Translating secondary electrospray ionization–high-resolution mass spectrometry to the clinical environment

Kapil Dev Singh,Martin Thomas Gaugg,Renato Zenobi,Alfredo J Ibañez,Pablo M-L Sinues,Urs Frey,Malcolm Kohler,Guillermo Vidal Del Miguel

doi:10.1088/1752-7163/aa9ee3

Abstract

While there has been progress in making use of breath tests to guide clinical decision making, the full potential of exhaled breath analysis still remains to be exploited. Here we summarize some of the reasons why this is the case, what we have done so far to overcome some of the existing obstacles, and our vision of how we think breath analysis will play a more prominent role in the coming years. In particular, we envision that real-time high-resolution mass spectrometry will provide valuable information in biomarker discovery studies. However, this can only be achieved by a coordinated effort, using standardized equipment and methods in multi-center studies to eventually deliver tangible advances in the field of breath analysis in a clinical setting. Concrete aspects such as sample integrity, compound identification, quantification and standardization are discussed. Novel secondary electrospray ionization developments with the aim of facilitating inter-groups comparisons and biomarker validation studies are also presented.

Highlights

No patient will be surprised when the physician, faced with some diagnostic hypothesis, requests a blood or urine analysis to confirm or reject the suspected diagnosis
We summarize why we think breath analysis may soon be routinely used for clinical decision making
This development allowed us to showcase the power of SESIHRMS [51] and, more importantly, we learned what improvements were required for this technique to be broadly used: namely, reducing the background levels and memory effects so as to properly identify low volatility species, and easing operation and maintenance procedures

Summary

February 2018

Commons Attribution 3.0 Keywords: real-time analyis, secondary electrospray ionization-mass spectrometry, biomarker discovery licence. We envision that real-time high-resolution mass spectrometry will provide valuable information in biomarker discovery studies. This can only be achieved by a coordinated effort, using standardized equipment and methods in multi-center studies to eventually deliver tangible advances in the field of breath analysis in a clinical setting. Concrete aspects such as sample integrity, compound identification, quantification and standardization are discussed. Novel secondary electrospray ionization developments with the aim of facilitating inter-groups comparisons and biomarker validation studies are presented

Introduction

Biomarker discovery: shortcomings and suggested strategies to overcome them

Clinical Infection control

Operational Reproducibility and quality control

Findings

Conclusion