Exhaled breath analysis: from occupational to respiratory medicine.

Breath analysis is a technique rapidly gaining ground as a non-invasive tool to diagnose and monitor various aspects of lung diseases. Measurement of exhaled breath is safe, rapid, simple to perform, and effort independent. Given that human breath contains upwards of 250 chemicals, the potential for developing new applications is high. Much of the current knowledge on breath analysis in respiratory medicine derives from years of experience gained in occupational settings, where breath analysis has been used mainly to assess exposure to volatile chemicals. Laboratory based analysis of exhaled air is a complex, expensive and time consuming process and thus is not in wide spread use in occupational medicine. However, recent knowledge of exhaled breath analysis in pulmonology, in particular in bronchial asthma and lung cancer, and the development of fast, and easy to perform non-invasive procedures for breath analysis, re-opened possible application of exhaled breath as a novel approach for biological monitoring of inhaled pneumotoxic substances. The simultaneous quantification of biomarkers of dose and effect in exhaled air may provide new insights into lung damage occurring in workers exposed to inhaled toxicants, thus representing a new and fascinating application in risk assessment strategies.

[1]  A. Mutti,et al.  Absorption and alveolar excretion of cyclohexane in workers in a shoe factory , 1981, Journal of applied toxicology : JAT.

[2]  A. Mutti,et al.  n-Hexane metabolism in occupationally exposed workers. , 1984, British journal of industrial medicine.

[3]  H. J. O’neill,et al.  Volatile organic compounds in exhaled air from patients with lung cancer. , 1985, Clinical chemistry.

[4]  P O Droz,et al.  Occupational exposure monitoring using breath analysis. , 1986, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[5]  D. Gompertz,et al.  CADMIUM FUME INHALATION AND EMPHYSEMA , 1988, The Lancet.

[6]  W. Pryor Mechanisms of radical formation from reactions of ozone with target molecules in the lung. , 1994, Free radical biology & medicine.

[7]  L. Wallace,et al.  Breath measurements as volatile organic compound biomarkers. , 1996 .

[8]  P. Montuschi,et al.  Increased 8-isoprostane, a marker of oxidative stress, in exhaled condensate of asthma patients. , 1999, American journal of respiratory and critical care medicine.

[9]  R. Cataneo,et al.  Volatile organic compounds in breath as markers of lung cancer: a cross-sectional study , 1999, The Lancet.

[10]  A Mutti,et al.  Biological monitoring in occupational and environmental toxicology. , 1999, Toxicology letters.

[11]  P. Montuschi,et al.  Increased carbon monoxide in exhaled air of patients with cystic fibrosis , 1999, Thorax.

[12]  S. Flora,et al.  Threshold mechanisms and site specificity in chromium(VI) carcinogenesis , 2000 .

[13]  F. Hargreave,et al.  A comparison of exhaled nitric oxide and induced sputum as markers of airway inflammation. , 2000, The Journal of allergy and clinical immunology.

[14]  I. Horváth,et al.  "Haemoxygenase-1 induction and exhaled markers of oxidative stress in lung diseases", summary of the ERS Research Seminar in Budapest, Hungary, September, 1999. , 2001, The European respiratory journal.

[15]  P. Barnes,et al.  Elevated concentrations of exhaled hydrogen peroxide in asthmatic patients. , 2001, Chest.

[16]  P. Montuschi,et al.  Increased nitrosothiols in exhaled breath condensate in inflammatory airway diseases. , 2001, American journal of respiratory and critical care medicine.

[17]  Z. Kováčiková,et al.  Comparative in vitro toxicity of cadmium and lead on redox cycling in type II pneumocytes , 2001, Journal of applied toxicology : JAT.

[18]  W. Lindinger,et al.  Analysis of volatile organic compounds: possible applications in metabolic disorders and cancer screening. , 2001, Wiener klinische Wochenschrift.

[19]  P. Piirilä,et al.  Exhaled nitric oxide in specific challenge tests to assess occupational asthma , 2002, European Respiratory Journal.

[20]  Kevin Gleeson,et al.  Detection of lung cancer with volatile markers in the breath. , 2003, Chest.

[21]  P. Montuschi,et al.  Validation of 8-isoprostane and prostaglandin E2 measurements in exhaled breath condensate , 2003, Inflammation Research.

[22]  M. Corradi,et al.  Aldehydes in exhaled breath condensate of patients with chronic obstructive pulmonary disease. , 2003, American journal of respiratory and critical care medicine.

[23]  M. Corradi,et al.  Aldehydes and glutathione in exhaled breath condensate of children with asthma exacerbation. , 2003, American journal of respiratory and critical care medicine.

[24]  A Smith,et al.  Exhaled breath condensate pH is a robust and reproducible assay of airway acidity , 2003, European Respiratory Journal.

[25]  Joachim Schauer,et al.  Exhaled breath condensate acidification in acute lung injury. , 2003, Respiratory medicine.

[26]  P. Barnes Cytokine-directed therapies for the treatment of chronic airway diseases. , 2003, Cytokine & growth factor reviews.

[27]  Massimo Corradi,et al.  Determination of patterns of biologically relevant aldehydes in exhaled breath condensate of healthy subjects by liquid chromatography/atmospheric chemical ionization tandem mass spectrometry. , 2003, Rapid communications in mass spectrometry : RCM.

[28]  D. Hendrick Smoking, cadmium, and emphysema , 2004, Thorax.

[29]  W. P. Watson,et al.  Role of biomarkers in monitoring exposures to chemicals: present position, future prospects , 2004, Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals.

[30]  S. Deveci,et al.  The measurement of exhaled carbon monoxide in healthy smokers and non-smokers. , 2004, Respiratory medicine.

[31]  R. Pauwels,et al.  Burden and clinical features of chronic obstructive pulmonary disease (COPD) , 2004, The Lancet.

[32]  P. Montuschi,et al.  Gas chromatography/mass spectrometry analysis of exhaled leukotrienes in asthmatic patients , 2004, Thorax.

[33]  Kjell Torén,et al.  Determination of hydrogen peroxide in exhaled breath condensate by flow injection analysis with fluorescence detection. , 2004, Journal of chromatography. B, Analytical technologies in the biomedical and life sciences.

[34]  Gert Folkerts,et al.  Nitric Oxide in Health and Disease of the Respiratory System , 2022 .

[35]  B. Balbi,et al.  Comparison between exhaled and sputum oxidative stress biomarkers in chronic airway inflammation , 2004, European Respiratory Journal.

[36]  A. Boner,et al.  Exhaled breath condensate eicosanoids and sputum eosinophils in asthmatic children: A pilot study , 2004, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[37]  D. Doherty The pathophysiology of airway dysfunction. , 2004, The American journal of medicine.

[38]  P. Apostoli,et al.  Exhaled Breath Condensate as a Suitable Matrix to Assess Lung Dose and Effects in Workers Exposed to Cobalt and Tungsten , 2004, Environmental health perspectives.

[39]  F. Dente,et al.  Granulocyte markers in hypertonic and isotonic saline-induced sputum of asthmatic subjects , 2004, European Respiratory Journal.

[40]  P. J. Barnes,et al.  Exhaled breath condensate: methodological recommendations and unresolved questions , 2005, European Respiratory Journal.

[41]  O. Holz Catching breath: monitoring airway inflammation using exhaled breath condensate , 2005, European Respiratory Journal.

[42]  P. Barnes,et al.  Exhaled 8-isoprostane in childhood asthma , 2005, Respiratory research.

[43]  P. Mazzone,et al.  Detection of lung cancer by sensor array analyses of exhaled breath. , 2005, American journal of respiratory and critical care medicine.

[44]  Pieter Zanen,et al.  Markers of inflammation and oxidative stress in exacerbated chronic obstructive pulmonary disease patients. , 2005, Respiratory medicine.

[45]  Jennifer Su,et al.  Epithelial lining fluid solute concentrations in chronic obstructive lung disease patients and normal subjects. , 2005, Journal of applied physiology.

[46]  Gianna Camiciottoli,et al.  Chronic obstructive pulmonary disease: thin-section CT measurement of airway wall thickness and lung attenuation. , 2005, Radiology.

[47]  A. Papi,et al.  Is there a difference between chronic airway inflammation in chronic severe asthma and chronic obstructive pulmonary disease? , 2005, Current opinion in allergy and clinical immunology.

[48]  A. Mangia,et al.  3p microsatellite alterations in exhaled breath condensate from non- small cell lung cancer patients , 2005 .

[49]  L. Bianchi,et al.  Exhaled volatile organic compounds in patients with non-small cell lung cancer: cross sectional and nested short-term follow-up study , 2005, Respiratory research.

[50]  K. Caidahl,et al.  Selective quantification of free 3-nitrotyrosine in exhaled breath condensate in asthma using gas chromatography/tandem mass spectrometry. , 2005, Nitric oxide : biology and chemistry.

[51]  R. Casaburi,et al.  Utility of exhaled breath condensates in chronic obstructive pulmonary disease: a critical review , 2005, Current opinion in pulmonary medicine.

[52]  U. Sack,et al.  Exhaled breath condensate cytokine patterns in chronic obstructive pulmonary disease. , 2005, Respiratory medicine.

[53]  I. Pavord,et al.  Biomarkers Predicting Response to Corticosteroid Therapy in Asthma , 2005, Treatments in respiratory medicine.

[54]  M. Corradi,et al.  Heart rate variability in non-apneic snorers and controls before and after continuous positive airway pressure , 2005, BMC Pulmonary Medicine.

[55]  M. Corradi,et al.  Exhaled breath condensate cysteinyl leukotrienes are increased in children with exercise-induced bronchoconstriction. , 2005, The Journal of allergy and clinical immunology.