Michael Wilde at BBCon 2023
Plenary Speaker: Evidence of Breath Metabolite Networks
00:00 ‘Evidence of Breath Metabolite Networks’
44:54 Question and Answer Session
Talk Abstract:
Acute breathlessness due to cardio-respiratory diseases accounts for more than 1 in 8 of all emergency admissions to hospital [1]. Diagnostic evaluation based on blood-based biomarkers and radiological tests is difficult in patients with multifactorial presentations of acute breathlessness and particularly challenging to interpret in the context of pre-admission treatment exposure [2]. The assessment of exhaled, low-molecular weight metabolites, chemically classified as volatile organic compounds (VOCs), offers new opportunities for the development of rapid, non-invasive diagnostic and prognostic biomarkers.
As part of the East Midlands Breathomics Pathology Node (EMBER), breath VOCs were sampled from acutely unwell hospitalised patients presenting with breathlessness due to severe exacerbations of asthma, chronic obstructive pulmonary disease, heart failure or pneumonia and matched healthy controls (n=277) [3]. By isolating and visualizing exhaled VOCs with multidimensional gas chromatography-mass spectrometry (GC×GC-MS), coupled with rigorous clinical phenotyping, exhaled breath metabolites were shown to have high diagnostic accuracy (79% sensitivity, 85% specificity) for severe cardiorespiratory exacerbations, including in the presence of clinical uncertainty [4].
The discovery of significantly enriched metabolite sets with high chemical similarity revealed new insights into the dysregulation of breath metabolite networks across several pertinent volatile classes in different clinical subtypes of cardiorespiratory exacerbation. Research from the EMBER Node demonstrates how breath biomarker platforms may be used in acute care and the potential for the translation of this technology into a real-world clinical setting.
References:
[1] Hutchinson, A., et al., Breathlessness and presentation to the emergency department: a survey and clinical record review. BMC pulmonary medicine, 2017. 17(1): p. 53-53.
[2] Parshall, M.B., et al., An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea. American Journal of Respiratory and Critical Care Medicine, 2012. 185(4): p. 435-452.
[3] Ibrahim, W., et al., Assessment of breath volatile organic compounds in acute cardiorespiratory breathlessness: a protocol describing a prospective real-world observational study. BMJ open, 2019. 9(3): p. e025486.
[4] Ibrahim, W., Wilde, M. and Cordell, C., et al., Visualization of exhaled breath metabolites reveals distinct diagnostic signatures for acute cardiorespiratory breathlessness. Science Translational Medicine, 2022. 14(671): p. eabl5849.
Speaker Biography:
Dr Michael Wilde is a lecturer in Analytical & Environmental Chemistry at the University of Plymouth. He is also a recent recipient of a CAMS UK Lectureship award in Bioanalytical Measurement and Volatilomics from the Community of Analytical Measurement Science, and he’s been settling in at Plymouth by acquiring state-of-the-art equipment for the analysis of biological and environmental samples.
Before his appointment at Plymouth, Mike was previously a research fellow at the University of Leicester, where his research contributions were significant in the MRC Molecular Pathology Node, called EMBER becoming recognized as an internationally leading centre in breath research. By developing cutting-edge analytical technologies for the measurement of volatile metabolites in breath, working between the hospital and the lab, Mike was central in delivering over 2000 patient breath/VOC samples, integrating advanced chromatographic and mass spectrometric technologies in over 5 clinical studies across respiratory and cardiovascular science.
His research portfolio reflects a passion for discovery, the separation of complex mixtures, and advancing the application of multidimensional gas chromatography-mass spectrometry. Consequently, he has a continued interest in the improvement of chemometric workflows, and alongside breath, his research interests include volatile metabolites in vitro, environmental health such as air quality, and microplastics.
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