Imagine talking to your best friend on the phone, when suddenly a text message from your doctor pops up. A plug-in module on your smartphone has detected an unusual chemical pattern in your breath, and you need to come in to be evaluated for early signs of cancer.

Physicians have been detecting disease from the smell of breath, urine, and feces for over 2,000 years. Illness can change the metabolism in our bodies, causing our cells to release volatile organic compounds (VOCs), molecules that travel through the bloodstream to the lungs and are exhaled. People with early stage cancer, for example, breathe out different concentrations of VOCs than healthy individuals.


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Haick began developing the device 10 years ago when he joined the faculty at Technion after completing a postdoc at the California Institute of Technology. The screening tool is made up of two parts: a white, desktop box with tube into which a person exhales, sending his or her breath into an array of sensors; and an attached computer with machine-learning software trained to recognize patterns from those sensors.

The kidneys remove toxic chemicals from the blood by creating urine. In kidney failure, also known as end-stage renal disease, the kidneys become so damaged that they are no longer able to filter waste products and toxic chemicals from the blood. When this happens, the dangerous toxins and waste not discharged from your body accumulate and affect nearly every part of your body.

But the slowed production of saliva during sleep can sometimes be caused by leaving your mouth open for long periods of time. People with sleep disorders such as sleep apnea and snoring may have trouble breathing through the nose and are more likely to breathe through their mouths, which is a cause of bad breath, according to the Cleveland Clinic.

Allergies and postnasal drip may also be what causes bad breath because these conditions tend to clog your nose. This nasal congestion may force you to breathe through your mouth, which can lead to dryness and the growth of bacteria that cause foul breath.

Early breath devices depended on finding a convenient chemical reaction in which a compound of interest, when added to all the other required ingredients, would generate a color change. As the tools of chemistry became more sophisticated (e.g. chromatography, spectroscopy, sequencing, immunoassays) detecting a wider range of foreign compounds has become straightforward. Over the past 20 years, the miniaturization of innovative sensors and electronics led to the development of numerous hand-held breath devices. Devices exist for an almost infinite range of compounds found in breathable air, whether ingested environmental pollutants, toxic substances or metabolic byproducts that are subsequently expired in breath. The Human Breathomics DataBase (HBDB) created and maintained by National Taiwan University, lists 913 VOCs found in 60 human diseases that are detectable in expired breath.

Yet dogs seem able to sniff-out COVID-19, and we know infection occurs from inhaling infected expired air, so it seems that it has to be possible to identify COVID-19 this way. The active virus and its fragments are found in microscopic breath droplets, but the problem is their concentration is 1,000 to 10,000 times lower than in saliva. So the question we are left with is this: Is there a way forward to use breath as an accurate enough, fast and cheap diagnostic, when it can be more convenient to focus on saliva for an easy and low-cost screening method?

The most likely opportunity being pursued is to discover a more subtle and complex VOC signature, like a fingerprint or breathprint, involving measurement of hundreds of VOC candidates all at once. Typically trained artificial intelligence (AI) principal component analysis (PCA) is used for this purpose. AI/PCA is a very powerful technique, but the diagnostic result is provided from a computational black-box, an algorithm similar to those used in block-chain transactions, and it is quite hard to disaggregate the contributing factors in any intuitive way. Validation therefore requires observing accuracy in clinical cases. This means very large data sets to rule out bias, but none have yet been published to allow independent evaluation. Several companies and institutions are exploring breath diagnostics this way for diseases, including COVID-19, using proprietary AI fingerprinting e.g. Owlstone (UK), Canary (US), Deep Sensing Algorithms (Finland), Ben Gurion University (Israel). No clinical data is yet publicly available to evaluate possible success.

Twenty-five years ago, perhaps the first clinical application of breath diagnosis was the use of expired nitric oxide, or NO, to evaluate asthma. NO is highly specific for this purpose because it is a signaling molecule that expands blood flow to compensate for the reduced oxygen availability that asthma generates. Many other diseases are amenable to a similar approach, but despite a long history of investigation of expired breath, to date there is no clinical adoption of this technique for viral disease diagnosis. Over the next 12 months, as small trials are initiated by breath pioneers, we may discover reliable fingerprints, but any broad clinical usage will likely be beyond the 2021 forecast of the end of this particular pandemic. So, probably not a good idea to hold our breath for its arrival.

Although diagnostic techniques based on breath samples have been demonstrated in the past, until now there has not been scientific proof that different and unrelated diseases are characterized by distinct chemical breath signatures. Also, technologies developed to date for this type of diagnosis have been limited to detecting a small number of diseases.

The researchers tested the chemical composition of the breath samples using an accepted analytical method (mass spectrometry). They discovered that all 17 of the diseases contained the same 13 chemical components, albeit in different compositions.

Haick is already well known for the SNIFFPHONE, a device he developed that can sense disease on the breath, much like a breathalyzer test. The SNIFFPHONE uses nanotechnology sensors to analyze the particles on the breath and can pinpoint exact diseases, like certain kinds of cancer, pulmonary and even the early stages of neurodegenerative diseases.

 What if you could detect cancer by a gadget that can sniff for cancer or some other disease? The theory that disease is detectable from exhaled breath dates back to about 400 BC when the Greek physician Hippocrates used to smell his patients' breath to find out what ailed them. More recently a number of individual diseases, such as diabetes, have been detected with "breath analysis".

The study used breath samples collected from 1,404 people from 2011 to 2014 in 5 countries (Israel, the United States, Latvia, China, and France). The test subjects were either known to be healthy or to be suffering from one of the 17 diseases. Please note that this diagnostic tool is currently being further researched and developed. It is not available yet.

Exhaled breath contains nitrogen, carbon dioxide and oxygen, as well as a small amount of more than 100 other volatile chemical components. The relative amounts of these substances vary depending on the state of a person's health. As far back as around 400 B.C., Hippocrates told his students to "smell your patients' breath" to search for clues of diseases such as diabetes (which creates a sweet smell). In more recent times, several teams of scientists have developed experimental breath analyzers, but most of these instruments focus on a single type of disease, such as cancer. In their own work, Hossam Haick and a team of collaborators in 14 clinical departments worldwide wanted to create a breathalyzer that could distinguish among multiple diseases.

The researchers developed an array of nanoscale sensors to detect the individual components in thousands of breath samples from patients who were either healthy or had one of 17 different diseases, such as kidney cancer or Parkinson's disease. By analyzing the results with artificial intelligence techniques, the team could use the array to classify and diagnose the conditions. The team used mass spectrometry to identify the breath components associated with the diseases. They found that each disease produces a unique volatile chemical breathprint, based on differing amounts of 13 components. They also showed that the presence of one disease would not prevent the detection of others -- a prerequisite for developing a practical device to screen and diagnose various diseases in a noninvasive, inexpensive and portable manner.

Both males and females should consider trying to lower their exposure to endocrine disrupting chemicals (hormone disrupting chemicals) when contemplating pregnancy. These chemicals are found in many personal care, food packaging, and plastic products. They can interfere with natural hormone function and are linked to a wide assortment of health problems. Evidence (like this study) is mounting that higher levels of endocrine disruptors in the body have a negative effect on the developing embryo. So men - an important time to try to lower your exposure to endocrine disruptors is the 3 months preconception (it takes about 3 months for sperm to mature), and for women it's the entire pregnancy period (from conception to birth). You can't totally avoid endocrine disrupting chemicals (they're detected in almost all of us), but you can lower your exposure.

"Just as each of us has a unique fingerprint that distinguishes us from others, each disease has a chemical signature that distinguishes it from other diseases and from a normal state of health," explains lead researcher Hossam Haick, an Israeli nanotech expert whose name is synonymous with disease-detecting sensors. "These odor signatures are what enables us to identify the diseases using the technology that we developed." be457b7860

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