of lung-related disorders are expansively explained.
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Affiliation(s)
- Avinash Sharma
- Faculty of Applied Sciences and Biotechnology, Shoolini University, Solan, Himachal Pradesh, India
| | - Abija James
- Faculty of Applied Sciences and Biotechnology, Shoolini University, Solan, Himachal Pradesh, India
| | - Deepak N Kapoor
- Faculty of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh, India
| | - Hemlata Kaurav
- Faculty of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh, India
| | - Abhishek Kumar Sharma
- Faculty of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh, India
| | - Rupak Nagraik
- Faculty of Applied Sciences and Biotechnology, Shoolini University, Solan, Himachal Pradesh, India
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5
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Savito L, Scarlata S, Bikov A, Carratù P, Carpagnano GE, Dragonieri S. Exhaled volatile organic compounds for diagnosis and monitoring of asthma. World J Clin Cases 2023; 11:4996-5013. [PMID: 37583852 PMCID: PMC10424019 DOI: 10.12998/wjcc.v11.i21.4996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/08/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
The asthmatic inflammatory process results in the generation of volatile organic compounds (VOCs), which are subsequently secreted by the airways. The study of these elements through gas chromatography-mass spectrometry (GC-MS), which can identify individual molecules with a discriminatory capacity of over 85%, and electronic-Nose (e-NOSE), which is able to perform a quick onboard pattern-recognition analysis of VOCs, has allowed new prospects for non-invasive analysis of the disease in an "omics" approach. In this review, we aim to collect and compare the progress made in VOCs analysis using the two methods and their instrumental characteristics. Studies have described the potential of GC-MS and e-NOSE in a multitude of relevant aspects of the disease in both children and adults, as well as differential diagnosis between asthma and other conditions such as wheezing, cystic fibrosis, COPD, allergic rhinitis and last but not least, the accuracy of these methods compared to other diagnostic tools such as lung function, FeNO and eosinophil count. Due to significant limitations of both methods, it is still necessary to improve and standardize techniques. Currently, e-NOSE appears to be the most promising aid in clinical practice, whereas GC-MS, as the gold standard for the structural analysis of molecules, remains an essential tool in terms of research for further studies on the pathophysiologic pathways of the asthmatic inflammatory process. In conclusion, the study of VOCs through GC-MS and e-NOSE appears to hold promise for the non-invasive diagnosis, assessment, and monitoring of asthma, as well as for further research studies on the disease.
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Affiliation(s)
- Luisa Savito
- Department of Internal Medicine, Unit of Respiratory Pathophysiology and Thoracic Endoscopy, Fondazione Policlinico Universitario Campus Bio Medico, Rome 00128, Italy
| | - Simone Scarlata
- Department of Internal Medicine, Unit of Respiratory Pathophysiology and Thoracic Endoscopy, Fondazione Policlinico Universitario Campus Bio Medico, Rome 00128, Italy
| | - Andras Bikov
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, United Kingdom
| | - Pierluigi Carratù
- Department of Internal Medicine "A.Murri", University of Bari "Aldo Moro", Bari 70124, Italy
| | | | - Silvano Dragonieri
- Department of Respiratory Diseases, University of Bari, Bari 70124, Italy
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6
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Lee D, Chae M, Jung J, Kim HD. Correlation between Sensing Accuracy and Read Margin of a Memristor-Based NO Gas Sensor Array Estimated by Neural Network Analysis. ACS Sens 2023; 8:2105-2114. [PMID: 37161287 DOI: 10.1021/acssensors.3c00541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Memristor-based gas sensors (gasistors) have been considered as the most promising candidate for detecting NO gas suitable for neural network (NN) analysis. In this work, in order to solve an overfitting issue arising from the training data when using a single gasistor, which degrades the accuracy of NN, we here propose a metal-insulator-silicon (MIS)-structured Zr3N4-based gasistor array that results in an improvement in both the accuracy of the NN analysis and the efficiency of the operating power. As a result, the proposed gasistor array showed a decrease of epoch and a 2.5% improvement of prediction accuracy at room temperature compared to single cells with metal/insulator/metal (MIM) and MIS structures. These results imply that an array structure based on MIS can efficiently solve the overfitting issue by receiving multiple responses at once, compared to a single gas sensor that obtains one response per sensing.
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Affiliation(s)
- Doowon Lee
- Department of Electrical Engineering, Semiconductor Systems Engineering, and Convergence Engineering for Intelligent Drone, Institute of Semiconductor and System IC, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Myoungsu Chae
- Department of Electrical Engineering, Semiconductor Systems Engineering, and Convergence Engineering for Intelligent Drone, Institute of Semiconductor and System IC, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Jinsu Jung
- Department of Electrical Engineering, Semiconductor Systems Engineering, and Convergence Engineering for Intelligent Drone, Institute of Semiconductor and System IC, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Hee-Dong Kim
- Department of Electrical Engineering, Semiconductor Systems Engineering, and Convergence Engineering for Intelligent Drone, Institute of Semiconductor and System IC, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
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7
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Sharma A, Kumar R, Varadwaj P. Smelling the Disease: Diagnostic Potential of Breath Analysis. Mol Diagn Ther 2023; 27:321-347. [PMID: 36729362 PMCID: PMC9893210 DOI: 10.1007/s40291-023-00640-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/03/2023]
Abstract
Breath analysis is a relatively recent field of research with much promise in scientific and clinical studies. Breath contains endogenously produced volatile organic components (VOCs) resulting from metabolites of ingested precursors, gut and air-passage bacteria, environmental contacts, etc. Numerous recent studies have suggested changes in breath composition during the course of many diseases, and breath analysis may lead to the diagnosis of such diseases. Therefore, it is important to identify the disease-specific variations in the concentration of breath to diagnose the diseases. In this review, we explore methods that are used to detect VOCs in laboratory settings, VOC constituents in exhaled air and other body fluids (e.g., sweat, saliva, skin, urine, blood, fecal matter, vaginal secretions, etc.), VOC identification in various diseases, and recently developed electronic (E)-nose-based sensors to detect VOCs. Identifying such VOCs and applying them as disease-specific biomarkers to obtain accurate, reproducible, and fast disease diagnosis could serve as an alternative to traditional invasive diagnosis methods. However, the success of VOC-based identification of diseases is limited to laboratory settings. Large-scale clinical data are warranted for establishing the robustness of disease diagnosis. Also, to identify specific VOCs associated with illness states, extensive clinical trials must be performed using both analytical instruments and electronic noses equipped with stable and precise sensors.
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Affiliation(s)
- Anju Sharma
- Systems Biology Lab, Indian Institute of Information Technology, Allahabad, Uttar Pradesh, India
| | - Rajnish Kumar
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Uttar Pradesh, Lucknow Campus, Lucknow, India
| | - Pritish Varadwaj
- Systems Biology Lab, Indian Institute of Information Technology, Allahabad, Uttar Pradesh, India.
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Kiss H, Örlős Z, Gellért Á, Megyesfalvi Z, Mikáczó A, Sárközi A, Vaskó A, Miklós Z, Horváth I. Exhaled Biomarkers for Point-of-Care Diagnosis: Recent Advances and New Challenges in Breathomics. MICROMACHINES 2023; 14:391. [PMID: 36838091 PMCID: PMC9964519 DOI: 10.3390/mi14020391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/29/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Cancers, chronic diseases and respiratory infections are major causes of mortality and present diagnostic and therapeutic challenges for health care. There is an unmet medical need for non-invasive, easy-to-use biomarkers for the early diagnosis, phenotyping, predicting and monitoring of the therapeutic responses of these disorders. Exhaled breath sampling is an attractive choice that has gained attention in recent years. Exhaled nitric oxide measurement used as a predictive biomarker of the response to anti-eosinophil therapy in severe asthma has paved the way for other exhaled breath biomarkers. Advances in laser and nanosensor technologies and spectrometry together with widespread use of algorithms and artificial intelligence have facilitated research on volatile organic compounds and artificial olfaction systems to develop new exhaled biomarkers. We aim to provide an overview of the recent advances in and challenges of exhaled biomarker measurements with an emphasis on the applicability of their measurement as a non-invasive, point-of-care diagnostic and monitoring tool.
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Affiliation(s)
- Helga Kiss
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Zoltán Örlős
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Áron Gellért
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Zsolt Megyesfalvi
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Angéla Mikáczó
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Anna Sárközi
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Attila Vaskó
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
| | - Zsuzsanna Miklós
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
| | - Ildikó Horváth
- National Koranyi Institute for Pulmonology, Koranyi F Street 1, 1121 Budapest, Hungary
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary
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Sun P, Shi Y, Shi Y. Multivariate Regression in Conjunction with GA-BP for Optimization of Data Processing of Trace NO Gas Flow in Active Pumping Electronic Nose. SENSORS (BASEL, SWITZERLAND) 2023; 23:1524. [PMID: 36772572 PMCID: PMC9919135 DOI: 10.3390/s23031524] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Exhaled nitric oxide trace gas at the ppb level is a biomarker of human airway inflammation. To detect this, we developed a method for the collection of active pumping electronic nose bionic chamber gas. An optimization algorithm based on multivariate regression (MR) and genetic algorithm-back propagation (GA-BP) was proposed to improve the accuracy of trace-level gas detection. An electronic nose was used to detect NO gas at the ppb level by substituting breathing gas with a sample gas. The impact of the pump suction flow capacity variation on the response of the electronic nose system was determined using an ANOVA. Further, the optimization algorithm based on MR and GA-BP was studied for flow correction. The results of this study demonstrate an increase in the detection accuracy of the system by more than twofold, from 17.40%FS before correction to 6.86%FS after correction. The findings of this research lay the technical groundwork for the practical application of electronic nose systems in the daily monitoring of FeNO.
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Affiliation(s)
- Pengjiao Sun
- The Higher Educational Key Laboratory for Measuring & Control Technology and Instrumentation of Heilongjiang Province, Harbin University of Science and Technology, Harbin 150080, China
- Electronics and Communication Engineering School, Jilin Technology College of Electronic Information, Jilin 132021, China
| | - Yunbo Shi
- The Higher Educational Key Laboratory for Measuring & Control Technology and Instrumentation of Heilongjiang Province, Harbin University of Science and Technology, Harbin 150080, China
- Heilongjiang Province Key Laboratory of Laser Spectroscopy Technology and Application, Harbin University of Science and Technology, Harbin 150080, China
- National Experimental Teaching Demonstration Center for Measurement and Control Technology and Instrumentation, Harbin University of Science and Technology, Harbin 150080, China
| | - Yeping Shi
- The Higher Educational Key Laboratory for Measuring & Control Technology and Instrumentation of Heilongjiang Province, Harbin University of Science and Technology, Harbin 150080, China
- Electronics and Communication Engineering School, Jilin Technology College of Electronic Information, Jilin 132021, China
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Garg S, Mishra V, Vega LF, Sharma RS, Dumée LF. Hydrogen Biosensing: Prospects, Parallels, and Challenges. Ind Eng Chem Res 2023. [DOI: 10.1021/acs.iecr.2c03965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Shafali Garg
- Department of Environmental Studies, Bioresources and Environmental Biotechnology Laboratory, University of Delhi, Delhi110007, India
| | - Vandana Mishra
- Department of Environmental Studies, Bioresources and Environmental Biotechnology Laboratory, University of Delhi, Delhi110007, India
- Centre for Inter-disciplinary Studies of Mountain & Hill Environment (CISMHE), University of Delhi, Delhi110007, India
- Delhi School of Climate Change and Sustainability, Institute of Eminence, University of Delhi, Delhi110007, India
| | - Lourdes F. Vega
- Khalifa University, Department of Chemical Engineering, Abu Dhabi127788, United Arab Emirates
- Khalifa University, Research, and Innovation Center on CO2 and Hydrogen, Abu Dhabi127788, United Arab Emirates
| | - Radhey Shyam Sharma
- Department of Environmental Studies, Bioresources and Environmental Biotechnology Laboratory, University of Delhi, Delhi110007, India
- Centre for Inter-disciplinary Studies of Mountain & Hill Environment (CISMHE), University of Delhi, Delhi110007, India
- Delhi School of Climate Change and Sustainability, Institute of Eminence, University of Delhi, Delhi110007, India
| | - Ludovic F. Dumée
- Khalifa University, Department of Chemical Engineering, Abu Dhabi127788, United Arab Emirates
- Khalifa University, Research, and Innovation Center on CO2 and Hydrogen, Abu Dhabi127788, United Arab Emirates
- Khalifa University, Center for Membrane and Advanced Water Technology, Abu Dhabi127788, United Arab Emirates
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Kaloumenou M, Skotadis E, Lagopati N, Efstathopoulos E, Tsoukalas D. Breath Analysis: A Promising Tool for Disease Diagnosis-The Role of Sensors. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22031238. [PMID: 35161984 PMCID: PMC8840008 DOI: 10.3390/s22031238] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 05/07/2023]
Abstract
Early-stage disease diagnosis is of particular importance for effective patient identification as well as their treatment. Lack of patient compliance for the existing diagnostic methods, however, limits prompt diagnosis, rendering the development of non-invasive diagnostic tools mandatory. One of the most promising non-invasive diagnostic methods that has also attracted great research interest during the last years is breath analysis; the method detects gas-analytes such as exhaled volatile organic compounds (VOCs) and inorganic gases that are considered to be important biomarkers for various disease-types. The diagnostic ability of gas-pattern detection using analytical techniques and especially sensors has been widely discussed in the literature; however, the incorporation of novel nanomaterials in sensor-development has also proved to enhance sensor performance, for both selective and cross-reactive applications. The aim of the first part of this review is to provide an up-to-date overview of the main categories of sensors studied for disease diagnosis applications via the detection of exhaled gas-analytes and to highlight the role of nanomaterials. The second and most novel part of this review concentrates on the remarkable applicability of breath analysis in differential diagnosis, phenotyping, and the staging of several disease-types, which are currently amongst the most pressing challenges in the field.
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Affiliation(s)
- Maria Kaloumenou
- Department of Applied Physics, National Technical University of Athens, 15780 Athens, Greece; (M.K.); (D.T.)
| | - Evangelos Skotadis
- Department of Applied Physics, National Technical University of Athens, 15780 Athens, Greece; (M.K.); (D.T.)
- Correspondence:
| | - Nefeli Lagopati
- Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias Str., Goudi, 11527 Athens, Greece; (N.L.); (E.E.)
| | - Efstathios Efstathopoulos
- Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias Str., Goudi, 11527 Athens, Greece; (N.L.); (E.E.)
| | - Dimitris Tsoukalas
- Department of Applied Physics, National Technical University of Athens, 15780 Athens, Greece; (M.K.); (D.T.)
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12
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AIM in Respiratory Disorders. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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Lee D, Yun MJ, Kim KH, kim S, Kim HD. Advanced Recovery and High-Sensitive Properties of Memristor-Based Gas Sensor Devices Operated at Room Temperature. ACS Sens 2021; 6:4217-4224. [PMID: 34783247 DOI: 10.1021/acssensors.1c01840] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Fast recovery, high sensitivity, high selectivity, and room temperature (RT) sensing characteristics of NO gas sensors are essential for environmental monitoring, artificial intelligence, and inflammatory diagnosis of asthma patients. However, the conventional semiconductor-type gas sensors have poor sensing characteristics that need to be solved, such as slow recovery speeds (>360 s), low sensitivity (3.8), and high operating temperatures (>300 °C). We propose here a memristor-based NO gas sensor as a gasistor (gas sensor + memory resistor) with SnO2, Ta2O5, and HfO2 films, which successfully demonstrated the feasibility of fast reaction/recovery (<1 s/90 ns) and high sensitivities such as 11.66 and 5.22 in Ta2O5 and HfO2 gasistors for NO gas, at RT. Furthermore, so as to reinforce the selectivity in multigas ambient, we suggest a parallel circuit using three kinds of gasistors having different sensitivities for NO, O2, and C2H6 gases, which results in an improvement of selectivity for the selected gas at RT.
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Affiliation(s)
- Doowon Lee
- Department of Electrical Engineering and Convergence Engineering for Intelligent Drone, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Min Ju Yun
- Department of Electrical Engineering and Convergence Engineering for Intelligent Drone, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Kyeong Heon Kim
- School of Convergence Electronic Engineering, Gyeongsang National University of Science and Technology, 33, Dongjin-ro, Jinju-si 52725, Korea
| | - Sungho kim
- Department of Electrical Engineering and Convergence Engineering for Intelligent Drone, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Hee-Dong Kim
- Department of Electrical Engineering and Convergence Engineering for Intelligent Drone, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
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14
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Yang HY, Chen WC, Tsai RC. Accuracy of the Electronic Nose Breath Tests in Clinical Application: A Systematic Review and Meta-Analysis. BIOSENSORS 2021; 11:bios11110469. [PMID: 34821685 PMCID: PMC8615633 DOI: 10.3390/bios11110469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 11/20/2021] [Accepted: 11/20/2021] [Indexed: 05/25/2023]
Abstract
(1) Background: An electronic nose applies a sensor array to detect volatile biomarkers in exhaled breath to diagnose diseases. The overall diagnostic accuracy remains unknown. The objective of this review was to provide an estimate of the diagnostic accuracy of sensor-based breath tests for the diagnosis of diseases. (2) Methods: We searched the PubMed and Web of Science databases for studies published between 1 January 2010 and 14 October 2021. The search was limited to human studies published in the English language. Clinical trials were not included in this review. (3) Results: Of the 2418 records identified, 44 publications were eligible, and 5728 patients were included in the final analyses. The pooled sensitivity was 90.0% (95% CI, 86.3-92.8%, I2 = 47.7%), the specificity was 88.4% (95% CI, 87.1-89.5%, I2 = 81.4%), and the pooled area under the curve was 0.93 (95% CI 0.91-0.95). (4) Conclusion: The findings of our review suggest that a standardized report of diagnostic accuracy and a report of the accuracy in a test set are needed. Sensor array systems of electronic noses have the potential for noninvasiveness at the point-of-care in hospitals. Nevertheless, the procedure for reporting the accuracy of a diagnostic test must be standardized.
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Affiliation(s)
- Hsiao-Yu Yang
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei 10055, Taiwan; (W.-C.C.); (R.-C.T.)
- Department of Public Health, National Taiwan University College of Public Health, Taipei 10055, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Wan-Chin Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei 10055, Taiwan; (W.-C.C.); (R.-C.T.)
- Department of Family Medicine, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Rodger-Chen Tsai
- Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei 10055, Taiwan; (W.-C.C.); (R.-C.T.)
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15
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van der Sar IG, Wijbenga N, Nakshbandi G, Aerts JGJV, Manintveld OC, Wijsenbeek MS, Hellemons ME, Moor CC. The smell of lung disease: a review of the current status of electronic nose technology. Respir Res 2021; 22:246. [PMID: 34535144 PMCID: PMC8448171 DOI: 10.1186/s12931-021-01835-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/26/2021] [Indexed: 02/08/2023] Open
Abstract
There is a need for timely, accurate diagnosis, and personalised management in lung diseases. Exhaled breath reflects inflammatory and metabolic processes in the human body, especially in the lungs. The analysis of exhaled breath using electronic nose (eNose) technology has gained increasing attention in the past years. This technique has great potential to be used in clinical practice as a real-time non-invasive diagnostic tool, and for monitoring disease course and therapeutic effects. To date, multiple eNoses have been developed and evaluated in clinical studies across a wide spectrum of lung diseases, mainly for diagnostic purposes. Heterogeneity in study design, analysis techniques, and differences between eNose devices currently hamper generalization and comparison of study results. Moreover, many pilot studies have been performed, while validation and implementation studies are scarce. These studies are needed before implementation in clinical practice can be realised. This review summarises the technical aspects of available eNose devices and the available evidence for clinical application of eNose technology in different lung diseases. Furthermore, recommendations for future research to pave the way for clinical implementation of eNose technology are provided.
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Affiliation(s)
- I G van der Sar
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - N Wijbenga
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - G Nakshbandi
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - J G J V Aerts
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - O C Manintveld
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M S Wijsenbeek
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M E Hellemons
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - C C Moor
- Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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16
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Metabolic Phenotypes in Asthmatic Adults: Relationship with Inflammatory and Clinical Phenotypes and Prognostic Implications. Metabolites 2021; 11:metabo11080534. [PMID: 34436475 PMCID: PMC8400680 DOI: 10.3390/metabo11080534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 12/26/2022] Open
Abstract
Bronchial asthma is a chronic disease that affects individuals of all ages. It has a high prevalence and is associated with high morbidity and considerable levels of mortality. However, asthma is not a single disease, and multiple subtypes or phenotypes (clinical, inflammatory or combinations thereof) can be detected, namely in aggregated clusters. Most studies have characterised asthma phenotypes and clusters of phenotypes using mainly clinical and inflammatory parameters. These studies are important because they may have clinical and prognostic implications and may also help to tailor personalised treatment approaches. In addition, various metabolomics studies have helped to further define the metabolic features of asthma, using electronic noses or targeted and untargeted approaches. Besides discriminating between asthma and a healthy state, metabolomics can detect the metabolic signatures associated with some asthma subtypes, namely eosinophilic and non-eosinophilic phenotypes or the obese asthma phenotype, and this may prove very useful in point-of-care application. Furthermore, metabolomics also discriminates between asthma and other “phenotypes” of chronic obstructive airway diseases, such as chronic obstructive pulmonary disease (COPD) or Asthma–COPD Overlap (ACO). However, there are still various aspects that need to be more thoroughly investigated in the context of asthma phenotypes in adequately designed, homogeneous, multicentre studies, using adequate tools and integrating metabolomics into a multiple-level approach.
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17
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Ibrahim W, Natarajan S, Wilde M, Cordell R, Monks PS, Greening N, Brightling CE, Evans R, Siddiqui S. A systematic review of the diagnostic accuracy of volatile organic compounds in airway diseases and their relation to markers of type-2 inflammation. ERJ Open Res 2021; 7:00030-2021. [PMID: 34476250 PMCID: PMC8405872 DOI: 10.1183/23120541.00030-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/27/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Asthma and COPD continue to cause considerable diagnostic and treatment stratification challenges. Volatile organic compounds (VOCs) have been proposed as feasible diagnostic and monitoring biomarkers in airway diseases. AIMS To 1) conduct a systematic review evaluating the diagnostic accuracy of VOCs in diagnosing airway diseases; 2) understand the relationship between reported VOCs and biomarkers of type-2 inflammation; 3) assess the standardisation of reporting according to STARD and TRIPOD criteria; 4) review current methods of breath sampling and analysis. METHODS A PRISMA-oriented systematic search was conducted (January 1997 to December 2020). Search terms included: "asthma", "volatile organic compound(s)", "VOC" and "COPD". Two independent reviewers examined the extracted titles against review objectives. RESULTS 44 full-text papers were included; 40/44 studies were cross-sectional and four studies were interventional in design; 17/44 studies used sensor-array technologies (e.g. eNose). Cross-study comparison was not possible across identified studies due to the heterogeneity in design. The commonest airway diseases differentiating VOCs belonged to carbonyl-containing classes (i.e. aldehydes, esters and ketones) and hydrocarbons (i.e. alkanes and alkenes). Although individual markers that are associated with clinical biomarkers of type-2 inflammation were recognised (i.e. ethane and 3,7-dimethylnonane for asthma and α-methylstyrene and decane for COPD), these were not consistently identified across studies. Only 3/44 reported following STARD or TRIPOD criteria for diagnostic accuracy and multivariate reporting, respectively. CONCLUSIONS Breath VOCs show promise as diagnostic biomarkers of airway diseases and for type-2 inflammation profiling. However, future studies should focus on transparent reporting of diagnostic accuracy and multivariate models and continue to focus on chemical identification of volatile metabolites.
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Affiliation(s)
- Wadah Ibrahim
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- These authors contributed equally
| | - Sushiladevi Natarajan
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- These authors contributed equally
| | - Michael Wilde
- Dept of Chemistry, University of Leicester, Leicester, UK
| | | | - Paul S. Monks
- Dept of Chemistry, University of Leicester, Leicester, UK
| | - Neil Greening
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Christopher E. Brightling
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Rachael Evans
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Salman Siddiqui
- Leicester NIHR Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
- Dept of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- See Acknowledgements for contributors
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18
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Jaeschke C, Padilla M, Glöckler J, Polaka I, Leja M, Veliks V, Mitrovics J, Leja M, Mizaikoff B. Modular Breath Analyzer (MBA): Introduction of a Breath Analyzer Platform Based on an Innovative and Unique, Modular eNose Concept for Breath Diagnostics and Utilization of Calibration Transfer Methods in Breath Analysis Studies. Molecules 2021; 26:3776. [PMID: 34205805 PMCID: PMC8235513 DOI: 10.3390/molecules26123776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 11/17/2022] Open
Abstract
Exhaled breath analysis for early disease detection may provide a convenient method for painless and non-invasive diagnosis. In this work, a novel, compact and easy-to-use breath analyzer platform with a modular sensing chamber and direct breath sampling unit is presented. The developed analyzer system comprises a compact, low volume, temperature-controlled sensing chamber in three modules that can host any type of resistive gas sensor arrays. Furthermore, in this study three modular breath analyzers are explicitly tested for reproducibility in a real-life breath analysis experiment with several calibration transfer (CT) techniques using transfer samples from the experiment. The experiment consists of classifying breath samples from 15 subjects before and after eating a specific meal using three instruments. We investigate the possibility to transfer calibration models across instruments using transfer samples from the experiment under study, since representative samples of human breath at some conditions are difficult to simulate in a laboratory. For example, exhaled breath from subjects suffering from a disease for which the biomarkers are mostly unknown. Results show that many transfer samples of all the classes under study (in our case meal/no meal) are needed, although some CT methods present reasonably good results with only one class.
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Affiliation(s)
- Carsten Jaeschke
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Albert-Einstein-Allee 11, 89081 Ulm, Germany; (C.J.); (J.G.)
| | - Marta Padilla
- JLM Innovation GmbH, Vor dem Kreuzberg 17, 72070 Tuebingen, Germany; (M.P.); (J.M.)
| | - Johannes Glöckler
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Albert-Einstein-Allee 11, 89081 Ulm, Germany; (C.J.); (J.G.)
| | - Inese Polaka
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1079 Riga, Latvia; (I.P.); (M.L.); (V.V.); (M.L.)
| | - Martins Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1079 Riga, Latvia; (I.P.); (M.L.); (V.V.); (M.L.)
| | - Viktors Veliks
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1079 Riga, Latvia; (I.P.); (M.L.); (V.V.); (M.L.)
| | - Jan Mitrovics
- JLM Innovation GmbH, Vor dem Kreuzberg 17, 72070 Tuebingen, Germany; (M.P.); (J.M.)
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, LV-1079 Riga, Latvia; (I.P.); (M.L.); (V.V.); (M.L.)
| | - Boris Mizaikoff
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Albert-Einstein-Allee 11, 89081 Ulm, Germany; (C.J.); (J.G.)
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19
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Abstract
PURPOSE OF REVIEW Severe asthma remains a debilitating disease and a challenge for the clinicians. Novel therapies have been introduced and have greatly improved asthma control and more are under development or in clinical studies. These include anti-IL5/IL5R, anti-IL4/IL4R, anti IL13, anti- thymic stromal lymphopoietin (TSLP) and more, and severe asthma is currently managed in personalized medicine approach. However, there is still an unmet need to discover new, clinically available biomarkers and targeted therapies for a large group of severe asthma patients, particularly those with T2-low asthma. In this review, we briefly present the phenotypes and endotypes of severe asthma, the omics technologies in asthma as well as current and future treatments for both T2-high and T2-low asthma. RECENT FINDINGS In this review, we are going to present the effectiveness and safety of anti-IL5 therapies, the clinical trials for dupilumab and tezepelumab and the most significant molecules and biological agents used in trials as possible treatments forT2-low asthma. SUMMARY Novel anti-IL5 agents have changed the management of T2-high asthma resulting in improved disease control, QoL and lung function and importantly, fewer exacerbations. Nevertheless, there is still the need to find new treatments, particularly for T2-low asthma, which remains a challenge.
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20
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Segreti A, Incalzi RA, Lombardi M, Miglionico M, Nusca A, Pennazza G, Santonico M, Grasso S, Grigioni F, Di Sciascio G. Characterization of inflammatory profile by breath analysis in chronic coronary syndromes. J Cardiovasc Med (Hagerstown) 2021; 21:675-681. [PMID: 32740499 DOI: 10.2459/jcm.0000000000001032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Exhaled breath contains thousands of volatile organic compounds (VOCs) produced during various metabolic processes both in health and disease.Analysis of breath with electronic nose BIONOTE-V allows modifications of exhaled VOCs to be studied, which are clinically recognized to be a marker for several disorders, including heart failure. New noninvasive tests based on VOCs analysis might be a useful tool for early detection of chronic coronary syndromes (CCS). METHODS Exhaled air was collected and measured in individuals with an indication to perform invasive coronary angiography (ICA). All patients' samples were obtained before ICA. RESULTS Analysis with BIONOTE-V was performed in a total cohort of 42 patients consecutively enrolled, of whom 19 did not require myocardial revascularization and 23 with indication for myocardial revascularization. BIONOTE-V was able to correctly identify 18 out of 23 patients affected by severe coronary artery disease (sensitivity = 78.3% and specificity = 68.4%). Our predicted model had a tight correlation with SYNTAX score (error of the BIONOTE-V = 15). CONCLUSION CCS patients have a distinctive fingerprint of exhaled breath, and analysis by BIONOTE-V has the potential for identifying these patients. Moreover, it seems that this technique can correctly identify patients according to anatomical disease severity at ICA. If the preliminary data of this proof of concept study will be confirmed, this rapid and noninvasive diagnostic tool able to identify CCS might have an impact in routine clinical practice.
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Affiliation(s)
| | | | | | | | | | - Giorgio Pennazza
- Unit of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy
| | - Marco Santonico
- Unit of Electronics for Sensor Systems, Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, Rome, Italy
| | - Simone Grasso
- Unit of Electronics for Sensor Systems, Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, Rome, Italy
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21
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Sharma R, Zang W, Zhou M, Schafer N, Begley LA, Huang YJ, Fan X. Real Time Breath Analysis Using Portable Gas Chromatography for Adult Asthma Phenotypes. Metabolites 2021; 11:265. [PMID: 33922762 PMCID: PMC8145057 DOI: 10.3390/metabo11050265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
Asthma is heterogeneous but accessible biomarkers to distinguish relevant phenotypes remain lacking, particularly in non-Type 2 (T2)-high asthma. Moreover, common clinical characteristics in both T2-high and T2-low asthma (e.g., atopy, obesity, inhaled steroid use) may confound interpretation of putative biomarkers and of underlying biology. This study aimed to identify volatile organic compounds (VOCs) in exhaled breath that distinguish not only asthmatic and non-asthmatic subjects, but also atopic non-asthmatic controls and also by variables that reflect clinical differences among asthmatic adults. A total of 73 participants (30 asthma, eight atopic non-asthma, and 35 non-asthma/non-atopic subjects) were recruited for this pilot study. A total of 79 breath samples were analyzed in real-time using an automated portable gas chromatography (GC) device developed in-house. GC-mass spectrometry was also used to identify the VOCs in breath. Machine learning, linear discriminant analysis, and principal component analysis were used to identify the biomarkers. Our results show that the portable GC was able to complete breath analysis in 30 min. A set of nine biomarkers distinguished asthma and non-asthma/non-atopic subjects, while sets of two and of four biomarkers, respectively, further distinguished asthmatic from atopic controls, and between atopic and non-atopic controls. Additional unique biomarkers were identified that discriminate subjects by blood eosinophil levels, obese status, inhaled corticosteroid treatment, and also acute upper respiratory illnesses within asthmatic groups. Our work demonstrates that breath VOC profiling can be a clinically accessible tool for asthma diagnosis and phenotyping. A portable GC system is a viable option for rapid assessment in asthma.
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Affiliation(s)
- Ruchi Sharma
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (R.S.); (W.Z.); (M.Z.)
| | - Wenzhe Zang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (R.S.); (W.Z.); (M.Z.)
| | - Menglian Zhou
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (R.S.); (W.Z.); (M.Z.)
| | - Nicole Schafer
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; (N.S.); (L.A.B.)
| | - Lesa A. Begley
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; (N.S.); (L.A.B.)
| | - Yvonne J. Huang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; (N.S.); (L.A.B.)
| | - Xudong Fan
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; (R.S.); (W.Z.); (M.Z.)
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22
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Liu L, Li W, He Z, Chen W, Liu H, Chen K, Pi X. Detection of lung cancer with electronic nose using a novel ensemble learning framework. J Breath Res 2021; 15. [PMID: 33578407 DOI: 10.1088/1752-7163/abe5c9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/12/2021] [Indexed: 02/02/2023]
Abstract
Breath analysis based on electronic nose (e-nose) is a promising new technology for the detection of lung cancer that is non-invasive, simple to operate and cost-effective. Lung cancer screening by e-nose relies on predictive models established using machine learning methods. However, using only a single machine learning method to detect lung cancer has some disadvantages, including low detection accuracy and high false negative rate. To address these problems, groups of individual learning models with excellent performance were selected from classic models, including Support Vector Machine, Decision Tree, Random Forest, Logistic Regression and K-nearest neighbor regression, to build an ensemble learning framework (PCA-SVE). The output result of the PCA-SVE framework was obtained by voting. To test this approach, we analyzed 214 breath samples measured by e-nose with 11 gas sensors of four types using the proposed PCA-SVE framework. Experimental results indicated that the accuracy, sensitivity, and specificity of the proposed framework were 95.75%, 94.78%, and 96.96%, respectively. This framework overcomes the disadvantages of a single model, thereby providing an improved, practical alternative for exhaled breath analysis by e-nose.
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Affiliation(s)
- Lei Liu
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, P.R. China, Chongqing, Chongqing, 400044, CHINA
| | - Wang Li
- School of Pharmacy and Bioengineering, Chongqing University of Technology, No.174 Shazhengjie, Shapingba, Chongqing, Chongqing, 400044, CHINA
| | - ZiChun He
- Chongqing Red Cross Hospital (People's Hospital of Jiangbei District), Chongqing Red Cross Hospital, 168 Hai'er Rd, Chongqing, 400020 , CHINA
| | - Weimin Chen
- Kunming University, No.727 South Jingming Rd, Chenggong District, Kunming, Yunnan, 650500, CHINA
| | - Hongying Liu
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, No.174 Shazhengjie, Shapingba, Chongqing, Chongqing, 400044, CHINA
| | - Ke Chen
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, , Chongqing University, No.174 Shazhengjie, Shapingba, Chongqing, Chongqing, 400044, CHINA
| | - Xitian Pi
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, , Chongqing University, No.174 Shazhengjie, Shapingba, Chongqing, Chongqing, 400044, CHINA
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23
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Bobak CA, Kang L, Workman L, Bateman L, Khan MS, Prins M, May L, Franchina FA, Baard C, Nicol MP, Zar HJ, Hill JE. Breath can discriminate tuberculosis from other lower respiratory illness in children. Sci Rep 2021; 11:2704. [PMID: 33526828 PMCID: PMC7851130 DOI: 10.1038/s41598-021-80970-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/28/2020] [Indexed: 01/30/2023] Open
Abstract
Pediatric tuberculosis (TB) remains a global health crisis. Despite progress, pediatric patients remain difficult to diagnose, with approximately half of all childhood TB patients lacking bacterial confirmation. In this pilot study (n = 31), we identify a 4-compound breathprint and subsequent machine learning model that accurately classifies children with confirmed TB (n = 10) from children with another lower respiratory tract infection (LRTI) (n = 10) with a sensitivity of 80% and specificity of 100% observed across cross validation folds. Importantly, we demonstrate that the breathprint identified an additional nine of eleven patients who had unconfirmed clinical TB and whose symptoms improved while treated for TB. While more work is necessary to validate the utility of using patient breath to diagnose pediatric TB, it shows promise as a triage instrument or paired as part of an aggregate diagnostic scheme.
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Affiliation(s)
- Carly A. Bobak
- grid.254880.30000 0001 2179 2404Thayer School of Engineering, Dartmouth College, Hanover, NH USA ,grid.254880.30000 0001 2179 2404Geisel School of Medicine, Dartmouth College, Hanover, NH USA
| | - Lili Kang
- grid.254880.30000 0001 2179 2404Thayer School of Engineering, Dartmouth College, Hanover, NH USA
| | - Lesley Workman
- grid.415742.10000 0001 2296 3850Department of Pediatrics and Child Health, MRC Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Lindy Bateman
- grid.415742.10000 0001 2296 3850Department of Pediatrics and Child Health, MRC Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Mohammad S. Khan
- grid.254880.30000 0001 2179 2404Thayer School of Engineering, Dartmouth College, Hanover, NH USA
| | - Margaretha Prins
- grid.415742.10000 0001 2296 3850Department of Pediatrics and Child Health, MRC Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Lloyd May
- grid.254880.30000 0001 2179 2404Thayer School of Engineering, Dartmouth College, Hanover, NH USA
| | - Flavio A. Franchina
- grid.254880.30000 0001 2179 2404Thayer School of Engineering, Dartmouth College, Hanover, NH USA ,grid.4861.b0000 0001 0805 7253Molecular Systems, Organic and Biological Analytical Chemistry Group, University of Liège, Liège, Belgium
| | - Cynthia Baard
- grid.415742.10000 0001 2296 3850Department of Pediatrics and Child Health, MRC Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Mark P. Nicol
- grid.7836.a0000 0004 1937 1151Division of Medical Microbiology and Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa ,grid.1012.20000 0004 1936 7910School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Heather J. Zar
- grid.415742.10000 0001 2296 3850Department of Pediatrics and Child Health, MRC Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - Jane E. Hill
- grid.254880.30000 0001 2179 2404Thayer School of Engineering, Dartmouth College, Hanover, NH USA
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Tozlu BH, Şimşek C, Aydemir O, Karavelioglu Y. A High performance electronic nose system for the recognition of myocardial infarction and coronary artery diseases. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2020.102247] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lammers A, van Bragt J, Brinkman P, Neerincx A, Bos L, Vijverberg S, Maitland-van der Zee A. Breathomics in Chronic Airway Diseases. SYSTEMS MEDICINE 2021. [DOI: 10.1016/b978-0-12-801238-3.11589-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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26
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Das N, Topalovic M, Janssens W. AIM in Respiratory Disorders. Artif Intell Med 2021. [DOI: 10.1007/978-3-030-58080-3_178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mule NM, Patil DD, Kaur M. A comprehensive survey on investigation techniques of exhaled breath (EB) for diagnosis of diseases in human body. INFORMATICS IN MEDICINE UNLOCKED 2021. [DOI: 10.1016/j.imu.2021.100715] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Volatile Organic Compounds in Exhaled Breath as Fingerprints of Lung Cancer, Asthma and COPD. J Clin Med 2020; 10:jcm10010032. [PMID: 33374433 PMCID: PMC7796324 DOI: 10.3390/jcm10010032] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/14/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022] Open
Abstract
Lung cancer, chronic obstructive pulmonary disease (COPD) and asthma are inflammatory diseases that have risen worldwide, posing a major public health issue, encompassing not only physical and psychological morbidity and mortality, but also incurring significant societal costs. The leading cause of death worldwide by cancer is that of the lung, which, in large part, is a result of the disease often not being detected until a late stage. Although COPD and asthma are conditions with considerably lower mortality, they are extremely distressful to people and involve high healthcare overheads. Moreover, for these diseases, diagnostic methods are not only costly but are also invasive, thereby adding to people’s stress. It has been appreciated for many decades that the analysis of trace volatile organic compounds (VOCs) in exhaled breath could potentially provide cheaper, rapid, and non-invasive screening procedures to diagnose and monitor the above diseases of the lung. However, after decades of research associated with breath biomarker discovery, no breath VOC tests are clinically available. Reasons for this include the little consensus as to which breath volatiles (or pattern of volatiles) can be used to discriminate people with lung diseases, and our limited understanding of the biological origin of the identified VOCs. Lung disease diagnosis using breath VOCs is challenging. Nevertheless, the numerous studies of breath volatiles and lung disease provide guidance as to what volatiles need further investigation for use in differential diagnosis, highlight the urgent need for non-invasive clinical breath tests, illustrate the way forward for future studies, and provide significant guidance to achieve the goal of developing non-invasive diagnostic tests for lung disease. This review provides an overview of these issues from evaluating key studies that have been undertaken in the years 2010–2019, in order to present objective and comprehensive updated information that presents the progress that has been made in this field. The potential of this approach is highlighted, while strengths, weaknesses, opportunities, and threats are discussed. This review will be of interest to chemists, biologists, medical doctors and researchers involved in the development of analytical instruments for breath diagnosis.
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Potential of the Electronic Nose for the Detection of Respiratory Diseases with and without Infection. Int J Mol Sci 2020; 21:ijms21249416. [PMID: 33321951 PMCID: PMC7763696 DOI: 10.3390/ijms21249416] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/16/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023] Open
Abstract
Respiratory tract infections are common, and when affecting the lower airways and lungs, can result in significant morbidity and mortality. There is an unfilled need for simple, non-invasive tools that can be used to screen for such infections at the clinical point of care. The electronic nose (eNose) is a novel technology that detects volatile organic compounds (VOCs). Early studies have shown that certain diseases and infections can result in characteristic changes in VOC profiles in the exhaled breath. This review summarizes current knowledge on breath analysis by the electronic nose and its potential for the detection of respiratory diseases with and without infection.
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Holden KA, Ibrahim W, Salman D, Cordell R, McNally T, Patel B, Phillips R, Beardsmore C, Wilde M, Bryant L, Singapuri A, Monks P, Brightling C, Greening N, Thomas P, Siddiqui S, Gaillard EA. Use of the ReCIVA device in breath sampling of patients with acute breathlessness: a feasibility study. ERJ Open Res 2020; 6:00119-2020. [PMID: 33263021 PMCID: PMC7680907 DOI: 10.1183/23120541.00119-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/17/2020] [Indexed: 01/24/2023] Open
Abstract
Introduction Investigating acute multifactorial undifferentiated breathlessness and understanding the driving inflammatory processes can be technically challenging in both adults and children. Being able to validate noninvasive methods such as breath analysis would be a huge clinical advance. The ReCIVA® device allows breath samples to be collected directly onto sorbent tubes at the bedside for analysis of exhaled volatile organic compounds (eVOCs). We aimed to assess the feasibility of using this device in acutely breathless patients. Methods Adults hospitalised with acute breathlessness and children aged 5–16 years with acute asthma or chronic stable asthma, as well as healthy adult and child volunteers, were recruited. Breath samples were collected onto sorbent tubes using the ReCIVA® device and sent for analysis by means of two-dimensional gas chromatography-mass spectrometry (GCxGC-MS). The NASA Task Load Index (NASA-TLX) was used to assess the perceived task workload of undertaking sampling from the patient's perspective. Results Data were available for 65 adults and 61 children recruited. In total, 98.4% of adults and 75.4% of children were able to provide the full target breath sample using the ReCIVA® device. NASA-TLX measurements were available in the adult population with mean values of 3.37 for effort, 2.34 for frustration, 3.8 for mental demand, 2.8 for performance, 3.9 for physical demand and 2.8 for temporal demand. Discussion This feasibility study demonstrates it is possible and acceptable to collect breath samples from both adults and children at the bedside for breathomics analysis using the ReCIVA® device. It is feasible to collect breath samples for breath analysis at the bedside using the ReCIVA device in acutely breathless adults and childrenhttps://bit.ly/2ZTonWo
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Affiliation(s)
- Karl A Holden
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK.,These authors contributed equally
| | - Wadah Ibrahim
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK.,These authors contributed equally
| | | | | | - Teresa McNally
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
| | - Bharti Patel
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
| | - Rachael Phillips
- NIHR Leicester Clinical Research Facility, Leicester Royal Infirmary, Leicester, UK
| | - Caroline Beardsmore
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
| | - Michael Wilde
- Dept of Chemistry, University of Leicester, Leicester, UK
| | - Luke Bryant
- Dept of Chemistry, University of Leicester, Leicester, UK
| | - Amisha Singapuri
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
| | - Paul Monks
- Dept of Chemistry, University of Leicester, Leicester, UK
| | - Chris Brightling
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
| | - Neil Greening
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
| | - Paul Thomas
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK
| | - Salman Siddiqui
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK.,These authors contributed equally
| | - Erol A Gaillard
- NIHR Leicester Biomedical Research Centre (Respiratory Theme), Glenfield Hospital, Leicester, UK.,These authors contributed equally
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Zanella D, Henket M, Schleich F, Dejong T, Louis R, Focant JF, Stefanuto PH. Comparison of the effect of chemically and biologically induced inflammation on the volatile metabolite production of lung epithelial cells by GC×GC-TOFMS. Analyst 2020; 145:5148-5157. [PMID: 32633741 DOI: 10.1039/d0an00720j] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Exhaled breath analysis has a high potential for early non-invasive diagnosis of lung inflammatory diseases, such as asthma. The characterization and understanding of the inflammatory metabolic pathways involved into volatile organic compounds (VOCs) production could bring exhaled breath analysis into clinical practice and thus open new therapeutic routes for inflammatory diseases. In this study, lung inflammation was simulated in vitro using A549 epithelial cells. We compared the VOC production from A549 epithelial cells after a chemically induced oxidative stress in vitro, exposing the cells to H2O2, and a biological stress, exposing the cells to an inflammatory pool of sputum supernatants. Special attention was devoted to define proper negative and positive controls (8 different types) for our in vitro models, including healthy sputum co-culture. Sputum from 25 asthmatic and 8 healthy patients were collected to create each pool of supernatants. Each sample type was analyzed in 4 replicates using solid-phase microextraction (SPME) comprehensive two-dimensional gas chromatography hyphenated to time-of-flight mass spectrometry (GC×GC-TOFMS). This approach offers high resolving power for complex VOC mixtures. According to the type of inflammation induced, significantly different VOCs were produced by the epithelial cells compared to all controls. For both chemical and biological challenges, an increase of carbonyl compounds (54%) and hydrocarbons (31%) was observed. Interestingly, only the biological inflammation model showed a significant cell proliferation together with an increased VOC production linked to asthma airway inflammation. This study presents a complete GC×GC-TOFMS workflow for in vitro VOC analysis, and its potential to characterize complex lung inflammatory mechanisms.
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Affiliation(s)
- Delphine Zanella
- University of Liege, Molecular System, Organic & Biological Analytical Chemistry Group, 11 Allee du Six Aout, 4000 Liege, Belgium.
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Freddi S, Emelianov AV, Bobrinetskiy II, Drera G, Pagliara S, Kopylova DS, Chiesa M, Santini G, Mores N, Moscato U, Nasibulin AG, Montuschi P, Sangaletti L. Development of a Sensing Array for Human Breath Analysis Based on SWCNT Layers Functionalized with Semiconductor Organic Molecules. Adv Healthc Mater 2020; 9:e2000377. [PMID: 32378358 DOI: 10.1002/adhm.202000377] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/09/2020] [Indexed: 02/04/2023]
Abstract
A sensor array based on heterojunctions between semiconducting organic layers and single walled carbon nanotube (SWCNT) films is produced to explore applications in breathomics, the molecular analysis of exhaled breath. The array is exposed to gas/volatiles relevant to specific diseases (ammonia, ethanol, acetone, 2-propanol, sodium hypochlorite, benzene, hydrogen sulfide, and nitrogen dioxide). Then, to evaluate its capability to operate with real relevant biological samples the array is exposed to human breath exhaled from healthy subjects. Finally, to provide a proof of concept of its diagnostic potential, the array is exposed to exhaled breath samples collected from subjects with chronic obstructive pulmonary disease (COPD), an airway chronic inflammatory disease not yet investigated with CNT-based sensor arrays, and breathprints are compared with those obtained from of healthy subjects. Principal component analysis shows that the sensor array is able to detect various target gas/volatiles with a clear fingerprint on a 2D subspace, is suitable for breath profiling in exhaled human breath, and is able to distinguish subjects with COPD from healthy subjects based on their breathprints. This classification ability is further improved by selecting the most responsive sensors to nitrogen dioxide, a potential biomarker of COPD.
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Affiliation(s)
- Sonia Freddi
- Mathematics and Physics DepartmentUniversità Cattolica del Sacro Cuore via dei Musei 41 Brescia 25121 Italy
- Surface Science and Spectroscopy Lab @ I‐LampUniversità Cattolica del Sacro Cuore Brescia 25121 Italy
- Department of ChemistryDivision of Molecular Imaging and PhotonicsKU Leuven Celestijnenlaan 200F Leuven 3001 Belgium
| | - Aleksei V. Emelianov
- National Research University of Electronic Technology Zelenograd Moscow 124498 Russia
- P.N. Lebedev Physical Institute of the Russian Academy of Sciences Moscow 119991 Russia
| | - Ivan I. Bobrinetskiy
- National Research University of Electronic Technology Zelenograd Moscow 124498 Russia
- BioSense Institute – Research and Development Institute for Information Technologies in BiosystemsUniversity of Novi Sad Dr Zorana Djindjica 1a Novi Sad 21000 Serbia
| | - Giovanni Drera
- Mathematics and Physics DepartmentUniversità Cattolica del Sacro Cuore via dei Musei 41 Brescia 25121 Italy
- Surface Science and Spectroscopy Lab @ I‐LampUniversità Cattolica del Sacro Cuore Brescia 25121 Italy
| | - Stefania Pagliara
- Mathematics and Physics DepartmentUniversità Cattolica del Sacro Cuore via dei Musei 41 Brescia 25121 Italy
- Surface Science and Spectroscopy Lab @ I‐LampUniversità Cattolica del Sacro Cuore Brescia 25121 Italy
| | | | - Maria Chiesa
- Mathematics and Physics DepartmentUniversità Cattolica del Sacro Cuore via dei Musei 41 Brescia 25121 Italy
| | - Giuseppe Santini
- Department of PharmacologyFaculty of MedicineCatholic University of the Sacred HeartFondazione Policlinico Universitario Agostino GemelliIRCCS Largo Francesco Vito, 1 Roma 00168 Italy
| | - Nadia Mores
- Department of PharmacologyFaculty of MedicineCatholic University of the Sacred HeartFondazione Policlinico Universitario Agostino GemelliIRCCS Largo Francesco Vito, 1 Roma 00168 Italy
| | - Umberto Moscato
- Occupational MedicineFaculty of MedicineCatholic University of the Sacred HeartFondazione Policlinico Universitario Agostino GemelliIRCCS Largo Francesco Vito, 1 Roma 00168 Italy
| | - Albert G. Nasibulin
- Skolkovo Institute of Science and Technology Moscow 121205 Russia
- Aalto University P. O. Box 16100 Aalto FI‐00076 Finland
| | - Paolo Montuschi
- Department of PharmacologyFaculty of MedicineCatholic University of the Sacred HeartFondazione Policlinico Universitario Agostino GemelliIRCCS Largo Francesco Vito, 1 Roma 00168 Italy
| | - Luigi Sangaletti
- Mathematics and Physics DepartmentUniversità Cattolica del Sacro Cuore via dei Musei 41 Brescia 25121 Italy
- Surface Science and Spectroscopy Lab @ I‐LampUniversità Cattolica del Sacro Cuore Brescia 25121 Italy
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Peel AM, Wilkinson M, Sinha A, Loke YK, Fowler SJ, Wilson AM. Volatile organic compounds associated with diagnosis and disease characteristics in asthma - A systematic review. Respir Med 2020; 169:105984. [PMID: 32510334 DOI: 10.1016/j.rmed.2020.105984] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 03/30/2020] [Accepted: 04/19/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Metabolomics refers to study of the metabolome, the entire set of metabolites produced by a biological system. The application of metabolomics to exhaled breath samples - breathomics - is a rapidly growing field with potential application to asthma diagnosis and management. OBJECTIVES We aimed to review the adult asthma breathomic literature and present a comprehensive list of volatile organic compounds identified by asthma breathomic models. METHODS We undertook a systematic search for literature on exhaled volatile organic compounds in adult asthma. We assessed the quality of studies and performed a qualitative synthesis. RESULTS We identified twenty studies; these were methodologically heterogenous with a variable risk of bias. Studies almost universally reported breathomics to be capable of differentiating - with moderate or greater accuracy - between samples from healthy controls and those with asthma; and to be capable of phenotyping disease. However, there was little concordance in the compounds upon which discriminatory models were based. CONCLUSION Results to-date are promising but validation in independent prospective cohorts is needed. This may be challenging given the high levels of inter-individual variation. However, large-scale, multi-centre studies are underway and validation efforts have been aided by the publication of technical standards likely to increase inter-study comparability. Successful validation of breathomic models for diagnosis and phenotyping would constitute an important step towards personalised medicine in asthma.
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Affiliation(s)
- Adam M Peel
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Maxim Wilkinson
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester; Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Ashnish Sinha
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Yoon K Loke
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Stephen J Fowler
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester; Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Andrew M Wilson
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
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Schleich FN, Zanella D, Stefanuto PH, Bessonov K, Smolinska A, Dallinga JW, Henket M, Paulus V, Guissard F, Graff S, Moermans C, Wouters EFM, Van Steen K, van Schooten FJ, Focant JF, Louis R. Exhaled Volatile Organic Compounds Are Able to Discriminate between Neutrophilic and Eosinophilic Asthma. Am J Respir Crit Care Med 2020; 200:444-453. [PMID: 30973757 DOI: 10.1164/rccm.201811-2210oc] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Rationale: Analysis of exhaled breath for asthma phenotyping using endogenously generated volatile organic compounds (VOCs) offers the possibility of noninvasive diagnosis and therapeutic monitoring. Induced sputum is indeed not widely available and markers of neutrophilic asthma are still lacking.Objectives: To determine whether analysis of exhaled breath using endogenously generated VOCs can be a surrogate marker for recognition of sputum inflammatory phenotypes.Methods: We conducted a prospective study on 521 patients with asthma recruited from the University Asthma Clinic of Liege. Patients underwent VOC measurement, fraction of exhaled nitric oxide (FeNO) spirometry, sputum induction, and gave a blood sample. Subjects with asthma were classified in three inflammatory phenotypes according to their sputum granulocytic cell count.Measurements and Main Results: In the discovery study, seven potential biomarkers were highlighted by gas chromatography-mass spectrometry in a training cohort of 276 patients with asthma. In the replication study (n = 245), we confirmed four VOCs of interest to discriminate among asthma inflammatory phenotypes using comprehensive two-dimensional gas chromatography coupled to high-resolution time-of-flight mass spectrometry. Hexane and 2-hexanone were identified as compounds with the highest classification performance in eosinophilic asthma with accuracy comparable to that of blood eosinophils and FeNO. Moreover, the combination of FeNO, blood eosinophils, and VOCs gave a very good prediction of eosinophilic asthma (area under the receiver operating characteristic curve, 0.9). For neutrophilic asthma, the combination of nonanal, 1-propanol, and hexane had a classification performance similar to FeNO or blood eosinophils in eosinophilic asthma. Those compounds were found in higher levels in neutrophilic asthma.Conclusions: Our study is the first attempt to characterize VOCs according to sputum granulocytic profile in a large population of patients with asthma and provide surrogate markers for neutrophilic asthma.
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Affiliation(s)
| | | | | | - Kirill Bessonov
- 3Medical Genomics-BIO3, GIGA-R, University of Liege, Sart-Tilman, Liege, Belgium
| | - Agnieska Smolinska
- 4Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands; and
| | - Jan W Dallinga
- 4Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands; and
| | - Monique Henket
- 1Respiratory Medicine, GIGA I3, CHU Sart-Tilman, Liege, Belgium
| | - Virginie Paulus
- 1Respiratory Medicine, GIGA I3, CHU Sart-Tilman, Liege, Belgium
| | | | - Sophie Graff
- 1Respiratory Medicine, GIGA I3, CHU Sart-Tilman, Liege, Belgium
| | | | - Emiel F M Wouters
- 5Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Kristel Van Steen
- 3Medical Genomics-BIO3, GIGA-R, University of Liege, Sart-Tilman, Liege, Belgium
| | - Frederik-Jan van Schooten
- 4Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands; and
| | | | - Renaud Louis
- 1Respiratory Medicine, GIGA I3, CHU Sart-Tilman, Liege, Belgium
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Töreyin ZN, Ghosh M, Göksel Ö, Göksel T, Godderis L. Exhaled Breath Analysis in Diagnosis of Malignant Pleural Mesothelioma: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1110. [PMID: 32050546 PMCID: PMC7036862 DOI: 10.3390/ijerph17031110] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 12/12/2022]
Abstract
Malignant pleural mesothelioma (MPM) is mainly related to previous asbestos exposure. There is still dearth of information on non-invasive biomarkers to detect MPM at early stages. Human studies on exhaled breath biomarkers of cancer and asbestos-related diseases show encouraging results. The aim of this systematic review was to provide an overview on the current knowledge about exhaled breath analysis in MPM diagnosis. A systematic review was conducted on MEDLINE (PubMed), EMBASE and Web of Science databases to identify relevant studies. Quality assessment was done by the Newcastle-Ottawa Scale. Six studies were identified, all of which showed fair quality and explored volatile organic compounds (VOC) based breath profile using Gas Chromatography Coupled to Mass Spectrometry (GC-MS), Ion Mobility Spectrometry Coupled to Multi-capillary Columns (IMS-MCC) or pattern-recognition technologies. Sample sizes varied between 39 and 330. Some compounds (i.e, cyclohexane, P3, P5, P50, P71, diethyl ether, limonene, nonanal, VOC IK 1287) that can be indicative of MPM development in asbestos exposed population were identified with high diagnostic accuracy rates. E-nose studies reported breathprints being able to distinguish MPM from asbestos exposed individuals with high sensitivity and a negative predictive value. Small sample sizes and methodological diversities among studies limit the translation of results into clinical practice. More prospective studies with standardized methodologies should be conducted on larger populations.
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Affiliation(s)
- Zehra Nur Töreyin
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
| | - Manosij Ghosh
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
| | - Özlem Göksel
- Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Laboratory of Occupational and Environmental Respiratory Diseases, Bornova, 35100 Izmir, Turkey;
| | - Tuncay Göksel
- Ege University, Faculty of Medicine, Department of Pulmonary Medicine, Bornova, 35100 Izmir, Turkey;
| | - Lode Godderis
- University of Leuven (KU Leuven), Department of Public Health and Primary Care, Centre for Environment and Health, 3000 Leuven, Belgium; (M.G.); (L.G.)
- Idewe, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
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Takke A, Shende P. Non-invasive Biodiversified Sensors: A Modernized Screening Technology for Cancer. Curr Pharm Des 2019; 25:4108-4120. [DOI: 10.2174/1381612825666191022162232] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/14/2019] [Indexed: 01/30/2023]
Abstract
Background:
Biological sensors revolutionize the method of diagnoses of diseases from early to final
stages using the biomarkers present in the body. Biosensors are advantageous due to the involvement of minimal
sample collection with improved specificity and sensitivity for the detection of biomarkers.
Methods:
Conventional biopsies restrict problems like patient non-compliance, cross-infection and high cost and to
overcome these issues biological samples like saliva, sweat, urine, tears and sputum progress into clinical and diagnostic
research for the development of non-invasive biosensors. This article covers various non-invasive measurements
of biological samples, optical-based, mass-based, wearable and smartphone-based biosensors for the detection
of cancer.
Results:
The demand for non-invasive, rapid and economic analysis techniques escalated due to the modernization
of the introduction of self-diagnostics and miniature forms of devices. Biosensors have high sensitivity and
specificity for whole cells, microorganisms, enzymes, antibodies, and genetic materials.
Conclusion:
Biosensors provide a reliable early diagnosis of cancer, which results in faster therapeutic outcomes
with in-depth fundamental understanding of the disease progression.
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Affiliation(s)
- Anjali Takke
- Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM's NMIMS, V. L. Mehta Road, Vile Parle (W), Mumbai, India
| | - Pravin Shende
- Shobhaben Pratapbhai Patel School of Pharmacy and Technology Management, SVKM's NMIMS, V. L. Mehta Road, Vile Parle (W), Mumbai, India
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Lu B, Fu L, Nie B, Peng Z, Liu H. A Novel Framework with High Diagnostic Sensitivity for Lung Cancer Detection by Electronic Nose. SENSORS 2019; 19:s19235333. [PMID: 31817006 PMCID: PMC6928832 DOI: 10.3390/s19235333] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 12/11/2022]
Abstract
The electronic nose (e-nose) system is a newly developing detection technology for its advantages of non-invasiveness, simple operation, and low cost. However, lung cancer screening through e-nose requires effective pattern recognition frameworks. Existing frameworks rely heavily on hand-crafted features and have relatively low diagnostic sensitivity. To handle these problems, gated recurrent unit based autoencoder (GRU-AE) is adopted to automatically extract features from temporal and high-dimensional e-nose data. Moreover, we propose a novel margin and sensitivity based ordering ensemble pruning (MSEP) model for effective classification. The proposed heuristic model aims to reduce missed diagnosis rate of lung cancer patients while maintaining a high rate of overall identification. In the experiments, five state-of-the-art classification models and two popular dimensionality reduction methods were involved for comparison to demonstrate the validity of the proposed GRU-AE-MSEP framework, through 214 collected breath samples measured by e-nose. Experimental results indicated that the proposed intelligent framework achieved high sensitivity of 94.22%, accuracy of 93.55%, and specificity of 92.80%, thereby providing a new practical means for wide disease screening by e-nose in medical scenarios.
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Affiliation(s)
- Binchun Lu
- Chongqing University-University of Cincinnati Joint Co-op Institute, Chongqing University, Chongqing 400030, China; (B.L.); (L.F.)
| | - Lidan Fu
- Chongqing University-University of Cincinnati Joint Co-op Institute, Chongqing University, Chongqing 400030, China; (B.L.); (L.F.)
| | - Bo Nie
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China;
| | - Zhiyun Peng
- State Key Laboratory of Power Transmission Equipment & System Security and New Technology, Chongqing University, Chongqing 400030, China;
| | - Hongying Liu
- Key Laboratory of Biotechnology Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China;
- Correspondence:
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Narendra D, Blixt J, Hanania NA. Immunological biomarkers in severe asthma. Semin Immunol 2019; 46:101332. [PMID: 31735516 DOI: 10.1016/j.smim.2019.101332] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 12/13/2022]
Abstract
Severe asthma is heterogeneous in its clinical presentation, underlying pathophysiology, course and response to therapy. Clinical and physiological assessment of severe asthma is often inadequate in predicting underlying disease mechanisms and or response to medications. With the emergence of novel targeted therapies in severe asthma, the need for reproducible, easily measured biomarkers became obvious but only few are currently available for clinical use. These biomarkers along with the clinical presentation of the patient play an important role in identifying phenotypes and endotypes, predicting the clinical course and prognosis and improving the precision therapeutic approach to asthma.
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Affiliation(s)
- Dharani Narendra
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, United States
| | - John Blixt
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, United States
| | - Nicola A Hanania
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, United States.
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Azim A, Barber C, Dennison P, Riley J, Howarth P. Exhaled volatile organic compounds in adult asthma: a systematic review. Eur Respir J 2019; 54:13993003.00056-2019. [PMID: 31273044 DOI: 10.1183/13993003.00056-2019] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022]
Abstract
The search for biomarkers that can guide precision medicine in asthma, particularly those that can be translated to the clinic, has seen recent interest in exhaled volatile organic compounds (VOCs). Given the number of studies reporting "breathomics" findings and its growing integration in clinical trials, we performed a systematic review of the literature to summarise current evidence and understanding of breathomics technology in asthma.A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-oriented systematic search was performed (CRD42017084145) of MEDLINE, Embase and the Cochrane databases to search for any reports that assessed exhaled VOCs in adult asthma patients, using the following terms (asthma AND (volatile organic compounds AND exhaled) OR breathomics).Two authors independently determined the eligibility of 2957 unique records, of which 66 underwent full-text review. Data extraction and risk of bias assessment was performed on the 22 studies deemed to fulfil the search criteria. The studies are described in terms of methodology and the evidence narratively summarised under the following clinical headings: diagnostics, phenotyping, treatment stratification, treatment monitoring and exacerbation prediction/assessment.Our review found that most studies were designed to assess diagnostic potential rather than focus on underlying biology or treatable traits. Results are generally limited by a lack of methodological standardisation and external validation and by insufficiently powered studies, but there is consistency across the literature that exhaled VOCs are sensitive to underlying inflammation. Modern studies are applying robust breath analysis workflows to large multi-centre study designs, which should unlock the full potential of measurement of exhaled volatile organic compounds in airways diseases such as asthma.
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Affiliation(s)
- Adnan Azim
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK .,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Clair Barber
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Paddy Dennison
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - John Riley
- Galaxy Asthma, GSK, Medicines Research Centre, Stevenage, UK
| | - Peter Howarth
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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40
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Hashoul D, Haick H. Sensors for detecting pulmonary diseases from exhaled breath. Eur Respir Rev 2019; 28:28/152/190011. [PMID: 31243097 PMCID: PMC9489036 DOI: 10.1183/16000617.0011-2019] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/13/2019] [Indexed: 01/09/2023] Open
Abstract
This review presents and discusses a new frontier for fast, risk-free and potentially inexpensive diagnostics of respiratory diseases by detecting volatile organic compounds (VOCs) present in exhaled breath. One part of the review is a didactic presentation of the overlaying concept and the chemistry of exhaled breath. The other part discusses diverse sensors that have been developed and used for the detection of respiratory diseases (e.g. chronic obstructive pulmonary disease, asthma, lung cancer, pulmonary arterial hypertension, tuberculosis, cystic fibrosis, obstructive sleep apnoea syndrome and pneumoconiosis) by analysis of VOCs in exhaled breath. The strengths and pitfalls are discussed and criticised, particularly in the perspective in disseminating information regarding these advances. Ideas regarding the improvement of sensors, sensor arrays, sensing devices and the further planning of workflow are also discussed. Detection of volatile organic compounds from exhaled breath by nanomaterial-based sensors is a new diagnostics frontier in the screening of pulmonary diseases.http://bit.ly/2JoBKXn
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Affiliation(s)
- Dina Hashoul
- Dept of Chemical Engineering, Russell Berrie Nanotechnology Institute, and the Technion Integrated Cancer Center, Haifa, Israel
| | - Hossam Haick
- Dept of Chemical Engineering, Russell Berrie Nanotechnology Institute, and the Technion Integrated Cancer Center, Haifa, Israel
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Bannier MAGE, van de Kant KDG, Jöbsis Q, Dompeling E. Feasibility and diagnostic accuracy of an electronic nose in children with asthma and cystic fibrosis. J Breath Res 2019; 13:036009. [PMID: 30213921 DOI: 10.1088/1752-7163/aae158] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The measurement of volatile organic compounds (VOCs) in exhaled breath is a promising tool for diagnosing and monitoring various lung diseases in children. Gas chromatography mass spectrometry (GC-MS) analysis is a frequently used standard technique for VOCs analysis. However, as GC-MS is an expensive and time-consuming technique, hand-held devices or electronic noses have been developed. Recently, the Aeonose was introduced as an easy-to-use hand-held eNose capable of point-of-care testing. Although first results using this eNose in adults are promising, studies in children are lacking. We therefore performed a cross-sectional study in 55 children and adolescents ≥6 years of age (20 children with moderate to severe asthma, 13 children with CF, and 22 healthy controls). The feasibility of the Aeonose was high (>98% successful measurements). The diagnostic accuracy was high for discriminating asthma from CF (Area Under the Receiver Operating Characteristic Curve [AUC] 0.90 [95% Confidence Interval 0.78-1.00] sensitivity 89% [65%-98%], specificity 77% [46%-94%]), and for the distinction between CF and healthy controls (AUC 0.87 [0.74-1.00], sensitivity 85% [54%-97%], specificity 77% [54%-91%]). However, the diagnostic accuracy for the discrimination between asthma and healthy controls was modest (AUC 0.79 [0.63-0.94], sensitivity 74% [49%-90%], specificity 91% [69%-98%]). This is the first study to report test results of the Aeonose in children and adolescents ≥6 years. This eNose showed a high feasibility with modest to good diagnostic accuracies in asthma and CF. This study was registered at clinicaltrial.gov (NCT03377686).
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Affiliation(s)
- Michiel A G E Bannier
- Department of Paediatric Respiratory Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre+, Maastricht, The Netherlands
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Fasola S, Ferrante G, Sabatini A, Santonico M, Zompanti A, Grasso S, Antonelli Incalzi R, La Grutta S. Repeatability of exhaled breath fingerprint collected by a modern sampling system in asthmatic and healthy children. J Breath Res 2019; 13:036007. [PMID: 30965288 DOI: 10.1088/1752-7163/ab1765] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
E-noses provide potential non-invasive metabolic biomarkers for diagnosing and monitoring pulmonary diseases. The primary aim of the present study was to assess the within-day and between-day repeatability of a modern breath sampling system (Pneumopipe® plus an array of e-nose sensors) in asthmatic and healthy children. The secondary aim was to compare the repeatability of the breath sampling system, spirometry and exhaled nitric oxide (eNO). Fifteen children (age 6-11 years) with asthma and thirty healthy children matched by age and gender (1:2 allocation) were recruited; of them, three healthy children did not complete the study. All measurements were collected twice during the baseline visit, 30 min apart, and once during the final visit, after 7 d. Repeatability was assessed through the intra-cluster correlation coefficient (ICC), and a significance test was performed to detect an at least 'fair' repeatability (ICC > 0.2). In asthmatic children, the within-day (0-30 min) ICCs for e-nose sensors (8 sensors × 4 desorption temperatures) ranged from 0.24 to 0.84 (median 0.57, IQR 0.47-0.71), while the between-day (0-7 d) ICCs ranged from 0.25 to 0.83 (median 0.66, IQR 0.55-0.72). In healthy children, the within-day ICCs for e-nose sensors ranged from 0.29 to 0.85 (median 0.58, IQR 0.49-0.63), while the between-day ICCs ranged from 0.33 to 0.82 (median 0.55, IQR 0.49-0.63). In both groups, most of the within-day and between-day ICCs for e-nose sensors were statistically significant. Moreover, the within-day and between-day ICCs for all spirometry parameters and eNO were significant and similar to those of the most reliable sensors. The modern breath sampling system showed more than acceptable within-day and between-day repeatability, in both asthmatic and healthy children. The present study was registered on the central registration system ClinicalTrials.gov (ID: NCT03025061).
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Affiliation(s)
- Salvatore Fasola
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
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Wojnowski W, Dymerski T, Gębicki J, Namieśnik J. Electronic Noses in Medical Diagnostics. Curr Med Chem 2019; 26:197-215. [PMID: 28982314 DOI: 10.2174/0929867324666171004164636] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 05/24/2016] [Accepted: 09/05/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Electronic nose technology is being developed in order to analyse complex mixtures of volatiles in a way parallel to biologic olfaction. When applied in the field of medicine, the use of such devices should enable the identification and discrimination between different diseases. In this review, a comprehensive summary of research in medical diagnostics using electronic noses is presented. A special attention has been paid to the application of these devices and sensor technologies, in response to current trends in medicine. METHODS Peer-reviewed research literature pertaining to the subject matter was identified based on a search of bibliographic databases. The quality and relevance of retrieved papers was assessed using standard tools. Their content was critically reviewed and certain information contained therein was compiled in tabularized form. RESULTS The majority of reviewed studies show promising results, often surpassing the accuracy and sensitivity of established diagnostic methods. However, only a relatively small number of devices have been field tested. The methods used for sample collection and data processing in various studies were listed in a table, together with electronic nose models used in these investigations. CONCLUSION Despite the fact that devices equipped with arrays of chemical sensors are not routinely used in everyday medical practice, their prospective use would solve some established issues in medical diagnostics, as well as lead to developments in prophylactics by facilitating a widespread use of non-invasive screening tests.
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Affiliation(s)
- Wojciech Wojnowski
- Department of Analytical Chemistry, Chemical Faculty, Gdansk University of Technology, Gdansk, Poland
| | - Tomasz Dymerski
- Department of Analytical Chemistry, Chemical Faculty, Gdansk University of Technology, Gdansk, Poland
| | - Jacek Gębicki
- Department of Chemical and Process Engineering, Chemical Faculty, Gdansk University of Technology, Gdansk, Poland
| | - Jacek Namieśnik
- Department of Analytical Chemistry, Chemical Faculty, Gdansk University of Technology, Gdansk, Poland
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Ibrahim W, Wilde M, Cordell R, Salman D, Ruszkiewicz D, Bryant L, Richardson M, Free RC, Zhao B, Yousuf A, White C, Russell R, Jones S, Patel B, Awal A, Phillips R, Fowkes G, McNally T, Foxon C, Bhatt H, Peltrini R, Singapuri A, Hargadon B, Suzuki T, Ng LL, Gaillard E, Beardsmore C, Ryanna K, Pandya H, Coates T, Monks PS, Greening N, Brightling CE, Thomas P, Siddiqui S. Assessment of breath volatile organic compounds in acute cardiorespiratory breathlessness: a protocol describing a prospective real-world observational study. BMJ Open 2019; 9:e025486. [PMID: 30852546 PMCID: PMC6429860 DOI: 10.1136/bmjopen-2018-025486] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Patients presenting with acute undifferentiated breathlessness are commonly encountered in admissions units across the UK. Existing blood biomarkers have clinical utility in distinguishing patients with single organ pathologies but have poor discriminatory power in multifactorial presentations. Evaluation of volatile organic compounds (VOCs) in exhaled breath offers the potential to develop biomarkers of disease states that underpin acute cardiorespiratory breathlessness, owing to their proximity to the cardiorespiratory system. To date, there has been no systematic evaluation of VOC in acute cardiorespiratory breathlessness. The proposed study will seek to use both offline and online VOC technologies to evaluate the predictive value of VOC in identifying common conditions that present with acute cardiorespiratory breathlessness. METHODS AND ANALYSIS A prospective real-world observational study carried out across three acute admissions units within Leicestershire. Participants with self-reported acute breathlessness, with a confirmed primary diagnosis of either acute heart failure, community-acquired pneumonia and acute exacerbation of asthma or chronic obstructive pulmonary disease will be recruited within 24 hours of admission. Additionally, school-age children admitted with severe asthma will be evaluated. All participants will undergo breath sampling on admission and on recovery following discharge. A range of online technologies including: proton transfer reaction mass spectrometry, gas chromatography ion mobility spectrometry, atmospheric pressure chemical ionisation-mass spectrometry and offline technologies including gas chromatography mass spectroscopy and comprehensive two-dimensional gas chromatography-mass spectrometry will be used for VOC discovery and replication. For offline technologies, a standardised CE-marked breath sampling device (ReCIVA) will be used. All recruited participants will be characterised using existing blood biomarkers including C reactive protein, brain-derived natriuretic peptide, troponin-I and blood eosinophil levels and further evaluated using a range of standardised questionnaires, lung function testing, sputum cell counts and other diagnostic tests pertinent to acute disease. ETHICS AND DISSEMINATION The National Research Ethics Service Committee East Midlands has approved the study protocol (REC number: 16/LO/1747). Integrated Research Approval System (IRAS) 198921. Findings will be presented at academic conferences and published in peer-reviewed scientific journals. Dissemination will be facilitated via a partnership with the East Midlands Academic Health Sciences Network and via interaction with all UK-funded Medical Research Council and Engineering and Physical Sciences Research Council molecular pathology nodes. TRIAL REGISTRATION NUMBER NCT03672994.
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Affiliation(s)
- Wadah Ibrahim
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Michael Wilde
- Department of Chemistry, University of Leicester, Leicester, UK
| | - Rebecca Cordell
- Department of Chemistry, University of Leicester, Leicester, UK
| | - Dahlia Salman
- Department of Chemistry, Loughborough University, Loughborough, UK
| | | | - Luke Bryant
- Department of Chemistry, University of Leicester, Leicester, UK
| | - Matthew Richardson
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Robert C Free
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Bo Zhao
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Ahmed Yousuf
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Christobelle White
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Richard Russell
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sheila Jones
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Bharti Patel
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Asia Awal
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Graham Fowkes
- NIHR Leicester Clinical Research Facility, Leicester, UK
| | | | - Clare Foxon
- Paediatric Clinical Investigation Centre, Leicester, UK
| | - Hetan Bhatt
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Rosa Peltrini
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Amisha Singapuri
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Beverley Hargadon
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Toru Suzuki
- Department of Cardiovascular Sciences, Cardiovascular Research Centre, University of Leicester, Leicester, UK
- Leicester NIHR Biomedical Research Centre (Cardiovascular Theme), Leicester, UK
| | - Leong L Ng
- Department of Cardiovascular Sciences, Cardiovascular Research Centre, University of Leicester, Leicester, UK
- Leicester NIHR Biomedical Research Centre (Cardiovascular Theme), Leicester, UK
| | - Erol Gaillard
- Paediatric Clinical Investigation Centre, Leicester, UK
| | | | - Kimuli Ryanna
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Hitesh Pandya
- Discovery Medicine, Respiratory Therapeutic Area, GlaxoSmithKline PLC, Stevenage, UK
| | - Tim Coates
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Paul S Monks
- Department of Chemistry, University of Leicester, Leicester, UK
| | - Neil Greening
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Christopher E Brightling
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Paul Thomas
- Department of Chemistry, Loughborough University, Loughborough, UK
| | - Salman Siddiqui
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
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Cavaleiro Rufo J, Paciência I, Mendes FC, Farraia M, Rodolfo A, Silva D, de Oliveira Fernandes E, Delgado L, Moreira A. Exhaled breath condensate volatilome allows sensitive diagnosis of persistent asthma. Allergy 2019; 74:527-534. [PMID: 30156012 DOI: 10.1111/all.13596] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/26/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The diagnosis and phenotyping of paediatric asthma are particularly complex due to the lack of currently available sensitive diagnostic tools. This often results in uncertainties associated with inhaled steroid therapy prescription. Therefore, this study aimed to investigate whether volatile organic compounds measured in exhaled breath condensate can be used as biomarkers for asthma diagnosis in the paediatric population. METHODS A total of 64 participants, aged 6-18 years, were recruited on a random basis during visits to an outpatient allergy clinic and to a juvenile football team training session. Lung function, airway reversibility and skin prick tests were performed. Exhaled breath condensate samples were collected, and breathprints were assessed using an electronic nose. Information on medical diagnosis of asthma, rhinitis and atopic dermatitis was retrieved for each participant. A hierarchical cluster model based on the volatilome profiles was then created. RESULTS A two-cluster exhaled volatile organic compound-based hierarchical model was able to significantly discriminate individuals with asthma from those without the disease (AUC = 0.81 [0.69-0.93], P < 0.001). Individuals who had persistent asthma and were prescribed corticosteroid therapy by the physician were also significantly distinguished in the model (AUC = 0.81 [0.70-0.92], P < 0.001). Despite being less specific, the method showed higher overall accuracy, sensitivity and AUC values when compared to spirometry with bronchodilation. CONCLUSIONS Analysis of the exhaled breath condensate volatilome allowed the distinction of paediatric individuals with a medical diagnosis of asthma, identifying those in need of corticosteroid therapy.
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Affiliation(s)
- João Cavaleiro Rufo
- Imunologia Básica e Clínica; Departamento de Patologia; Faculdade de Medicina; Universidade do Porto; Porto Portugal
- EPIUnit - Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Grupo de Energia e Ambiente Construído; Instituto de Ciência e Inovação em Engenharia Mecânica e Industrial; Porto Portugal
| | - Inês Paciência
- Imunologia Básica e Clínica; Departamento de Patologia; Faculdade de Medicina; Universidade do Porto; Porto Portugal
- EPIUnit - Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Grupo de Energia e Ambiente Construído; Instituto de Ciência e Inovação em Engenharia Mecânica e Industrial; Porto Portugal
| | - Francisca Castro Mendes
- Imunologia Básica e Clínica; Departamento de Patologia; Faculdade de Medicina; Universidade do Porto; Porto Portugal
| | - Mariana Farraia
- Imunologia Básica e Clínica; Departamento de Patologia; Faculdade de Medicina; Universidade do Porto; Porto Portugal
| | - Ana Rodolfo
- Imunologia Básica e Clínica; Departamento de Patologia; Faculdade de Medicina; Universidade do Porto; Porto Portugal
- Departamento de Imunoalergologia; Centro Hospitalar S. João EPE; Porto Portugal
| | - Diana Silva
- Imunologia Básica e Clínica; Departamento de Patologia; Faculdade de Medicina; Universidade do Porto; Porto Portugal
- Departamento de Imunoalergologia; Centro Hospitalar S. João EPE; Porto Portugal
| | - Eduardo de Oliveira Fernandes
- Grupo de Energia e Ambiente Construído; Instituto de Ciência e Inovação em Engenharia Mecânica e Industrial; Porto Portugal
| | - Luís Delgado
- Imunologia Básica e Clínica; Departamento de Patologia; Faculdade de Medicina; Universidade do Porto; Porto Portugal
- Departamento de Imunoalergologia; Centro Hospitalar S. João EPE; Porto Portugal
| | - André Moreira
- Imunologia Básica e Clínica; Departamento de Patologia; Faculdade de Medicina; Universidade do Porto; Porto Portugal
- EPIUnit - Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Departamento de Imunoalergologia; Centro Hospitalar S. João EPE; Porto Portugal
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Sánchez C, Santos JP, Lozano J. Use of Electronic Noses for Diagnosis of Digestive and Respiratory Diseases through the Breath. BIOSENSORS 2019; 9:E35. [PMID: 30823459 PMCID: PMC6468564 DOI: 10.3390/bios9010035] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 02/18/2019] [Accepted: 02/21/2019] [Indexed: 12/12/2022]
Abstract
The increased occurrence of chronic diseases related to lifestyle or environmental conditions may have a detrimental effect on long-term health if not diagnosed and controlled in time. For this reason, it is important to develop new noninvasive early diagnosis equipment that allows improvement of the current diagnostic methods. This, in turn, has led to an exponential development of technology applied to the medical sector, such as the electronic nose. In addition, the appearance of this type of technology has allowed the possibility of studying diseases from another point of view, such as through breath analysis. This paper presents a bibliographic review of past and recent studies, selecting those investigations in which a patient population was studied with electronic nose technology, in order to identify potential applications of this technology in the detection of respiratory and digestive diseases through the analysis of volatile organic compounds present in the breath.
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Affiliation(s)
- Carlos Sánchez
- Institute of Physics Technology and Information (CSIC), 28006 Madrid, Spain.
- Up Devices and Technologies, 28021 Madrid, Spain.
| | - J Pedro Santos
- Institute of Physics Technology and Information (CSIC), 28006 Madrid, Spain.
| | - Jesús Lozano
- Industrial Engineering School, University of Extremadura, 06006 Badajoz, Spain.
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Artificial intelligence in diagnosis of obstructive lung disease: current status and future potential. Curr Opin Pulm Med 2019; 24:117-123. [PMID: 29251699 DOI: 10.1097/mcp.0000000000000459] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW The application of artificial intelligence in the diagnosis of obstructive lung diseases is an exciting phenomenon. Artificial intelligence algorithms work by finding patterns in data obtained from diagnostic tests, which can be used to predict clinical outcomes or to detect obstructive phenotypes. The purpose of this review is to describe the latest trends and to discuss the future potential of artificial intelligence in the diagnosis of obstructive lung diseases. RECENT FINDINGS Machine learning has been successfully used in automated interpretation of pulmonary function tests for differential diagnosis of obstructive lung diseases. Deep learning models such as convolutional neural network are state-of-the art for obstructive pattern recognition in computed tomography. Machine learning has also been applied in other diagnostic approaches such as forced oscillation test, breath analysis, lung sound analysis and telemedicine with promising results in small-scale studies. SUMMARY Overall, the application of artificial intelligence has produced encouraging results in the diagnosis of obstructive lung diseases. However, large-scale studies are still required to validate current findings and to boost its adoption by the medical community.
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Brinkman P, Wagener AH, Hekking PP, Bansal AT, Maitland-van der Zee AH, Wang Y, Weda H, Knobel HH, Vink TJ, Rattray NJ, D'Amico A, Pennazza G, Santonico M, Lefaudeux D, De Meulder B, Auffray C, Bakke PS, Caruso M, Chanez P, Chung KF, Corfield J, Dahlén SE, Djukanovic R, Geiser T, Horvath I, Krug N, Musial J, Sun K, Riley JH, Shaw DE, Sandström T, Sousa AR, Montuschi P, Fowler SJ, Sterk PJ. Identification and prospective stability of electronic nose (eNose)-derived inflammatory phenotypes in patients with severe asthma. J Allergy Clin Immunol 2018; 143:1811-1820.e7. [PMID: 30529449 DOI: 10.1016/j.jaci.2018.10.058] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 10/04/2018] [Accepted: 10/22/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Severe asthma is a heterogeneous condition, as shown by independent cluster analyses based on demographic, clinical, and inflammatory characteristics. A next step is to identify molecularly driven phenotypes using "omics" technologies. Molecular fingerprints of exhaled breath are associated with inflammation and can qualify as noninvasive assessment of severe asthma phenotypes. OBJECTIVES We aimed (1) to identify severe asthma phenotypes using exhaled metabolomic fingerprints obtained from a composite of electronic noses (eNoses) and (2) to assess the stability of eNose-derived phenotypes in relation to within-patient clinical and inflammatory changes. METHODS In this longitudinal multicenter study exhaled breath samples were taken from an unselected subset of adults with severe asthma from the U-BIOPRED cohort. Exhaled metabolites were analyzed centrally by using an assembly of eNoses. Unsupervised Ward clustering enhanced by similarity profile analysis together with K-means clustering was performed. For internal validation, partitioning around medoids and topological data analysis were applied. Samples at 12 to 18 months of prospective follow-up were used to assess longitudinal within-patient stability. RESULTS Data were available for 78 subjects (age, 55 years [interquartile range, 45-64 years]; 41% male). Three eNose-driven clusters (n = 26/33/19) were revealed, showing differences in circulating eosinophil (P = .045) and neutrophil (P = .017) percentages and ratios of patients using oral corticosteroids (P = .035). Longitudinal within-patient cluster stability was associated with changes in sputum eosinophil percentages (P = .045). CONCLUSIONS We have identified and followed up exhaled molecular phenotypes of severe asthma, which were associated with changing inflammatory profile and oral steroid use. This suggests that breath analysis can contribute to the management of severe asthma.
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Affiliation(s)
- Paul Brinkman
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Ariane H Wagener
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Pieter-Paul Hekking
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Aruna T Bansal
- Acclarogen, St John's Innovation Centre, Cambridge, United Kingdom
| | | | | | - Hans Weda
- Philips Research, Eindhoven, The Netherlands
| | | | | | - Nicholas J Rattray
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Conn
| | - Arnaldo D'Amico
- Department of Electronic Engineering, University of Rome "Tor Vergata," Rome, Italy
| | - Giorgio Pennazza
- Center for Integrated Research-CIR, Unit for Electronics for Sensor Systems, Campus Bio-Medico U, Rome, Italy
| | - Marco Santonico
- Center for Integrated Research-CIR, Unit for Electronics for Sensor Systems, Campus Bio-Medico U, Rome, Italy
| | - Diane Lefaudeux
- European Institute for Systems Biology and Medicine, CIRI UMR5308, CNRS-ENS-UCBL-INSERM, Lyon, France
| | - Bertrand De Meulder
- European Institute for Systems Biology and Medicine, CIRI UMR5308, CNRS-ENS-UCBL-INSERM, Lyon, France
| | - Charles Auffray
- European Institute for Systems Biology and Medicine, CIRI UMR5308, CNRS-ENS-UCBL-INSERM, Lyon, France
| | - Per S Bakke
- Institute of Medicine, University of Bergen, Bergen, Norway
| | - Massimo Caruso
- Department of Clinical and Experimental Medicine Hospital University, University of Catania, Catania, Italy
| | - Pascal Chanez
- Département des Maladies Respiratoires APHM,U1067 INSERM, Aix Marseille Université Marseille, Marseille, Italy
| | - Kian F Chung
- National Heart and Lung Institute, Imperial College, London, UK Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, United Kingdom
| | - Julie Corfield
- AstraZeneca R&D, Mölndal, Sweden; Areteva R&D, Nottingham, United Kingdom
| | - Sven-Erik Dahlén
- Centre for Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ratko Djukanovic
- NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Thomas Geiser
- the Department of Pulmonary Medicine, University Hospital Bern, Bern, Switzerland
| | - Ildiko Horvath
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Nobert Krug
- Fraunhofer Institute for Toxicology and Experimental Medicine Hannover, Hannover, Germany
| | - Jacek Musial
- Department of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Kai Sun
- Data Science Institute, South Kensington Campus, Imperial College Londont, London, United Kingdom
| | - John H Riley
- Respiratory Therapeutic Unit, GlaxoSmithKline, Stockley Park, United Kingdom
| | - Dominic E Shaw
- Respiratory Research Unit, University of Nottingham, Nottingham, United Kingdom
| | - Thomas Sandström
- Department of Public Health and Clinical Medicine, Department of Medicine, Respiratory Medicine Unit, Umeå University, Umeå, Sweden
| | - Ana R Sousa
- Respiratory Therapeutic Unit, GlaxoSmithKline, Stockley Park, United Kingdom
| | - Paolo Montuschi
- Department of Pharmacology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Stephen J Fowler
- Respiratory Research Group, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Healthy Science Centre, and NIHR Translational Research Faculty in Respiratory Medicine, University Hospital of South Manchester, Manchester, United Kingdom; Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Peter J Sterk
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Dai C, Huang X, Lv R, Zhang Z, Sun J, Aheto JH. Analysis of volatile compounds of
Tremella aurantialba
fermentation
via
electronic nose and HS‐SPME‐GC‐MS. J Food Saf 2018. [DOI: 10.1111/jfs.12555] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Chunxia Dai
- School of Food and Biological EngineeringJiangsu University Zhenjiang China
- School of Electrical and Information EngineeringJiangsu University Zhenjiang China
| | - Xingyi Huang
- School of Food and Biological EngineeringJiangsu University Zhenjiang China
| | - Riqin Lv
- School of Food and Biological EngineeringJiangsu University Zhenjiang China
| | - Zhicai Zhang
- School of Food and Biological EngineeringJiangsu University Zhenjiang China
| | - Jun Sun
- School of Electrical and Information EngineeringJiangsu University Zhenjiang China
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50
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Wallace MAG, Pleil JD. Evolution of clinical and environmental health applications of exhaled breath research: Review of methods and instrumentation for gas-phase, condensate, and aerosols. Anal Chim Acta 2018; 1024:18-38. [PMID: 29776545 PMCID: PMC6082128 DOI: 10.1016/j.aca.2018.01.069] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 12/20/2022]
Abstract
Human breath, along with urine and blood, has long been one of the three major biological media for assessing human health and environmental exposure. In fact, the detection of odor on human breath, as described by Hippocrates in 400 BC, is considered the first analytical health assessment tool. Although less common in comparison to contemporary bio-fluids analyses, breath has become an attractive diagnostic medium as sampling is non-invasive, unlimited in timing and volume, and does not require clinical personnel. Exhaled breath, exhaled breath condensate (EBC), and exhaled breath aerosol (EBA) are different types of breath matrices used to assess human health and disease state. Over the past 20 years, breath research has made many advances in assessing health state, overcoming many of its initial challenges related to sampling and analysis. The wide variety of sampling techniques and collection devices that have been developed for these media are discussed herein. The different types of sensors and mass spectrometry instruments currently available for breath analysis are evaluated as well as emerging breath research topics, such as cytokines, security and airport surveillance, cellular respiration, and canine olfaction.
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Affiliation(s)
- M Ariel Geer Wallace
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 109 T.W. Alexander Drive, Research Triangle Park, NC, 27711, USA.
| | - Joachim D Pleil
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 109 T.W. Alexander Drive, Research Triangle Park, NC, 27711, USA.
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