Submitted Successfully!
To reward your contribution, here is a gift for you: A free trial for our video production service.
Thank you for your contribution! You can also upload a video entry or images related to this topic.
Version Summary Created by Modification Content Size Created at Operation
1 -- 2005 2023-07-12 08:24:25 |
2 format correct Meta information modification 2005 2023-07-12 08:25:20 | |
3 Added reference journal article Meta information modification 2005 2023-07-28 01:39:35 |

Video Upload Options

Do you have a full video?


Are you sure to Delete?
If you have any further questions, please contact Encyclopedia Editorial Office.
Kiss, H.; Örlős, Z.; Gellért, �.; Megyesfalvi, Z.; Mikáczó, A.; Sárközi, A.; Vaskó, A.; Miklós, Z.; Horváth, I.; Thomas, D. Exhaled Biomarkers for Point-of-Care Diagnosis. Encyclopedia. Available online: (accessed on 15 June 2024).
Kiss H, Örlős Z, Gellért �, Megyesfalvi Z, Mikáczó A, Sárközi A, et al. Exhaled Biomarkers for Point-of-Care Diagnosis. Encyclopedia. Available at: Accessed June 15, 2024.
Kiss, Helga, Zoltán Örlős, Áron Gellért, Zsolt Megyesfalvi, Angéla Mikáczó, Anna Sárközi, Attila Vaskó, Zsuzsanna Miklós, Ildikó Horváth, Dylan Thomas. "Exhaled Biomarkers for Point-of-Care Diagnosis" Encyclopedia, (accessed June 15, 2024).
Kiss, H., Örlős, Z., Gellért, �., Megyesfalvi, Z., Mikáczó, A., Sárközi, A., Vaskó, A., Miklós, Z., Horváth, I., & Thomas, D. (2023, July 12). Exhaled Biomarkers for Point-of-Care Diagnosis. In Encyclopedia.
Kiss, Helga, et al. "Exhaled Biomarkers for Point-of-Care Diagnosis." Encyclopedia. Web. 12 July, 2023.
Exhaled Biomarkers for Point-of-Care Diagnosis

Cancers, chronic diseases and respiratory infections are major causes of mortality and present diagnostic and therapeutic challenges for health care. There is an unmet medical need for non-invasive, easy-to-use biomarkers for the early diagnosis, phenotyping, predicting and monitoring of the therapeutic responses of these disorders. Exhaled breath sampling is an attractive choice that has gained attention in recent years. Exhaled nitric oxide measurement used as a predictive biomarker of the response to anti-eosinophil therapy in severe asthma has paved the way for other exhaled breath biomarkers. Advances in laser and nanosensor technologies and spectrometry together with widespread use of algorithms and artificial intelligence have facilitated research on volatile organic compounds and artificial olfaction systems to develop new exhaled biomarkers. 

exhaled nitric oxide exhaled carbon monoxide exhaled hydrogen sulfide biosensors breathomics

1. Introduction

The lung is an important interphase between the environment and the human body, and it serves as a major getaway for different biomolecules. Complex biological processes in different body organs have their fingerprints on exhaled breath by releasing gas phase mediators and other biomolecules that are transported to the lungs and released into the exhaled breath through the alveoli. The lung parenchyma and the airways are major sources of mediators released to the airways and make a substantial contribution to the content of exhaled breath.

1.1. The Path of Using Exhaled Volatile Compounds in Medicine

The potential of using exhaled breath to obtain information about different body functions was first recognized at the time of ancient Greek medicine when special odors were linked with different diseases such as liver cirrhosis and diabetes. It took centuries to identify and quantify the biomolecules responsible for the signals sensed by human olfaction. A landmark study was published by Pauling L et al. [1] in 1971 demonstrating the presence of hundreds of volatiles in exhaled breath samples using gas–liquid partition chromatography. With the advent of gas chromatography and mass spectrometry researchers have identified and quantified thousands of volatile organic compounds (VOCs) in the breath, most of them in picomolar (10–12 mol/L or particles per trillion) concentrations [2][3][4]. Different diseases have characteristic metabolic profiles that can be captured by using exhaled VOC profiles (“breathprints”). For the interpretation of huge datasets arising from a complex mixture of thousands of widely different volatile molecules to provide clinically relevant information for discrimination between health and disease and for the prediction of therapeutical responses, several statistical algorithms have been used resulting in variable levels of diagnostic accuracy [5][6]. The large size of mass spectrometers, and the substantial expense and heavy workload required for sample processing have represented a major bottleneck for the point-of-care (POC) clinical applicability of these measurements. Two small molecules, hydrogen (H2) and methane (CH4), represent good examples of this transition, as they have made their way to be measured by POC tests and are widely used in the differential diagnosis of gastrointestinal disorders [7][8]. Hydrogen and methane-based breath tests are used to diagnose and monitor small intestinal bacterial overgrowth and carbohydrate maldigestion and guide clinicians to prescribe appropriate medication [9][10]. These tests are based on the observation that H2 and CH4 are produced by the bacterial fermentation of unabsorbed carbohydrate in the small intestine during digestion and diffused to the blood that carries them to the alveoli from where they are exhaled. Since human cells do not produce them, their concentrations in breath are related to the interstitial bacterial flora.

1.2. Gaso-Transmitters in Exhaled Breath

As well as VOCs, the environmental-pollutant-free radical nitric oxide (NO), a known gaso-transmitter in the body, was also detected in exhaled breath with trace concentrations in healthy subjects and elevated levels in asthmatic patients [11][12]. Determination of fractional exhaled NO (FeNO) has generated great interest as a potential biomarker of asthma.[13] This was mainly based on its correlation with eosinophils and its increase after allergen exposure, suggesting that it may be useful as a predictive marker of asthma attacks and the therapeutic response [14][15][16]. FeNO has served as a prototype of exhaled biomarkers for disease monitoring and medical decision making. Several machines have US Food and Drug Administration approval and/or a European Union CE-mark as medical device for its measurement [17]. The other two toxic environmental pollutants with known gaso-transmitter functions in the human body, carbon monoxide (CO) and hydrogen sulfide (H2S), can also be detected in exhaled breath. Their levels are altered in different diseases, such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis [18][19][20][21][22]. However, the use of exhaled CO as a biomarker of heme oxygenase activity is hampered by the strong and long-standing effect of smoking on the exhaled CO level, and the exhaled H2S level is profoundly influenced by its oral and gastrointestinal bacterial production [21][23].

1.3. Biological and Artificial Olfaction Systems to Assess Exhaled Volatiles

Several species have a lot more sensitive olfactory systems than humans including dogs, rats and different insects. The specific coupling of large numbers of receptors with the brain neural network enables these species to recognize minor changes in the volatome of different human samples including the breath. This led to the idea of involving trained animals in human medicine and diagnostics. Sniffer dogs have been trained successfully to distinguish biological samples obtained from healthy and diseased individuals. They have been shown to identify patients with Parkinson’s disease [24], lung cancer [25], prostate cancer [26], ovarian cancer [27] and different infectious diseases [28] from samples such as urine, blood, serum, cell lines and bacterial cultures with very high sensitivity. Dogs can also be trained to alert to hypoglycemic periods in type 1 diabetics [29]. Moreover, even untrained dogs have been shown to sniff out the prodromal phase of seizures and respond to the unusual odor changes with an increase in affiliative behaviour directed at their owners [30]. As well as dogs, other animal species have been tested in odor-pattern-based diagnostics. For instance, African giant pouched rats can detect Mycobacterium tuberculosis, the pathogens causing tuberculosis very sensitively [31][32], and are indeed used for first line diagnostics in Africa. Insects, such as mosquitos and honeybees also have a very sensitive olfaction with great discriminatory power to detect a tremendous amount of chemical signals [33][34]. Moreover, bees have already been successfully trained to detect specific odors [35].
Compared to the detection and quantification of individual molecules, using the biological olfactory systems of animals as a model to build artificial olfaction systems, so-called electronic noses, is a completely different approach. Electronic noses consist of arrays of chemical vapor sensors that respond to certain characteristics of odorant molecules including exhaled VOCs. Sensors are not specific to a given molecule, a sensor may react with several different molecules and a given molecule may also generate responses from several sensors. In this approach individual molecules are not identified and quantified as they are by mass spectrometry; only the pattern of sensor responses (“breathprint”) induced by a complex mixture of different volatiles is clustered. Despite the limitation of the black box approach due to the versatile nature of potential arrays of chemosensitive sensors, their small size and low cost, they have gained great attention as potential point-of-care clinical tools [36][37][38]. Their integration with artificial intelligence for data analysis has contributed importantly to the rapid development of this field [39].

2. Exhaled Gaso-Transmitters

There are three known gaso-transmitters in the human body: NO, CO and H2S. They are widely different molecules. They are all counted as environmental pollutants and toxic gases. As bioactive molecules they have important anti-inflammatory, antioxidative, antiproliferative and antiapoptotic properties, and their low-dose inhalation or administration of their donor molecules can provide therapeutic effects in different conditions [40][41][42]. Due to their environmental occurrence, when their levels are measured in exhaled breath, special attention is required to limit the potential environmental influence. This is a complex task because it is not enough to determine the background environmental levels as environmental gases once inhaled could stay in the human body for different time lengths that depends on their physicochemical nature. They either could be exhaled immediately, or they might pass the alveolo-capillary membranes and circulate in the body for several hours and be added to exhaled breath in later breathing cycles [23][43]. They interact with different molecules, and in this way, they can be transformed into other molecules that may result in lower than environmental concentrations in exhaled breath. The other methodological challenge is that their bodily production and transportation results in very low concentrations being present in exhaled breath, requiring very sensitive detection systems.

3. Exhaled Hydrogen Peroxide

H2O2 is an oxygen metabolite that diffuses through cells and tissues and serves important metabolic and regulatory roles under physiological and pathophysiological circumstances. It is an important signaling molecule playing a part in cellular adaptation to environmental stress as a part of redox signaling pathways [44][45][46]. In oxidative stress and inflammation, NO, CO and H2S are interrelated with H2O2 and other reactive oxygen species in multiple ways [47][48][49][50][51][52]. Exhaled H2O2 can be captured in exhaled breath condensate (EBC), a cooled breath sample containing large numbers of volatile and non-volatile biomaterials [53][54]. The level of exhaled H2O2 is extremely variable and depends on several factors that having a direct or indirect influence on its level. Environmental conditions, ventilatory pattern, measurement techniques and storage influence its concentration directly, but they may also act indirectly by changing the pH of EBC [53][55][56][57][58][59][60]. To limit variability due to sample storage and support point-of-care detection, different online detection systems and disposable sensors have been built and tested [57][61][62][63][64][65][66].
To allow deeper understanding of oxidative-stress-related processes and interactions between different mediators, micromachines able to detect complete sets of molecules from the same sample are desirable.

4. Breathomics—Breath Fingerprinting

Different diseases have characteristic metabolic profiles that can be captured by using metabolomics, proteomics and other “omic” technologies in different biological samples. Using “omics” for biomarker discovery studies is one of the important pathways enabling us to reconstruct our understanding of different chronic diseases by measuring exhaled breath volatiles [67][68]. Thousands of different VOCs have been detected in exhaled breath that can be identified and quantified by mass-spectrometry-based methodologies or samples that can be discriminated based on the patterns by electronic or biological noses [2][36][37][38][39][69]. Exhaled VOCs are principally isoprene, alkanes, methylalkanes and benzene derivatives. They are related to widely different cellular functions and metabolic processes including lipid peroxidation, oxidative stress and cholesterol synthesis among others [5]. Endogenously produced VOCs can be detected in different samples, such as exhaled breath, urine, feces, saliva and blood. The concentration of a given VOC in exhaled breath is also influenced by alveolar minute ventilation and cardiac output together with its blood–gas partition coefficient. As well as endogenous formation, they can also be found in the environment or in other exogenous sources (food and drink, diagnostic test drugs, medication, smoking, etc.). VOCs found in biological samples cannot, therefore, solely reflect bodily functions because exogenous VOCs also have an influence on the exhaled samples. Discrimination between the two sources in exhaled breath samples is challenging and relies on using different breathing maneuvers, assessing the effect of VOC clean gases for inhalation, using filters in the inhalation loop of the sampling device and keeping a certain time gap between exposure and sampling (i.e., subject is requested not to smoke for 1–12 h before sample collection). A specific potential confounding source is the collecting device itself because several materials and most cleaning fluids release VOCs, and that is extremely hard to exclude. In general, environmental influence on the concentration of exhaled VOCs cannot be completely ruled out by any of the currently used approaches [53].

5. Conclusions

Various sampling and analytical methods have been used to assess the metabolome through exhaled breath. While individual gaso-transmitters paved the way for clinically useful point-of-care measurements, currently, the rapid development in sensor technology and the application of artificial intelligence have resulted in major developments in the field of breathomics, a promising field for easy-to-use, point-of-care machines for diagnostic and monitoring purposes. Advanced wearable sensors to detect biomolecules in fluids or exhaled breath open a way for potential online home monitoring [70]. The main areas of interest are screening, diagnosis, phenotyping, exacerbation prediction, exacerbation etiology and prediction of the treatment response where a major breakthrough can be achieved with the envisioned micromachines.


  1. Pauling, L.; Robinson, A.B.; Teranishi, R.; Cary, P. Quantitative analysis of urine vapor and breath by gas-liquid partition chromatography. Proc. Natl. Acad. Sci. USA 1971, 68, 2374–2376.
  2. Amann, A.; Costello Bde, L.; Miekisch, W.; Schubert, J.; Buszewski, B.; Pleil, J.; Ratcliffe, N.; Risby, T. The human volatilome: Volatile organic compounds (VOCs) in exhaled breath, skin emanations, urine, feces and saliva. J. Breath Res. 2014, 8, 034001.
  3. Gordon, S.M.; Szidon, J.P.; Krotoszynski, B.K.; Gibbons, R.D.; O’Neill, H.J. Volatile organic compounds in exhaled air from patients with lung cancer. Clin. Chem. 1985, 31, 1278–1282.
  4. Phillips, M.; Gleeson, K.; Hughes, J.M.; Greenberg, J.; Cataneo, R.N.; Baker, L.; McVay, W.P. Volatile organic compounds in breath as markers of lung cancer: A cross-sectional study. Lancet 1999, 353, 1930–1933.
  5. Horvath, I.; Lazar, Z.; Gyulai, N.; Kollai, M.; Losonczy, G. Exhaled biomarkers in lung cancer. Eur. Respir. J. 2009, 34, 261–275.
  6. Hanna, G.B.; Boshier, P.R.; Markar, S.R.; Romano, A. Accuracy and Methodologic Challenges of Volatile Organic Compound-Based Exhaled Breath Tests for Cancer Diagnosis: A Systematic Review and Meta-analysis. JAMA Oncol. 2019, 5, e182815.
  7. de Lacy Costello, B.P.; Ledochowski, M.; Ratcliffe, N.M. The importance of methane breath testing: A review. J. Breath Res. 2013, 7, 024001.
  8. Rana, S.V.; Malik, A. Breath tests and irritable bowel syndrome. World J. Gastroenterol. 2014, 20, 7587–7601.
  9. Gilat, T.; Ben Hur, H.; Gelman-Malachi, E.; Terdiman, R.; Peled, Y. Alterations of the colonic flora and their effect on the hydrogen breath test. Gut 1978, 19, 602–605.
  10. Rezaie, A.; Buresi, M.; Lembo, A.; Lin, H.; McCallum, R.; Rao, S.; Schmulson, M.; Valdovinos, M.; Zakko, S.; Pimentel, M.; et al. Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus. Off. J. Am. Coll. Gastroenterol.|ACG 2017, 112, 775–784.
  11. Alving, K.; Weitzberg, E.; Lundberg, J.M. Increased amount of nitric oxide in exhaled air of asthmatics. Eur. Respir. J. 1993, 6, 1368–1370.
  12. Gustafsson, L.E.; Leone, A.M.; Persson, M.G.; Wiklund, N.P.; Moncada, S. Endogenous nitric oxide is present in the exhaled air of rabbits, guinea pigs and humans. Biochem. Biophys. Res. Commun. 1991, 181, 852–857.
  13. Farraia, Mariana; Rufo, João Cavaleiro; Paciência , Inês; Mendes,Francisca Castro; Rodolfo,Ana; Rama,Tiago; Rocha,Sílvia M.; Delgado,Luís; Brinkman,Paul; Moreira,André; et al. Human volatilome analysis using eNose to assess uncontrolled asthma in a clinical setting. Allergy 2020, 75, 1630-1639.
  14. Jatakanon, A.; Lim, S.; Kharitonov, S.A.; Chung, K.F.; Barnes, P.J. Correlation between exhaled nitric oxide, sputum eosinophils, and methacholine responsiveness in patients with mild asthma. Thorax 1998, 53, 91–95.
  15. Kharitonov, S.A.; Yates, D.; Robbins, R.A.; Logan-Sinclair, R.; Shinebourne, E.A.; Barnes, P.J. Increased nitric oxide in exhaled air of asthmatic patients. Lancet 1994, 343, 133–135.
  16. Paredi, P.; Leckie, M.J.; Horvath, I.; Allegra, L.; Kharitonov, S.A.; Barnes, P.J. Changes in exhaled carbon monoxide and nitric oxide levels following allergen challenge in patients with asthma. Eur. Respir. J. 1999, 13, 48–52.
  17. Rupani, H.; Kent, B.D. Using Fractional Exhaled Nitric Oxide Measurement in Clinical Asthma Management. Chest 2022, 161, 906–917.
  18. Choi, A.M.; Alam, J. Heme oxygenase-1: Function, regulation, and implication of a novel stress-inducible protein in oxidant-induced lung injury. Am. J. Respir. Cell Mol. Biol. 1996, 15, 9–19.
  19. Horvath, I.; Donnelly, L.E.; Kiss, A.; Paredi, P.; Kharitonov, S.A.; Barnes, P.J. Raised levels of exhaled carbon monoxide are associated with an increased expression of heme oxygenase-1 in airway macrophages in asthma: A new marker of oxidative stress. Thorax 1998, 53, 668–672.
  20. Kimura, H. Hydrogen Sulfide (H2S) and Polysulfide (H2Sn) Signaling: The First 25 Years. Biomolecules 2021, 11, 896.
  21. Pysanenko, A.; Spanel, P.; Smith, D. A study of sulfur-containing compounds in mouth- and nose-exhaled breath and in the oral cavity using selected ion flow tube mass spectrometry. J. Breath Res. 2008, 2, 046004.
  22. Zayasu, K.; Sekizawa, K.; Okinaga, S.; Yamaya, M.; Ohrui, T.; Sasaki, H. Increased carbon monoxide in exhaled air of asthmatic patients. Am. J. Respir. Crit. Care Med. 1997, 156, 1140–1143.
  23. Pan, K.T.; Leonardi, G.S.; Ucci, M.; Croxford, B. Can Exhaled Carbon Monoxide Be Used as a Marker of Exposure? A Cross-Sectional Study in Young Adults. Int. J. Environ. Res. Public Health 2021, 18, 11893.
  24. Gao, C.Q.; Wang, S.N.; Wang, M.M.; Li, J.J.; Qiao, J.J.; Huang, J.J.; Zhang, X.X.; Xiang, Y.Q.; Xu, Q.; Wang, J.L.; et al. Sensitivity of Sniffer Dogs for a Diagnosis of Parkinson’s Disease: A Diagnostic Accuracy Study. Mov. Disord. 2022, 37, 1807–1816.
  25. Feil, C.; Staib, F.; Berger, M.R.; Stein, T.; Schmidtmann, I.; Forster, A.; Schimanski, C.C. Sniffer dogs can identify lung cancer patients from breath and urine samples. BMC Cancer 2021, 21, 917.
  26. Taverna, G.; Tidu, L.; Grizzi, F.; Torri, V.; Mandressi, A.; Sardella, P.; La Torre, G.; Cocciolone, G.; Seveso, M.; Giusti, G.; et al. Olfactory system of highly trained dogs detects prostate cancer in urine samples. J. Urol. 2015, 193, 1382–1387.
  27. Horvath, G.; Andersson, H.; Nemes, S. Cancer odor in the blood of ovarian cancer patients: A retrospective study of detection by dogs during treatment, 3 and 6 months afterward. BMC Cancer 2013, 13, 396.
  28. Cambau, E.; Poljak, M. Sniffing animals as a diagnostic tool in infectious diseases. Clin. Microbiol. Infect. 2020, 26, 431–435.
  29. Hardin, D.S.; Anderson, W.; Cattet, J. Dogs Can Be Successfully Trained to Alert to Hypoglycemia Samples from Patients with Type 1 Diabetes. Diabetes Ther. 2015, 6, 509–517.
  30. Powell, N.A.; Ruffell, A.; Arnott, G. The Untrained Response of Pet Dogs to Human Epileptic Seizures. Animals 2021, 11, 2267.
  31. Poling, A.; Weetjens, B.; Cox, C.; Beyene, N.; Durgin, A.; Mahoney, A. Tuberculosis detection by giant african pouched rats. Behav Anal 2011, 34, 47–54.
  32. Ellis, H.; Mulder, C.; Valverde, E.; Poling, A.; Edwards, T. Reproducibility of African giant pouched rats detecting Mycobacterium tuberculosis. BMC Infect. Dis. 2017, 17, 298.
  33. Laska, M.; Galizia, C.G.; Giurfa, M.; Menzel, R. Olfactory discrimination ability and odor structure-activity relationships in honeybees. Chem. Senses 1999, 24, 429–438.
  34. Carey, A.F.; Carlson, J.R. Insect olfaction from model systems to disease control. Proc. Natl. Acad. Sci. USA 2011, 108, 12987–12995.
  35. Lu, Y.; Liu, Q. Insect olfactory system inspired biosensors for odorant detection. Sens. Diagn. 2022, 1, 1126–1142.
  36. Di Natale, C.; Macagnano, A.; Martinelli, E.; Paolesse, R.; D’Arcangelo, G.; Roscioni, C.; Finazzi-Agro, A.; D’Amico, A. Lung cancer identification by the analysis of breath by means of an array of non-selective gas sensors. Biosens. Bioelectron. 2003, 18, 1209–1218.
  37. Yang, H.Y.; Chen, W.C.; Tsai, R.C. Accuracy of the Electronic Nose Breath Tests in Clinical Application: A Systematic Review and Meta-Analysis. Biosensors 2021, 11, 469.
  38. Machado, R.F.; Laskowski, D.; Deffenderfer, O.; Burch, T.; Zheng, S.; Mazzone, P.J.; Mekhail, T.; Jennings, C.; Stoller, J.K.; Pyle, J.; et al. Detection of lung cancer by sensor array analyses of exhaled breath. Am. J. Respir. Crit. Care Med. 2005, 171, 1286–1291.
  39. Kim, C.; Raja, I.S.; Lee, J.M.; Lee, J.H.; Kang, M.S.; Lee, S.H.; Oh, J.W.; Han, D.W. Recent Trends in Exhaled Breath Diagnosis Using an Artificial Olfactory System. Biosensors 2021, 11, 337.
  40. Chen, Y.; Yuan, S.; Cao, Y.; Kong, G.; Jiang, F.; Li, Y.; Wang, Q.; Tang, M.; Zhang, Q.; Wang, Q.; et al. Gasotransmitters: Potential Therapeutic Molecules of Fibrotic Diseases. Oxidative Med. Cell. Longev. 2021, 2021, 3206982.
  41. Fagone, P.; Mazzon, E.; Bramanti, P.; Bendtzen, K.; Nicoletti, F. Gasotransmitters and the immune system: Mode of action and novel therapeutic targets. Eur. J. Pharmacol. 2018, 834, 92–102.
  42. Salihi, A.; Al-Naqshabandi, M.A.; Khudhur, Z.O.; Housein, Z.; Hama, H.A.; Abdullah, R.M.; Hussen, B.M.; Alkasalias, T. Gasotransmitters in the tumor microenvironment: Impacts on cancer chemotherapy (Review). Mol. Med. Rep. 2022, 26, 233.
  43. American Thoracic, S.; European Respiratory, S. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am. J. Respir. Crit. Care Med. 2005, 171, 912–930.
  44. Halliwell, B.; Clement, M.V.; Long, L.H. Hydrogen peroxide in the human body. FEBS Lett. 2000, 486, 10–13.
  45. Robinson, N.; Ganesan, R.; Hegedus, C.; Kovacs, K.; Kufer, T.A.; Virag, L. Programmed necrotic cell death of macrophages: Focus on pyroptosis, necroptosis, and parthanatos. Redox Biol. 2019, 26, 101239.
  46. Sies, H. Hydrogen peroxide as a central redox signaling molecule in physiological oxidative stress: Oxidative eustress. Redox Biol. 2017, 11, 613–619.
  47. Szabo, I.L.; Kenyeres, A.; Szegedi, A.; Szollosi, A.G. Heme Oxygenase and the Skin in Health and Disease. Curr. Pharm. Des. 2018, 24, 2303–2310.
  48. Barnes, P.J. Oxidative Stress in Chronic Obstructive Pulmonary Disease. Antioxidants 2022, 11, 965.
  49. Cai, M.Y.; Yip, C.Y.; Pan, K.; Zhang, Y.; Chan, R.W.; Chan, W.Y.; Ko, W.H. Role of Carbon Monoxide in Oxidative Stress-Induced Senescence in Human Bronchial Epithelium. Oxid. Med. Cell Longev. 2022, 2022, 5199572.
  50. Huang, Y.Q.; Jin, H.F.; Zhang, H.; Tang, C.S.; Du, J.B. Interaction among Hydrogen Sulfide and Other Gasotransmitters in Mammalian Physiology and Pathophysiology. Adv. Exp. Med. Biol. 2021, 1315, 205–236.
  51. Szabo, R.; Szabo, Z.; Borzsei, D.; Hoffmann, A.; Lesi, Z.N.; Palszabo, P.; Palszabo, A.; Dvoracsko, S.; Gesztelyi, R.; Kupai, K.; et al. Potential Implications of Rimonabant on Age-Related Oxidative Stress and Inflammation. Antioxidants 2022, 11, 162.
  52. Szentesi, P.; Csernoch, L.; Dux, L.; Keller-Pinter, A. Changes in Redox Signaling in the Skeletal Muscle with Aging. Oxid. Med. Cell Longev. 2019, 2019, 4617801.
  53. Horvath, I.; Barnes, P.J.; Loukides, S.; Sterk, P.J.; Hogman, M.; Olin, A.C.; Amann, A.; Antus, B.; Baraldi, E.; Bikov, A.; et al. A European Respiratory Society technical standard: Exhaled biomarkers in lung disease. Eur. Respir. J. 2017, 49, 1600965.
  54. Horvath, I.; Donnelly, L.E.; Kiss, A.; Kharitonov, S.A.; Lim, S.; Chung, K.F.; Barnes, P.J. Combined use of exhaled hydrogen peroxide and nitric oxide in monitoring asthma. Am. J. Respir. Crit. Care Med. 1998, 158, 1042–1046.
  55. Czebe, K.; Barta, I.; Antus, B.; Valyon, M.; Horvath, I.; Kullmann, T. Influence of condensing equipment and temperature on exhaled breath condensate pH, total protein and leukotriene concentrations. Respir. Med. 2008, 102, 720–725.
  56. Gajdocsi, R.; Bikov, A.; Antus, B.; Horvath, I.; Barnes, P.J.; Kharitonov, S.A. Assessment of reproducibility of exhaled hydrogen peroxide concentration and the effect of breathing pattern in healthy subjects. J. Aerosol. Med. Pulm. Drug Deliv. 2011, 24, 271–275.
  57. Kakeshpour, T.; Metaferia, B.; Zare, R.N.; Bax, A. Quantitative detection of hydrogen peroxide in rain, air, exhaled breath, and biological fluids by NMR spectroscopy. Proc. Natl. Acad. Sci. USA 2022, 119, e2121542119.
  58. Kullmann, T.; Barta, I.; Antus, B.; Valyon, M.; Horvath, I. Environmental temperature and relative humidity influence exhaled breath condensate pH. Eur. Respir. J. 2008, 31, 474–475.
  59. Peters, S.; Kronseder, A.; Karrasch, S.; Neff, P.A.; Haaks, M.; Koczulla, A.R.; Reinhold, P.; Nowak, D.; Jorres, R.A. Hydrogen peroxide in exhaled air: A source of error, a paradox and its resolution. ERJ Open Res. 2016, 2, 00052–2015.
  60. Rastinfard, A.; Dalisson, B.; Barralet, J. Aqueous decomposition behavior of solid peroxides: Effect of pH and buffer composition on oxygen and hydrogen peroxide formation. Acta Biomater. 2022, 145, 390–402.
  61. Chen, Y.C.; O’Hare, D. Exhaled breath condensate based breath analyser—A disposable hydrogen peroxide sensor and smart analyser. Analyst 2020, 145, 3549–3556.
  62. Fox, L.; Gates, J.; De Vos, R.; Wiffen, L.; Hicks, A.; Rupani, H.; Williams, J.; Brown, T.; Chauhan, A.J. The VICTORY (Investigation of Inflammacheck to Measure Exhaled Breath Condensate Hydrogen Peroxide in Respiratory Conditions) Study: Protocol for a Cross-sectional Observational Study. JMIR Res. Protoc. 2021, 10, e23831.
  63. Giaretta, J.E.; Duan, H.; Oveissi, F.; Farajikhah, S.; Dehghani, F.; Naficy, S. Flexible Sensors for Hydrogen Peroxide Detection: A Critical Review. ACS Appl. Mater. Interfaces 2022, 14, 20491–20505.
  64. Horvath, I.; Hunt, J.; Barnes, P.J.; Alving, K.; Antczak, A.; Baraldi, E.; Becher, G.; van Beurden, W.J.; Corradi, M.; Dekhuijzen, R.; et al. Exhaled breath condensate: Methodological recommendations and unresolved questions. Eur. Respir. J. 2005, 26, 523–548.
  65. Maier, D.; Laubender, E.; Basavanna, A.; Schumann, S.; Guder, F.; Urban, G.A.; Dincer, C. Toward Continuous Monitoring of Breath Biochemistry: A Paper-Based Wearable Sensor for Real-Time Hydrogen Peroxide Measurement in Simulated Breath. ACS Sens. 2019, 4, 2945–2951.
  66. Neville, D.M.; Fogg, C.; Brown, T.P.; Jones, T.L.; Lanning, E.; Bassett, P.; Chauhan, A.J. Using the Inflammacheck Device to Measure the Level of Exhaled Breath Condensate Hydrogen Peroxide in Patients With Asthma and Chronic Obstructive Pulmonary Disease (The EXHALE Pilot Study): Protocol for a Cross-Sectional Feasibility Study. JMIR Res. Protoc. 2018, 7, e25.
  67. Nakhleh, M.K.; Amal, H.; Jeries, R.; Broza, Y.Y.; Aboud, M.; Gharra, A.; Ivgi, H.; Khatib, S.; Badarneh, S.; Har-Shai, L.; et al. Diagnosis and Classification of 17 Diseases from 1404 Subjects via Pattern Analysis of Exhaled Molecules. ACS Nano 2017, 11, 112–125.
  68. Wheelock, C.E.; Goss, V.M.; Balgoma, D.; Nicholas, B.; Brandsma, J.; Skipp, P.J.; Snowden, S.; Burg, D.; D’Amico, A.; Horvath, I.; et al. Application of ‘omics technologies to biomarker discovery in inflammatory lung diseases. Eur. Respir. J. 2013, 42, 802–825.
  69. Khoubnasabjafari, M.; Mogaddam, M.R.A.; Rahimpour, E.; Soleymani, J.; Saei, A.A.; Jouyban, A. Breathomics: Review of Sample Collection and Analysis, Data Modeling and Clinical Applications. Crit. Rev. Anal. Chem. 2022, 52, 1461–1487.
  70. Singh, S.U.; Chatterjee, S.; Lone, S.A.; Ho, H.H.; Kaswan, K.; Peringeth, K.; Khan, A.; Chiang, Y.W.; Lee, S.; Lin, Z.H. Advanced wearable biosensors for the detection of body fluids and exhaled breath by graphene. Mikrochim. Acta 2022, 189, 236.
Subjects: Respiratory System
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to : , , , , , , , , ,
View Times: 250
Revisions: 3 times (View History)
Update Date: 28 Jul 2023
Video Production Service