Evaluation of volatile sulfur compounds in the expired alveolar gas in patients with liver cirrhosis

Kaji, Hiroshi; Hisamura, Masaya; Saito, Nariyoshi; Murao, Makoto

doi:10.1016/0009-8981(78)90305-4

Cited by 55 publications

(13 citation statements)

References 10 publications

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“…Increased concentrations of dimethyl sulfide in the breath of patients with cirrhosis has been reported previously in multiple studies. (39)(40)(41) Interestingly, a previous study using the same SIFT-MS device found that sulfur-containing compounds were decreased in childhood chronic liver disease compared with healthy controls. (42) In the same study, (E)-2-nonene was significantly decreased in children with chronic liver disease compared with healthy controls.…”

Section: Discussionmentioning

confidence: 97%

Breath Metabolomics Provides an Accurate and Noninvasive Approach for Screening Cirrhosis, Primary, and Secondary Liver Tumors

Miller‐Atkins¹,

Acevedo‐Moreno²,

Grove³

et al. 2020

Hepatol Commun

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Hepatocellular carcinoma (HCC) and secondary liver tumors, such as colorectal cancer liver metastases are significant contributors to the overall burden of cancer-related morality. Current biomarkers, such as alpha-fetoprotein (AFP) for HCC, result in too many false negatives, necessitating noninvasive approaches with improved sensitivity. Volatile organic compounds (VOCs) detected in the breath of patients can provide valuable insight into disease processes and can differentiate patients by disease status. Here, we investigate whether 22 VOCs from the breath of 296 patients can distinguish those with no liver disease (n = 54), cirrhosis (n = 30), HCC (n = 112), pulmonary hypertension (n = 49), or colorectal cancer liver metastases (n = 51). This work extends previous studies by evaluating the ability for VOC signatures to differentiate multiple diseases in a large cohort of patients. Pairwise disease comparisons demonstrated that most of the VOCs tested are present in significantly different relative abundances (false discovery rate P < 0.1), indicating broad impacts on the breath metabolome across diseases. A predictive model developed using random forest machine learning and cross validation classified patients with 85% classification accuracy and 75% balanced accuracy. Importantly, the model detected HCC with 73% sensitivity compared with 53% for AFP in the same cohort. An added value of this approach is that influential VOCs in the predictive model may provide insight into disease etiology. Acetaldehyde and acetone, both of which have roles in tumor promotion, were considered important VOCs for differentiating disease groups in the predictive model and were increased in patients with cirrhosis and HCC compared to patients with no liver disease (false discovery rate P < 0.1). Conclusion: The use of machine learning and breath VOCs shows promise as an approach to develop improved, noninvasive screening tools for chronic liver disease and primary and secondary liver tumors. (Hepatology Communications 2020;4:1041-1055).

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Section: Discussionmentioning

confidence: 97%

Breath Metabolomics Provides an Accurate and Noninvasive Approach for Screening Cirrhosis, Primary, and Secondary Liver Tumors

Miller‐Atkins¹,

Acevedo‐Moreno²,

Grove³

et al. 2020

Hepatol Commun

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“…The first works date back to 1970, when Chen et al[8] examined the exhaled breath of two independent groups of 13 and 15 patients with liver cirrhosis (LC), evidencing increased levels of sulfur compounds (such as mercaptans) and volatile aliphatic acids (mainly acetic and propionic acid)[9]. These findings were then confirmed by additional studies[10-16], which further extended this list to nitrogen compounds, various aliphatic acids, alkanes, alkenes, terpenes, ketones, and alcoholic derivatives. Dimethylsulfide was finally identified as the main compound responsible for fetor hepaticus[12].…”

Section: Study Analysis and Discussionmentioning

confidence: 99%

Exhaled breath analysis in hepatology: State-of-the-art and perspectives

Vincentis

Vespasiani‐Gentilucci

Sabatini

et al. 2019

WJG

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Liver disease is characterized by breath exhalation of peculiar volatile organic compounds (VOCs). Thanks to the availability of sensitive technologies for breath analysis, this empiric approach has recently gained increasing attention in the context of hepatology, following the good results obtained in other fields of medicine. After the first studies that led to the identification of selected VOCs for pathophysiological purposes, subsequent research has progressively turned towards the comprehensive assessment of exhaled breath for potential clinical application. Specific VOC patterns were found to discriminate subjects with liver cirrhosis, to rate disease severity, and, eventually, to forecast adverse clinical outcomes even beyond existing scores. Preliminary results suggest that breath analysis could be useful also for detecting and staging hepatic encephalopathy and for predicting steatohepatitis in patients with nonalcoholic fatty liver disease. However, clinical translation is still hampered by a number of methodological limitations, including the lack of standardization and the consequent poor comparability between studies and the absence of external validation of obtained results. Given the low-cost and easy execution at bedside of the new technologies (e-nose), larger and well-structured studies are expected in order to provide the adequate level of evidence to support VOC analysis in clinical practice.

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“…It was suggested that the VSC produced in the gastrointestinal tract could diffuse into the lung air after being carried to the lungs via blood. [17,39] Yoo et al [40] found that erosive changes in esophagogastroduodenal mucosa were strongly correlated with increased VSC levels, suggesting that H pylori -associated eroded and inflamed mucosa might aggravate halitosis by making VSC diffusion much easier into blood. It was also shown that in accordance with higher levels of VSC produced in patients with erosive mucosal changes and ulcerative changes, the enzymes cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE) prerequisite for VSC generation were obviously highly induced.…”

Section: Discussionmentioning

confidence: 99%

Halitosis and helicobacter pylori infection

Dou

et al. 2016

Medicine

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Background:Halitosis is used to describe any disagreeable odor of expired air regardless of its origin. Numerous trials published have investigated the relation between Helicobacter pylori (H pylori) infection and halitosis, and even some regimes of H pylori eradication have been prescribed to those patients with halitosis in the clinic. We conducted a meta-analysis to define the correlation between H pylori infection and halitosis.Objectives:To evaluate whether there is a real correlation between H pylori infection and halitosis, and whether H pylori eradication therapy will help relieve halitosis.Methods:We searched several electronic databases (The Cochrane Library, MEDLINE, EMBASE, PubMed, Web of Science, and Wanfangdata) up to December 2015. Studies published in English and Chinese were considered in this review. After a final set of studies was identified, the list of references reported in the included reports was reviewed to identify additional studies. Screening of titles and abstracts, data extraction and quality assessment was undertaken independently and in duplicate. All analyses were done using Review Manager 5.2 software.Results:A total of 115 articles were identified, 21 of which met the inclusion criteria and presented data that could be used in the analysis. The results showed that the OR of H pylori infection in the stomach between halitosis-positive patients and halitosis-negative patients was 4.03 (95% CI: 1.41–11.50; P = 0.009). The OR of halitosis between H pylori-positive patients and H pylori-negative patients was 2.85 (95% CI: 1.40–5.83; P = 0.004); The RR of halitosis after successful H pylori eradication in those H pylori-infected halitosis-positive patients was 0.17 (95% CI: 0.08–0.39; P <0.0001), compared with those patients without successful H pylori eradication. And the RR of halitosis before successful H pylori eradication therapy was 4.78 (95% CI: 1.45–15.80; P = 0.01), compared with after successful H pylori eradication therapy.Conclusions:There is clear evidence that H pylori infection correlates with halitosis. H pylori infection might be important in the pathophysiological mechanism of halitosis, and H pylori eradication therapy may be helpful in those patients with refractory halitosis.

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Evaluation of volatile sulfur compounds in the expired alveolar gas in patients with liver cirrhosis

Cited by 55 publications

References 10 publications

Breath Metabolomics Provides an Accurate and Noninvasive Approach for Screening Cirrhosis, Primary, and Secondary Liver Tumors

Breath Metabolomics Provides an Accurate and Noninvasive Approach for Screening Cirrhosis, Primary, and Secondary Liver Tumors

Exhaled breath analysis in hepatology: State-of-the-art and perspectives

Halitosis and helicobacter pylori infection

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