Consider Dr. Max Allsworth a health detective, working to uncover hidden signs of disease — from cirrhosis to cancer — just from analyzing one’s breath. As the Chief Science Officer of Owlstone Medical, Dr. Allsworth has helped build an “atlas of chemicals” found on our breath. When deciphered, this atlas can pinpoint potentially nascent medical concerns. The ensuing tests, designed for home use, empower people to access their own health details and provides clinicians insight to guide patient care.
“These tests detect diseases when they’re asymptomatic, early enough that you can make a difference, maximizing health, for as long as possible for everyone,” he says. At DOC 2025, the DOC community had the opportunity to engage with Owlstone’s next-gen technologies at our Living Room Lab.
You can hear more from Dr. Allsworth’s DOC 2025 presentation during the “Blood (Proteomics), Breath and Microplastics” session in the video below, or read our lightly edited transcript.
TRANSCRIPT:
Dr. Max Allsworth
I’m going to talk today about breath analysis, and how it can be used and how it can be used in the home by everyone.The first thing is why have you got so many chemicals on your breath? They represent pretty much everything you’re exposed to in your in your lives. They’re the food you eat, the things you drink, the chemicals in the environment. But they’re also representative of what your body’s doing that endogenous compounds that are generated as you process sugars, as your muscles operate, these these mixtures of chemicals, represent that that everything that’s happening in your body and the exposure and the risks that you’re involved with.
The thing that Owlstone has been doing is building up an atlas of all these chemicals. With the support of one of our investors the Gates Foundation, we also built an interactive, sample biobank that links all those different chemicals in breath to the patient data that’s there, where we can play models to understand what’s happening. There’s all these compounds on breath. But what can you do with them? I’m going to tell you quickly three examples of tests under development agreement. Some are already available. This one’s a the device is FDA-approved, others, so in late stage clinical trials, so this first one is talking about hydrogen and methane on breath. Now this comes from your microbiome. When you eat any carbohydrates, they need to be broken down by the bacteria in your gut. Now, if some of these bacteria aren’t in the right place or they’re too many certain types of bacteria, that fermentation produces gases, hydrogen and methane. They drive some of this cold comfort, bloating and all the side effects of IBS.
Being able to measure those all the time, gives you great capabilities in diagnosing problems. This device is a pure point of care device, something you can take home with you, links to your phone, the app that it’s connected to tracks symptoms, your food, and the hydrogen methane and provides the information to a doctor to be able to make clinical decisions.
A quick example of that, this is a case report of something you could never do with regular with standard testing at the moment, because you wouldn’t have a number of data points. Each one of these blue dots is a measurement of, of methane, one of the two gases this device is measuring. Every day they were taking multiple measurements of the methane as they ate different foods. These methane levels for this patient was particularly high. It was causing all sorts of G.I symptoms. The doctor was consulted, they identified, message ionic, overgrowth. So too much of a certain type of bacteria, and they’re given an antibiotics regime that’s just a standard of care. But as you can see, after that, at first, antibiotic dose, it didn’t it knocked it down a bit, but it didn’t solve the problem.
Normally in this case, they would have gone on to something else. But the doctor quick look and say it did do something. It was just it wasn’t an option of treatment. So a second treatment knocked it down. This is where this sort of, continuous information, the amount of data you can get from a breath sample, which is available all the time, you can always breathe.
We’ve got other problems. Let’s a patient take many samples and really delve deeply into the data that can be generated. But that’s not the only application. So we’ve been exploring, another big problem in the world is, liver disease. Especially advanced liver disease. And the kicking into cirrhosis and decompensated cirrhosis. The problem is definitely real because it’s most often diagnosed in emergency rooms. So 50% up to 75% of people get find out their life is decompensated, and it’s too late to do anything about it in an emergency room. So there’s definitely something we’re not doing right today.
Here we were looking at this thinking like, how can we use a breath test to help us? You test your liver every day when you eat food, drink, drink, particularly alcohol. Your liver is there to take the chemicals out of your bloodstream, metabolize them away so they’re safe. So every time you eat, you are challenging your liver. If your liver is not very well working very well, and you drink a glass of orange juice instead of those, compounds in there being sucked out of the bloodstream and processed away. They go straight into your circulatory system, and they’re being continuously breathed out. So you can make a test with orange juice and a breath test. We went slightly more controlled than how much pulp is an orange juice to how much compound you receive, and build a small test where you receive a compound, a cocktail of compounds, those three compounds that you drink, a few minutes later, you take a breath test.
What this is doing is looking at how those compounds are extracted from the liver and how they were metabolized. So a simple core function or test of the liver, now, you might think there are lots of really simple liver function tests out there already. There are things that called liver function blood tests. But in fact, these really look at how much damage the damage markers in the liver. They’re not telling you how much function the liver has, and its imaging techniques, as you say, ultrasound and, things to measure the fibrotic state of the liver. But again, they’re looking at the damage, not how well your liver is working.
Having these sort of tools that let you really screen what the liver is functionally doing, lets you, well, test only what’s happening to liver, but also these tests, like, can post them out to someone. They bring screening to everyone. You can try and reach these patients that otherwise wouldn’t be found. So they hit the emergency room and if you get them early, you don’t have the treatment can be lifestyle. There are a couple of drugs now. It’s much simpler treatment if they’re caught late. Treatment is very difficult. So the final one is lung cancer the biggest cancer killer in the US. And this is what Owlstone was founded on, was trying to find a way to get lung cancer tests to the individual in the home.
There are tests out there at the moment. They have limitations. They either can’t detect cancers at the earliest stage when, a, treatment is most effective or they require hospital visits. People are resistant to it, and their compliance is really poor, like, low dose CT, is no co-pay free in the US. Only 4% of people comply with it, and state to state that’s in some states it’s incredibly low. So people just don’t want to do the test. So if we can bring a test to a patient, we can hopefully increase the compliance rate as long as we can get not good enough sensitivity. Early stage, and I talked about using a probe, taking something and testing your liver.
We’ve taken exactly the same approach with lung cancer. So here we’ve looked at an inhaled probe and inhaled compounds that you breathe in. And then this reacts with, certain enzymes in the tumor microenvironment and you breathe it out again. So this is a test that again can be done at home. There is no limitations, on who can do it as long as you can, so easily suck in a dry powder from an inhaler, like many children do for asthma. Wait a few minutes and breathe out into a collector. This gives you a at home, hopefully highly compliant test. We started this test without in, without using an inhaler form. We injected the probe into patients. We formed a stage two trial last year. Last year, and even at the earliest stage from cancers, we were already getting, close to 70 or 68.5% sensitivity.
So you can detect cancers this early using these sort of approaches. And we’re aiming to, well, we’re running a stage one this week, on our inhaled probe where we hope to make this test usable for everyone. Okay. And I’ll just close up. I’ve given a whistle stop, the different applications you can use for breath. You can see this is a thread through them. It’s about getting these diagnostic tests into the home. Maximizing compliance, finding diseases as early as possible, where they’re easily treatable. And I think it fits with what other speakers have been talking about. Prevention. These are all hitting the diseases when they’re asymptomatic early enough that you can make a difference, maximizing health, for as long as possible for everyone.Thank you very much.