Real-time Breath Analysis Research Articles

Phase-resolved real-time breath analysis during exercise by means of smart processing of PTR-MS data

Separation of inspiratory, mixed expired and alveolar air is indispensable for reliable analysis of VOC breath biomarkers. Time resolution of direct mass spectrometers often is not sufficient to reliably resolve the phases of a breathing cycle. To realise fast on-line breath monitoring by means of direct MS utilising low-fragmentation soft ionisation, a data processing algorithm was developed to identify inspiratory and alveolar phases from MS data without any additional equipment. To test the algorithm selected breath biomarkers (acetone, isoprene, acetaldehyde and hexanal) were determined by means of quadrupole proton transfer reaction mass spectrometry (PTR-MS) in seven healthy volunteers during exercise on a stationary bicycle. The results were compared to an off-line reference method consisting of controlled alveolar breath sampling in Tedlar® bags, preconcentration by solid-phase micro extraction (SPME), separation and identification by GC-MS. Based on the data processing method, quantitative attribution of biomarkers to inspiratory, alveolar and mixed expiratory phases was possible at any time during the experiment, even under respiratory rates up to 60/min. Alveolar concentrations of the breath markers, measured by PTR-MS ranged from 130 to 2,600 ppb (acetone), 10 to 540 ppb (isoprene), 2 to 31 ppb (acetaldehyde), whereas the concentrations of hexanal were always below the limit of detection (LOD) of 3 ppb. There was good correlation between on-line PTR-MS and SPME-GC-MS measurements during phases with stable physiological parameters but results diverged during rapid changes of heart rate and minute ventilation. This clearly demonstrates the benefits of breath-resolved MS for fast on-line monitoring of exhaled VOCs.

Breath ammonia and trimethylamine allow real-time monitoring of haemodialysis efficacy

Non-invasive monitoring of breath ammonia and trimethylamine using Selected-ion-flow-tube mass spectroscopy (SIFT-MS) could provide a real-time alternative to current invasive techniques. Breath ammonia and trimethylamine were monitored by SIFT-MS before, during and after haemodialysis in 20 patients. In 15 patients (41 sessions), breath was collected hourly into Tedlar bags and analysed immediately (group A). During multiple dialyses over 8 days, five patients breathed directly into the SIFT-MS analyser every 30 min (group B). Pre- and post-dialysis direct breath concentrations were compared with urea reduction, Kt/V and creatinine concentrations. Dialysis decreased breath ammonia, but a transient increase occurred mid treatment in some patients. Trimethylamine decreased more rapidly than reported previously. Pre-dialysis breath ammonia correlated with pre-dialysis urea in group B (r2 = 0.71) and with change in urea (group A, r2 = 0.24; group B, r2 = 0.74). In group B, ammonia correlated with change in creatinine (r2 = 0.35), weight (r2 = 0.52) and Kt/V (r2 = 0.30). The ammonia reduction ratio correlated with the urea reduction ratio (URR) (r2 = 0.42) and Kt/V (r2 = 0.38). Pre-dialysis trimethylamine correlated with Kt/V (r2 = 0.21), and the trimethylamine reduction ratio with URR (r2 = 0.49) and Kt/V (r2 = 0.36). Real-time breath analysis revealed previously unmeasurable differences in clearance kinetics of ammonia and trimethylamine. Breath ammonia is potentially useful in assessment of dialysis efficacy.

Dispersal kinetics of deuterated water in the lungs and airways following mouth inhalation: real-time breath analysis by flowing afterglow mass spectrometry (FA-MS)

Pulmonary oedema is a medical condition characterized by abnormal accumulation of fluid in the extravascular space in the alveoli. Effective oxygenation is impaired and this leads to significant short- and long-term morbidity and mortality. The detection and monitoring of pulmonary oedema by measuring lung water volume is therefore crucial in the initiation and guidance of therapeutic intervention. The current gold standard bedside measurement of extravascular lung water volume (EVLW) is the dilution method using various indicators, but despite the good correlation of the results with those obtained using the post-mortem gravimetric method, the invasiveness of the dilution technique limits its general application in the wider clinical setting. In the present preliminary experiments, the dispersal kinetics of deuterium (actually HDO) in exhaled breath of three healthy participants following the inhalation of deuterium oxide (D2O) vapour are explored as monitored using flowing afterglow mass spectrometry (FA-MS). Here, we present the basic ideas of lung water estimation using this novel technique, and briefly discuss its limitations and required future work.

The potential offered by real-time, high-sensitivity monitoring of ethane in breath and some pilot studies using optical spectroscopy

Breath analysis applied to biomedical applications has gained much momentum is recent years due to the growing research demonstrating that breath gas can provide clinically useful data. Particularly exciting is the area of real-time breath analysis which, when coupled with appropriately chosen target species, can offer a novel method for non-invasive patient monitoring. Here we describe the role of ethane, a breath gas of universal appeal in assessing in vivo oxidative stress (cell damage). We first present a review of emerging applications where real-time ethane monitoring could yield original new results for healthcare. We then report on results from a portable ethane spectroscopy system (accuracy better then 100 parts per trillion (1?part in 1010) over a 1?s time response) that we have developed to exploit some of these applications. By presenting some initial results from pilot studies in the life sciences, we comment on the requirements that the next stage of optical spectroscopy technology has to meet in order to benefit clinical end-users.

Evaluation of the Dermal Bioavailability of Aqueous Xylene in F344 Rats and Human Volunteers

Xylene is a clear, colorless liquid used as a solvent in the printing, rubber, and leather industries and is commonly found in paint thinners, paints, varnishes, and adhesives. Although humans are most likely to be exposed to xylene via inhalation, xylene is also found in well and surface water. Therefore, an assessment of the dermal contribution to total xylene uptake is useful for understanding human exposures. To evaluate the significance of these exposures, the dermal absorption of o-xylene was assessed in F344 male rats and human volunteers using a combination of real-time exhaled breath analysis and physiologically based pharmacokinetic (PBPK) modeling. Animals were exposed to o-xylene dermally. Immediately following the initiation of exposure, individual animals were placed in a glass off-gassing chamber and exhaled breath was monitored. Human volunteers participating in the study placed both legs into a stainless steel hydrotherapy tub containing an initial concentration of approximately 500 w g/L o-xylene. Exhaled breath was continually analyzed from each volunteer before, during, and after exposure to track absorption and subsequent elimination of the compound in real time. In both animal and human studies, a PBPK model was used to estimate the dermal permeability coefficient (K p ) to describe each set of exhaled breath data. Rat skin was found to be approximately 12 times more permeable to aqueous o-xylene than human skin. The estimated human and rat aqueous o-xylene K p values were 0.005 - 0.001 cm/h and 0.058 - 0.009 cm/h, respectively.

EVALUATION OF THE DERMAL ABSORPTION OF AQUEOUS TOLUENE IN F344 RATS USING REAL-TIME BREATH ANALYSIS AND PHYSIOLOGICALLY BASED PHARMACOKINETIC MODELING

Toluene is a ubiquitous chemical that is commonly used for its solvent properties in industry and manufacturing, and is a component of many paint products. Because of its widespread use, there is potential for both occupational and nonoccupational dermal exposure to toluene. To understand the significance of these exposures, the dermal bioavailability of toluene was assessed in F344 male rats using a combination of real-time exhaled breath analysis and physiologically based pharmacokinetic (PBPK) modeling. Animals were exposed to toluene at 0.5 or 0.2 mg/ml aqueous concentration (0.05% or 0.02%) using a 2.5-cm-diameter occluded glass patch system attached to a clipper-shaved area on the back of the rat. Immediately following exposure, individual animals were placed in a glass off-gassing chamber and exhaled breath was monitored as chamber concentration in real time using an ion-trap mass spectrometer (MS/MS). The real-time exhaled breath profile clearly demonstrated the rapid absorption of toluene, with peak chamber concentrations observed within 1 h from the start of exposure. The PBPK model describing the exposure and off-gassing chamber was used to estimate a dermal permeability coefficient ( K p ) to describe each set of exhaled breath data. Regardless of exposure level, a single K p value of 0.074 - 0.005 cm/h provided a good fit to all data sets. These rat studies using aqueous toluene will form the basis for comparing the dermal bioavailability of toluene in various paint products and may ultimately aid in understanding human health risk under a variety of exposure scenarios.

Use of real-time breath analysis and physiologically based pharmacokinetic modeling to evaluate dermal absorption of aqueous toluene in human volunteers.

Toluene is a ubiquitous chemical that is commonly used for its solvent properties in industry and manufacturing, and is a component of many paint products. Although human exposure to toluene is most likely to be through inhalation, toluene is also found in well and surface water. Therefore, an assessment of the dermal contribution to total toluene uptake is useful for understanding human exposures. To evaluate the significance of these exposures, the dermal absorption of toluene was assessed in human volunteers using a combination of real-time exhaled breath analysis and physiologically based pharmacokinetic (PBPK) modeling. Human volunteers wearing swimsuits were submerged in warm tap water to neck level in a stainless steel hydrotherapy tub containing an initial concentration of approximately 500-microg/l toluene. Volunteers were provided purified breathing air to eliminate inhalation exposures, and exhaled breath was continually analyzed before, during, and post exposure to track the absorption and subsequent elimination of the compound in real time. A PBPK model was used to estimate the dermal permeability coefficient (K(p)) to describe each set of exhaled breath data from 4-6 human volunteers. An average K(p) value of 0.012 +/- 0.007 cm/h was found to provide a good fit to all data sets. Volunteers also participated in a second study phase, in which the subject was allowed to breathe the room air during immersion, thus both dermal and inhalation exposures to toluene occurred. Exhaled breath analyses revealed that concurrent inhalation of volatilized toluene resulted in a transient increase in the peak exhaled-breath level by 100 ppb, or an approximate 50% increase over breath levels observed in dermal-only studies. For perspective, the total intake of toluene associated with oral consumption of 2 liters of water containing toluene at bath water concentrations were estimated to be more than 30 times greater than the dermal contribution due to bathing.

An innovative method to determine percutaneous absorption: Real-time breath analysis and physiologically based pharmacokinetic modeling

From the 1950s through the 1970s, the rate of uptake of a chemical through the skin was generally estimated from studies of humans using radiolabeled compounds [1]. More recently, estimates of derm...

Assessment of the percutaneous absorption of trichloroethylene in rats and humans using MS/MS real-time breath analysis and physiologically based pharmacokinetic modeling.

The development and validation of noninvasive techniques for estimating the dermal bioavailability of solvents in contaminated soil and water can facilitate the overall understanding of human health risk. To assess the dermal bioavailability of trichloroethylene (TCE), exhaled breath was monitored in real time using an ion trap mass spectrometer (MS/MS) to track the uptake and elimination of TCE from dermal exposures in rats and humans. A physiologically based pharmacokinetic (PBPK) model was used to estimate total bioavailability. Male F344 rats were exposed to TCE in water or soil under occluded or nonoccluded conditions by applying a patch to a clipper-shaved area of the back. Rats were placed in off-gassing chambers and chamber air TCE concentration was quantified for 3-5 h postdosing using the MS/MS. Human volunteers were exposed either by whole-hand immersion or by attaching patches containing TCE in soil or water on each forearm. Volunteers were provided breathing air via a face mask to eliminate inhalation exposure, and exhaled breath was analyzed using the MS/MS. The total TCE absorbed and the dermal permeability coefficient (K(P)) were estimated for each individual by optimization of the PBPK model to the exhaled breath data and the changing media and/or dermal patch concentrations. Rat skin was significantly more permeable than human skin. Estimates for K(P) in a water matrix were 0.31 +/- 0.01 cm/h and 0.015 +/- 0.003 cm/h in rats and humans, respectively. K(P) estimates were more than three times higher from water than soil matrices in both species. K(P) values calculated using the standard Fick's Law equation were strongly affected by exposure length and volatilization of TCE. In comparison, K(P) values estimated using noninvasive real-time breath analysis coupled with the PBPK model were consistent, regardless of volatilization, exposure concentration, or duration.

DETERMINATION OF BIOKINETIC INTERACTIONS IN CHEMICAL MIXTURES USING REAL-TIME BREATH ANALYSIS AND PHYSIOLOGICALLY BASED PHARMACOKINETIC MODELING

Regulatory agencies are challenged to conduct risk assessments on chemical mixtures without full information on toxicological interactions that may occur at real-world, lowdose exposure levels. The present study was undertaken to investigate the pharmacokinetic impact of low-dose coexposures to toluene and trichloroethylene in vivo in male F344 rats using a real-time breath analysis system coupled with physiologically based pharmacokinetic (PBPK) modeling. Rats were exposed to compounds alone or as a binary mixture, at low (5 to 25 mg/kg) or high (240 to 800 mg/kg) dose levels. Exhaled breath from the exposed animals was monitored for the parent compounds and a PBPK model was used to analyze the data. At low doses, exhaled breath kinetics from the binary mixture exposure compared with those obtained during single exposures, thus indicating that no metabolic interaction occurred with these low doses. In contract, at higher doses the binary PBPK model simulating independent metabolism was found to underpredict the exhaled breath concentration, suggesting an inhibition of metabolism. Therefore the binary mixture PBPK model was used to compare the measured exhaled breath levels from high- and low-dose exposures with the predicted levels under various metabolic interaction simulations (competitive, noncompetitive, or uncompetitive inhibition). Of these simulations, the optimized competitive metabolic interaction description yielded a K i value closest to the K m of the inhibitor solvent, indicating that competitive inhibition is the most plausible type of metabolic interaction between these two solvents.

A real-time in-vivo method for studying the percutaneous absorption of volatile chemicals.

Realistic estimates of percutaneous absorption following exposures to solvents in the workplace, or through contaminated soil and water, are critical to understanding human health risks. A method was developed to determine dermal uptake of solvents under non-steady-state conditions using real-time breath analysis in rats, monkeys, and humans. The exhaled breath was analyzed using an ion-trap mass spectrometer, which can quantitate chemicals in the exhaled breath stream in the 1-5 ppb range. The resulting data were evaluated using physiologically-based pharmacokinetic (PBPK) models to estimate dermal permeability constants (Kp) under various exposure conditions. The effects of exposure matrix (soil versus water), occlusion versus non-occlusion, and species differences on the absorption of methyl chloroform, trichloroethylene, and benzene were compared. Exposure concentrations were analyzed before and at 0.5-hour intervals throughout the exposures. The percentage of each chemical absorbed and the corresponding Kp were estimated by optimization of the PBPK model to the medium concentration and the exhaled-breath data. The method was found to be sufficiently sensitive for animal and human dermal studies at low exposure concentrations over small body surface areas, for short periods, using non-steady-state exposure conditions.

Utility of real time breath analysis and physiologically based pharmacokinetic modeling to determine the percutaneous absorption of methyl chloroform in rats and humans.

Due to the large surface area of the skin, percutaneous absorption has the potential to contribute significantly to the total bioavailability of some compounds. Breath elimination data, acquired in real-time using a novel MS/MS system, was assessed using a PBPK model with a dermal compartment to determine the percutaneous absorption of methyl chloroform (MC) in rats and humans from exposures to MC in non-occluded soil or occluded water matrices. Rats were exposed to MC using a dermal exposure cell attached to a clipper-shaved area on their back. The soil exposure cell was covered with a charcoal patch to capture volatilized MC and prevent contamination of exhaled breath. This technique allowed the determination of MC dermal absorption kinetics under realistic, non-occluded conditions. Human exposures were conducted by immersing one hand in 0.1% MC in water, or 0.75% MC in soil. The dermal PBPK model was used to estimate skin permeability (Kp) based on the fit of the exhaled breath data. Rat skin K(p)s were estimated to be 0.25 and 0.15 cm/h for MC in water and soil matrices, respectively. In comparison, human permeability coefficients for water matrix exposures were 40-fold lower at 0.006 cm/h. Due to evaporation and differences in apparent Kp, nearly twice as much MC was absorbed from the occluded water (61.3%) compared to the non-occluded soil (32.5%) system in the rat. The PBPK model was used to simulate dermal exposures to MC-contaminated water and soil in children and adults using worst-case EPA default assumptions. The simulations indicate that neither children nor adults will absorb significant amounts of MC from non-occluded exposures, independent of the length of exposure. The results from these simulations reiterate the importance of conducting dermal exposures under realistic conditions.