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On-Line Analysis of Exhaled Breath
journal contribution
posted on 2019-08-21, 18:07 authored by Tobias Bruderer, Thomas Gaisl, Martin T. Gaugg, Nora Nowak, Bettina Streckenbach, Simona Müller, Alexander Moeller, Malcolm Kohler, Renato ZenobiOn-line analysis of exhaled breath
offers insight into a person’s
metabolism without the need for sample preparation or sample collection.
Due to its noninvasive nature and the possibility to sample continuously,
the analysis of breath has great clinical potential. The unique features
of this technology make it an attractive candidate for applications
in medicine, beyond the task of diagnosis. We review the current methodologies
for on-line breath analysis, discuss current and future applications,
and critically evaluate challenges and pitfalls such as the need for
standardization. Special emphasis is given to the use of the technology
in diagnosing respiratory diseases, potential niche applications,
and the promise of breath analysis for personalized medicine. The
analytical methodologies used range from very small and low-cost chemical
sensors, which are ideal for continuous monitoring of disease status,
to optical spectroscopy and state-of-the-art, high-resolution mass
spectrometry. The latter can be utilized for untargeted analysis of
exhaled breath, with the capability to identify hitherto unknown molecules.
The interpretation of the resulting big data sets is complex and often
constrained due to a limited number of participants. Even larger data
sets will be needed for assessing reproducibility and for validation
of biomarker candidates. In addition, molecular structures and quantification
of compounds are generally not easily available from on-line measurements
and require complementary measurements, for example, a separation
method coupled to mass spectrometry. Furthermore, a lack of standardization
still hampers the application of the technique to screen larger cohorts
of patients. This review summarizes the present status and continuous
improvements of the principal on-line breath analysis methods and
evaluates obstacles for their wider application.