Breath diagnostics involves the analysis of a sample of human breath to monitor, diagnose, and detect diseases and conditions. Besides its primary constituents –

nitrogen Nitrogen is a chemical element; it has Symbol (chemistry), symbol N and atomic number 7. Nitrogen is a Nonmetal (chemistry), nonmetal and the lightest member of pnictogen, group 15 of the periodic table, often called the Pnictogen, pnictogens. ...

oxygen Oxygen is a chemical element; it has chemical symbol, symbol O and atomic number 8. It is a member of the chalcogen group (periodic table), group in the periodic table, a highly reactivity (chemistry), reactive nonmetal (chemistry), non ...

carbon dioxide Carbon dioxide is a chemical compound with the chemical formula . It is made up of molecules that each have one carbon atom covalent bond, covalently double bonded to two oxygen atoms. It is found in a gas state at room temperature and at norma ...

and

water vapour Water vapor, water vapour, or aqueous vapor is the gaseous phase of water. It is one state of water within the hydrosphere. Water vapor can be produced from the evaporation or boiling of liquid water or from the sublimation of ice. Water vapor ...

– exhaled human breath contains over one thousand other compounds at trace levels.Wang et al. (2009). "Breath Analysis Using Laser Spectroscopic Techniques: Breath Biomarkers, Spectral Fingerprints, and Detection Limits" Sensors 2009, 9(10) Many of these species are formed as the by-products of metabolic processes and can be indicative of a number of different diseases and conditions. Examples of such

biomarkers In biomedical contexts, a biomarker, or biological marker, is a measurable indicator of some biological state or condition. Biomarkers are often measured and evaluated using blood, urine, or soft tissues to examine normal biological processes, p ...

are outlined below:

Acetone Acetone (2-propanone or dimethyl ketone) is an organic compound with the chemical formula, formula . It is the simplest and smallest ketone (). It is a colorless, highly Volatile organic compound, volatile, and flammable liquid with a charact ...

Diabetes mellitus Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained hyperglycemia, high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or th ...

Ammonia Ammonia is an inorganic chemical compound of nitrogen and hydrogen with the chemical formula, formula . A Binary compounds of hydrogen, stable binary hydride and the simplest pnictogen hydride, ammonia is a colourless gas with a distinctive pu ...

Renal Disease Kidney disease, or renal disease, technically referred to as nephropathy, is damage to or disease of a kidney. Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can b ...

Hydrogen Sulfide Hydrogen sulfide is a chemical compound with the formula . It is a colorless chalcogen-hydride gas, and is toxic, corrosive, and flammable. Trace amounts in ambient atmosphere have a characteristic foul odor of rotten eggs. Swedish chemist ...

- Liver

Cirrhosis Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, chronic liver failure or chronic hepatic failure and end-stage liver disease, is a chronic condition of the liver in which the normal functioning tissue, or parenchyma, is replaced ...

Methane Methane ( , ) is a chemical compound with the chemical formula (one carbon atom bonded to four hydrogen atoms). It is a group-14 hydride, the simplest alkane, and the main constituent of natural gas. The abundance of methane on Earth makes ...

- Colonic Fermentation

Breath Acetone for Diabetes Diagnosis

is a serious chronic illness that affects how the body uses food, and is a life-threatening human disease if left untreated. It affects more than 171 million people worldwide.

can be subdivided into; type I

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

, where the body does not produce

insulin Insulin (, from Latin ''insula'', 'island') is a peptide hormone produced by beta cells of the pancreatic islets encoded in humans by the insulin (''INS)'' gene. It is the main Anabolism, anabolic hormone of the body. It regulates the metabol ...

, the hormone which facilitates the uptake of glucose by cells; and type II

, where the body becomes resistant to

, thus inhibiting the extent of glucose usage. In each case, the ineffective use of glucose as a source of energy leads to the subsequent breakdown of

fatty acids In chemistry, in particular in biochemistry, a fatty acid is a carboxylic acid with an aliphatic chain, which is either saturated or unsaturated. Most naturally occurring fatty acids have an unbranched chain of an even number of carbon atoms, ...

to compensate. This consumption of fatty acids by

ketosis Ketosis is a metabolic state characterized by elevated levels of ketone bodies in the blood or urine. Physiological ketosis is a normal response to low glucose availability. In physiological ketosis, ketones in the blood are elevated above bas ...

, produces

acetone Acetone (2-propanone or dimethyl ketone) is an organic compound with the chemical formula, formula . It is the simplest and smallest ketone (). It is a colorless, highly Volatile organic compound, volatile, and flammable liquid with a charact ...

which is excreted into the blood, before equilibrating with air in the lungs.

Diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

may therefore be characterised by elevated breath acetone levels. There are several new technologies being developed to diagnose and monitor

by means of an

breath test. It is hoped that the breath test will one day supersede the use of finger-prick blood tests and provide non-invasive diabetes monitoring. These technologies include Cavity Enhanced Absorption Spectroscopy (CEAS) and Plasma Emission

Spectroscopy Spectroscopy is the field of study that measures and interprets electromagnetic spectra. In narrower contexts, spectroscopy is the precise study of color as generalized from visible light to all bands of the electromagnetic spectrum. Spectro ...

(PES).

Volatile Organic compound mixture for early diagnosis, phenotyping, and therapy response prediction

The current state of the art of breath diagnostics is the use of an Electronic nose to detect the complete mixture of

Volatile organic compound Volatile organic compounds (VOCs) are organic compounds that have a high vapor pressure at room temperature. They are common and exist in a variety of settings and products, not limited to Indoor mold, house mold, Upholstery, upholstered furnitur ...

(VOCs) in the human breath. Breathomix BV is providing the latest advancement: BreathBase®, that is able to diagnose lung cancer up to two years earlier than standard clinical care. It can tell doctors who will respond to

immunotherapy Immunotherapy or biological therapy is the treatment of disease by activating or suppressing the immune system. Immunotherapies designed to elicit or amplify an immune response are classified as ''activation immunotherapies,'' while immunotherap ...

and it is able to distinguish different subtypes of disease in asthma and COPD. Therefore, treatment of asthma / COPD will be easier and tailored to the individual patient bringing us a step closer to personalized medicine /

precision medicine Precision, precise or precisely may refer to: Arts and media * ''Precision'' (march), the official marching music of the Royal Military College of Canada * "Precision" (song), by Big Sean * ''Precisely'' (sketch), a dramatic sketch by the Eng ...

Breath aerosol analysis

Breath aerosol analysis consists in the sampling and analysis of particles emitted in the respiratory tract and present in exhaled breath. This is a relatively new field that holds great promise for direct diagnostics of pathogens, such as

Influenza Influenza, commonly known as the flu, is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These sympto ...

, and for in-vivo monitoring of the respiratory lining fluid (

Respiratory epithelium Respiratory epithelium, or airway epithelium, is ciliated pseudostratified columnar epithelium a type of columnar epithelium found lining most of the respiratory tract as respiratory mucosa, where it serves to moisten and protect the airways ...

) components, such as

proteins Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residues. Proteins perform a vast array of functions within organisms, including catalysing metabolic reactions, DNA replication, re ...

and

phospholipids Phospholipids are a class of lipids whose molecule has a hydrophilic "head" containing a phosphate group and two hydrophobic "tails" derived from fatty acids, joined by an alcohol residue (usually a glycerol molecule). Marine phospholipids typi ...

.Almstrand A-C, Ljungström E, Lausmaa J, Bake B, Sjövall P, Olin A-C. Airway Monitoring by Collection and Mass Spectrometric Analysis of Exhaled Particles. Anal Chem. 2009 Jan 15;81(2):662–8. Various methods are used for sampling exhaled breath aerosols, such as filters, impactors,

impingement filter {{no footnotes, date=July 2014 An impingement filter can be used to purify a polluted solution, be it gas or liquid. The impingement filter acts by inducing the solution to change direction and the particles to adhere to the filter medium. In many ...

, or electrostatic precipitators. This latter field is related to that of

Bioaerosol Bioaerosols (short for biological aerosols) are a subcategory of particles released from terrestrial and marine ecosystems into the atmosphere. They consist of both living and non-living components, such as fungi, pollen, bacteria and viruses. Comm ...

sampling and analysis.

References

{{DEFAULTSORT:Breath Diagnostics Breath tests