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All sourcesNASA NTRSDOE OSTI
DOE OSTI2023

Exhaled breath condensate profiles of U.S. Navy divers following prolonged hyperbaric oxygen (HBO) and nitrogen-oxygen (Nitrox) chamber exposures

Prolonged exposure to hyperbaric hyperoxia can lead to pulmonary oxygen toxicity (PO 2 tox). PO 2 tox is a mission limiting factor for special operations forces divers using closed-circuit rebreathing apparatus and a potential side effect for patients undergoing hyperbaric oxygen (HBO) treatment. In this study, we aim to determine if there is a specific breath profile of compounds in exhaled breath condensate (EBC) that is indicative of the early stages of pulmonary hyperoxic stress/PO 2 tox. Using a double-blind, randomized 'sham' controlled, cross-over design 14 U.S. Navy trained diver volunteers breathed two different gas mixtures at an ambient pressure of 2 ATA (33 fsw, 10 msw) for 6.5 h. One test gas consisted of 100% O 2 (HBO) and the other was a gas mixture containing 30.6% O 2 with the balance N 2 (Nitrox). The high O 2 stress dive (HBO) and low O 2 stress dive (Nitrox) were separated by at least seven days and were conducted dry and at rest inside a hyperbaric chamber. EBC samples were taken immediately before and after each dive and subsequently underwent a targeted and untargeted metabolomics analysis using liquid chromatography coupled to mass spectrometry (LC-MS). Following the HBO dive, 10 out of 14 subjects reported symptoms of the early stages of PO 2 tox and one subject terminated the dive early due to severe symptoms of PO 2 tox. No symptoms of PO 2 tox were reported following the nitrox dive. A partial least-squares discriminant analysis of the normalized (relative to pre-dive) untargeted data gave good classification abilities between the HBO and nitrox EBC with an AUC of 0.99 (±2%) and sensitivity and specificity of 0.93 (±10%) and 0.94 (±10%), respectively. Furthermore, the resulting classifications identified specific biomarkers that included human metabolites and lipids and their derivatives from different metabolic pathways that may explain metabolomic changes resulting from prolonged HBO exposure.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2021

Exhaled breath biomarkers of influenza infection and influenza vaccination

Respiratory viral infections are considered a major public health threat, and breath metabolomics can provide new ways to detect and understand how specific viruses affect the human pulmonary system. In this pilot study, we characterized the metabolic composition of human breath for an early diagnosis and differentiation of influenza viral infection, as well as other types of upper respiratory viral infections. We first studied the non-specific effects of planned seasonal influenza vaccines on breath metabolites in healthy subjects after receiving the immunization. We then investigated changes in breath content from hospitalized patients with flu-like symptoms and confirmed upper respiratory viral infection. The exhaled breath was sampled using a custom-made breath condenser, and exhaled breath condensate (EBC) samples were analysed using liquid chromatography coupled to quadruplole-time-of-flight mass spectrometer (LC-qTOF). All metabolomic data was analysed using both targeted and untargeted approaches to detect specific known biomarkers from inflammatory and oxidative stress biomarkers, as well as new molecules associated with specific infections. We were able to find clear differences between breath samples collected before and after flu vaccine administration, together with potential biomarkers that are related to inflammatory processes and oxidative stress. Moreover, we were also able to discriminate samples from patients with flu-related symptoms that were diagnosed with confirmatory respiratory viral panels (RVPs). RVP positive and negative differences were identified, as well as differences between specific viruses defined. These results provide very promising information for the further study of the effect of influenza A and other viruses in human systems by using a simple and non-invasive specimen like breath.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

BRAVE_EBC-TMT.1.0

Exhaled breath condensate (EBC) represents a low-cost and non-invasive means of examining respiratory health. EBC has been used to discover and validate exhaled volatile and non-volatile biomarkers of disease related to the respiratory system distress such as asthma, COPD, lung cancer, and secondary infections. One newly emerging utilization of EBC, is proteomics analysis, which can provide an unbiased snapshot into ongoing biological processes in the airway. Fully characterizing the biological landscape of EBC collections is challenging though, due to sample variability, and low detection sensitivity. EBC is primarily composed of condensed water, causing technical challenges with detecting key macromolecules from the dilute sample matrix; therefore, high sensitivity techniques are required to unlock the full capability of EBC as a method for non-invasive biomarker detection. To overcome some of these technical challenges for proteomic analyses, we applied our recently developed microscale proteomic techniques and developed a novel TMT based approach which enabled reliable, relative quantification with significantly improved detection of low abundance peptides/proteins across multiple healthy volunteer EBC samples. Our EBC collection design includes longitudinal EBC collections from five individual healthy volunteers on three separate days of the week with triplicate, back-to-back donations each day. Here, we report a total of 235 quantifiable proteins corresponding to 1,877 non-redundant peptides for evaluating sample collection reproducibility and establishing a healthy (human host) baseline EBC biomarker proteome studies. This work will pave the way for further investigations of EBC protein expression profiles and showcase the value of using non-invasive collection method techniques for clinically relevant biomarker discovery. This research was supported by the LDRD Biomedical Resilience And Readiness in AdVerse Operating Environments (BRAVE) Project (73748), and was conducted at Pacific Northwest National Laboratory (PNNL) in Richland, WA. PNNL is a multiprogram national laboratory operated by Battelle for the Department of Energy (DOE) under Contract DE-AC05-76RLO 1830.

59 BASIC BIOLOGICAL SCIENCES↗
NASA NTRS2019

Development of a Point of Care Technology for Military Medical Applications in Austere Environments

NASA, Lawrence Livermore National Laboratory (LLNL) and the Department of Defense (DoD) share a common interest in compact medical diagnostic technologies—also known as “point of care testing” (POCT) technologies. For NASA, the need is to take care of astronauts on deep space missions. For LLNL, the focus is on technologies needed to support homeland security applications. For DoD, the need is to support warfighters in military theaters of operation, especially for prolonged field care and en route care. A recently patented technology, “Portable Medical Diagnosis Instrument” (U.S. Patent 9824870), co-invented by NASA and LLNL, is being developed further in a partnership between NASA, LLNL and Travis Air Force Base, with a focus on military applications. This instrument, the NASA-LLNL Medical Tricorder, can be used for a wide range of clinical samples including breath, saliva and blood. One component of the Tricorder is the NASA E-Nose, a carbon nanotube-based chemical sensor, integrated into a hand-held smart phone, that can detect and measure “breath biomarkers” in the gas phase of exhaled breath. The response of the NASA E-Nose is rapid, which makes it possible to detect various gas-phase substances in real time. The NASA E-Nose, with modification, can also be used for breath condensate analysis. Another component of the Tricorder is a miniaturized microfluidic analyzer, under development by LLNL, that does not require any pumps. The microfluidic analyzer can detect and measure biomarkers in liquid samples, such as blood, saliva and breath condensate. This microfluidic system requires small quantities of liquid sample and can perform analysis very rapidly (seconds to minutes), which makes it possible to detect relevant biomarkers in near real time in the field. The Clinical Investigation Facility (CIF) at Travis Air Force Base is currently conducting research with the goal to develop improved field-able technologies and procedures for the emergency response to life threatening injuries soldiers may receive in theater. This work includes experimental large animal systems and comprehensive collection of clinical specimens and physiological data. NASA and LLNL are partnering with Travis to test and further develop the Tricorder technology for high priority military applications, initially focused on lung injury models and traumatic brain injury.

Loftus, David J.↗