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Bohórquez JA, Adduri S, Ansari D, John S, Florence J, Adejare O, Singh G, Konduru NV, Jagannath C, Yi G. A novel humanized mouse model for HIV and tuberculosis co-infection studies. Front Immunol 2024; 15:1395018. [PMID: 38799434 PMCID: PMC11116656 DOI: 10.3389/fimmu.2024.1395018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
Background Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), continues to be a major public health problem worldwide. The human immunodeficiency virus (HIV) is another equally important life-threatening pathogen. HIV infection decreases CD4+ T cell levels markedly increasing Mtb co-infections. An appropriate animal model for HIV/Mtb co-infection that can recapitulate the diversity of the immune response in humans during co-infection would facilitate basic and translational research in HIV/Mtb infections. Herein, we describe a novel humanized mouse model. Methods The irradiated NSG-SGM3 mice were transplanted with human CD34+ hematopoietic stem cells, and the humanization was monitored by staining various immune cell markers for flow cytometry. They were challenged with HIV and/or Mtb, and the CD4+ T cell depletion and HIV viral load were monitored over time. Before necropsy, the live mice were subjected to pulmonary function test and CT scan, and after sacrifice, the lung and spleen homogenates were used to determine Mtb load (CFU) and cytokine/chemokine levels by multiplex assay, and lung sections were analyzed for histopathology. The mouse sera were subjected to metabolomics analysis. Results Our humanized NSG-SGM3 mice were able to engraft human CD34+ stem cells, which then differentiated into a full-lineage of human immune cell subsets. After co-infection with HIV and Mtb, these mice showed decrease in CD4+ T cell counts overtime and elevated HIV load in the sera, similar to the infection pattern of humans. Additionally, Mtb caused infections in both lungs and spleen, and induced granulomatous lesions in the lungs. Distinct metabolomic profiles were also observed in the tissues from different mouse groups after co-infections. Conclusion The humanized NSG-SGM3 mice are able to recapitulate the pathogenic effects of HIV and Mtb infections and co-infection at the pathological, immunological and metabolism levels and are therefore a reproducible small animal model for studying HIV/Mtb co-infection.
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Affiliation(s)
- José Alejandro Bohórquez
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Center for Biomedical Research, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Department of Medicine, The University of Texas at Tyler School of Medicine, Tyler, TX, United States
| | - Sitaramaraju Adduri
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Center for Biomedical Research, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
| | - Danish Ansari
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Center for Biomedical Research, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Department of Medicine, The University of Texas at Tyler School of Medicine, Tyler, TX, United States
| | - Sahana John
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Center for Biomedical Research, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Department of Medicine, The University of Texas at Tyler School of Medicine, Tyler, TX, United States
| | - Jon Florence
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Center for Biomedical Research, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
| | - Omoyeni Adejare
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Center for Biomedical Research, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
| | - Gaurav Singh
- Department of Medicine, The University of Texas at Tyler School of Medicine, Tyler, TX, United States
| | - Nagarjun V. Konduru
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Center for Biomedical Research, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
| | - Chinnaswamy Jagannath
- Department of Pathology and Genomic Medicine, Center for Infectious Diseases and Translational Medicine, Houston Methodist Research Institute, Houston, TX, United States
| | - Guohua Yi
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Center for Biomedical Research, The University of Texas Health Science Center at Tyler, Tyler, TX, United States
- Department of Medicine, The University of Texas at Tyler School of Medicine, Tyler, TX, United States
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Allosh A, Pantis-Simut CA, Filipoiu N, Preda AT, Necula G, Ghitiu I, Anghel DV, Dulea MA, Nemnes GA. Tuning phosphorene and MoS 2 2D materials for detecting volatile organic compounds associated with respiratory diseases. RSC Adv 2024; 14:1803-1812. [PMID: 38192312 PMCID: PMC10772541 DOI: 10.1039/d3ra07685g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Abstract
Efficient identification of volatile organic compounds (VOCs) is essential for the rapid diagnostication of respiratory diseases. By detecting specific biomarkers associated with different pathologies one may distinguish between tuberculosis, nosocomial pneumonia, Aspergillus fumigatus, influenza and SARS-CoV-2 virus infections. Phosphorene and MoS2 are potential candidates from the class of 2D graphene-like materials, which can be used as active layers for sensing elements. However, as the target molecules poorly adhere to the pristine layers, binding centers are created by introducing substitutional impurities. The adsorbed VOCs induce modifications in the electrical properties of the customized active layers. For each biomarker and a sequence of substitutional impurities, a pattern of conductivities is obtained, which enables the detection of an unknown test specimen. Exploring multiple biosensor configurations we find an optimal design yielding a considerable selectivity for the five biomarker compounds.
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Affiliation(s)
- Alaa Allosh
- Horia Hulubei National Institute for Physics and Nuclear Engineering Magurele-Ilfov 077126 Romania
- University of Bucharest, Faculty of Physics Magurele-Ilfov 077125 Romania
| | - Calin-Andrei Pantis-Simut
- Horia Hulubei National Institute for Physics and Nuclear Engineering Magurele-Ilfov 077126 Romania
- University of Bucharest, Faculty of Physics Magurele-Ilfov 077125 Romania
- Research Institute of the University of Bucharest (ICUB) 90 Panduri Street Bucharest 050663 Romania
| | - Nicolae Filipoiu
- Horia Hulubei National Institute for Physics and Nuclear Engineering Magurele-Ilfov 077126 Romania
- University of Bucharest, Faculty of Physics Magurele-Ilfov 077125 Romania
| | - Amanda Teodora Preda
- Horia Hulubei National Institute for Physics and Nuclear Engineering Magurele-Ilfov 077126 Romania
- University of Bucharest, Faculty of Physics Magurele-Ilfov 077125 Romania
- Research Institute of the University of Bucharest (ICUB) 90 Panduri Street Bucharest 050663 Romania
| | - George Necula
- Horia Hulubei National Institute for Physics and Nuclear Engineering Magurele-Ilfov 077126 Romania
| | - Ioan Ghitiu
- University of Bucharest, Faculty of Physics Magurele-Ilfov 077125 Romania
- National Institute for Laser, Plasma and Radiation Physics Magurele-Ilfov 077125 Romania
| | - Dragos-Victor Anghel
- Horia Hulubei National Institute for Physics and Nuclear Engineering Magurele-Ilfov 077126 Romania
- University of Bucharest, Faculty of Physics Magurele-Ilfov 077125 Romania
- Research Institute of the University of Bucharest (ICUB) 90 Panduri Street Bucharest 050663 Romania
| | - Mihnea Alexandru Dulea
- Horia Hulubei National Institute for Physics and Nuclear Engineering Magurele-Ilfov 077126 Romania
| | - George Alexandru Nemnes
- Horia Hulubei National Institute for Physics and Nuclear Engineering Magurele-Ilfov 077126 Romania
- University of Bucharest, Faculty of Physics Magurele-Ilfov 077125 Romania
- Research Institute of the University of Bucharest (ICUB) 90 Panduri Street Bucharest 050663 Romania
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3
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Makhubela PCK, Rohwer ER, Naudé Y. Detection of tuberculosis-associated compounds from human skin by GCxGC-TOFMS. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1231:123937. [PMID: 37995549 DOI: 10.1016/j.jchromb.2023.123937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023]
Abstract
Tuberculosis (TB) remains a global health concern. This study aimed to investigate the potential of human skin volatile organic compounds (VOCs) as prospective biomarkers for TB diagnosis. It employed a non-invasive approach using a wearable silicone rubber band for VOC sampling, comprehensive gas chromatography - time of flight mass spectrometry (GCxGC-TOFMS), and chemometric techniques. Both targeted and untargeted biochemical screening was utilized to explore biochemical differences between healthy individuals and those with TB infection. Results confirmed a correlation between compounds found in this study, and those reported for TB from other biofluids. In a comparison to known TB-associated compounds from other biofluids our analysis established the presence of 27 of these compounds emanating from human skin. Additionally, 16 previously unreported compounds were found as potential biomarkers. The diagnostic ability of the VOCs selected by statistical methods was investigated using predictive modelling techniques. Artificial neural network multi-layered perceptron (ANN) yielded two compounds, 1H-indene, 2,3 dihydro-1,1,3-trimethyl-3-phenyl; and heptane-3-ethyl-2-methyl, as the most discriminatory, and could differentiate between TB-positive (n = 15) and TB-negative (n = 23) individuals with an area under the receiver operating characteristic curve (AUROC) of 92 %, a sensitivity of 100 % and a specificity of 94 % for six targeted features. For untargeted analysis, ANN assigned 3-methylhexane as the most discriminatory between TB-positive and TB- negative individuals. An AUROC of 98.5 %, a sensitivity of 83 %, and a specificity of 88 % were obtained for 16 untargeted features as chosen by high performance variable selection. The obtained values compare highly favourable to alternative diagnostic methods such as breath analysis and GeneXpert. Consequently, human skin VOCs hold considerable potential as a TB diagnostic screening test.
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Affiliation(s)
- Portia C K Makhubela
- Department of Chemistry, University of Pretoria, Private Bag X20, Hatfield, 0028 Pretoria, South Africa
| | - Egmont R Rohwer
- Department of Chemistry, University of Pretoria, Private Bag X20, Hatfield, 0028 Pretoria, South Africa
| | - Yvette Naudé
- Department of Chemistry, University of Pretoria, Private Bag X20, Hatfield, 0028 Pretoria, South Africa.
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4
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Sim D, Huang T, Kim SS. Peptide-Functionalized Carbon Nanotube Chemiresistors: The Effect of Nanotube Density on Gas Sensing. SENSORS (BASEL, SWITZERLAND) 2023; 23:8469. [PMID: 37896562 PMCID: PMC10611220 DOI: 10.3390/s23208469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
Biorecognition element (BRE)-based carbon nanotube (CNT) chemiresistors have tremendous potential to serve as highly sensitive, selective, and power-efficient volatile organic compound (VOC) sensors. While many research groups have studied BRE-functionalized CNTs in material science and device development, little attention has been paid to optimizing CNT density to improve chemiresistor performance. To probe the effect of CNT density on VOC detection, we present the chemiresistor-based sensing results from two peptide-based CNT devices counting more than 60 different individual measurements. We find that a lower CNT density shows a significantly higher noise level and device-to-device variation while exhibiting mildly better sensitivity. Further investigation with SEM images suggests that moderately high CNT density with a stable connection of the nanotube network is desirable to achieve the best signal-to-noise ratio. Our results show an essential design guideline for tuning the nanotube density to provide sensitive and stable chemiresistors.
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Affiliation(s)
- Daniel Sim
- Air Force Research Laboratory (AFRL), 711th Human Performance Wing, Wright-Patterson Air Force Base, Dayton, OH 45433, USA; (D.S.); (T.H.)
- Integrative Health & Performance Sciences Division, UES Inc., Dayton, OH 45432, USA
| | - Tiffany Huang
- Air Force Research Laboratory (AFRL), 711th Human Performance Wing, Wright-Patterson Air Force Base, Dayton, OH 45433, USA; (D.S.); (T.H.)
| | - Steve S. Kim
- Air Force Research Laboratory (AFRL), 711th Human Performance Wing, Wright-Patterson Air Force Base, Dayton, OH 45433, USA; (D.S.); (T.H.)
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5
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Kim T, Kim J, Kim T, Oak CH, Ryoo S. Transrenal DNA detection of Mycobacterium tuberculosis in patients with pulmonary tuberculosis. Int J Mycobacteriol 2023; 12:66-72. [PMID: 36926765 DOI: 10.4103/ijmy.ijmy_12_23] [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: 03/15/2023] Open
Abstract
Background Multiple attempts have been made to use biological samples other than sputum to diagnose tuberculosis (TB). Sputum acid-fast bacillus (AFB) microscopy is the fastest, most straightforward, and most inexpensive method for diagnosing pulmonary TB. However, urine can be used in place of sputum owing to its various advantages, such as a noninvasive method of collection, convenient handling and storage, and minimal risk of infection in health-care workers involved in sample collection. In this study, we aimed to assess the suitability of urine as a sample to obtain transrenal DNA (trDNA) to diagnose TB. This study involved several patients with TB undergoing inpatient treatment, whose AFB microscopy showed negative inversion. Methods Here, 51 urine samples were collected from 40 patients with TB and examined to confirm the presence of trDNA. First, we compared the efficiency of two trDNA extraction methods. An automated magnetic bead-based method and a more efficient anchoring extraction method. Statistical analyses were performed using Excel software (Microsoft Office Professional Plus 2019). Results Although molecular diagnosis using GeneXpert yielded negative results, a peculiarity was observed. There was no significant difference between GeneXpert findings and our results nor was there any difference in the sequential trDNA samples obtained. However, even when GeneXpert results were negative, trDNA was detected in seven out of ten samples using the anchor extraction method. Conclusions Further studies are needed to establish biomarkers for the progression of TB treatment.
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Affiliation(s)
- Taeyoon Kim
- Clinical Research Center, Masan National Tuberculosis Hospital, Changwon, Republic of Korea
| | - Jehun Kim
- Department of Internal Medicine, Division of Pulmonology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Taeyun Kim
- Department of Internal Medicine, Division of Pulmonology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Chul-Ho Oak
- Department of Internal Medicine, Division of Pulmonology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Sungweon Ryoo
- Clinical Research Center, Masan National Tuberculosis Hospital, Changwon, Republic of Korea
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6
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Mass spectrometry for breath analysis. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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7
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Zhang P, Ren T, Chen H, Li Q, He M, Feng Y, Wang L, Huang T, Yuan J, Deng G, Lu H. A feasibility study of COVID-19 detection using breath analysis by high-pressure photon ionization time-of-flight mass spectrometry. J Breath Res 2022; 16. [PMID: 36052728 DOI: 10.1088/1752-7163/ac8ea1] [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: 03/03/2022] [Accepted: 08/11/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND SARS-CoV-2 has caused a tremendous threat to global health. PCR and antigen testing have played a prominent role in the detection of SARS-CoV-2-infected individuals and disease control. An efficient, reliable detection tool is still urgently needed to halt the global COVID-19 pandemic. Recently, FDA emergency approved VOC as an alternative test for COVID-19 detection. METHODS AND MATERIALS In this case-control study, we prospectively and consecutively recruited 95 confirmed COVID-19 patients and 106 healthy controls in the designated hospital for treatment of COVID-19 patients in Shenzhen, China. Exhaled breath samples were collected and stored in customized bags and then detected by HPPI-TOFMS for volatile organic components (VOCs). Machine learning (ML) algorithms were employed for COVID-19 detection model construction. Participants were randomly assigned in a 5:2:3 ratio to the training, validation, and blinded test sets. The sensitivity (SEN), specificity (SPE), and other general metrics were employed for the VOCs based COVID-19 detection model performance evaluation. RESULTS The VOCs based COVID-19 detection model achieved good performance, with a SEN of 92.2% (95% CI: 83.8%, 95.6%), a SPE of 86.1% (95% CI: 74.8%, 97.4%) on blinded test set. Five potential VOC ions related to COVID-19 infection were discovered, which are significantly different between COVID-19 infected patients and controls. CONCLUSIONS This study evaluated a simple, fast, non-invasive VOCs-based COVID-19 detection method and demonstrated that it has good sensitivity and specificity in distinguishing COVID-19 infected patients from controls. It has great potential for fast and accurate COVID-19 detection.
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Affiliation(s)
- Peize Zhang
- Department of Pulmonary medicine and Tuberculosis, Shenzhen Third People's Hospital, No. 29, Bulan Road, Longgang District, Shenzhen, 518112, CHINA
| | - Tantan Ren
- Department of Pulmonary medicine and Tuberculosis, Shenzhen Third People's Hospital, No. 29, Bulan Road, Longgang District, Shenzhen, 518112, CHINA
| | - Haibin Chen
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, 3rd Gangnanli, Fengtai Distinct, Beijing, 100071, CHINA
| | - Qingyun Li
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, 3rd Gangnanli, Fengtai Distinct, Beijing, 100071, CHINA
| | - Mengqi He
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, 3rd Gangnanli, Fengtai Distinct, Beijing, 100071, CHINA
| | - Yong Feng
- Breax Laboratory, PCAB Research Center of Breath and Metabolism,, 3rd Gangnanli, Fengtai Distinct, Beijing, 100071, CHINA
| | - Lei Wang
- Breax Laboratory, PCAB Research Center of Breath and Metabolism, 3rd Gangnanli, Fengtai Distinct, Beijing, 100071, CHINA
| | - Ting Huang
- Department of Disease Control, Shenzhen Third People's Hospital, No. 29, Bulan Road, Longgang District, Beijing, 100071, CHINA
| | - Jing Yuan
- Department of Infectious Disease, Shenzhen Third People's Hospital, No. 29, Bulan Road, Longgang District, Shenzhen, 518112, CHINA
| | - Guofang Deng
- Department of Pulmonary medicine and Tuberculosis,, Shenzhen Third People's Hospital, No. 29, Bulan Road, Longgang District, Shenzhen, Shenzhen, 518112, CHINA
| | - Hongzhou Lu
- Department of Infectious Disease, Shenzhen Third People's Hospital, No. 29, Bulan Road, Longgang District, Shenzhen, 518112, CHINA
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Mani-Varnosfaderani A, Gao A, Poch KR, Caceres SM, Nick JA, Hill JE. Breath biomarkers associated with nontuberculosis mycobacteriadisease status in persons with cystic fibrosis: a pilot study. J Breath Res 2022; 16:031001. [PMID: 35487186 DOI: 10.1088/1752-7163/ac6bb6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/29/2022] [Indexed: 11/11/2022]
Abstract
Pulmonary infections caused by mycobacteria cause significant mortality and morbidity in the human population. Diagnosing mycobacterial infections is challenging. An infection can lead to active disease or remain indolent with little clinical consequence. In patients with pulmonarynontuberculosis mycobacteria(PNTM) identification of infection and diagnosis of disease can take months to years. Our previous studies showed the potential diagnostic power of volatile molecules in the exhaled breath samples to detect active pulmonaryM. tuberculosisinfection. Herein, we demonstrate the ability to detect the disease status of PNTM in the breath of persons with cystic fibrosis (PwCF). We putatively identified 17 volatile molecules that could discriminate between active-NTM disease (n= 6), indolent patients (n= 3), and those patients who have never cultured an NTM (n= 2). The results suggest that further confirmation of the breath biomarkers as a non-invasive and culture-independent tool for diagnosis of NTM disease in a larger cohort of PwCF is warranted.
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Affiliation(s)
- Ahmad Mani-Varnosfaderani
- Department of Chemical and Biological Engineering, School of Biomedical Engineering, The University of British Columbia, Vancouver, Canada
| | - Antao Gao
- Department of Chemical and Biological Engineering, School of Biomedical Engineering, The University of British Columbia, Vancouver, Canada
| | - Katie R Poch
- Department of Medicine, National Jewish Health, Denver, CO, United States of America
| | - Silvia M Caceres
- Department of Medicine, National Jewish Health, Denver, CO, United States of America
| | - Jerry A Nick
- Department of Medicine, National Jewish Health, Denver, CO, United States of America
| | - Jane E Hill
- Department of Chemical and Biological Engineering, School of Biomedical Engineering, The University of British Columbia, Vancouver, Canada
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9
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Magdalena D, Michal S, Marta S, Magdalena KP, Anna P, Magdalena G, Rafał S. Targeted metabolomics analysis of serum and Mycobacterium tuberculosis antigen-stimulated blood cultures of pediatric patients with active and latent tuberculosis. Sci Rep 2022; 12:4131. [PMID: 35260782 PMCID: PMC8904507 DOI: 10.1038/s41598-022-08201-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/03/2022] [Indexed: 12/28/2022] Open
Abstract
Profound tuberculosis (TB)-induced metabolic changes reflected in the blood metabolomic profile may provide an opportunity to identify specific markers of Mycobacterium tuberculosis infection. Using targeted liquid chromatography tandem mass spectrometry, we compared the levels of 30 small metabolites, including amino acids and derivatives, and small organic compounds in serum and M.tb antigen-stimulated whole blood cultures of active TB children, latent TB (LTBI) children, nonmycobacterial pneumonia (NMP) children, and healthy controls (HCs) to assess their potential as biomarkers of childhood TB. We found elevated levels of leucine and kynurenine combined with reduced concentrations of citrulline and glutamine in serum and blood cultures of TB and LTBI groups. LTBI status was additionally associated with a decrease in valine levels in blood cultures. The NMP metabolite profile was characterized by an increase in citrulline and glutamine and a decrease in leucine, kynurenine and valine concentrations. The highest discriminatory potential for identifying M.tb infection was observed for leucine detected in serum and kynurenine in stimulated blood cultures. The use of targeted metabolomics may reveal metabolic changes in M.tb-infected children, and the obtained results are a proof of principle of the usefulness of metabolites in the auxiliary diagnosis of TB in children.
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Affiliation(s)
- Druszczynska Magdalena
- Department of Immunology and Infectious Biology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland.
| | - Seweryn Michal
- Biobank Lab, Department of Molecular Biophysics, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland
| | | | - Kowalewska-Pietrzak Magdalena
- Regional Specialized Hospital of Tuberculosis, Lung Diseases, and Rehabilitation in Lodz, Okolna 181, 91-520, Lodz, Poland
| | - Pankowska Anna
- Regional Specialized Hospital of Tuberculosis, Lung Diseases, and Rehabilitation in Lodz, Okolna 181, 91-520, Lodz, Poland
| | - Godkowicz Magdalena
- Department of Immunology and Infectious Biology, Institute of Microbiology, Biotechnology and Immunology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland
| | - Szewczyk Rafał
- , Labexperts sp z o. o. Piekarnicza 5, 80-126, Gdansk, Poland
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10
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Jiang J, Li Z, Chen C, Jiang W, Xu B, Zhao Q. Metabolomics Strategy Assisted by Transcriptomics Analysis to Identify Potential Biomarkers Associated with Tuberculosis. Infect Drug Resist 2021; 14:4795-4807. [PMID: 34815677 PMCID: PMC8604652 DOI: 10.2147/idr.s330493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/28/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the dysregulated pathways and identify reliable diagnostic biomarkers for tuberculosis using integrated analysis of metabolomics and transcriptomics. Methods Three groups of samples, untargeted metabolomics analysis of healthy controls (HC), latent tuberculosis infection patients (LTBI), and active tuberculosis patients (TB), were analyzed using gas chromatography time-of-flight mass spectrometry (GC-TOF MS) and ultra-high performance liquid chromatography-quantitative mass spectrometry (UHPLC-QE-MS). Both univariate and multivariate and statistical analyses were used to select differential metabolites (DMs) among group comparison, and LASSO regression analysis was employed to discover potential diagnostic biomarkers. Metabolite set enrichment analysis was performed to identify the altered metabolic pathways specifically in patients with TB. Meanwhile, a transcriptomic dataset GSEG4992 was downloaded from the GEO database to explore the differentially expressed genes (DEGs) between TB and HC identified in significantly enriched pathways. Finally, an integrative analysis of DMs and DEGs was performed to investigate the possible molecular mechanisms of TB. Results Thirty-three specific metabolites were significantly different between TB and HC, of which 7 (5-hydroxyindoleacetic acid, isoleucyl-isoleucine, heptadecanoic acid, indole acetaldehyde, 5-ethyl-2,4-dimethyloxazole, and 2-hydroxycaproic acid, unknown 71) were chosen as combinational potential biomarkers for TB. The area under the curve (AUC) value of these biomarkers was 0.97 (95% CI: 0.92–1.00). Metabolites set enrichment analysis (MSEA) displayed that there were 3 significantly enriched pathways among all. The genes in 3 significantly enriched pathways were further analyzed, of which 9(ALDH3B1, BCAT1, BCAT2, GLYAT, GOT1, IL4I1, MIF, SDS, SDSL) were expressed differentially. The area under the curve (AUC) values of these DEGs enriched in pathways mostly were greater than 0.8. As a result, a connected network of metabolites and genes in the pathways were established, which provides insights into the credibility of selected metabolites. Conclusion The newly identified metabolic biomarkers display a high potential to be developed into a promising tool for TB screening, diagnosis, and therapeutic effect monitoring.
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Affiliation(s)
- Jiayan Jiang
- School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People's Republic of China
| | - Zhipeng Li
- School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People's Republic of China
| | - Cheng Chen
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu, People's Republic of China
| | - Weili Jiang
- School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People's Republic of China
| | - Biao Xu
- School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People's Republic of China
| | - Qi Zhao
- School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People's Republic of China.,NHC Key Laboratory of Health Technology Assessment,Fudan University, Shanghai, People's Republic of China.,Shanghai Clinical Research Center for infectious disease (Tuberculosis), Shanghai, People's Republic of China
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11
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Gong W, Wu X. Differential Diagnosis of Latent Tuberculosis Infection and Active Tuberculosis: A Key to a Successful Tuberculosis Control Strategy. Front Microbiol 2021; 12:745592. [PMID: 34745048 PMCID: PMC8570039 DOI: 10.3389/fmicb.2021.745592] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/24/2021] [Indexed: 12/16/2022] Open
Abstract
As an ancient infectious disease, tuberculosis (TB) is still the leading cause of death from a single infectious agent worldwide. Latent TB infection (LTBI) has been recognized as the largest source of new TB cases and is one of the biggest obstacles to achieving the aim of the End TB Strategy. The latest data indicate that a considerable percentage of the population with LTBI and the lack of differential diagnosis between LTBI and active TB (aTB) may be potential reasons for the high TB morbidity and mortality in countries with high TB burdens. The tuberculin skin test (TST) has been used to diagnose TB for > 100 years, but it fails to distinguish patients with LTBI from those with aTB and people who have received Bacillus Calmette–Guérin vaccination. To overcome the limitations of TST, several new skin tests and interferon-gamma release assays have been developed, such as the Diaskintest, C-Tb skin test, EC-Test, and T-cell spot of the TB assay, QuantiFERON-TB Gold In-Tube, QuantiFERON-TB Gold-Plus, LIAISON QuantiFERON-TB Gold Plus test, and LIOFeron TB/LTBI. However, these methods cannot distinguish LTBI from aTB. To investigate the reasons why all these methods cannot distinguish LTBI from aTB, we have explained the concept and definition of LTBI and expounded on the immunological mechanism of LTBI in this review. In addition, we have outlined the research status, future directions, and challenges of LTBI differential diagnosis, including novel biomarkers derived from Mycobacterium tuberculosis and hosts, new models and algorithms, omics technologies, and microbiota.
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Affiliation(s)
- Wenping Gong
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
| | - Xueqiong Wu
- Tuberculosis Prevention and Control Key Laboratory/Beijing Key Laboratory of New Techniques of Tuberculosis Diagnosis and Treatment, Senior Department of Tuberculosis, The 8th Medical Center of PLA General Hospital, Beijing, China
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12
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Ghosh C, Leon A, Koshy S, Aloum O, Al-Jabawi Y, Ismail N, Weiss ZF, Koo S. Breath-Based Diagnosis of Infectious Diseases: A Review of the Current Landscape. Clin Lab Med 2021; 41:185-202. [PMID: 34020759 DOI: 10.1016/j.cll.2021.03.002] [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: 10/21/2022]
Abstract
Various analytical methods can be applied to concentrate, separate, and examine trace volatile organic metabolites in the breath, with the potential for noninvasive, rapid, real-time identification of various disease processes, including an array of microbial infections. Although biomarker discovery and validation in microbial infections can be technically challenging, it is an approach that has shown great promise, especially for infections that are particularly difficult to identify with standard culture and molecular amplification-based approaches. This article discusses the current state of breath analysis for the diagnosis of infectious diseases.
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Affiliation(s)
- Chiranjit Ghosh
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Armando Leon
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Seena Koshy
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Obadah Aloum
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Yazan Al-Jabawi
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Nour Ismail
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Zoe Freeman Weiss
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sophia Koo
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
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13
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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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14
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Kanabalan RD, Lee LJ, Lee TY, Chong PP, Hassan L, Ismail R, Chin VK. Human tuberculosis and Mycobacterium tuberculosis complex: A review on genetic diversity, pathogenesis and omics approaches in host biomarkers discovery. Microbiol Res 2021; 246:126674. [PMID: 33549960 DOI: 10.1016/j.micres.2020.126674] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022]
Abstract
Mycobacterium tuberculosis complex (MTBC) refers to a group of mycobacteria encompassing nine members of closely related species that causes tuberculosis in animals and humans. Among the nine members, Mycobacterium tuberculosis (M. tuberculosis) remains the main causative agent for human tuberculosis that results in high mortality and morbidity globally. In general, MTBC species are low in diversity but exhibit distinctive biological differences and phenotypes among different MTBC lineages. MTBC species are likely to have evolved from a common ancestor through insertions/deletions processes resulting in species speciation with different degrees of pathogenicity. The pathogenesis of human tuberculosis is complex and remains poorly understood. It involves multi-interactions or evolutionary co-options between host factors and bacterial determinants for survival of the MTBC. Granuloma formation as a protection or survival mechanism in hosts by MTBC remains controversial. Additionally, MTBC species are capable of modulating host immune response and have adopted several mechanisms to evade from host immune attack in order to survive in humans. On the other hand, current diagnostic tools for human tuberculosis are inadequate and have several shortcomings. Numerous studies have suggested the potential of host biomarkers in early diagnosis of tuberculosis, in disease differentiation and in treatment monitoring. "Multi-omics" approaches provide holistic views to dissect the association of MTBC species with humans and offer great advantages in host biomarkers discovery. Thus, in this review, we seek to understand how the genetic variations in MTBC lead to species speciation with different pathogenicity. Furthermore, we also discuss how the host and bacterial players contribute to the pathogenesis of human tuberculosis. Lastly, we provide an overview of the journey of "omics" approaches in host biomarkers discovery in human tuberculosis and provide some interesting insights on the challenges and directions of "omics" approaches in host biomarkers innovation and clinical implementation.
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Affiliation(s)
- Renuga Devi Kanabalan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Le Jie Lee
- Prima Nexus Sdn. Bhd., Menara CIMB, Jalan Stesen Sentral 2, Kuala Lumpur, Malaysia
| | - Tze Yan Lee
- Perdana University School of Liberal Arts, Science and Technology (PUScLST), Suite 9.2, 9th Floor, Wisma Chase Perdana, Changkat Semantan Damansara Heights, Kuala Lumpur, 50490, Malaysia
| | - Pei Pei Chong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University Lakeside Campus, Subang Jaya, 47500, Malaysia
| | - Latiffah Hassan
- Department of Veterinary Laboratory Diagnostics, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, 43400 UPM, Malaysia
| | - Rosnah Ismail
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia.
| | - Voon Kin Chin
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400 UPM, Malaysia; Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak Alam, Selangor, 42300, Malaysia.
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15
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Chen X, Hu TY. Strategies for advanced personalized tuberculosis diagnosis: Current technologies and clinical approaches. PRECISION CLINICAL MEDICINE 2021; 4:35-44. [PMID: 33842836 PMCID: PMC8023014 DOI: 10.1093/pcmedi/pbaa041] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/21/2020] [Accepted: 12/21/2020] [Indexed: 02/05/2023] Open
Abstract
Diagnosis of tuberculosis can be difficult as advances in molecular diagnosis approaches (especially nanoparticles combined with high-throughput mass spectrometry for detecting mycobacteria peptide) and personalized medicine result in many changes to the diagnostic framework. This review will address issues concerning novel technologies from bench to bed and new strategies for personalized tuberculosis diagnosis.
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Affiliation(s)
- Xuerong Chen
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Tony Y Hu
- Center for Cellular and Molecular Diagnostics, School of Medicine, Tulane University, New Orleans, LA 70112, USA
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16
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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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17
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Chen B, Guo H, Liu C, Shang L, Ye X, Chen L, Feng C, Hayashi K. Molecularly imprinted sol-gel/Au@Ag core-shell nano-urchin localized surface plasmon resonance sensor designed in reflection mode for detection of organic acid vapors. Biosens Bioelectron 2020; 169:112639. [PMID: 32979590 DOI: 10.1016/j.bios.2020.112639] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/03/2020] [Accepted: 09/17/2020] [Indexed: 01/01/2023]
Abstract
A molecularly imprinted sol-gel (MISG)/Au@Ag core-shell NU sensor is proposed for organic vapor detection in an optical fiber-based reflection mode. The compact structure design of the system in the reflection model is promising for practical use as a portable and rapid responsivity sensing probe. Volatile organic acids (OAs) are analogs to biogenetic volatile organic vapors related to specific human diseases. Here, Au@Ag core-shell nano-urchins exhibiting branched tips were synthesized and deposited on indium tin oxide (ITO) glass in small dimer and trimmer clusters to generate an enhanced electric field. A MISG solution was then spin-coated on the substrate to fabricate MISG-LSPR sensors, and three types of MISGs were developed for the detection of hexanoic acid, heptanoic acid and octanoic acid. The normalized spectral response indicated selectivity of the MISG-LSPR sensors for the corresponding template OAs. With Native Bayes and linear discriminant analysis of the sensor responses, where the latter were detected by the proposed system, single- and mixed-OA vapors could be classified into separate clusters. This signified that the proposed MISG-LSPR sensor can be applied toward pattern recognition of single vapors or multiple vapor mixtures.
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Affiliation(s)
- Bin Chen
- Chongqing Key Laboratory of Non-linear Circuit and Intelligent Information Processing, College of Electronic and Information Engineering, Southwest University, Chongqing, 400715, PR China.
| | - Hao Guo
- Department of Electronics, Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, 819-0395, Japan
| | - Chuanjun Liu
- Department of Electronics, Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, 819-0395, Japan
| | - Liang Shang
- Department of Electronics, Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, 819-0395, Japan
| | - Xiao Ye
- Department of Electronics, Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, 819-0395, Japan
| | - Lin Chen
- Department of Electronics, Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, 819-0395, Japan
| | - Changhao Feng
- Chongqing Key Laboratory of Non-linear Circuit and Intelligent Information Processing, College of Electronic and Information Engineering, Southwest University, Chongqing, 400715, PR China
| | - Kenshi Hayashi
- Department of Electronics, Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, 819-0395, Japan.
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18
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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: 92] [Impact Index Per Article: 23.0] [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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19
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Identification of serum biomarkers for active pulmonary tuberculosis using a targeted metabolomics approach. Sci Rep 2020; 10:3825. [PMID: 32123207 PMCID: PMC7052258 DOI: 10.1038/s41598-020-60669-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 02/13/2020] [Indexed: 12/13/2022] Open
Abstract
Although tuberculosis (TB) is a severe health problem worldwide, the current diagnostic methods are far from optimal. Metabolomics is increasingly being used in the study of infectious diseases. We performed metabolome profiling to identify potential biomarkers in patients with active TB. Serum samples from 21 patients with active pulmonary TB, 20 subjects with latent TB infection (LTBI), and 28 healthy controls were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) followed by multivariate and univariate analyses. Metabolic profiles indicated higher serum levels of glutamate, sulfoxy methionine, and aspartate and lower serum levels of glutamine, methionine, and asparagine in active TB patients than in LTBI subjects or healthy controls. The ratios between metabolically related partners (glutamate/glutamine, sulfoxy methionine/methionine, and aspartate/asparagine) were also elevated in the active TB group. There was no significant difference in the serum concentration of these metabolites according to the disease extent or risk of relapse in active TB patients. Novel serum biomarkers such as glutamate, sulfoxy methionine, aspartate, glutamine, methionine, and asparagine are potentially useful for adjunctive, rapid, and noninvasive pulmonary TB diagnosis.
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20
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Maurer DL, Ellis CK, Thacker TC, Rice S, Koziel JA, Nol P, VerCauteren KC. Screening of Microbial Volatile Organic Compounds for Detection of Disease in Cattle: Development of Lab-scale Method. Sci Rep 2019; 9:12103. [PMID: 31431630 PMCID: PMC6702204 DOI: 10.1038/s41598-019-47907-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 07/26/2019] [Indexed: 12/22/2022] Open
Abstract
The primary hurdle for diagnosis of some diseases is the long incubation required to culture and confirm the presence of bacteria. The concept of using microbial VOCs as "signature markers" could provide a faster and noninvasive diagnosis. Finding biomarkers is challenging due to the specificity required in complex matrices. The objectives of this study were to (1) build/test a lab-scale platform for screening of microbial VOCs and (2) apply it to Mycobacterium avium paratuberculosis; the vaccine strain of M. bovis Bacillus Calmette-Guérin; and M. kansasii to demonstrate detection times greater those typically required for culture. SPME-GC-MS was used for sampling, sample preparation, and analyses. For objective (1), a testing platform was built for headspace sampling of bacterial cultures grown in standard culture flasks via a biosecure closed-loop circulating airflow system. For (2), results show that the suites of VOCs produced by Mycobacteria ssp. change over time and that individual strains produce different VOCs. The developed method was successful in discriminating between strains using a pooled multi-group analysis, and in timepoint-specific multi- and pair-wise comparisons. The developed testing platform can be useful for minimally invasive and biosecure collection of biomarkers associated with human, wildlife and livestock diseases for development of diagnostic point-of-care and field surveillance.
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Affiliation(s)
- Devin L Maurer
- Iowa State University, Dept. of Agricultural & Biosystems Engineering, Ames, IA, 50011, USA
| | - Christine K Ellis
- USDA-APHIS-WS-National Wildlife Research Center, Fort Collins, CO, 80521, USA
| | - Tyler C Thacker
- USDA-ARS, National Animal Disease Center, Mycobacterial Diseases, Ames, IA, 50010, USA
| | - Somchai Rice
- Iowa State University, Dept. of Agricultural & Biosystems Engineering, Ames, IA, 50011, USA
| | - Jacek A Koziel
- Iowa State University, Dept. of Agricultural & Biosystems Engineering, Ames, IA, 50011, USA.
| | - Pauline Nol
- USDA-APHIS-WS-Wildlife Livestock Disease Investigations Team, Fort Collins, CO, 80521, USA
| | - Kurt C VerCauteren
- USDA-APHIS-WS-National Wildlife Research Center, Fort Collins, CO, 80521, USA
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21
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Saktiawati AMI, Putera DD, Setyawan A, Mahendradhata Y, van der Werf TS. Diagnosis of tuberculosis through breath test: A systematic review. EBioMedicine 2019; 46:202-214. [PMID: 31401197 PMCID: PMC6712009 DOI: 10.1016/j.ebiom.2019.07.056] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/28/2022] Open
Abstract
Background Breath tests may diagnose tuberculosis (TB) through detecting specific volatile organic compounds produced by Mycobacterium tuberculosis or the infected host. Methods To estimate the diagnostic accuracy of breath test with electronic-nose and other devices against culture or other tests for TB, we screened multiple databases until January 6, 2019. Findings We included fourteen studies, with 1715 subjects in the analysis. The pooled sensitivity and specificity of electronic-nose were 0.93 (95% CI 0.82–0.97) and 0.93 (95% CI 0.82–0.97), respectively, and no heterogeneity was found. The sensitivity and specificity of other breath test devices ranged from 0.62 to 1.00, and 0.11 to 0.84, respectively. Interpretation The low to moderate evidence of these studies shows that breath tests can diagnose TB accurately, however, to give a real-time test result, additional development is needed. Research should also focus on sputum smear negative TB, children, and the positioning of breath testing in the diagnostic work flow. Funding The authors received no specific funding for this work.
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Affiliation(s)
- Antonia M I Saktiawati
- Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; University of Groningen, University Medical Centre Groningen, Department of Pulmonary Diseases and Tuberculosis, Groningen, the Netherlands; Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Althaf Setyawan
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yodi Mahendradhata
- Center for Tropical Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tjip S van der Werf
- University of Groningen, University Medical Centre Groningen, Department of Pulmonary Diseases and Tuberculosis, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Internal Medicine-Infectious Diseases, Groningen, the Netherlands.
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22
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A visual sensor array based on an indicator displacement assay for the detection of carboxylic acids. Mikrochim Acta 2019; 186:496. [DOI: 10.1007/s00604-019-3601-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 06/12/2019] [Indexed: 12/23/2022]
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23
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Picó C, Serra F, Rodríguez AM, Keijer J, Palou A. Biomarkers of Nutrition and Health: New Tools for New Approaches. Nutrients 2019; 11:E1092. [PMID: 31100942 PMCID: PMC6567133 DOI: 10.3390/nu11051092] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 12/18/2022] Open
Abstract
A main challenge in nutritional studies is the valid and reliable assessment of food intake, as well as its effects on the body. Generally, food intake measurement is based on self-reported dietary intake questionnaires, which have inherent limitations. They can be overcome by the use of biomarkers, capable of objectively assessing food consumption without the bias of self-reported dietary assessment. Another major goal is to determine the biological effects of foods and their impact on health. Systems analysis of dynamic responses may help to identify biomarkers indicative of intake and effects on the body at the same time, possibly in relation to individuals' health/disease states. Such biomarkers could be used to quantify intake and validate intake questionnaires, analyse physiological or pathological responses to certain food components or diets, identify persons with specific dietary deficiency, provide information on inter-individual variations or help to formulate personalized dietary recommendations to achieve optimal health for particular phenotypes, currently referred as "precision nutrition." In this regard, holistic approaches using global analysis methods (omics approaches), capable of gathering high amounts of data, appear to be very useful to identify new biomarkers and to enhance our understanding of the role of food in health and disease.
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Affiliation(s)
- Catalina Picó
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn) and Instituto de Investigación Sanitaria Illes Balears (IdISBa), University of the Balearic Islands, ES-07122 Palma de Mallorca, Spain.
| | - Francisca Serra
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn) and Instituto de Investigación Sanitaria Illes Balears (IdISBa), University of the Balearic Islands, ES-07122 Palma de Mallorca, Spain.
| | - Ana María Rodríguez
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn) and Instituto de Investigación Sanitaria Illes Balears (IdISBa), University of the Balearic Islands, ES-07122 Palma de Mallorca, Spain.
| | - Jaap Keijer
- Human and Animal Physiology, Wageningen University, PO Box 338, 6700 AH Wageningen, The Netherlands.
| | - Andreu Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn) and Instituto de Investigación Sanitaria Illes Balears (IdISBa), University of the Balearic Islands, ES-07122 Palma de Mallorca, Spain.
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du Preez I, Luies L, Loots DT. The application of metabolomics toward pulmonary tuberculosis research. Tuberculosis (Edinb) 2019; 115:126-139. [PMID: 30948167 DOI: 10.1016/j.tube.2019.03.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/27/2019] [Accepted: 03/08/2019] [Indexed: 02/07/2023]
Abstract
In the quest to identify novel biomarkers for pulmonary tuberculosis (TB), high-throughput systems biology approaches such as metabolomics has become increasingly widespread. Such biomarkers have not only successfully been used for better disease characterization, but have also provided new insights toward the future development of improved diagnostic and therapeutic approaches. In this review, we give a summary of the metabolomics studies done to date, with a specific focus on those investigating various aspects of pulmonary TB, and the infectious agent responsible, Mycobacterium tuberculosis. These studies, done on a variety of sample matrices, including bacteriological culture, sputum, blood, urine, tissue, and breath, are discussed in terms of their intended research outcomes or future clinical applications. Additionally, a summary of the research model, sample cohort, analytical apparatus and statistical methods used for biomarker identification in each of these studies, is provided.
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Affiliation(s)
- Ilse du Preez
- Human Metabolomics, North-West University, Private Bag X6001, Box 269, Potchefstroom, 2531, South Africa.
| | - Laneke Luies
- Human Metabolomics, North-West University, Private Bag X6001, Box 269, Potchefstroom, 2531, South Africa.
| | - Du Toit Loots
- Human Metabolomics, North-West University, Private Bag X6001, Box 269, Potchefstroom, 2531, South Africa.
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MacLean E, Broger T, Yerlikaya S, Fernandez-Carballo BL, Pai M, Denkinger CM. A systematic review of biomarkers to detect active tuberculosis. Nat Microbiol 2019; 4:748-758. [PMID: 30804546 DOI: 10.1038/s41564-019-0380-2] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 01/18/2019] [Indexed: 12/12/2022]
Abstract
Millions of cases of tuberculosis (TB) go undiagnosed each year. Better diagnostic tools are urgently needed. Biomarker-based or multiple marker biosignature-based tests, ideally performed on blood or urine, for the detection of active TB might help to meet target product profiles proposed by the World Health Organization for point-of-care testing. We conducted a systematic review to summarize evidence on proposed biomarkers and biosignatures and evaluate their quality and level of evidence. We screened the titles and abstracts of 7,631 citations and included 443 publications that fulfilled the inclusion criteria and were published in 2010-2017. The types of biomarkers identified included antibodies, cytokines, metabolic activity markers, mycobacterial antigens and volatile organic compounds. Only 47% of studies reported a culture-based reference standard and diagnostic sensitivity and specificity. Forty-four biomarkers (4%) were identified in high-quality studies and met the target product profile minimum criteria, of which two have been incorporated into commercial assays. Of the 44 highest-quality biomarkers, 24 (55%) were multiple marker biosignatures. No meta-analyses were performed owing to between-study heterogeneity. In conclusion, TB biomarker discovery studies are often poorly designed and findings are rarely confirmed in independent studies. Few markers progress to a further developmental stage. More validation studies that consider the intended diagnostic use cases and apply rigorous design are needed. The extracted data from this review are currently being used by FIND as the foundation of a dynamic database in which biomarker data and developmental status will be presented.
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Affiliation(s)
- Emily MacLean
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
| | | | | | | | - Madhukar Pai
- McGill International TB Centre, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
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Leclaire S, Strandh M, Dell'Ariccia G, Gabirot M, Westerdahl H, Bonadonna F. Plumage microbiota covaries with the major histocompatibility complex in blue petrels. Mol Ecol 2019; 28:833-846. [PMID: 30582649 DOI: 10.1111/mec.14993] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/05/2018] [Accepted: 12/17/2018] [Indexed: 01/04/2023]
Abstract
To increase fitness, a wide range of vertebrates preferentially mate with partners that are dissimilar at the major histocompatibility complex (MHC) or that have high MHC diversity. Although MHC often can be assessed through olfactory cues, the mechanism by which MHC genes influence odour remains largely unclear. MHC class IIB molecules, which enable recognition and elimination of extracellular bacteria, have been suggested to influence odour indirectly by shaping odour-producing microbiota, i.e. bacterial communities. However, there is little evidence of the predicted covariation between an animal's MHC genotype and its bacterial communities in scent-producing body surfaces. Here, using high-throughput sequencing, we tested the covariation between MHC class IIB genotypes and feather microbiota in the blue petrel (Halobaena caerulea), a seabird with highly developed olfaction that has been suggested to rely on oduor cues during an MHC-based mate choice. First, we show that individuals with similar MHC class IIB profiles also have similar bacterial assemblages in their feathers. Then, we show that individuals with high MHC diversity have less diverse feather microbiota and also a reduced abundance of a bacterium of the genus Arsenophonus, a genus in which some species are symbionts of avian ectoparasites. Our results, showing that feather microbiota covary with MHC, are consistent with the hypothesis that individual MHC genotype may shape the semiochemical-producing microbiota in birds.
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Affiliation(s)
- Sarah Leclaire
- Laboratoire Evolution & Diversité Biologique, UMR 5174 (CNRS, Université Paul Sabatier, ENFA), Toulouse, France.,Centre d'Ecologie Fonctionnelle et Evolutive, CNRS-CEFE, Montpellier, France
| | - Maria Strandh
- Molecular Ecology and Evolution Lab, Lund University, Lund, Sweden
| | - Gaia Dell'Ariccia
- Centre d'Ecologie Fonctionnelle et Evolutive, CNRS-CEFE, Montpellier, France
| | - Marianne Gabirot
- Centre d'Ecologie Fonctionnelle et Evolutive, CNRS-CEFE, Montpellier, France
| | | | - Francesco Bonadonna
- Centre d'Ecologie Fonctionnelle et Evolutive, CNRS-CEFE, Montpellier, France
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An ensemble approach for supporting the respiratory isolation of presumed tuberculosis inpatients. Neurocomputing 2019. [DOI: 10.1016/j.neucom.2018.11.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Beccaria M, Bobak C, Maitshotlo B, Mellors TR, Purcaro G, Franchina FA, Rees CA, Nasir M, Black A, Hill JE. Exhaled human breath analysis in active pulmonary tuberculosis diagnostics by comprehensive gas chromatography-mass spectrometry and chemometric techniques. J Breath Res 2018; 13:016005. [PMID: 30394364 DOI: 10.1088/1752-7163/aae80e] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Tuberculosis (TB) is the deadliest infectious disease, and yet accurate diagnostics for the disease are unavailable for many subpopulations. In this study, we investigate the possibility of using human breath for the diagnosis of active TB among TB suspect patients, considering also several risk factors for TB for smokers and those with human immunodeficiency virus (HIV). The analysis of exhaled breath, as an alternative to sputum-dependent tests, has the potential to provide a simple, fast, non-invasive, and readily available diagnostic service that could positively change TB detection. A total of 50 individuals from a clinic in South Africa were included in this pilot study. Human breath has been investigated in the setting of active TB using the thermal desorption-comprehensive two-dimensional gas chromatography-time of flight mass spectrometry methodology and chemometric techniques. From the entire spectrum of volatile metabolites in breath, three machine learning algorithms (support vector machines, partial least squares discriminant analysis, and random forest) to select discriminatory volatile molecules that could potentially be useful for active TB diagnosis were employed. Random forest showed the best overall performance, with sensitivities of 0.82 and 1.00 and specificities of 0.92 and 0.60 in the training and test data respectively. Unsupervised analysis of the compounds implicated by these algorithms suggests that they provide important information to cluster active TB from other patients. These results suggest that developing a non-invasive diagnostic for active TB using patient breath is a potentially rich avenue of research, including among patients with HIV comorbidities.
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Affiliation(s)
- Marco Beccaria
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, United States of America. KU Leuven-University of Leuven, Department for Pharmaceutical and Pharmacological Sciences, Leuven, B-3000, Belgium
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Mellors TR, Nasir M, Franchina FA, Smolinska A, Blanchet L, Flynn JL, Tomko J, O’Malley M, Scanga CA, Lin PL, Wagner J, Hill JE. Identification of Mycobacterium tuberculosis using volatile biomarkers in culture and exhaled breath. J Breath Res 2018; 13:016004. [DOI: 10.1088/1752-7163/aacd18] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Improving clinical and epidemiological predictors of Buruli ulcer. PLoS Negl Trop Dis 2018; 12:e0006713. [PMID: 30080870 PMCID: PMC6095624 DOI: 10.1371/journal.pntd.0006713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/16/2018] [Accepted: 07/21/2018] [Indexed: 11/21/2022] Open
Abstract
Background Buruli ulcer (BU) is a chronic necrotizing infectious skin disease caused by Mycobacterium ulcerans. The treatment with BU-specific antibiotics is initiated after clinical suspicion based on the WHO clinical and epidemiological criteria. This study aimed to estimate the predictive values of these criteria and how they could be improved. Methodology/Principal findings A total of 224 consecutive patients presenting with skin and soft tissue lesions that could be compatible with BU, including those recognized as unlikely BU by experienced clinicians, were recruited in two BU treatment centers in southern Benin between March 2012 and March 2015. For each participant, the WHO and four additional epidemiological and clinical diagnostic criteria were recorded. For microbiological confirmation, direct smear examination and IS2404 PCR were performed. We fitted a logistic regression model with PCR positivity for BU confirmation as outcome variable. On univariate analysis, most of the clinical and epidemiological WHO criteria were associated with a positive PCR result. However, lesions on the lower limbs and WHO category 3 lesions were rather associated with a negative PCR result (respectively OR: 0.4, 95%CI: 0.3–0.8; OR: 0.5, 95%IC: 0.3–0.9). Among the additional characteristics studied, the characteristic smell of BU was strongest associated with a positive PCR result (OR = 16.4; 95%CI = 7.5–35.6). Conclusion/Significance The WHO diagnostic criteria could be improved upon by differentiating between lesions on the upper and lower limbs and by including lesion size and the characteristic smell recognized by experienced clinicians. Buruli ulcer (BU) is a neglected necrotizing skin disease caused by Mycobacterium ulcerans. The treatment with BU-specific antibiotics is initiated after clinical suspicion based on WHO diagnostic criteria. In this study we evaluated the WHO diagnostic guidelines for BU and how these criteria could be improved. A total of 224 patients presenting with skin lesions were recruited in two BU treatment centers in southern Benin between March 2012 and March 2015. Most of the clinical and epidemiological WHO criteria were associated with a confirmed BU diagnosis although lesions on the lower limbs were rather associated with a negative PCR result. Among the additional characteristics studied, the characteristic smell of BU was most strongly associated with a positive PCR result. The WHO diagnostic criteria could therefore be improved upon by discriminating between lesions on the upper and lower limbs and by including lesion size and the characteristic smell recognized by experienced clinicians. The volatiles responsible for this smell could serve as a Point-of-Care diagnostic test, useful for non-invasive confirmation during active case-finding activities, and for training of clinicians.
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Salgado-Bustamante M, Rocha-Viggiano AK, Rivas-Santiago C, Magaña-Aquino M, López JA, López-Hernández Y. Metabolomics applied to the discovery of tuberculosis and diabetes mellitus biomarkers. Biomark Med 2018; 12:1001-1013. [PMID: 30043640 DOI: 10.2217/bmm-2018-0050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Tuberculosis (TB) and diabetes mellitus Type 2 (DM2) are two diseases as ancient as they are harmful to human health. The outcome for both diseases in part depends on immune and metabolic individual responses. DM2 is increasing yearly, mainly due to environmental, genetic and lifestyle habits. There are multiple evidence that DM2 is one of the most important risk factor of becoming infected with TB or reactivating latent TB. Mass spectrometry-based metabolomics is an important tool for elucidating the metabolites and metabolic pathways that influence the immune responses to M. tuberculosis infection during diabetes. We provide an up-to-date review highlighting the importance and benefit of metabolomics for identifying biomarkers as candidate molecules for diagnosis, disease activity or prognosis.
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Affiliation(s)
- Mariana Salgado-Bustamante
- Biochemistry Department, Medicine Faculty, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico
| | - Ana K Rocha-Viggiano
- Biochemistry Department, Medicine Faculty, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico
| | - César Rivas-Santiago
- CONACyT, Unidad Academica de Ciencias Biologicas, Universidad Autonoma de Zacatecas, Zacatecas, Mexico
| | - Martín Magaña-Aquino
- Infectology Department, Hospital Central Ignacio Morones Prieto, San Luis Potosi, Mexico
| | - Jesús A López
- MicroRNAs Laboratory, Unidad Academica de Ciencias Biologicas, Universidad Autonoma de Zacatecas, Zacatecas, Mexico
| | - Yamilé López-Hernández
- CONACyT, Unidad Academica de Ciencias Biologicas, Universidad Autonoma de Zacatecas, Zacatecas, Mexico
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Liu C, Shang L, Yoshioka HT, Chen B, Hayashi K. Preparation of molecularly imprinted polymer nanobeads for selective sensing of carboxylic acid vapors. Anal Chim Acta 2018; 1010:1-10. [DOI: 10.1016/j.aca.2018.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 01/08/2018] [Indexed: 01/05/2023]
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Franchina FA, Mellors TR, Aliyeva M, Wagner J, Daphtary N, Lundblad LKA, Fortune SM, Rubin EJ, Hill JE. Towards the use of breath for detecting mycobacterial infection: a case study in a murine model. J Breath Res 2018; 12:026008. [PMID: 29219122 DOI: 10.1088/1752-7163/aaa016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In the present research, the potential of breath analysis by comprehensive two-dimensional gas chromatography coupled to mass spectrometry (GC×GC-MS) was investigated for the discrimination between healthy and infected mice. A pilot study employing a total of 16 animals was used to develop a method for breath analysis in a murine model for studying Mycobacterium tuberculosis complex (MTBC) using the M. bovis bacillus Calmette-Guérin. Breath was collected in Tedlar bags and concentrated onto thermal desorption tubes for subsequent analysis by GC×GC-MS. Immunological test and bacterial cell count in bronchoalveolar lavage fluid and mice lung homogenate confirmed the presence of bacteria in the infected group. From the GC×GC-MS analysis, 23 molecules were found to mainly drive the separation between control and infected mice and their tentative identification is provided.This study shows that the overall used methodology is able to differentiate breath between healthy and infected animals, and the information herein can be used to further develop the mouse breath model to study MTBC pathogenesis, evaluate pre-clinical drug regimen efficacy, and to further develop the concept of breath-based diagnostics.
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Affiliation(s)
- Flavio A Franchina
- School of Engineering at Dartmouth College, 14 Engineering Drive, NH 03755, Hanover, United States of America
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Preliminary investigation of human exhaled breath for tuberculosis diagnosis by multidimensional gas chromatography – Time of flight mass spectrometry and machine learning. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1074-1075:46-50. [DOI: 10.1016/j.jchromb.2018.01.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/31/2017] [Accepted: 01/03/2018] [Indexed: 11/20/2022]
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Mass spectrometric techniques for the analysis of volatile organic compounds emitted from bacteria. Bioanalysis 2017; 9:1069-1092. [PMID: 28737423 DOI: 10.4155/bio-2017-0051] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Bacteria are the main cause of many human diseases. Typical bacterial identification methods, for example culture-based, serological and genetic methods, are time-consuming, delaying the potential for an early and accurate diagnosis and the appropriate subsequent treatment. Nevertheless, there is a stringent need for in situ tests that are rapid, noninvasive and sensitive, which will greatly facilitate timely treatment of the patients. This review article presents volatile organic metabolites emitted from various micro-organism strains responsible for common bacterial infections in humans. Additionally, the manuscript shows the application of different analytical techniques for fast bacterial identification. Details of these techniques are given, which focuses on their advantages and drawbacks in using for volatile organic components analysis.
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Mellors TR, Rees CA, Wieland-Alter WF, von Reyn CF, Hill JE. The volatile molecule signature of four mycobacteria species. J Breath Res 2017; 11:031002. [PMID: 28424429 DOI: 10.1088/1752-7163/aa6e06] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Mycobacteria are the leading cause of death from infectious disease worldwide and limitations in current diagnostics are hampering control efforts. In recent years, the use of small volatile molecules as diagnostic biomarkers for mycobacteria has shown promise for use in the rapid analysis of in vitro cultures as well as ex vivo diagnosis using breath or sputum. In this study, 18 strains from four mycobacteria species (Mycobacterium avium, M. bovis BCG, M. intracellulare and M. xenopi) were analyzed for the first time using two-dimensional gas chromatography time-of-flight mass spectrometry (GC × GC-TOFMS). This study represents the first time volatile molecules associated with M. intracellulare and M. xenopi have ever been reported. A total of 217 chromatographic features were identified and 58 features were selected that discriminate between these four species. Putative identifications are provided for 17 of the 58 discriminatory features, three of which have been reported previously in mycobacteria. The identification of mycobacteria-associated volatile biomarker suites could reduce the time-to-diagnosis for mycobacterial infections, either from in vitro cultures prior to the visualization of colonies or directly from ex vivo specimens, thereby shortening the empiric treatment window and potentially improving outcomes.
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Affiliation(s)
- Theodore R Mellors
- Thayer School of Engineering, Dartmouth College, 14 Engineering Drive, Hanover, NH 03755, United States of America
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Blanchet L, Smolinska A, Baranska A, Tigchelaar E, Swertz M, Zhernakova A, Dallinga JW, Wijmenga C, van Schooten FJ. Factors that influence the volatile organic compound content in human breath. J Breath Res 2017; 11:016013. [PMID: 28140379 DOI: 10.1088/1752-7163/aa5cc5] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Thousands of endogenous and exogenous volatile organic compounds (VOCs) are excreted in each breath. Inflammatory and deviant metabolic processes affect the level of endogeneous VOCs, which can serve as specific biomarkers for clinical diagnosis and disease monitoring. Important issues that still need to be tackled are related to potential confounding factors like gender and age and endogenous and exogenous factors, like f.i. smoking. METHODS The aim of this study was to systematically access the effect of endogenous and exogenous factors on VOC composition of exhaled breath. In the current study breath samples from 1417 adult participants from the LifeLines cohort, a general population cohort in the Netherlands, were collected and the total content of VOCs was measured using gas chromatography-time-of-flight-mass spectrometry. Breath samples were collected in Groningen and transferred to carbon tubes immediately. These samples were then shipped to Maastricht and measured in batches. VOCs profiles were correlated to 14 relevant characteristics of all participants including age, BMI, smoking and blood cell counts and metabolic parameters as well as to 16 classes of medications. RESULTS VOCs profiles were shown to be significantly influenced by smoking behavior and to a lesser extent by age, BMI and gender. These factors need to be controlled for in breath analysis studies. We found no evidence whatsoever in this 1417 subjects' cohort that white blood cell counts, cholesterol or triglycerides levels have an influence on the VOC profile. Thus they may not have to be controlled for in exhaled breath studies. CONCLUSION The large cohort of volunteers used here represents a unique opportunity to gauge the factors influencing VOCs profiles in a general population i.e. the most clinically relevant population. Classical clinical parameters and smoking habits clearly influence breath content and should therefore be accounted for in future clinical studies involving breath analysis.
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Affiliation(s)
- L Blanchet
- Top Institute Food and Nutrition (TIFN), Wageningen, The Netherlands. Department of Pharmacology and Toxicology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, Maastricht, The Netherlands. Thayer school of engineering, Dartmouth College, Hanover, NH, United States of America
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Preez ID, Luies L, Loots DT. Metabolomics biomarkers for tuberculosis diagnostics: current status and future objectives. Biomark Med 2017; 11:179-194. [PMID: 28097879 DOI: 10.2217/bmm-2016-0287] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Numerous studies have contributed to our current understanding of the complex biology of pulmonary tuberculosis and subsequently provided solutions to its control or eradication. Metabolomics, a newcomer to the Omics research domain, has significantly contributed to this understanding by identifying biomarkers originating from the disease-associated metabolome adaptations of both the microbe and host. These biomarkers have shed light on previously unknown disease mechanisms, many of which have been implemented toward the development of improved diagnostic strategies. In this review, we will discuss the role that metabolomics has played in tuberculosis research to date, with a specific focus on new biomarker identification, and how these have contributed to improved disease characterization and diagnostics, and their potential clinical applications.
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Affiliation(s)
- Ilse du Preez
- School for Physical & Chemical Sciences, Human Metabolomics, North-West University (Potchefstroom Campus), Private Bag x6001, Box 269, Potchefstroom, South Africa, 2531
| | - Laneke Luies
- School for Physical & Chemical Sciences, Human Metabolomics, North-West University (Potchefstroom Campus), Private Bag x6001, Box 269, Potchefstroom, South Africa, 2531
| | - Du Toit Loots
- School for Physical & Chemical Sciences, Human Metabolomics, North-West University (Potchefstroom Campus), Private Bag x6001, Box 269, Potchefstroom, South Africa, 2531
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Mellors TR, Blanchet L, Flynn JL, Tomko J, O'Malley M, Scanga CA, Lin PL, Hill JE. A new method to evaluate macaque health using exhaled breath: A case study of M. tuberculosis in a BSL-3 setting. J Appl Physiol (1985) 2017; 122:695-701. [PMID: 28057819 DOI: 10.1152/japplphysiol.00888.2016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/28/2016] [Accepted: 01/02/2017] [Indexed: 01/10/2023] Open
Abstract
Breath is hypothesized to contain clinically relevant information, useful for the diagnosis and monitoring of disease, as well as understanding underlying pathogenesis. Nonhuman primates, such as the cynomolgus macaque, serve as an important model for the study of human disease, including over 70 different human infections. In this feasibility study, exhaled breath was successfully collected in less than 5 min under Biosafety Level 3 conditions from five anesthetized, intubated cynomolgus and rhesus macaques, before and after lung infection with M. tuberculosis The breath was subsequently analyzed using comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry. A total of 384 macaque breath features were detected, with hydrocarbons being the most abundant. We provide putative identification for 19 breath molecules and report on overlap between the identified macaque breath compounds and those identified in previous human studies.NEW & NOTEWORTHY To the best of our knowledge, this is the first time the volatile molecule content of macaque breath has been comprehensively sampled and analyzed. We do so here in a Biosafety Level 3 setting in the context of M. tuberculosis lung infection. The breath of nonhuman primates represents a novel fluid that could provide insight into disease pathogenesis.
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Affiliation(s)
| | - Lionel Blanchet
- School of Engineering, Dartmouth College, Hanover, New Hampshire
| | - JoAnne L Flynn
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - Jaime Tomko
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - Melanie O'Malley
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - Charles A Scanga
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
| | - Philana L Lin
- Department of Pediatrics, Division of Infectious Disease, Children's Hospital of UPMC, Pittsburgh, Pennsylvania
| | - Jane E Hill
- School of Engineering, Dartmouth College, Hanover, New Hampshire;
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40
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Loots DT. TB or not TB? Improving the understanding and diagnosis of tuberculosis through metabolomics. Biomark Med 2016; 10:1025-1028. [PMID: 27643758 DOI: 10.2217/bmm-2016-0206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Du Toit Loots
- Human Metabolomics, North-West University, Hoffman Street, Private Bag X6001, Box 269, Potchefstroom 2531, South Africa
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41
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Boots AW, Bos LD, van der Schee MP, van Schooten FJ, Sterk PJ. Exhaled Molecular Fingerprinting in Diagnosis and Monitoring: Validating Volatile Promises. Trends Mol Med 2016; 21:633-644. [PMID: 26432020 DOI: 10.1016/j.molmed.2015.08.001] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/23/2015] [Accepted: 08/04/2015] [Indexed: 12/19/2022]
Abstract
Medical diagnosis and phenotyping increasingly incorporate information from complex biological samples. This has promoted the development and clinical application of non-invasive metabolomics in exhaled air (breathomics). In respiratory medicine, expired volatile organic compounds (VOCs) are associated with inflammatory, oxidative, microbial, and neoplastic processes. After recent proof of concept studies demonstrating moderate to good diagnostic accuracies, the latest efforts in breathomics are focused on optimization of sensor technologies and analytical algorithms, as well as on independent validation of clinical classification and prediction. Current research strategies are revealing the underlying pathophysiological pathways as well as clinically-acceptable levels of diagnostic accuracy. Implementing recent guidelines on validating molecular signatures in medicine will enhance the clinical potential of breathomics and the development of point-of-care technologies.
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Affiliation(s)
- Agnes W Boots
- Department of Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
| | - Lieuwe D Bos
- Department of Respiratory Medicine, Academic Medical Centre, University of Medical Centre Amsterdam, The Netherlands
| | - Marc P van der Schee
- Department of Respiratory Medicine, Academic Medical Centre, University of Medical Centre Amsterdam, The Netherlands; Department of Pediatric Pulmonology, Emma's Children's Hospital, Academic Medical Centre Amsterdam, The Netherlands
| | - Frederik-Jan van Schooten
- Department of Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Peter J Sterk
- Department of Respiratory Medicine, Academic Medical Centre, University of Medical Centre Amsterdam, The Netherlands
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42
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Sahota AS, Gowda R, Arasaradnam RP, Daulton E, Savage RS, Skinner JR, Adams E, Ward SA, Covington JA. A simple breath test for tuberculosis using ion mobility: A pilot study. Tuberculosis (Edinb) 2016; 99:143-146. [PMID: 27450016 DOI: 10.1016/j.tube.2016.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/18/2016] [Accepted: 05/22/2016] [Indexed: 11/26/2022]
Abstract
Tuberculosis (TB) remains one of the world's major health burdens with 9.6 million new infections globally. Though considerable progress has been made in reduction of TB incidence and mortality, there is a continuous need for lower cost, simpler and more robust means of diagnosis. One method that may fulfil these requirements is in the area of breath analysis. In this study we analysed the breath of 21 patients with pulmonary or extra-pulmonary TB, recruited from a UK teaching hospital (University Hospital Coventry and Warwickshire) before or within 1 week of commencing treatment for TB. TB diagnosis was confirmed by reference tests (mycobacterial culture), histology or radiology. 19 controls were recruited to calculate specificity; these patients were all interferon-gamma release assay negative (T.SPOT(®).TB, Oxford Immunotec Ltd.). Whole breath samples were collected with subsequent chemical analysis undertaken by Ion Mobility Spectrometry. Our results produced a sensitivity of 81% and a specificity of 79% for all cases of TB (pulmonary and extra-pulmonary). Though lower than other studies analysing pulmonary TB alone, we believe that this technique shows promise, and a higher sensitivity could be achieved by further improving our sample capture methodology.
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Affiliation(s)
- Amandip S Sahota
- Dept. of Infection and Tropical Medicine, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK.
| | - Ravi Gowda
- Department of Infectious Diseases, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.
| | - Ramesh P Arasaradnam
- Dept. of Gastroenterology, University Hospital Coventry and Warwickshire, and Clinical Sciences Research Institute, University of Warwick, Coventry, CV2 2DX, UK.
| | - Emma Daulton
- School of Engineering, University of Warwick, Coventry, UK.
| | - Richard S Savage
- Systems Biology Centre/Medical School, University of Warwick, CV4 7AL, UK.
| | - Jim R Skinner
- Centre for Complexity Science, University of Warwick, CV4 7AL, UK.
| | - Emily Adams
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Stephen A Ward
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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43
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Abstract
Breath testing has enormous potential in the medical diagnostic field. The underlying complexity and perceived availability of adequate specimens, combined with a lack of knowledge of the metabolic pathways that give rise to compounds that are sources of analytes detectable in breath, has greatly slowed development. These real obstacles have recently been largely overcome in the use of breath testing to identify patients with cystic fibrosis associated Pseudomonas aeruginosa infection and tuberculosis. This review summarizes progress made in the characterization of microbial volatiles produced by major lower respiratory tract bacterial pathogens, and their potential use as diagnostic markers in patient breath testing.
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Affiliation(s)
- James E Graham
- Department of Microbiology and Immunology, and Department of Biology, University of Louisville, Louisville, KY, USA; E-mail:
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44
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Haas CT, Roe JK, Pollara G, Mehta M, Noursadeghi M. Diagnostic 'omics' for active tuberculosis. BMC Med 2016; 14:37. [PMID: 27005907 PMCID: PMC4804573 DOI: 10.1186/s12916-016-0583-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/08/2016] [Indexed: 12/12/2022] Open
Abstract
The decision to treat active tuberculosis (TB) is dependent on microbiological tests for the organism or evidence of disease compatible with TB in people with a high demographic risk of exposure. The tuberculin skin test and peripheral blood interferon-γ release assays do not distinguish active TB from a cleared or latent infection. Microbiological culture of mycobacteria is slow. Moreover, the sensitivities of culture and microscopy for acid-fast bacilli and nucleic acid detection by PCR are often compromised by difficulty in obtaining samples from the site of disease. Consequently, we need sensitive and rapid tests for easily obtained clinical samples, which can be deployed to assess patients exposed to TB, discriminate TB from other infectious, inflammatory or autoimmune diseases, and to identify subclinical TB in HIV-1 infected patients prior to commencing antiretroviral therapy. We discuss the evaluation of peripheral blood transcriptomics, proteomics and metabolomics to develop the next generation of rapid diagnostics for active TB. We catalogue the studies published to date seeking to discriminate active TB from healthy volunteers, patients with latent infection and those with other diseases. We identify the limitations of these studies and the barriers to their adoption in clinical practice. In so doing, we aim to develop a framework to guide our approach to discovery and development of diagnostic biomarkers for active TB.
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Affiliation(s)
- Carolin T Haas
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK
| | - Jennifer K Roe
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK
| | - Gabriele Pollara
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK
| | - Meera Mehta
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT, UK.
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45
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Abstract
The surge in computing power and mobile connectivity have fashioned a foundation for mobile health (mHealth) technologies that can transform the mode and quality of clinical research and health care on a global scale. Unimpeded by geographical boundaries, smartphone-linked wearable sensors, point-of-need diagnostic devices, and medical-grade imaging, all built around real-time data streams and supported by automated clinical decision-support tools, will enable care and enhance our understanding of physiological variability. However, the path to mHealth incorporation into clinical care is fraught with challenges. We currently lack high-quality evidence that supports the adoption of many new technologies and have financial, regulatory, and security hurdles to overcome. Fortunately, sweeping efforts are under way to establish the true capabilities and value of the evolving mHealth field.
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Affiliation(s)
| | - Evan D Muse
- Scripps Translational Science Institute, La Jolla, CA 92037, USA
| | - Eric J Topol
- Scripps Translational Science Institute, La Jolla, CA 92037, USA
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46
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Chingin K, Liang J, Liu Y, Chen L, Wu X, Hu L, Ouyang Y. Rapid detection of Mycobacterium tuberculosis cultures by direct ambient corona discharge ionization mass spectrometry of volatile metabolites. RSC Adv 2016. [DOI: 10.1039/c6ra12107a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
High-throughput TB screening with high chemical specificity is achieved using direct ambient corona discharge ionization MS analysis of volatile metabolites.
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Affiliation(s)
- Konstantin Chingin
- Jiangxi Key Laboratory for Mass Spectrometry and Instrumentation
- East China University of Technology
- Nanchang City
- P. R. China
| | - Juchao Liang
- Jiangxi Key Laboratory for Mass Spectrometry and Instrumentation
- East China University of Technology
- Nanchang City
- P. R. China
| | - Yanling Liu
- The Second Affiliated Hospital of Nanchang University
- Nanchang City
- P. R. China
| | - Linfei Chen
- Jiangxi Key Laboratory for Mass Spectrometry and Instrumentation
- East China University of Technology
- Nanchang City
- P. R. China
| | - Xiaoping Wu
- Department of Infections, the First Affiliated Hospital of Nanchang University
- Nanchang City
- P. R. China
| | - Longhua Hu
- The Second Affiliated Hospital of Nanchang University
- Nanchang City
- P. R. China
| | - Yongzhong Ouyang
- Jiangxi Key Laboratory for Mass Spectrometry and Instrumentation
- East China University of Technology
- Nanchang City
- P. R. China
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47
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Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia. Sci Rep 2015; 5:17179. [PMID: 26608483 PMCID: PMC4660425 DOI: 10.1038/srep17179] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/27/2015] [Indexed: 01/19/2023] Open
Abstract
Ventilator-associated pneumonia (VAP) is a nosocomial infection occurring in the
intensive care unit (ICU). The diagnostic standard is based on clinical criteria and
bronchoalveolar lavage (BAL). Exhaled breath analysis is a promising non-invasive
method for rapid diagnosis of diseases and contains volatile organic compounds
(VOCs) that can differentiate diseased from healthy individuals. The aim of this
study was to determine whether analysis of VOCs in exhaled breath can be used as a
non-invasive monitoring tool for VAP. One hundred critically ill patients with
clinical suspicion of VAP underwent BAL. Before BAL, exhaled air samples were
collected and analysed by gas chromatography time-of-flight mass spectrometry
(GC-tof-MS). The clinical suspicion of VAP was confirmed by BAL
diagnostic criteria in 32 patients [VAP(+)] and rejected in 68 patients
[VAP(−)]. Multivariate statistical comparison of VOC profiles between
VAP(+) and VAP(−) revealed a subset of 12 VOCs that correctly
discriminated between those two patient groups with a sensitivity and specificity of
75.8% ± 13.5% and 73.0% ± 11.8%, respectively. These results
suggest that detection of VAP in ICU patients is possible by examining exhaled
breath, enabling a simple, safe and non-invasive approach that could diminish
diagnostic burden of VAP.
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48
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Scarlata S, Pennazza G, Santonico M, Pedone C, Antonelli Incalzi R. Exhaled breath analysis by electronic nose in respiratory diseases. Expert Rev Mol Diagn 2015; 15:933-56. [PMID: 25959642 DOI: 10.1586/14737159.2015.1043895] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Breath analysis via electronic nose is a technique oriented around volatile organic compound (VOC) profiling in exhaled breath for diagnostic and prognostic purposes. This approach, when supported by methodologies for VOC identification, has been often referred to as metabolomics or breathomics. Although breath analysis may have a substantial impact on clinical practice, as it may allow early diagnosis and large-scale screening strategies while being noninvasive and inexpensive, some technical and methodological limitations must be solved, together with crucial interpretative issues. By integrating a review of the currently available literature with more speculative arguments about the potential interpretation and application of VOC analysis, the authors aim to provide an overview of the main relevant aspects of this promising field of research.
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Affiliation(s)
- Simone Scarlata
- Unit of Respiratory Pathophysiology, Campus Bio-Medico University and Teaching Hospital, Via Alvaro del Portillo 200 - 00128, Rome, Italy
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49
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van der Schee MP, Paff T, Brinkman P, van Aalderen WMC, Haarman EG, Sterk PJ. Breathomics in lung disease. Chest 2015; 147:224-231. [PMID: 25560860 DOI: 10.1378/chest.14-0781] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Volatile organic compounds (VOCs) are produced by virtually all metabolic processes of the body. As such, they have potential to serve as noninvasive metabolic biomarkers. Since exhaled VOCs are either derived from the respiratory tract itself or have passed the lungs from the circulation, they are candidate biomarkers in the diagnosis and monitoring of pulmonary diseases in particular. Good examples of the possibilities of exhaled volatiles in pulmonary medicine are provided by the potential use of VOCs to discriminate between patients with lung cancer and healthy control subjects and to noninvasively diagnose infectious diseases and the association between VOCs and markers of disease activity that has been established in obstructive lung diseases. Several steps are, however, required prior to implementation of breath-based diagnostics in daily clinical practice. First, VOCs should be studied in the intention-to-diagnose population, because biomarkers are likely to be affected by multiple (comorbid) conditions. Second, breath collection and analysis procedures need to be standardized to allow pooling of data. Finally, apart from probabilistic analysis for diagnostic purposes, detailed examination of the nature of volatile biomarkers not only will improve our understanding of the pathophysiologic origins of these markers and the nature of potential confounders but also can enable the development of sensors that exhibit maximum sensitivity and specificity toward specific applications. By adhering to such an approach, exhaled biomarkers can be validated in the diagnosis, monitoring, and treatment of patients in pulmonary medicine and contribute to the development of personalized medicine.
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Affiliation(s)
- Marc Philippe van der Schee
- Department of Respiratory Medicine, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam; Department of Pediatric Respiratory Medicine and Allergy, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam; Department of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Tamara Paff
- Department of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands; The Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands.; Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul Brinkman
- Department of Respiratory Medicine, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam
| | | | - Eric Gerardus Haarman
- Department of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands
| | - Peter Jan Sterk
- Department of Respiratory Medicine, Emma's Children Hospital, Academic Medical Centre, University of Amsterdam
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50
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Dang NA, Mourão M, Kuijper S, Walters E, Janssen HG, Kolk AHJ. Direct detection of Mycobacterium tuberculosis in sputum using combined solid phase extraction-gas chromatography-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 986-987:115-22. [PMID: 25728368 DOI: 10.1016/j.jchromb.2015.01.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 01/28/2015] [Accepted: 01/30/2015] [Indexed: 10/24/2022]
Abstract
Recently, thermally-assisted hydrolysis and methylation followed by gas chromatography-mass spectrometry (THM-GC-MS) in combination with chemometrics has been used to develop a 20-compound model for fast differentiation of Mycobacterium tuberculosis (MTB) from Non-tuberculous mycobacteria (NTM) in bacterial cultures. This model provided better than 95% accuracy. In our current work a hexane/methanol/water extraction followed by a solid phase extraction (SPE) clean-up procedure was developed for use before THM-GC-MS, to make the test suitable for the identification of mycobacteria in sputum. The 20 biomarker model had to be adapted since many compounds were also found in the sputum of non-tuberculosis patients. An algorithm was established based on tuberculostearic acid, hexacosanoic acid and mycoserosates. The detection limit of the method was approximately 1×10(4) bacteria/mL sputum. Sputum specimens from 32 patients from South Africa who were suspected of having tuberculosis were blindly tested using the new method. Eight of the nine culture-positive sputum specimens were detected by the new SPE-THM-GC-MS method, resulting in a sensitivity of 89%. The specimen that was missed by the new method was also microscopy negative. The specificity of the test was 100%; all 23 microscopy- and culture-negative specimens were correctly identified as negative by SPE-THM-GC-MS.
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Affiliation(s)
- Ngoc A Dang
- Analytical Chemistry & Forensic Science, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands.
| | - Marta Mourão
- Analytical Chemistry & Forensic Science, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - Sjoukje Kuijper
- Analytical Chemistry & Forensic Science, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - Elisabetta Walters
- Desmond Tutu TB Centre, Stellenbosch University, P.O. Box 19063, Tygerberg 7505, South Africa
| | - Hans-Gerd Janssen
- Analytical Chemistry & Forensic Science, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands; Unilever Research and Development, P.O. Box 114, 3130 AC Vlaardingen, The Netherlands
| | - Arend H J Kolk
- Analytical Chemistry & Forensic Science, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
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