Breath analysis in asbestos-related disorders: a review of the literature and potential future applications

Our plain-English summary of Breath analysis in asbestos-related disorders: a review of the literature and potential future applications, by E.A. Chapman, P.S. Thomas, D.H. Yates (Journal of Breath Research, 2010).

The study

• Authors: E.A. Chapman, P.S. Thomas, D.H. Yates
• Journal: Journal of Breath Research
• Published: 2010;4(3):034001
• Type of article: Review
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestos usage was very common worldwide in the last century and continues in several countries today. Several diseases occur due to asbestos exposure, including malignant tumours such as malignant mesothelioma of the pleura and lung cancer, which have a very poor prognosis. Asbestos inhalation may also result in more benign conditions such as asbestosis (or pulmonary fibrosis due to asbestos), pleural plaques and pleural thickening. It is predicted that asbestos-associated mortality and morbidity will continue to increase, but methods for diagnosing asbestos-related disease are currently invasive and unsuitable for an increasingly elderly population. New non-invasive methods such as analysis of exhaled breath biomarkers e.g. exhaled nitric oxide (F(E)NO), exhaled breath condensate or of exhaled volatile organic compounds could potentially be extremely useful in these conditions. This article reviews the current literature on this topic and suggests areas for their application in the future.

In plain English

This article was a topical review, not a new study. The authors reviewed published research on three breath methods for asbestos-related disorders: exhaled nitric oxide, chemicals in exhaled breath condensate, and electronic-nose 'smellprints' of breath compounds. They reported that three published studies had found raised exhaled nitric oxide in people with asbestos-related disorders, though not to the level seen in untreated asthma. One of those studies found a significant rise only in asbestosis, not in pleural disease. Two studies found the oxidative stress marker 8-isoprostane raised only in asbestosis, not in diffuse pleural thickening or pleural plaques. For mesothelioma, only one abstract had been published. In it, an electronic nose distinguished 10 patients with pleural malignant mesothelioma from 10 controls, with 90% cross validation. No electronic-nose work had been published specifically on asbestos-related lung cancer. The authors noted that methods for collecting breath condensate were not standardized. They concluded that information was still limited, but that non-invasive breath methods held promise for early detection of asbestos-related malignancy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative (topical) review of published literature; no search method is described
• Who was studied: published studies of breath analysis in people with asbestos-related disorders or asbestos exposure (summarized in Table 1), plus electronic-nose studies in lung cancer generally (Table 2)
• Exposure: asbestos exposure in general. No fiber types are named. Some of the reviewed studies combined asbestos and silica dust exposure.
• Main results:
  • The three published exhaled nitric oxide studies each found increased levels in subjects with asbestos-related disorders, though lower than in untreated asthma.
  • In the study by Chow et al, exhaled nitric oxide was significantly raised only in subjects with asbestosis, not in those with other asbestos-related pleural diseases.
  • Two studies found 8-isoprostane raised only in patients with asbestosis, not in patients with pleural disease (diffuse pleural thickening and pleural plaques).
  • Chow et al found a trend toward higher nitrogen oxides in breath condensate of patients with asbestosis and diffuse pleural thickening compared with controls, but the difference was not statistically significant.
  • Only one abstract had been published on electronic-nose testing in asbestos-related disease. It concerned pleural malignant mesothelioma, with 90% cross validation against control subjects.
  • The mesothelioma electronic-nose study (Table 1) included 10 patients with pleural malignant mesothelioma and 10 control subjects.
  • No electronic-nose work had been published specifically on asbestos-related lung cancer.
• The authors' conclusion: The authors concluded that information is still limited, but that non-invasive breath methods hold promise for early detection of asbestos-related malignancy.
• Limitations the authors state:
  • There is no standardized consensus method for collecting and analysing exhaled breath condensate.
  • No recommendations have been published for using the electronic nose in respiratory research.
  • The electronic-nose studies had small subject groups, and the technology is new.
  • Overall, little information is yet available in this area.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Malignant Mesothelioma, Pleura, Lung Cancer, Prognosis, Pulmonary Fibrosis, Pleural Plaques, Pleural Thickening.

Related studies

• A breath test for malignant mesothelioma using an electronic nose — E.A. Chapman, P.S. Thomas, et al. (2012)
• Potential application and prevalence of the CD30 (Ki-1) antigen among solid tumors: A focus review of the literature — G.K. Berger, K. Gee, et al. (2017)
• Exhaled breath to screen for malignant pleural mesothelioma: a validation study — K. Lamote, M. Vynck, et al. (2017)
• Detection of malignant pleural mesothelioma in exhaled breath by multicapillary column/ion mobility spectrometry (MCC/IMS) — K. Lamote, M. Vynck, et al. (2016)
• Exhaled Breath Analysis in Diagnosis of Malignant Pleural Mesothelioma: Systematic Review — Z.N. Töreyin, M. Ghosh, et al. (2020)
• Follow-up of Soluble Mesothelin-Related Protein Levels in Participants With Asbestos-Related Disorders — E.K. Park, A.R. Johnson, et al. (2020)

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