What our breath reveals
What our breath reveals
Breath analysis holds huge potential for unlocking a deeper understanding of our health. ETH professor Emma Slack shares her insights.
You run Zurich Exhalomics in partnership with your colleague Renato Zenobi, ETH Professor of Analytical Chemistry. Can you explain the project?
EMMA SLACK – We want analyses of exhaled air to become a valuable tool for medical practice. For our work, we use a mass spectrometer to determine a large variety of exhaled molecules – the exhalome. To put it simply, our aim is for a person to blow into a pipe and we immediately have key data about their state of health. Compared to diagnoses from blood analyses, this method is non-invasive and we have the results in almost real time.
What can breath analyses be used for?
Eleven interdisciplinary teams of biologists, clinicians and engineers are currently researching all kinds of possible applications, ranging from disease diagnosis to medication intake monitoring to dietary recommendations. One area of focus is the diagnosis of lung diseases such as asthma and infections in cystic fibrosis. Three hospitals are currently collecting data to create respiratory profiles for these diseases. This offers particular hope for paediatric medicine, as it’s difficult or even impossible for children to describe their symptoms. The method could also be used to monitor rare genetic diseases – such as urea cycle disorder, a metabolic condition that, if left untreated, can lead to severe brain damage – in real time. This would be particularly valuable in the early stages of newborn babies, as their exhaled air can be measured in the incubator, avoiding the need for invasive blood sampling. Another project that’s already at an advanced stage focusses on monitoring obesity therapy.
© ETH Foundation / Daniel Winkler
“With Zurich Exhalomics, we’re maximising the impact of our funding for the benefit of future patients.”
Chairman of the Evi Diethelm-Winteler Stiftung Board of Trustees
How does measuring breath help with obesity?
When treating obesity, one of the critical success factors is the optimal timing of food intake. For patients to monitor and tweak their diet efficiently, they need information on their fat metabolism. In cooperation with University Hospital Zurich (USZ), Professor Andreas Güntner has developed a breath sensor and an easy-to-handle measuring device that patients can use to measure the acetone content of their breath and obtain indications on their nutritional status. Since obesity is one of the main causes of diseases like type 2 diabetes and heart disease, combating the condition would reduce the burden on the healthcare system.
Where do you see the greatest opportunities for development with Zurich Exhalomics?
Hand-held analysers are certainly a great opportunity to make breath analysis widely accessible. We can then use mass spectrometry to determine other relevant breath markers. We want to develop measuring devices that, combined with the right sensors, can be produced cost-effectively and used at home, in clinics and in medical practices. The next step would be a plug-in installed on the device, which would save the data directly to an app on the patient’s mobile phone. In my view, Zurich Exhalomics has the potential to not only simplify the diagnosis and monitoring of diseases, but to also improve our understanding of them.
The project is financed by donors. Where can further funding make a difference?
The funding to date has enabled us to make major progress, for example in our ability to identify relevant disease markers. An important but costly and time-consuming next step involves validating these markers. Further funding would speed up further developments in the hand-held measuring device and enable the method to be tested for other diseases, such as metabolic disorders or infectious diseases.
Zurich Exhalomics pools the forces of nine different institutions. What’s ETH’s role in all this?
The large-scale project was initiated by Malcolm Kohler, then Director of UZH’s Clinic for Pneumology, and ETH’s Renato Zenobi, a leading figure in mass spectrometry research. The strengths that ETH brings to the table lie in technology development (not only in mass spectrometry, but also in optical spectroscopy and sensor technology), in reference gas management, and, of course, in data science and artificial intelligence. Alivion is an ETH spin-off that has succeeded in commercialising this outstanding expertise to create applications for medicine, the environment and food safety.
Besides your role as co-head of Zurich Exhalomics, you also lead the Laboratory for Mucosal Immunology at ETH and the University of Oxford. What is this lab researching?
We’re examining the connections between the microbiome and diet, the immune system and metabolism. The composition of our microbiome – the microorganisms that colonise us – has a stark influence on our health and, by improving our understanding of this connection, we want to prevent and treat diseases. Since our breath even contains clues to our microbiome, for example in our gut, Zurich Exhalomics offers exciting opportunities for our research.