MSACL 2019 EU Abstract

Impact of Oral Cleansing Strategies on Exhaled Volatile Organic Compound Levels

Bhamini Vadhwana (1), Ilaria Belluomo (1), Piers R Boshier (1), Chrystalla Pavlou (1), Patrik Španěl (2), George B Hanna (1)
(1) Department of Surgery and Cancer, Imperial College London, St Marys Hospital, London, UK (2) Heyrovský Institute of Physical Chemistry of the Czech Academy of Sciences, Prague, Czech Republic

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Bhamini Vadhwana (Presenter) Imperial College London >> POSTER (PDF)

Presenter Bio: Bhamini is a general surgical trainee undertaking a PhD degree in volatomic breath analysis in the early detection of oesophagogastric cancer at Imperial College London, under the supervision of Professor Hanna. Her work will involve multi-platform mass spectrometry analysis including the Selected Ion Flow Tube – Mass Spectrometry, Gas Chromotography – Mass Spectrometry and Proton Transfer Reaction – Mass Spectrometry.

Relevant Financial Disclosures (within past 24 months) No relevant financial relationship(s) to disclose. Conflict mitigation NOT REQUIRED.

Introduction
The analysis of volatile organic compounds (VOC) within exhaled breath offers a non-invasive method for the detection and surveillance of human disease. Oral microbial fermentation produces volatile sulphur and fatty acid metabolites. [1-4] Oral contamination of exhaled breath may influence the detection of systemic VOCs relevant to human disease. This study aims to assess oral contamination and cleansing methods in order to standardise practice for breath sampling.

Methods
Ten healthy volunteers consumed an oral nutrient challenge followed by four oral cleansing methods (i) water (ii) salt water (iii) toothbrushing and (iv) alcohol free mouthwash. Direct breath sampling was performed on the selected ion flow tube – mass spectrometry after each intervention. One target ion was used for identification and quantification of compounds. Volatile fatty acid, alcohol, aldehyde, phenol and sulphur metabolites were analysed in parts per billion by volume. Friedman’s statistical analysis was performed (p<0.05).

Results
Volatile fatty acid and alcohol levels (butanoic acid, p<0.001; pentanoic acid, p<0.001; ethanol, p=0.003) declined with oral cleansing interventions, predominantly after an oral rinse with water. Aldehydes and phenol levels (acetaldehyde, p=0.009; menthone, p=<0.001; p-cresol, p<0.001) declined with oral water rinse, however levels significantly increased after toothbrushing and mouthwash use, secondary to flavoured ingredients within the products. No significant reductions were observed with sulphur compounds. Acetone concentrations remained consistent (p=0.988).

Conclusion
Findings suggest that oral rinsing with water prior to breath sampling may reduce oral contamination of VOC levels, and further interventions for oral decontamination with flavoured products may falsify results. This intervention may serve as a simple and inexpensive method of standardisation within breath research.

References

1. Snel, J., et al., Volatile sulphur compounds in morning breath of human volunteers. Arch Oral Biol, 2011. 56(1): p. 29-34.
2. Porter SR, S.C., Oral malodour (halitosis). BMJ, 2006. 333(7569): p. 632-5.
3. van den Velde, S., et al., Halitosis associated volatiles in breath of healthy subjects. J Chromatogr B Analyt Technol Biomed Life Sci, 2007. 853(1-2): p. 54-61.
4. Scully, C. and J. Greenman, Halitology (breath odour: aetiopathogenesis and management). Oral Dis, 2012. 18(4): p. 333-45.