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Metabolites
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Pulmonary Oxygen Toxicity and Exhaled Breath Analysis in Diving and...
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Pulmonary Oxygen Toxicity and Exhaled Breath Analysis in Diving and Hyperbaric Medicine

A special issue of Metabolites (ISSN 2218-1989). This special issue belongs to the section "Metabolomic Profiling Technology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 4368

Special Issue Editors

Prof. Dr. Robert A. Van Hulst

E-Mail Website
Guest Editor
Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
Interests: diving and hyperbaric medicine; pulmonary medicine; cerebral air embolism
Dr. Thijs T. Wingelaar

E-Mail Website
Guest Editor
1. Royal Netherlands Navy Diving Medical Center, 1780 CA Den Helder, The Netherlands
2. Department of Anesthesiology, Amsterdam UMC, Location AMC, 1100 DD Amsterdam, The Netherlands
Interests: diving and hyperbaric medicine; pulmonary medicine; exhaled breath analysis; hy-peroxia

Special Issue Information

Dear Colleagues,

Exposure to high concentrations of oxygen can lead to pulmonary oxygen toxicity. In the early stages, the symptoms are reversible, but extended exposure can lead to chronic pulmonary injury. This can become problematic when individuals are frequently, or for extended periods of time, exposed to high concentrations of oxygen (hyperoxia), such as in technical, occupational or military diving and patients receiving hyperbaric oxygen therapy.

The current ‘safe limits’ of hyperoxic exposure are based on fundamental research published in the early 1970s. While the studies were sound, the used methods (pulmonary function testing) may not be accurate enough to detect subtle changes as a result of (hyperbaric) hyperoxia. The original authors acknowledged these limitations and hypothesized that in the future, more technologically advanced methods would be available to detect pulmonary oxygen toxicity.

Those suggested advanced methods to detect pulmonary disease are available presently: exhaled nitric oxide or diffusion capacity can assess the alveolar membrane function and exhaled breath analysis can detect single molecules. Airway resistance can be quantified using the forced oscillation technique, and volatile organic compounds can be detected through various methods, such as gas chromatography–mass spectrometry (GC-MS) or eNose technology, but it is uncertain which marker or method is the best replacement for the current gold standard from the 1970s.

This Special Issue of Metabolites is dedicated to the detection and quantification of pulmonary oxygen toxicity. We hope to provide leading experts a platform to share their research and thoughts to contribute to the direction of future research in this field.

Prof. Dr. Robert A. Van Hulst
Dr. Thijs T. Wingelaar
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Metabolites is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hyperoxia
  • hyperbaric oxygen therapy
  • diving medicine
  • pulmonary medicine
  • exhaled breath analysis
  • volatile organic compounds
  • GC-MS
  • eNose

Published Papers (3 papers)

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Research

15 pages, 258 KiB  
Article
Plasma Proteomics-Based Discovery of Mechanistic Biomarkers of Hyperbaric Stress and Pulmonary Oxygen Toxicity
by Kyle J. Mahoney, Jacob S. Bowie, Austin E. Ford, Neranjan Perera, Yasuki Sekiguchi, David M. Fothergill and Elaine C. Lee
Metabolites 2023, 13(9), 970; https://doi.org/10.3390/metabo13090970 - 23 Aug 2023
Viewed by 1186
Abstract
Our aim was to identify proteins that reflect an acute systemic response to prolonged hyperbaric stress and discover potential biomarker pathways for pulmonary O2 toxicity. The study was a double-blind, randomized, crossover design in trained male Navy diver subjects. Each subject completed [...] Read more.
Our aim was to identify proteins that reflect an acute systemic response to prolonged hyperbaric stress and discover potential biomarker pathways for pulmonary O2 toxicity. The study was a double-blind, randomized, crossover design in trained male Navy diver subjects. Each subject completed two dry resting hyperbaric chamber dives separated by a minimum of one week. One dive exposed the subject to 6.5 h of 100% oxygen (O2) at 2ATA. The alternate dive exposed the subjects to an enhanced air nitrox mixture (EAN) containing 30.6% O2 at the same depth for the same duration. Venous blood samples collected before (PRE) and after (POST) each dive were prepared and submitted to LC-MS/MS analysis (2 h runs). A total of 346 total proteins were detected and analyzed. A total of 12 proteins were significantly increased at EANPOST (vs. EANPRE), including proteins in hemostasis and immune signaling and activation. Significantly increased proteins at O2PRE (vs. O2POST) included neural cell adhesion molecule 1, glycoprotein Ib, catalase, hemoglobin subunit beta, fibulin-like proteins, and complement proteins. EANPOST and O2POST differed in biomarkers related to coagulation, immune signaling and activation, and metabolism. Of particular interest is (EANPOST vs. O2POST), which is protective against oxidative stress. Full article
(This article belongs to the Special Issue Pulmonary Oxygen Toxicity and Exhaled Breath Analysis in Diving and Hyperbaric Medicine)
14 pages, 592 KiB  
Article
Exhaled Nitric Oxide and Pulmonary Oxygen Toxicity Susceptibility
by David M. Fothergill and Jeffery W. Gertner
Metabolites 2023, 13(8), 930; https://doi.org/10.3390/metabo13080930 - 08 Aug 2023
Viewed by 780
Abstract
Individual susceptibility to pulmonary oxygen toxicity (PO2tox) is highly variable and currently lacks a reliable biomarker for predicting pulmonary hyperoxic stress. As nitric oxide (NO) is involved in many respiratory system processes and functions, we aimed to determine if expired nitric [...] Read more.
Individual susceptibility to pulmonary oxygen toxicity (PO2tox) is highly variable and currently lacks a reliable biomarker for predicting pulmonary hyperoxic stress. As nitric oxide (NO) is involved in many respiratory system processes and functions, we aimed to determine if expired nitric oxide (FENO) levels can provide an indication of PO2tox susceptibility in humans. Eight U.S. Navy-trained divers volunteered as subjects. The hyperoxic exposures consisted of six- and eight-hour hyperbaric chamber dives conducted on consecutive days in which subjects breathed 100% oxygen at 202.65 kPa. Subjects’ individual variability in pulmonary function and FENO was measured twice daily over five days and compared with their post-dive values to assess susceptibility to PO2tox. Only subjects who showed no decrements in pulmonary function following the six-hour exposure conducted the eight-hour dive. FENO decreased by 55% immediately following the six-hour oxygen exposure (n = 8, p < 0.0001) and by 63% following the eight-hour exposure (n = 4, p < 0.0001). Four subjects showed significant decreases in pulmonary function immediately following the six-hour exposure. These subjects had the lowest baseline FENO, had the lowest post-dive FENO, and had clinical symptoms of PO2tox. Individuals with low FENO were the first to develop PO2tox symptoms and deficits in pulmonary function from the hyperoxic exposures. These data suggest that endogenous levels of NO in the lungs may protect against the development of PO2tox. Full article
(This article belongs to the Special Issue Pulmonary Oxygen Toxicity and Exhaled Breath Analysis in Diving and Hyperbaric Medicine)
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18 pages, 21458 KiB  
Article
Analysis of Volatile Organic Compounds in Exhaled Breath Following a COMEX-30 Treatment Table
by Feiko J. M. de Jong, Thijs T. Wingelaar, Paul Brinkman, Pieter-Jan A. M. van Ooij, Anke H. Maitland-van der Zee, Markus W. Hollmann and Rob A. van Hulst
Metabolites 2023, 13(3), 316; https://doi.org/10.3390/metabo13030316 - 21 Feb 2023
Cited by 5 | Viewed by 1652
Abstract
The COMEX-30 hyperbaric treatment table is used to manage decompression sickness in divers but may result in pulmonary oxygen toxicity (POT). Volatile organic compounds (VOCs) in exhaled breath are early markers of hyperoxic stress that may be linked to POT. The present study [...] Read more.
The COMEX-30 hyperbaric treatment table is used to manage decompression sickness in divers but may result in pulmonary oxygen toxicity (POT). Volatile organic compounds (VOCs) in exhaled breath are early markers of hyperoxic stress that may be linked to POT. The present study assessed whether VOCs following COMEX-30 treatment are early markers of hyperoxic stress and/or POT in ten healthy, nonsmoking volunteers. Because more oxygen is inhaled during COMEX-30 treatment than with other treatment tables, this study hypothesized that VOCs exhaled following COMEX-30 treatment are indicators of POT. Breath samples were collected before and 0.5, 2, and 4 h after COMEX-30 treatment. All subjects were followed-up for signs of POT or other symptoms. Nine compounds were identified, with four (nonanal, decanal, ethyl acetate, and tridecane) increasing 33–500% in intensity from before to after COMEX-30 treatment. Seven subjects reported pulmonary symptoms, five reported out-of-proportion tiredness and transient ear fullness, and four had signs of mild dehydration. All VOCs identified following COMEX-30 treatment have been associated with inflammatory responses or pulmonary diseases, such as asthma or lung cancer. Because most subjects reported transient pulmonary symptoms reflecting early-stage POT, the identified VOCs are likely markers of POT, not just hyperbaric hyperoxic exposure. Full article
(This article belongs to the Special Issue Pulmonary Oxygen Toxicity and Exhaled Breath Analysis in Diving and Hyperbaric Medicine)
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