Jane E. Hill

Exercise induces metabolic and physiological changes across multiple organs. These changes have been studied via several human biofluids, including urine and blood; however, they remain mainly underexplored in exhaled breath. In this exploratory pilot study, we performed untargeted profiling of breath volatile compounds (VCs) to investigate how exercise and recovery influence breath chemical composition. Breath samples were collected from 71 university athletes from three sporting disciplines. Across 143 breath samples, a total of 1204 unique breath VCs were detected. There were distinct volatilomic responses to physical activity and recovery, regardless of the athlete ’ s sport. Comparison of paired samples using volcano analysis collected before and during exercise identified 80 breath VCs that significantly increased and 182 that significantly decreased. Similarly, a comparison of samples collected before and after exercise identified 11 compounds that decreased significantly. These findings demonstrate that exercise induces measurable changes in the breath volatilome. However, due to the lack of standardized exercise intensity measures and physiological monitoring, the results should be considered exploratory and interpreted cautiously within the field of exercise science.

When treated with doses of antibiotics below the minimum inhibitory concentration, bacterial cell division turns off, but cell growth does not. As a result, rod-like bacteria, including E. coli, can elongate many times their original length without increasing their width. The swimming behavior of these filamentous bacteria through small channels may provide insights into how bacteria that survive antibiotic treatment can reach channel walls. Such swimming behaviors in settings like hospital tubing may signal precursors to adhesion, biofilm formation, and infection. Despite the importance of understanding the behavior of bacteria not killed by antibiotics, the hydrodynamics of filamentous bacteria swimming in external flows has not received much attention. We study the swimming behavior of stressed, filamentous E. coli. In quiescence, highly elongated E. coli swim with a sinusoidal undulating motion, suggesting rigid body rotation of long, rigid, buckled cell bodies. In low Reynolds number pressure-driven flows through a microchannel, the undulating motion becomes irregular; it may even stop and start within a particular bacterial trajectory. We refer to this behavior in flow as “wiggling.” Rigid body rotation persists in flow, appearing as a high-frequency change in body orientation on top of a slower one. Chiral reorientation can explain the slower reorientation frequency. We quantify swimming behaviors in two different flow rates and observe rheotaxis in addition to the preferential orientation of bacterial bodies. Faster flow constrains wiggling bacteria trajectories and orientations compared to those observed in slower flow, with rheotaxis taking bacteria toward the wall. Interestingly, not all bacteria in flow wiggle. Populations of non-motile “non-wiggling” filamentous E. coli follow streamlines, without preferential alignment of their orientation. Non-motile bacteria do not behave like chiral rods propelled and rotated by flagellar bundles, but like rigid rods. Motility slows the swimmers in comparison. Differentiating these two populations may have important implications for understanding consequences of motility loss that inevitably occurs as bacteria die.

Breath volatile organic compounds (VOCs) are increasingly under consideration as biomarkers of respiratory disease. Although numerous studies have identified VOCs that distinguish patient groups, a lack of standardisation among published studies has impeded translation into clinical diagnostics. Standardised breath collection protocols have been proposed for adults and children aged >4 years, but optimal methods for collecting breath from younger children remain to be determined. The aim of this study was to assess the feasibility and acceptability of breath sampling among a young paediatric cohort. A total of 61 children (age 6 months–12 years) were recruited prospectively to observational studies of chronic cough at two study sites. Mixed expiratory breath was collected into 1 l Tedlar Bags using either a drinking straw, mouthpiece, or mask. After concentrating onto thermal desorption tubes, the breath was analysed using two-dimensional gas chromatography coupled with time-of-flight mass spectrometry. Breath collection via a mouthpiece was highly feasible for children aged >2 years. Mask-based collection was required for younger children but was poorly tolerated. Drinking straw-based collections were unsuitable for some children aged <4 years due to challenges maintaining a sufficient seal. At least 700 ml of breath was sampled from 72.6% of children. The number of peaks per sample, total peak area per sample, and composition of breath VOCs were all consistent with successful breath sampling. The high feasibility of breath collection via a mouthpiece in our study suggests established protocols designed for children aged over 4 years can be used with confidence for children from as young as 2 years of age.

Non-human primates remain the most useful and reliable pre-clinical model for many human diseases. Primate breath profiles have previously distinguished healthy animals from diseased, including non-human primates. Breath collection is relatively non-invasive, so this motivated us to define a healthy baseline breath profile that could be used in studies evaluating disease, therapies, and vaccines in non-human primates. A pilot study, which enrolled 30 healthy macaques, was conducted. Macaque breath molecules were sampled into a Tedlar bag, concentrated onto a thermal desorption tube, then desorbed and analyzed by comprehensive two-dimensional gas chromatography-time of flight mass spectrometry. These breath samples contained 2,017 features, of which 113 molecules were present in all breath samples. The core breathprint was dominated by aliphatic hydrocarbons, aromatic compounds, and carbonyl compounds. The data were internally validated with additional breath samples from a subset of 19 of these non-human primates. A critical core consisting of 23 highly abundant and invariant molecules was identified as a pragmatic breathprint set, useful for future validation studies in healthy primates.

Confirmatory diagnosis of childhood tuberculosis (TB) remains a challenge mainly due to its dependence on sputum samples and the paucibacillary nature of the disease. Thus, only ~ 30% of suspected cases in children are diagnosed and the need for minimally invasive, non-sputum-based biomarkers remains unmet. Understanding host molecular changes by measuring blood-based transcriptomic markers has shown promise as a diagnostic tool for TB. However, the implication of sex contributing to disease heterogeneity and therefore diagnosis remains to be understood. Using publicly available gene expression data (GSE39939, GSE39940; n = 370), we report a sex-specific RNA biomarker signature that could improve the diagnosis of TB disease in children. We found four gene biomarker signatures for male (SLAMF8, GBP2, WARS, and FCGR1C) and female pediatric patients (GBP6, CELSR3, ALDH1A1, and GBP4) from Kenya, South Africa, and Malawi. Both signatures achieved a sensitivity of 85% and a specificity of 70%, which approaches the WHO-recommended target product profile for a triage test. Our gene signatures outperform most other gene signatures reported previously for childhood TB diagnosis.

Headspace solid-phase micro-extraction (HS-SPME) is a prevalent technique in metabolomics and volatolomics research. However, the performance of HS-SPME can vary considerably depending on the sample matrix. As a result, fine-tuning the parameters for each specific sample matrix is crucial to maximize extraction efficacy. In this context, we conducted comprehensive HS-SPME optimization for bronchoalveolar lavage fluid (BALF) samples using two-dimensional gas chromatography with time-of-flight mass spectrometry (GC×GC-ToFMS). Our exploration spanned several HS-SPME parameters, including vial size, dilution factor, extraction time, extraction temperature, and ionic strength. The 10 mL vial size, no sample dilution, extraction time of 50 min, extraction temperature of 45 °C, and 40% salt were identified as the optimized parameters. The optimized method was then evaluated by a pair-wise comparison of ten sets of samples. The results revealed that the optimized method yielded an increase of 340% in total peak area and an increase of 80% in total peak number. Moreover, enhancements were observed across nine major chemical classes in both peak area and number. Notably, the optimized method also doubled the number of volatile compounds consistently detected across BALF samples, from 52 to 108.

Chronic wet cough for longer than 4 weeks is a hallmark of chronic suppurative lung diseases (CSLD), including protracted bacterial bronchitis (PBB), and bronchiectasis in children. Severe lower respiratory infection early in life is a major risk factor of PBB and paediatric bronchiectasis. In these conditions, failure to clear an underlying endobronchial infection is hypothesised to drive ongoing inflammation and progressive tissue damage that culminates in irreversible bronchiectasis. Historically, the microbiology of paediatric chronic wet cough has been defined by culture-based studies focused on the detection and eradication of specific bacterial pathogens. Various ‘omics technologies now allow for a more nuanced investigation of respiratory pathobiology and are enabling development of endotype-based models of care. Recent years have seen substantial advances in defining respiratory endotypes among adults with CSLD; however, less is understood about diseases affecting children. In this review, we explore the current understanding of the airway microbiome among children with chronic wet cough related to the PBB–bronchiectasis diagnostic continuum. We explore concepts emerging from the gut–lung axis and multi-omic studies that are expected to influence PBB and bronchiectasis endotyping efforts. We also consider how our evolving understanding of the airway microbiome is translating to new approaches in chronic wet cough diagnostics and treatments.