In the first of a new series of in-depth interviews, we spoke to Professor James Covington from the School of Engineering, University of Warwick. James Covington is a leader in VOC biomarker research, with published works spanning a wide range of applications including cancer, infections, gastrointestinal conditions such as IBD, and neurological conditions including Alzheimer’s. His research has involved VOC sampling from feces, swabs, urine and breath, and he has worked closely with Owlstone and Owlstone Medical since the early days of our work on detection of clinically relevant biomarkers.
As an expert with diverse experiences across the field, we asked Professor Covington for his views on how the field has changed and for his predictions of what lies ahead.
How did you first become interested in volatile organic compounds (VOCs) as biomarkers and what was the first project you undertook in this area?
For many years my research focus was centered on developing different commercial gas sensor products. During this time, I was writing and publishing plenty of papers and was comfortable – it’s a research area that’s well-supported financially.
During a meeting about ten years ago, I met a Professor from the medical school here at Warwick, who knew someone interested in VOCs for medical applications. I had already read about using VOCs for for this purpose and was really interested. I took a risk; it could have been a total failure, but I wanted to try it.
I was connected to Ramesh Arasaradnam, one of our medical colleagues at University Hospitals Coventry and Warwickshire (UHCW), and after an initial chat, I went over to the hospital one evening with some of our equipment. We sat in one of the research labs and ran our first samples and got some good results. We were just sitting there and they kept popping up! It was late on a Friday evening and I just thought, “wow, this works”, and that was how it started.
What is it about VOCs that interests you and what do you think are their biggest advantages as biomarkers?
For me a huge advantage is that they are non-invasive – you do not have to give injections or collect blood samples or wait for an expensive imaging system (like MRI). One of the things that makes VOCs so appealing to me is the wide range of opportunities, from explosive detection and security applications to health and biomedical. For me, VOC biomarkers have the potential to make a real impact.
"Since I started working on gas sensors more than 20 years ago, there have been real advancements in our ability to measure and separate VOCs."
What do you think has been the biggest change since you have been working with VOC biomarkers?
Really there has been two major changes. The first is technological. Since I started working on gas sensors more than 20 years ago, there have been real advancements in our ability to measure and separate VOCs. This is linked to how data is processed and in particular the use of machine learning. Secondly, there is a broader acceptance in the clinical area on the use of VOCs and more interest in using them in clinical practice.
When did you first come across FAIMS and in what context?
I knew Billy Boyle [CEO of Owlstone Medical] when I was studying for my PhD. We would both attend the same conferences and there was a network of us, working on different VOC analysis platforms. When Billy co-founded Owlstone in 2004, we continued to keep in touch and in 2009 I purchased my first FAIMS unit, type 1. I began running samples and I have one of the first papers with FAIMS using Owlstone technology.
For you, what have been the key benefits of working with Owlstone Medical?
First and foremost that its been a laugh… I know this sounds odd, but I have always enjoyed visiting and working with the Owlstone team (and winning the football cup sweep stake!). More seriously, they are a very professional group of people who are always keen to push the boundaries and try new things.
What do you hope to achieve long-term in your work?
I think if we can get one of these devices or tests into the clinical domain and it becomes a standard test, that would be the pinnacle of my career.
And, what do you think is currently the biggest challenge in making that happen?
Those doing the VOC analysis and the clinicians work very differently. I have found we need to work towards better communication between those two groups. I also think that the level of paperwork and attention to detail needed to achieve regulatory approval for your test or technology is considerable. Unfortunately, many of the people who are working in this area, do not have the necessary experience to make it to clinical success.
How do you think that working as a community could accelerate progress in the field?
The first problem is that most funding agencies fund individual researchers, so you are always in competition with everyone else in the room. It’s not cohesive for group working. The second thing is that we have a lot of differing opinions on the best way of doing things. Questions that are often discussed include…What is the best way of preparing the patient? What’s the best way of collecting and analyzing the sample?
Another point is to promote the technology/concept and to get more acceptance in the clinical profession. The key is to have something that works really well and this on its own will accelerate other research in the area.
"Point of care tests are needed where a decision needs to be made there and then. For the common cold, it might be to decide whether to provide antibiotics or not."
Where do you think we are most likely to see breath tests breaking into the clinic?
I think it will be diagnosing infection, though it is hard to say what type of infection it will be… At the moment, researchers and the general public are focused on Covid-19, but in the longer run, it may well be things like trying to help diagnose the common cold. Point of care tests are needed where a decision needs to be made there and then. For the common cold, it might be to decide whether to provide antibiotics or not. However, the key to this is to make sure there are biomarkers available for the diseases and conditions we want to detect. More work is needed and it’s important to make sure we’re prepared for how these tests will be used in clinical practice.
In November 2020, Professor Covington presented “The diagnosis and monitoring of inﬂammatory bowel disease by the analysis of breath and other human waste” at the Breath Biopsy Conference.
This is the first entry in a new series of in-depth interviews with influential leaders currently working in breath research. Our second interview from the 'Leaders in the Field' series is with Professor Richard Yost, inventor of the triple quadrupole mass spectrometer and a pioneer in analytical chemistry.