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Nakhleh M, Amal H, Jeries R, Broza YY, Aboud M, Gharra A, Ivgi H, Khatib S, Badarneh S, Har-Shai L, Glass-Marmor L, Lejbkowicz I, Miller A, Badarny S, Winer R, Finberg J, Cohen-Kaminsky S, Perros F, Montani D, Girerd B, Garcia G, Simonneau G, Nakhoul F, Baram S, Salim R, Hakim M, Gruber M, Ronen O, Marshak T, Doweck I, Nativ O, Bahouth Z, Shi DY, Zhang W, Hua QL, Pan YY, Tao L, Liu H, Karban A, Koifman E, Rainis T, Skapars R, Sivins A, Ancans G, Liepniece-Karele I, Kikuste I, Lasina I, Tolmanis I, Johnson D, Millstone SZ, Fulton J, Wells JW, Wilf LH, Humbert M, Leja M, Peled N, Haick H. Diagnosis and Classification of 17 Diseases from 1404 Subjects via Pattern Analysis of Exhaled Molecules. ACS Nano 2017; 11:112-125. [PMID: 28000444 PMCID: PMC5269643 DOI: 10.1021/acsnano.6b04930] [Citation(s) in RCA: 256] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 12/02/2016] [Indexed: 05/17/2023]
Abstract
We report on an artificially intelligent nanoarray based on molecularly modified gold nanoparticles and a random network of single-walled carbon nanotubes for noninvasive diagnosis and classification of a number of diseases from exhaled breath. The performance of this artificially intelligent nanoarray was clinically assessed on breath samples collected from 1404 subjects having one of 17 different disease conditions included in the study or having no evidence of any disease (healthy controls). Blind experiments showed that 86% accuracy could be achieved with the artificially intelligent nanoarray, allowing both detection and discrimination between the different disease conditions examined. Analysis of the artificially intelligent nanoarray also showed that each disease has its own unique breathprint, and that the presence of one disease would not screen out others. Cluster analysis showed a reasonable classification power of diseases from the same categories. The effect of confounding clinical and environmental factors on the performance of the nanoarray did not significantly alter the obtained results. The diagnosis and classification power of the nanoarray was also validated by an independent analytical technique, i.e., gas chromatography linked with mass spectrometry. This analysis found that 13 exhaled chemical species, called volatile organic compounds, are associated with certain diseases, and the composition of this assembly of volatile organic compounds differs from one disease to another. Overall, these findings could contribute to one of the most important criteria for successful health intervention in the modern era, viz. easy-to-use, inexpensive (affordable), and miniaturized tools that could also be used for personalized screening, diagnosis, and follow-up of a number of diseases, which can clearly be extended by further development.
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Affiliation(s)
- Morad
K. Nakhleh
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Haitham Amal
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Raneen Jeries
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Yoav Y. Broza
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Manal Aboud
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Alaa Gharra
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Hodaya Ivgi
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Salam Khatib
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Shifaa Badarneh
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| | - Lior Har-Shai
- Division of Neuroimmunology and Multiple
Sclerosis Center, Carmel Medical Center and Rappaport Family Faculty
of Medicine, Technion−Israel Institute
of Technology, Haifa 31096, Israel
| | - Lea Glass-Marmor
- Division of Neuroimmunology and Multiple
Sclerosis Center, Carmel Medical Center and Rappaport Family Faculty
of Medicine, Technion−Israel Institute
of Technology, Haifa 31096, Israel
| | - Izabella Lejbkowicz
- Division of Neuroimmunology and Multiple
Sclerosis Center, Carmel Medical Center and Rappaport Family Faculty
of Medicine, Technion−Israel Institute
of Technology, Haifa 31096, Israel
| | - Ariel Miller
- Division of Neuroimmunology and Multiple
Sclerosis Center, Carmel Medical Center and Rappaport Family Faculty
of Medicine, Technion−Israel Institute
of Technology, Haifa 31096, Israel
| | - Samih Badarny
- Movement
Disorders Clinic, Department of Neurology, Carmel Medical Center,
and Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 31096, Israel
| | - Raz Winer
- Movement
Disorders Clinic, Department of Neurology, Carmel Medical Center,
and Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 31096, Israel
| | - John Finberg
- Department of Molecular Pharmacology, Rappaport
Family Faculty of Medicine, Technion−Israel
Institute of Technology, Haifa 31096, Israel
| | - Sylvia Cohen-Kaminsky
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Frédéric Perros
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - David Montani
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Barbara Girerd
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Gilles Garcia
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Gérald Simonneau
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Farid Nakhoul
- Department of
Nephrology and Hypertension Baruch Padeh
Medical Center, Poriya 15208, Israel
| | - Shira Baram
- Department of Obstetrics
and Gynecology, Emek Medical Center, Afula 18101, and Rappaport Family
Faculty of Medicine, Technion−Israel
Institute of Technology, Haifa 31096, Israel
| | - Raed Salim
- Department of Obstetrics
and Gynecology, Emek Medical Center, Afula 18101, and Rappaport Family
Faculty of Medicine, Technion−Israel
Institute of Technology, Haifa 31096, Israel
| | - Marwan Hakim
- Department
of Obstetrics and Gynecology, Nazareth Hospital EMMS, Nazareth, and
Faculty of Medicine in the Galilee, Bar
Ilan University, Ramat
Gan, Israel
| | - Maayan Gruber
- The Department of Otolaryngology Head and
Neck Surgery, Carmel Medical Center, Haifa 3436212, Israel
| | - Ohad Ronen
- The Department of Otolaryngology Head and
Neck Surgery, Carmel Medical Center, Haifa 3436212, Israel
| | - Tal Marshak
- The Department of Otolaryngology Head and
Neck Surgery, Carmel Medical Center, Haifa 3436212, Israel
| | - Ilana Doweck
- The Department of Otolaryngology Head and
Neck Surgery, Carmel Medical Center, Haifa 3436212, Israel
| | - Ofer Nativ
- Department of Urology, Bnai Zion Medical Center, Haifa 31048, Israel
| | - Zaher Bahouth
- Department of Urology, Bnai Zion Medical Center, Haifa 31048, Israel
| | - Da-you Shi
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Wei Zhang
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Qing-ling Hua
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Yue-yin Pan
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Li Tao
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Hu Liu
- Department
of Oncology, The First Affiliated Hospital
of Anhui Medical University, Hefei 230032, China
| | - Amir Karban
- Internal Medicine C and Gastroenterology Departments,
Rambam Medical Center, Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 3525408, Israel
| | - Eduard Koifman
- Internal Medicine C and Gastroenterology Departments,
Rambam Medical Center, Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 3525408, Israel
| | - Tova Rainis
- Department of Gastroenterology, Bnai Zion
Hospital and Rappaport Family Faculty of Medicine, Technion−Israel Institute of Technology, Haifa 31096, Israel
| | - Roberts Skapars
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Armands Sivins
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Guntis Ancans
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Inta Liepniece-Karele
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Ilze Kikuste
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
- Digestive Diseases
Centre, GASTRO, 6 Linezeraiela, LV1006 Riga, Latvia
| | - Ieva Lasina
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
| | - Ivars Tolmanis
- Digestive Diseases
Centre, GASTRO, 6 Linezeraiela, LV1006 Riga, Latvia
| | - Douglas Johnson
- Department of Radiation
Oncology, Baptist Cancer Institute (BCI), 1235 San Marco Boulevard, Suite100, Jacksonville, Florida 32207, United States
| | - Stuart Z. Millstone
- Pulmonary
and Critical Care Associates, Orange Park, Florida 32073, United States
| | - Jennifer Fulton
- Pulmonary Diseases, Baptist Medical Center, Jacksonville, Florida 32217, United States
| | - John W. Wells
- Pulmonary
and Critical Care Associates, Orange Park, Florida 32073, United States
| | - Larry H. Wilf
- Oncologic Imaging Division, Florida Radiation Oncology Group, Jacksonville, Florida 32217, United States
| | - Marc Humbert
- Univ. Paris-Sud, Faculté
de Médecine, Université Paris-Saclay, AP-HP, Centre National de Référence
de l′Hypertension Pulmonaire Sévère, Département
Hospitalo-Universitaire (DHU) Thorax Innovation, Service de Pneumologie,
Hôpital de Bicêtre, UMRS _999, INSERM and Univ. Paris−Sud,
Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament
et l′Innovation Thérapeutique (LERMIT), Centre Chirurgical
Marie Lannelongue, Le Plessis Robinson 92350, France
| | - Marcis Leja
- Faculty of Medicine, University of Latvia, Digestive Diseases, Riga East University Hospital, 19 Rainisboulv, LV1586 Riga, Latvia
- Digestive Diseases
Centre, GASTRO, 6 Linezeraiela, LV1006 Riga, Latvia
| | - Nir Peled
- Thoracic
Cancer Unit, Davidoff Cancer Center, RMC, Kaplan Street, Petach Tiqwa 49100, Israel
| | - Hossam Haick
- Department of Chemical
Engineering and Russell Berrie Nanotechnology Institute, Technion−Israel Institute of Technology, Haifa 3200003, Israel
| |
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