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Breath Biopsies | a Breath of Fresh Air for Diagnostics

by | Aug 14, 2023 | Medical Device & Diagnostic

In the scary world of serious illness, early detection is crucial. The sooner someone knows he has cancer or rheumatoid arthritis, the sooner he can get moving with treatment. Early detection means a greater likelihood of a good outcome, saved time and money, and maybe even less heartache.

Sadly, diagnosing a disease can be grueling, painful, and time-consuming. Undoubtedly, patients know this best. However, medical researchers know it too. Some of them are working to improve the process. Maybe you’ve heard of liquid biopsies – cancer detection in a drop of blood or a urine sample rather than a traditional biopsy. If you think that’s amazing, what about a breath biopsy? Think of it as a cancer breathalyzer.

VOLATILE ORGANIC COMPOUND

Here’s a possible new perspective on that peanut butter sandwich or banana you may have just munched. It may have tasted like food, but really it’s fuel. Specifically, it’s energy that our bodies use to power cellular function courtesy of a series of chemical reactions. The whole miraculous affair, cellular metabolism, produces and ultimately releases organic (carbon-containing) compounds into our blood. When the blood passes through our lungs, some compounds are exchanged into the lungs and then exhaled. Once we breathe the stuff out, scientists call them volatile organic compounds (vOCs). Our breath contains more than a thousand VOCs, or metabolites, as they are also called.

THE DISRUPTIVE RHYTHM OF DISEASE

The disease affects our cellular metabolism, changing which VOCs it produces. The unique VOC “fingerprint” of different maladies may help researchers identify patients based on metabolic changes – many of which appear before other symptoms.

Science has long known that cancer cells have irregular metabolisms. For example, they consume glucose at a rate as much as two hundred times greater than their healthy counterparts. Malignant cells also use anaerobic (without oxygen) metabolic pathways rather than aerobic – with oxygen – pathways preferred by healthy cells. Cancer’s altered cellular rhythm manufactures different metabolic by-products, some of which can be detected as VOCs. Other diseases produce altered VOCs, too, including diabetes, liver impairment, kidney disease, asthma, cystic fibrosis, rheumatoid arthritis, atherosclerosis, and tuberculosis. These metabolic changes that come with illness underpin the whole notion of the disease breathalyzer.

BREATHING LIFE INTO VOC DIAGNOSTICS

Owlstone Medical (Cambridge, U.K.) is developing a diagnostic based on VOCs with their ReCIVA Breath Sampler. During testing, a patient typically inhales from a standardized air supply to ensure that the air source doesn’t impact the results. The air is exhaled into a breath biopsy cartridge, capturing the patient’s VOCs. The cartridge is then sent to a lab for analysis with Owlstone’s proprietary Field Asymmetric Ion Mobility Spectrometry (FAIMS).

WHAT’S NOT TO LOVE?

Breath biopsies possess a unique, obvious advantage over other diagnostic methods. No pain, no discomfort. They don’t even require a finger prick! The test is also extremely sensitive – detecting even miniscule concentrations of suspicious VOCs. That’s because it takes our entire blood supply only about a minute to circulate throughout the body. Yup, sixty seconds. The sampling period for breath biopsies is typically ten minutes. That allows all of our blood to get sampled several times, making discovering a questionable VOC extremely likely.

IN THE WIND

Unfortunately, no breath biopsies are on the market yet. However, Owlstone is already conducting several clinical trials to demonstrate its validity:

  • LuCID (Lung Cancer Indicator Detection): In partnership with the U.K. National Health Service, this trial has identified unique VOCs in lung cancer patients’ exhalations. Phase II aims to validate the detection of these biomarkers in clinical practice.
  • STRATA (Stratification of Asthma Treatment by Breath Analysis): This study is examining how VOCs may help select the best asthma treatment.
  • InTERCEPT: This study focuses on identifying and validating VOCs to detect colorectal cancer.
  • PAN (PAN-cancer early detection): In partnership with Cancer Research U.K, this trial aims to identify VOCs associated with many different cancers, including bladder, breast, head and neck, kidney, esophageal, pancreas, and prostate.

    COCKTAIL FODDER: CATCHING A WHIFF OF CANCER

    Whether you consider dogs best friend material or merely tolerate them, take one minute to appreciate their amazing snouts. Canine noses contain 220 million scent receptors. Puny little human noses only boast about five million. Their superior scent detection enables these super-sniffers to find lost people, explosives, and contraband. Scientists have also discovered that dogs can sniff out some kinds of cancer. That’s because VOCs are present in all of our emissions! Breath, sweat, saliva, and, well, you know. Fido definitely knows that cancer stinks!

    CONCLUSION

    Breath biopsies are a revolutionary stride in the world of diagnostics. By harnessing the power of volatile organic compounds (VOCs) present in our breath, researchers are on the brink of developing a non-invasive, painless, and highly sensitive method for early disease detection. From cancer to asthma, the unique VOC “fingerprints” of various diseases can transform how we approach diagnostics, making it more patient-friendly and efficient. While the market is yet to see a commercial breath biopsy, the ongoing research and clinical trials are promising. In a world where early detection can mean the difference between life and death, breath biopsies might just be the fresh air we’ve been waiting for.

    FREQUENTLY ASK QUESTIONS

    1. WHAT IS A BREATH BIOPSY?

    A breath biopsy is a diagnostic method that analyzes volatile organic compounds (VOCs) present in a person’s breath to detect diseases. It’s akin to a “disease breathalyzer.”

    2. HOW DO DISEASES AFFECT VOCS?

    Diseases can alter cellular metabolism, leading to changes in the production of VOCs. This unique VOC “fingerprint” can help researchers identify specific diseases based on these metabolic changes.

    3. WHAT IS THE SIGNIFICANCE OF VOCS IN DISEASE DETECTION?

    VOCs can indicate metabolic changes in the body, many of which appear before other disease symptoms. Detecting these changes can lead to early diagnosis and more effective treatment.

    4. HOW DOES OWLSTONE MEDICAL’S RECIVA BREATH SAMPLER WORK?

    The ReCIVA Breath Sampler allows a patient to inhale from a standardized air supply and then exhale into a breath biopsy cartridge, capturing the patient’s VOCs. This cartridge is then analyzed in a lab using Owlstone’s proprietary technology.

    5. WHAT ARE THE ADVANTAGES OF BREATH BIOPSIES OVER TRADITIONAL DIAGNOSTIC METHODS?

    Breath biopsies are non-invasive, painless, and don’t require even a finger prick. They are also highly sensitive, capable of detecting minute concentrations of suspicious VOCs.

    6. ARE THERE ANY BREATH BIOPSIES AVAILABLE IN THE MARKET?

    No, breath biopsies are not yet commercially available. However, Owlstone Medical is conducting several clinical trials to validate the technology.

    7. HOW CAN DOGS DETECT SOME TYPES OF CANCER?

    Dogs have an extraordinary sense of smell, with 220 million scent receptors compared to a human’s five million. This heightened olfactory ability allows them to detect specific VOCs associated with certain cancers in human emissions, such as breath and sweat.

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    Author: Emily Burke, PhD
    Editor: Sarah Van Tiems, MS
    Scientific Review: Tahir Hayat, MS

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