Journal of breath research最新文献

Exhaled breath volatile organic compounds (VOCs) are often collected and stored in sorbent tubes before thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) analysis. Information about the stability of VOCs during storage is needed to account for potential artifacts and monitor for losses. Additionally, information about the stability of VOC standards in solution is required to assess their performance as quality control and internal standards. We evaluated the stability of a standard mixture of 42 VOCs in dual-sorbent tubes containing Tenax® TA and Carbotrap 1TD over 60 d at commonly used storage conditions: room temperature (∼21 °C), 4 °C, and -80 °C. The same 42 VOCs were also evaluated for their stability in methanol over 60 d while stored at -20 °C. All samples were analyzed using TD-GC-MS. During storage, most VOCs were stable on sorbent after 60 d: 36/42 (86%), 39/42 (93%), and 41/42 (98%) had not statistically changed for room temperature, 4 °C and -80 °C, respectively, based on Spearman rank correlation coefficients and linear regression analysis. The isotopically labeled VOCs tested here are well-suited to serve as internal standards for pre-analysis or storage. Degradation of VOCs in solution was apparent after 60 d: 27/42 (64%) of VOCs had statistically decreased. The total VOC mixture had dropped to 90% of its original intensity after ∼22 d and a subset of VOCs typically used as internal standards dropped to 90% in ∼16 d. Analysts using similar mixtures should make a fresh solution at least every two weeks to ensure analytical accuracy. This study provides important insights into storage practices for both sorbent tubes and standard solutions, guiding analysts toward improved reliability and accuracy in exhaled breath analysis.

The ocean is facing many anthropogenic stressors caused from both pollution and climate change. These stressors are significantly impacting and changing the ocean's ecosystem, and as such, methods must continually be developed that can improve our ability to monitor the health of marine life. For cetaceans, the current practice for health assessments of individuals requires live capture and release, which is expensive, usually stressful, and for larger species impractical. In this study, we investigated the potential of exhaled breath condensate (EBC) samples to provide unique metabolomic profiles from healthy killer whales (Orcinus orca) of varying known age and sex. EBC collection is a non-invasive procedure that has potential for remote collection using unmanned aerial vehicles, thus improving our ability to understand physiologic parameters within wild populations while minimizing stress from collection procedures. However, descriptions of the available metabolome within EBC and its clinical significance within animals of known health and age must be described before this technique can be considered diagnostically useful. We describe normal variations of the metabolome across age and sex and provide evidence for the potential of this breath analysis method to become a valuable adjunctive tool for assessing the health of managed-care and free-ranging killer whales.

Volatolomics (or volatilomics), the study of volatile organic compounds, has emerged as a significant branch of metabolomics due to its potential for non-invasive diagnostics and disease monitoring. However, the analysis of high-resolution data from mass spectrometry and gas sensor array-based instruments remains challenging. The careful consideration of experimental design, data collection, and processing strategies is essential to enhance the quality of results obtained from subsequent analyses. This comprehensive guide provides an in-depth exploration of volatolomics data analysis, highlighting the essential steps, such as data cleaning, pretreatment, and the application of statistical and machine learning techniques, including dimensionality reduction, clustering, classification, and variable selection. The choice of these methodologies, along with data handling practices, such as missing data imputation, outlier detection, model validation, and data integration, is crucial for identifying meaningful metabolites and drawing accurate diagnostic conclusions. By offering researchers the tools and knowledge to navigate the complexities of volatolomics data analysis, this guide emphasizes the importance of understanding the strengths and limitations of each method. Such informed decision-making enhances the reliability of findings, ultimately advancing the field and improving the understanding of metabolic processes in health and disease.

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) show high variability in individual susceptibility and promote disease progression; thus, accurate diagnosis and treatment is essential. Unravelling the molecular metabolic changes during AECOPD in breath could promote understanding of AECOPD and its treatment. Our objective was to investigate the metabolic breath profiles during AECOPD for biomarker detection. We conducted real-time breath analysis in patients with COPD during AECOPD and during subsequent stable phase. Molecular breath patterns were compared between AECOPD and stable phase by dimension reduction techniques and paired t-tests. Pathway enrichment analyses were performed to investigate underlying metabolic pathways. Partial least-squares discriminant analysis and XGboost were utilised to build a prediction model to differentiate AECOPD from stable state. 35 patients (60% male) with a mean age of 65 (10.2) yr with AECOPD were included. AECOPD could be predicted with a high sensitivity of 82.5% (95% confidence interval of 68.8%-93.8%) and an excellent discriminative power (AUC = 0.86). Metabolic changes in the linoleate, tyrosine, and tryptophan pathways during AECOPD were predominant. Significant metabolic changes occur during COPD exacerbations, predominantly in the linoleate, tyrosine, and tryptophan pathways, which are all linked to inflammation. Real-time exhaled breath analysis enables a good prediction of AECOPD compared to stable state and thus could enhance precision of AECOPD diagnosis and efficacy in clinical practice.

Several clinical studies have reported promising correlations between propofol concentration in exhaled breath (Ce-pro) and the bispectral index (BIS) in patients, suggesting the potential of exhaled propofol measurement as a non-invasive method for adjusting anesthesia depth. However, these studies are still in the validation phase of instrument effectiveness, often limited by small sample sizes or inappropriate instrument selection, and thus lack convincing results regarding these correlations. In this study, one hundred patients aged 18-65, undergoing elective thyroid surgery under general anesthesia were included. The vacuum ultraviolet photoionization and time-of-flight mass spectrometry was employed to monitor Ce-pro at 20 s intervals, alongside continuous BIS measurement. The association between Ce-pro and BIS was analyzed using linear mixed-effects models, with marginalR²used to assess the correlation. The threshold of Ce-pro at awakening was also explored. Additionally, the univariate and multifactorial diagnostic model, including end-of-surgery Ce-pro, were employed to assess the accuracy of predicting delayed recovery. A weak correlation was observed between intraoperative Ce-pro and BIS (marginalR²= 0.348). Predictive models utilizing end-of-surgery Ce-pro levels showed good accuracy (area under the curve (AUC) = 0.75, 95% CI: 0.62-0.89,P= 0.003) in predicting delayed recovery, while the model using end-of-surgery Ce-pro combined with gender, sufentanil dosage, the time from the last administration of sufentanil to the end of surgery, and anesthesia duration demonstrated stronger predicting accuracy (AUC = 0.91, 95% CI: 0.85-0.98,P< 0.001). This study suggests that Ce-pro alone may not reliably predict the depth of anesthesia in clinical practice, but shows promising accuracy in predicting delayed recovery from anesthesia.

The differentiation between malignant and benign thyroid nodules represents a significant challenge for clinicians globally. The identification of volatile organic compounds (VOCs) has emerged as a novel approach in the field of cancer diagnosis. This prospective pilot study aims to identify VOCs in exhaled breath, blood, and urine that can differentiate benign from malignant thyroid nodules using gas chromatography-ion mobility spectrometry (GC-IMS). Patients with thyroid nodules scheduled for surgery were enrolled at the Maastricht University Medical Center (MUMC+). Breath samples were analyzed using a BreathSpec GC-IMS machine (G.A.S. Dortmund, Germany), specifically designed for breath analysis. All blood and urine samples were analyzed using a separate GC-IMS device, the FlavourSpec® (G.A.S., Dortmund, Germany). In this proof-of-concept study, 70 consecutive patients undergoing thyroid surgery at MUMC+ were included. Of these patients, 29 were confirmed to have thyroid cancer after surgical resection. The overall analysis did not reveal statistically significant differences in VOCs in breath, urine and blood, between patients with benign and malignant thyroid cancer. This proof-of-concept study demonstrated that GC-IMS could not effectively differentiate between the VOC profiles of malignant and benign thyroid nodules. However, due to the small sample size of this study, larger prospective studies are needed to investigate the potential of using VOCs to distinguish between benign and malignant thyroid nodules. Additionally, future research should focus on identifying potential confounding factors that may influence patient VOC profiles. (NCT04883294).

Oral malodor negatively impacts a person's quality of life and may affect up to 50% of the population. The aim of this randomized, placebo and no-product controlled, evaluator-blind, proof-of-concept study was to evaluate the effectiveness and safety of the single use of two experimental lozenges containing the laccase enzyme and green coffee extract (with and without flavor) in reducing intrinsic oral malodor. Following 12-16 h of avoidance of oral hygiene,156 generally healthy subjects presented at screening and baseline visits with a mean organoleptic odor intensity (OI) score of ⩾2 and an OralChroma^TMreading of ⩾125 parts per billion (ppb) hydrogen sulfide (H₂S) gas and were randomly assigned to receive either one of the two experimental lozenges, a placebo lozenge, or no-product. Following the supervised use of the assigned products, subjects' oral malodor was evaluated using OI assessments and OralChroma^TMmeasurement for volatile sulfur compounds (VSCs) immediately following product use (approximately 5 min), and at 30 min, 1 h, 2 h, 3 h and 4 h. The two experimental lozenges, with and without flavor, showed significant reductions in OI scores compared with the placebo and no-product groups at all time points (p< 0.001). At 5 min post-product use, the experimental lozenges, with and without flavor, were significantly better than the no-product group in reducing the VSCs (p< 0.04). The results of individual VSC components (hydrogen sulfide, methyl mercaptan and dimethyl sulfide) were variable; both experimental lozenges notably reduced hydrogen sulfide and methyl mercaptan levels in most post-use assessments. Four minor adverse events were reported, none of which were directly linked to the product. In conclusion, the experimental lozenges, whether flavored or not, were safe and effective in reducing oral malodor over a span of 4 h, based on organoleptic OI scores.Clinical Trial No: NCT05950529.

To investigate the halitosis level in oral lichen planus (OLP) patients and OLP-free participants. This cross-sectional study recruited 70 participants at the New Zealand's National Centre for Dentistry. Halitosis was determined using the objective measurements (parts per billion (ppb) volatile sulphur compounds (VSCs) in the exhaled air) and subjective measurement (self-reported halitosis questionnaire). The VSCs values of OLP participants (mean ± SD: 144.64 ± 23.85 ppb) were significantly greater than that in the OLP-free participants (105.52 ± 22.31ppb) (mean difference: 39.12 ppb;p< 0.05; 95% CI: 27.95, 50.29). The VSCs value of hyperplastic (mean difference: 34.11; 95% CI: 20.07, 48.15;p< 0.05) and erosive/ulcerative (mean difference: 57.47; 95% CI: 34.19, 80.76;p< 0.05) OLP participants were statistically greater than that of OLP-free participants. No statistical significance was found between hyperplastic and erosive/ulcerative OLP (p> 0.05). 'Type (OLP-free/OLP)' has a significant effect on the dependent variable VSCs. 78.6% of OLP and 90.5% of OLP-free brushed their teeth at least twice daily, with a statistically significant observation (Mean square: 1.61; F: 13.13;p< 0.05). The levels of VSCs were greater in participants with hyperplastic and erosive/ulcerative OLP than that in the OLP-free participants.

The measurement of trace breath gases is of growing interest for its potential to provide non-invasive physiological information in health and disease. While instrumental techniques such as selected-ion flow-tube mass spectrometry (SIFT-MS) can achieve this, these are less suitable for clinical application. Sensitive sensor-based systems for breath ammonia could be more widely deployed, but have proven challenging to develop. This work demonstrates the sequential analytical validation of an electrochemical impedance-based sensor system for the measurement of ammonia in breath using SIFT-MS. Qualitative and relative responses between the two methods were comparable, although there were consistent differences in absolute concentration. When tested in artificial breath ammonia, sensors had a relative impedance sensitivity of 3.43 × 10^-5ppbv^-1for each breath in the range of 249-1653 ppbv (r²= 0.87,p< 0.05). When correlated with SIFT-MS using human breath (n= 14), ammonia was detected in the range of 100-700 ppbv (r= 0.78,p< 0.001), demonstrating acceptable sensitivity, reproducibility and dynamic range for clinical application.

Idiopathic halitosis is an unusual condition of unclear causes, which has never been thoroughly investigated. We aimed to explore the role of small intestinal bacterial overgrowth (SIBO) in the pathogenesis of idiopathic halitosis, and to evaluate the therapeutic efficacy of a probiotic preparation on this condition. This retrospective observational study included 162 idiopathic halitosis patients and 198 healthy controls (HCs). Halitosis was diagnosed using the organoleptic test, and idiopathic halitosis was diagnosed by excluding known causes. SIBO was identified through the hydrogen/methane lactulose breath test, and accordingly, patients were identified as SIBO-positive or SIBO-negative. Idiopathic halitosis patients were treated with the probiotic preparationBifidobacteriumtriple viable capsule for two months, followed by re-evaluation of halitosis and SIBO. This study found that all cases of idiopathic halitosis were extra-oral. The SIBO positivity rate in idiopathic halitosis patients was significantly higher than that in HCs (74.69% [121/162] vs 3.03% [6/198],P< 0.001), with an odds ratio of 94.44% (95% CI: 39.99%-211.35%). After treatment, 80.17% (97/121) of the SIBO-positive patients became SIBO-negative. Moreover, 87.60% (106/121) of the SIBO-positive patients experienced improved halitosis, a rate significantly higher than that observed in SIBO-negative patients (2.75%, 3/41) (P< 0.001). In addition, 98.97% (96/97) of the post-treatment SIBO-negative patients experienced improved halitosis, a rate significantly higher than that of post-treatment sustained SIBO-positive patients (41.67%, 10/24) (P< 0.001). Our findings suggest that idiopathic halitosis is an extra-oral condition which mostly originates from the small intestine. SIBO is one of its underlying causes. The probiotic preparation can effectively improve idiopathic halitosis, probably through its impact on SIBO.