Reproducibility and reporting, the routes to progress in breath research - highlights from the Breath Biopsy Conference 2021

With the continued presence of COVID-19 worldwide, it has been a challenge for the breath research community to progress with clinical studies and travel restrictions have also limited the opportunities to meet up, share ideas and celebrate the latest advances. The Breath Biopsy Conference 2021 provided a much-needed opportunityoffered the chance to catch up with the latest breath research and to share the researchprogress that researchers in the community have been able to progress make in these difficult times. Limited opportunities for clinical research have provided opportunitiesled many in the field to look more closely at different methods for breath collection and have contributed to the growing calls for consistent standards in how results are reported, shared and even how breath studies themselves are carried out. As such, standardization was a key theme for this year's event and featured prominently in the keynotes, discussions and throughout many of the presentation sessions. With over 900 registrants, almost 400 live attendees and 16 speakers, the Breath Biopsy Conference continues to bring together breath research leaders from around the world. This article provides an overview of the highlights from this event

Targeted breath analysis: exogenous volatile organic compounds (EVOC) as metabolic pathway-specific probes

Breath research has almost invariably focussed on the identification of endogenous volatile organic compounds (VOCs) as disease biomarkers. After five decades, a very limited number of breath tests measuring endogenous VOCs is applied to the clinic. In this perspective article, we explore some of the factors that may have contributed to the current lack of clinical applications of breath endogenous VOCs. We discuss potential pitfalls of experimental design, analytical challenges, as well as considerations regarding the biochemical pathways that may impinge on the application of endogenous VOCs as specific disease biomarkers. We point towards several lines of evidence showing that breath analysis based on administration of exogenous compounds has been a more successful strategy, with several tests currently applied to the clinic, compared to measurement of endogenous VOCs. Finally, we propose a novel approach, based on the use of exogenous VOC (EVOC) probes as potential strategy to measure the activity of metabolic enzymes in vivo, as well as the function of organs, through breath analysis. We present longitudinal data showing the potential of EVOC probe strategies in breath analysis. We also gathered important data showing that administration of EVOC probes induces significant changes compared to previous exposures to the same compounds. EVOC strategies could herald a new wave of substrate-based breath tests, potentially bridging the gap between research tools and clinical applications

Iron Deficiency in Pulmonary Arterial Hypertension: A Deep Dive into the Mechanisms.

Pulmonary arterial hypertension (PAH) is a severe cardiovascular disease that is caused by the progressive occlusion of the distal pulmonary arteries, eventually leading to right heart failure and death. Almost 40% of patients with PAH are iron deficient. Although widely studied, the mechanisms linking between PAH and iron deficiency remain unclear. Here we review the mechanisms regulating iron homeostasis and the preclinical and clinical data available on iron deficiency in PAH. Then we discuss the potential implications of iron deficiency on the development and management of PAH

Baseline Clinical Characteristics according to ODI.

<p>Data are mean ± SD or number (%). Continuous variables were compared using unpaired <i>t</i> test. Categorical variables were compared by the χ² statistic.</p><p>ACE  =  Angiotensin converting enzyme; ARBs  =  Angiotensin II receptor blockers.</p

Unadjusted and Adjusted Cox's proportional Hazards Model for Clinical Endpoints in Patients with SDB.

<p>Models were adjusted for age, gender, BMI and PASP.</p

Kaplan-Meier curves for the clinical endpoints including mortality (A), readmission for heart failure (B), recurrent infarction (C) and the combined endpoint of mortality, readmission for heart failure and recurrent infarctions (D).

<p>Kaplan-Meier curves for the clinical endpoints including mortality (A), readmission for heart failure (B), recurrent infarction (C) and the combined endpoint of mortality, readmission for heart failure and recurrent infarctions (D).</p

Markers of inflammation and oxidative stress in patients with and without SDB.

<p>Markers of inflammation and oxidative stress in patients with and without SDB.</p

Echocardiographic characteristics of patients with and without SDB.

<p>Echocardiographic characteristics of patients with and without SDB.</p

Receiver-operating characteristic curves for the performance of ODI in the prediction of mortality (A), congestive heart failure (B), recurrent infarction (C) and the combined endpoint of mortality, readmission for heart failure and recurrent infarctions (D).

<p>Receiver-operating characteristic curves for the performance of ODI in the prediction of mortality (A), congestive heart failure (B), recurrent infarction (C) and the combined endpoint of mortality, readmission for heart failure and recurrent infarctions (D).</p

between ODI and pulmonary artery systolic pressure.

<p>between ODI and pulmonary artery systolic pressure.</p