Weil Institute team seeks insight into the injured brain through exhaled breath
Researchers examine if breath exhaled after injury could provide a potential pathway to non-invasive, point-of-care monitoring.
Contact:
Katelyn Murphy,
Marketing Communications Specialist, Weil Institute
mukately@med.umich.edu
ANN ARBOR, MI – Every breath a patient exhales contains numerous volatile organic compounds (VOCs), many of which can provide vital information about the patient’s wellbeing. Previous studies have revealed patterns of VOCs that might be indicative of the metabolic changes and inflammatory states associated with various diseases. Investigators from the University of Michigan Max Harry Weil Institute for Critical Care Research and Innovation now seek to understand if these unique signatures in exhaled breath can also tell clinicians about injuries of the brain.
A team led by Dr. Hakam Tiba, Director of the Weil Institute’s Preclinical Critical Care Laboratory and Research Assistant Professor of Emergency Medicine, has received an $80,000 grant through the U-M Medical School Office of Research to study breath signatures in the setting of moderate to severe traumatic brain injury (TBI). Using a portable gas chromatography (GC) device, the team will compare VOCs produced before and after injury in search of any that show dynamic changes post-TBI. If found, the team will then study how these VOCs relate to current metrics for assessing brain injury severity, with the ultimate goal of identifying breath signatures that may be specific to TBI.
Brain injuries are a major source of morbidity and mortality, affecting at least 2.8 million Americans each year (1). Current methods of assessing TBI severity rely on expensive and repetitive radiologic imaging as well as the frequent need to invasively monitor patients using techniques such as intracranial pressure monitoring. Despite this, these techniques cannot provide continuous metabolic information regarding the status of the brain. While new blood-based brain biomarkers are showing promise in following brain health after injury and during treatment, they require repetitive blood sampling. As such, there is an urgent need for methods of early, non-invasive monitoring in a setting of TBI—something Dr. Tiba and his team hope their work will help open the door for.
“The results of our investigation might lead to the identification of VOCs and VOC patterns that could be effective for providing insight towards the progression, severity of injury and prognosis throughout the patient’s care,” said Dr. Tiba.
The GC device the team will use was developed by study co-investigators Dr. Xudong (Sherman) Fan, Dr. Ruchi Sharma, and Dr. Kevin Ward. It is portable, provides results within minutes, and can be attached to ventilators to allow for continuous monitoring and analysis even when a patient is unable to breathe on their own. The device has previously been deployed to detect VOCs indicative of conditions such as acute respiratory distress syndrome (ARDS), and its advanced sensing capabilities even allow it to detect specific VOC-signatures between different variants of SARS-CoV-2 (the strain of coronavirus that causes COVID-19).
"If successful, their device would change this [TBI diagnosis] dramatically by offering a biomarker-based test that allows us to diagnose TBI in minutes with barely any effort. Such a device would not only benefit our patients but could also find major applications outside of the hospital setting."
Matthias Truttmann, PhD
Assistant Professor, Molecular & Integrative Physiology; Research Assistant Professor, Institute of Gerontology
University of Michigan, Michigan Medicine
Support for the team’s research was provided by the Medical School’s Research Scouts program, an agile, low-burden funding initiative which gives money to scientists (the “Scouts”) to invest in other scientists' bold ideas. The Scouts seek early-stage ideas that can transform current understanding of a scientific concept or field, challenge common dogma, or are wildly new and imaginative.
The potential impact of both Dr. Tiba’s study and the portable GC device were what initially drew Dr. Matthias Truttmann, Professor of Molecular and Integrative Physiology and a Research Scout himself, to approach the team about their work and, later, fund it.
“I was looking for a project that I believed would have an immediate and substantial impact on our ability to provide our patients with the best possible support,” said Dr. Truttmann. “It is my understanding that, currently, a TBI diagnosis relies on the patient's anamnesis and/or imaging. If successful, their device would change this dramatically by offering a biomarker-based test that allows us to diagnose TBI in minutes with barely any effort. Such a device would not only benefit our patients but could also find major applications outside of the hospital setting.”
Through the support of Dr. Truttmann and the Research Scouts, the team’s next steps will be to establish the preclinical model through which they will examine the brain’s inflammatory response to trauma, including cerebral and systemic hemodynamics. The team will also present their work alongside other Research Scout awardees at an upcoming symposium.
“It [the Research Scouts] is an innovative funding program that allows University scientists to invest in other scientists' and colleagues’ bold ideas, enabling the much-needed initial boost and de-risking of those ideas and setting these proposals on the road for additional funding by federal and industry agencies,” said Dr. Tiba. “We are grateful to receive this support and are looking forward to seeing how our work might help transform care for patients with TBI.”
Further Reading
Project Team
Hakam Tiba, M.D., M.S. (PI; Weil Institute, Emergency Medicine)
Ruchi Sharma, Ph.D. (Co-I; Weil Institute, Biomedical Engineering)
Kevin Ward, M.D. (Co-I; Weil Institute, Emergency Medicine, Biomedical Engineering)
Xudong (Sherman) Fan, Ph.D. (Co-I; Weil Institute, Mechanical Engineering)
Disclosures
The University of Michigan is a partial owner and Drs. Fan, Sharma and Ward are inventors of technology being used in this research project. The technology is licensed to Nanova Environmental, Inc., ChromX Health, and to RUA Diagnostics, Inc., the latter of which is partially owned by Dr. Fan and Dr. Ward and was created to commercialize this technology. Dr. Fan serves as an outside consultant to ChromX Health unrelated to this project.
About the Weil Institute, formerly MCIRCC
The team at the Max Harry Weil Institute for Critical Care Research and Innovation (formerly the Michigan Center for Integrative Research in Critical Care) is dedicated to pushing the leading edge of research to develop new technologies and novel therapies for the most critically ill and injured patients. Through a unique formula of innovation, integration and entrepreneurship that was first imagined by Weil, their multi-disciplinary teams of health providers, basic scientists, engineers, data scientists, commercialization coaches, donors and industry partners are taking a boundless approach to re-imagining every aspect of critical care medicine. For more information, visit weilinstitute.med.umich.edu.