Fecal volatile organic compounds: a novel, cheaper method of diagnosing inflammatory bowel disease?

Probert, Chris; Reade, S; Ahmed, Iftikhar

doi:10.1586/1744666x.2014.943664

Cited by 22 publications

(16 citation statements)

References 17 publications

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“…The gut microbiome is critical in maintaining mucosal homeostasis and it is altered in IBD compared with healthy controls, showing reduced diversity. 36 , 37 The VOCs of fecal matter are distinct in IBD compared with healthy controls 38 supporting this link. Walton et al 39 demonstrated that several VOCs in the headspace of feces differ markedly between patients with CD and other gastrointestinal conditions including UC and irritable bowel syndrome.…”

Section: Discussionmentioning

confidence: 89%

A Distinct Colon-Derived Breath Metabolome is Associated with Inflammatory Bowel Disease, but not its Complications

Rieder

Kurada

Grove

et al. 2016

Clinical and Translational Gastroenterology

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OBJECTIVES:The accuracy of available noninvasive biomarkers for diagnosis, stratification, and prediction of inflammatory bowel disease (IBD) courses is limited. We analyzed volatile organic compounds (VOCs) in the breath of IBD patients and controls for diagnosis and differentiation of IBD as well as their link with disease location, activity, and phenotype.METHODS:A prospective study of diagnostic testing was conducted, recruiting Crohn's disease (CD), ulcerative colitis (UC), other inflammatory gastrointestinal diseases (OGDs), and healthy controls (HCs), as well as subjects with ileal pouch anal anastomosis (IPAA). The breath VOC profile was analyzed using selective ion flow tube-mass spectrometry.RESULTS:One hundred and twenty-four subjects (n=24 CD, n=11 UC, n=6 OGD, n=53 HC, n=30 IPAA) were included. The breath metabolome was significantly different in patients with IBD, CD, or UC compared with OGD and HC (7 out of 22 VOCs), but not between CD and UC. No link between the level of VOCs with complications, disease location, and clinical or radiologic disease activity, as well as lab parameters or type of medication was found. Breath VOCs were markedly different in patients with IPAA compared with any other group (17 out of 22 VOCs) and the presence of pouch inflammation did not alter the VOC levels.CONCLUSIONS:A specific breath metabolome is associated with IBD and markedly changes in patients with IPAA. Analysis of a broader spectrum of VOCs can potentially aid in the development of breath prints to diagnose or differentiate inflammatory bowel disorders.

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Section: Discussionmentioning

confidence: 89%

A Distinct Colon-Derived Breath Metabolome is Associated with Inflammatory Bowel Disease, but not its Complications

Rieder

Kurada

Grove

et al. 2016

Clinical and Translational Gastroenterology

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“… 3 − 11 Various studies have demonstrated the diagnostic potential of VOCs in both pediatric and adult IBD populations by analyzing VOCs deriving from urine, exhaled breath, and feces. 6 , 12 − 14 The majority of studies on fecal VOCs has been performed using gas chromatography/mass spectrometry (GC/MS), allowing for the identification of individual VOCs on a molecular level. This technique is expensive, time consuming, and requires specialized personnel and is therefore not suitable for utilization in a clinical setting.…”

mentioning

confidence: 99%

Optimized Sampling Conditions for Fecal Volatile Organic Compound Analysis by Means of Field Asymmetric Ion Mobility Spectrometry

Bosch¹,

Hassani²,

Covington

et al. 2018

Anal. Chem.

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Fecal volatile organic compounds (VOCs) are increasingly considered to be potential noninvasive, diagnostic biomarkers for various gastrointestinal diseases. Knowledge of the influence of sampling conditions on VOC outcomes is limited. We aimed to evaluate the effects of sampling conditions on fecal VOC profiles and to assess under which conditions an optimal diagnostic accuracy in the discrimination between pediatric inflammatory bowel disease (IBD) and controls could be obtained. Fecal samples from de novo treatment-naïve pediatric IBD patients and healthy controls (HC) were used to assess the effects of sampling conditions compared to the standard operating procedure (reference standard), defined as 500 mg of sample mass diluted with 10 mL tap water, using field asymmetric ion mobility spectrometry (FAIMS). A total of 17 IBD (15 CD (Crohn's disease) and 2 UC (ulcerative colitis)) and 25 HC were included. IBD and HC could be discriminated with high accuracy (accuracy = 0.93, AUC = 0.99, p < 0.0001). A smaller fecal sample mass resulted in a decreased diagnostic accuracy (300 mg accuracy = 0.77, AUC = 0.69, p = 0.02; 100 mg accuracy = 0.70, AUC = 0.74, p = 0.003). A loss of diagnostic accuracy was seen toward increased numbers of thaw–freeze cycles (one cycle, accuracy = 0.61, AUC = 0.80, p = 0.0004; two cycles, accuracy = 0.64, AUC = 0.56, p = 0.753; and three cycles, accuracy = 0.57, AUC = 0.50, p = 0.5101) and when samples were kept at room temperature for 180 min prior to analysis (accuracy = 0.60, AUC = 0.51, p = 0.46). Diagnostic accuracy of VOC profiles was not significantly influenced by storage duration differences of 20 months. The application of a 500 mg sample mass analyzed after one thaw–freeze cycle showed the best discriminative accuracy for the differentiation of IBD and HC. VOC profiles and diagnostic accuracy were significantly affected by sampling conditions, underlining the need for the implementation of standardized protocols in fecal VOC analysis.

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“…that evaporate or sublimate readily under ambient conditions. They can be captured from a variety of body mediums and have been shown to alter in different disease states [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Colorectal cancer and adenoma screening using urinary volatile organic compound (VOC) detection: early results from a single-centre bowel screening population (UK BCSP)

et al. 2019

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Background The United Kingdom (UK) bowel cancer screening programme has reduced mortality from colorectal cancer (CRC), but poor uptake with stool-based tests and lack of specificity of faecal occult blood testing (FOBT), has prompted investigation for a more suitable screening test. The aim of this study was to investigate the feasibility of a urinary volatile organic compounds (VOC)-based screening tool for CRC. Methods The urine from FOBT-positive patients was analysed using field asymmetric ion mobility spectrometry (FAIMS) and gas chromatography coupled with ion mobility spectrometry (GC–IMS). Data were analysed using a machine learning algorithm to calculate the test accuracy for correct classification of CRC against adenomas and other gastrointestinal pathology. Results One hundred and sixty-three patients were enrolled in the study. Test accuracy was high for differentiating CRC from control: area under the curve (AUC) 0.98 (95% CI 0.93–1) and 0.82 (95% CI 0.67–0.97) using FAIMS and GC–IMS respectively. Correct classification of CRC from adenoma was high with AUC range 0.83–0.92 (95% CI 0.43–1.0). Classification of adenoma from control was poor with AUC range 0.54–0.61 (95% CI 0.47–0.75) using both analytical modalities. Conclusions CRC was correctly distinguished from adenomas or no bowel pathology using urinary VOC markers, within the bowel screening population. This pilot study demonstrates the potential of this method for CRC detection, with higher test uptake and superior sensitivity than FOBT. In addition, this is the first application of GC–IMS in CRC detection which has shown high test accuracy and usability. Electronic supplementary material The online version of this article (10.1007/s10151-019-01963-6) contains supplementary material, which is available to authorized users.

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Fecal volatile organic compounds: a novel, cheaper method of diagnosing inflammatory bowel disease?

Cited by 22 publications

References 17 publications

A Distinct Colon-Derived Breath Metabolome is Associated with Inflammatory Bowel Disease, but not its Complications

A Distinct Colon-Derived Breath Metabolome is Associated with Inflammatory Bowel Disease, but not its Complications

Optimized Sampling Conditions for Fecal Volatile Organic Compound Analysis by Means of Field Asymmetric Ion Mobility Spectrometry

Colorectal cancer and adenoma screening using urinary volatile organic compound (VOC) detection: early results from a single-centre bowel screening population (UK BCSP)

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