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Ion-molecule reactions: Significance of Exhaled Breath Test in Clinical Diagnosis

Posted on February 27, 2020 at 8:15 AM

Analysis of volatile organic compounds (VOCs) emanating from human exhaled breath can provide deep insight into the status of various biochemical processes in the human body. VOCs can serve as potential biomarkers of physiological and pathophysiological conditions related to several diseases. Breath VOC analysis, a noninvasive and quick biomonitoring approach, also has potential for the early detection and progress monitoring of several diseases. This paper gives an overview of the major VOCs present in human exhaled breath, possible biochemical pathways of breath VOC generation, diagnostic importance of their analysis, and analytical techniques used in the breath test. Breath analysis relating to diabetes mellitus and its characteristic breath biomarkers is focused on. Finally, some challenges and limitations of the breath test are discussed.


Keywords: Breath analysis, Volatile organic compound, Disease diagnosis, Noninvasive method, Breath biomarkers, Diabetes mellitus


Bioinformation obtained from volatile organic compounds (VOCs) in the exhaled breath of humans can aid the early diagnosis of several diseases and can be used to decide relevant medical therapies. The analysis of exhaled breath and associated VOCs has gained a considerable scientific, clinical, and research attention due to its potential in enabling the noninvasive observation of the biochemical processes of the human body [1–3]. The first initiatives of breath analysis for determining the physiological state of humans originated during the time of Hippocrates (460-370 BC), when the ancient Greek physicians realized that some diseases could be diagnosed from the characteristic odor of patients’ breath and knew that the human breath might provide sound information on health conditions [1–6]. In the period 1782–1783, Lavoisier for the first time analyzed the breath CO2 of Guinea pigs and showed that the gas is a product of combustion in the body [1, 5]. Practically, it is not difficult for a skilled technician to recognize the characteristic ‘fruity smell’ of acetone, ‘musty and fishy smell’, ‘urine-like smell’, and ‘putrid smell’ in the breath of patients with diabetes, advanced liver disease, kidney failure, and lung abscess, respectively [1]. The analysis of VOCs present in exhaled breath can thus provide valuable information about the subjects’ physiological and pathophysiological conditions. Such compounds can be useful indicators and potential biomarkers of various diseases and metabolic activities, facilitating disease diagnosis. It 

should be noted that biological monitoring is generally based on the analysis of blood. However, this involves an invasive and time-consuming technique, which is often unacceptable concerning patient care system. This invasive technique also needs skilled medical staff. Breath analysis is thus a very attractive alternative as it is a noninvasive and quick method that allows repeated sampling. ....

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