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Biomedical Engineering

The Biomedical Engineering blog is the place for conversation and discussion about topics related to engineering principles of the medical field. Here, you'll find everything from discussions about emerging medical technologies to advances in medical research. The blog's owner, Chelsey H, is a graduate of Rensselaer Polytechnic Institute (RPI) with a degree in Biomedical Engineering.

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Breath Analysis For Disease Detection

Posted February 13, 2012 12:00 AM by Chelsey H

You may be breathing into a breathalyzer at your next checkup. The new "breathalyzer" technology is an advance in disease diagnosis. The technique is currently under development at the University of Wisconsin-Madison. It's a simple but very sensitive method used to distinguish normal and disease-state glucose metabolism. Breath testing is an exciting development in diagnostics because it is non-invasive and even more sensitive than the blood-based assays.

Image Credit: yourdictionary.com

The Science

Often, the process for disease detection is tedious, complicated, and many times leaves the patient and the doctor with ambiguous answers. Metabolomics is a new area of research that studies and characterizes the small molecules called metabolites found in an organism. Metabolomics allow scientists to look at genotype- phenotype and genotype-environment relationships by observing how a metabolome relates to the genotype of an organism, its physiology and its environment (what it eats or breaths). The relationship between a metabolome and its genotype or environment is critical information which can be used in many fields including pharmacology, drug trials and screenings. Here is a video with more information about this field.

Many diseases, including diabetes, cancer, and infections, alter the body's metabolism in a distinctive way. Metabolic changes can be detected by measuring the isotopic signature of carbon-containing metabolic byproducts in the blood or breath. The ratio of the isotopes in the blood or breath produces different patterns for a wide range of diseases. "Your body changes its fuel source. When we're healthy we use the food that we eat," senior author Fariba Assadi-Porter says. "When we get sick, the immune system takes over the body and starts tearing apart proteins to make antibodies and use them as an energy source." Scientists have advanced methods of tracing metabolic pathways that are disturbed from disease. When the body shifts from sugar to protein it engages different biochemical pathways and causes changes in the carbon isotope. The changes can be detected in exhaled carbon dioxide and analyzed for information on disease identification, development or recovery.

Image Credit: Wikipedia

The Study

The new study on metabolomics was published in the February 2012 issue of the journal Metabolism. Researchers from UWM studied mice with metabolic symptoms similar to those seen in women with polycystic ovary syndrome (PCOS). PCOS affects approximately 1 in 10 women by causing infertility, ovarian cysts, and metabolic dysfunction. Unfortunately the disease can only be diagnosed after puberty and only after ruling out many other diseases. The goal of this study was to use the change in isotope ratio due to metabolic changes to identify the earliest stages of a disease, which can be treated with diet and medication.

The mice were injected with glucose containing a single atom of the heavier isotope carbon-13. This isotope allowed scientists to trace which metabolic pathways were most active in sick or healthy mice. The change in ratio from carbon-12 to carbon-13 could be measured in minutes within the carbon dioxide exhaled by the mice.

Researchers were able to identify similar patterns using two independent assays. The study used nuclear magnetic resonance spectroscopy on blood serum and cavity ring-down spectroscopy on exhaled breath. These techniques were sensitive enough to detect a statistically significant difference between even small populations of healthy and sick mice. Currently, the cavity ring-down spectroscopy analysis uses a machine about the size of a shoebox, but a company called Isomark, LLC (co-founded by the researchers) is developing a hand-held "breathalyzer" that could be taken into rural or remote areas.

Take a Deep Breath

The new research shows that these biochemical changes can be detected much sooner than typical symptoms would appear- even within a few hours- offering hope of early disease detection and diagnosis. Another advantage of the breathalyzer is that it surveys the workings of the entire body with a single test and could provide almost immediate feedback on the effectiveness of treatments. "It's a cheaper, faster, and more sensitive method of diagnosis" says Porter.

There is currently a project underway called The Human Metabolome Project tasked with identifying and classifying every human metabolite, much like the classification of the human genome. Results have been promising and the more metabolites that are classified, the more scientists and doctors will be able to use the information to develop diagnostic tests for a wide range of diseases.

Resources

Metabolic "breathalyzer" reveals early signs of disease

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#1

Re: Breath Analysis For Disease Detection

02/14/2012 12:30 AM

If I understand this at all, it is pretty exciting! Testing without needles? When will it be available here in podunk?

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Re: Breath Analysis For Disease Detection

02/14/2012 1:21 AM

I'm glad to hear that this is now taking off. From what I know, the contents of our breath - different traces of gases - provide us with useful statistical data. Certain trace gases may be linked to certain diseases, eating habits or life-style traits. E.g. vegetarians will have higher traces of methane if I can remember correctly. I would imagine, by now, they have sophisticated linked data-bases set up to cross-link data between patients and ailments.

A few yrs ago I played around with an instrument called the gas chromatograph. I had learnt how to take old GC parts and reconstruct it into a working instrument that is tuned in and calibrated for selected gases. We also tried to set it up for analysis of the human breath. The instrument was pretty primitive by modern standards. We did try to link the results to a computer.

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#3
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Re: Breath Analysis For Disease Detection

02/14/2012 4:07 AM

It's quite a way to go before you can say "testing without needles". the mice in the study were injected with a test glucose first. Even if they rearrange the test to allow swallowing the test glucose, that will still be testing for only the limited range of diseases that result in altered patterns of glucose metabolism.
For the management of diabetes I would be much more excited by the development of an implanted glucose sensor

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Re: Breath Analysis For Disease Detection

02/14/2012 11:10 AM

True, but still, an injection is a lot less objectionable than taking blood samples...

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#4

Re: Breath Analysis For Disease Detection

02/14/2012 6:16 AM

This is indeed exciting news. It's an indication of the dynamic challenge in research science. There is perseverance in the hearts of the scientist and engineers/technologist in finding clues that support our existence. They deserve the credit.

Just not long ago it was the introduction of the GeneXpert as one of the quickest technologies for TB diagnostics. It used to take days but with the GeneExpert system, diagnosed can be within two to three hours.

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#5

Re: Breath Analysis For Disease Detection

02/14/2012 8:37 AM

Wow! Shades of Star Trek and their analyser. Think of stories from nursing homes that cats and dogs can detect impending death and spend more time with that person.

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#6

Re: Breath Analysis For Disease Detection

02/14/2012 11:02 AM

This sounds like a scientific extention of the "mom" test. That's how mom can tell if you're getting sick, really sick, or just faking. She just smells your breath.

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#8

Re: Breath Analysis For Disease Detection

02/14/2012 5:03 PM

The part played by the breathalyser used to be played by the GP who could sniff out many malfunctions by what he could detect on your breath, (the GP's that didn't smoke that is).

Nowadays they are too interested in keeping their keyboards warm, and not getting too near smelly patients, so I guess this will go some way to finding our way back to the way we were.

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#9

Re: Breath Analysis For Disease Detection

02/17/2012 3:26 PM

Wait...Not so fast....until the metabolomes....or metabolites that are excreted in the exhaled breath of normal individiduals must first be documented before any correlation to a particular disease or pathology can be derived...

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