Metabolomic analysis of breath volatile organic compounds reveals unique breathprints in children with inflammatory bowel disease: a pilot study

Abstract

Background Breath testing is becoming an important diagnostic method to evaluate many disease states. In light of rising healthcare costs, is important to develop a simple non-invasive tool to potentially identify pediatric patients who need endoscopy for suspected inflammatory bowel disease (IBD). Aim The primary aim of this study was to analyze exhaled volatile organic compounds (VOCs) to evaluate for the presence of a unique breath pattern to differentiate pediatric patients with (IBD) from healthy controls. Methods A cross-sectional, single-center study included pediatric IBD patients and healthy controls (age range, 5-21 years). The diagnosis of IBD was confirmed by endoscopic, histologic, and radiographic data. Exhaled breath was collected and analyzed using a selective ion flow tube mass spectroscopy (SIFT-MS) to identify new markers or patterns of IBD. Results 117 patients (62 with IBD and 55 healthy controls) were included in the study. Linear discriminant analysis and principle component analysis of mass scanning ion peak data demonstrated 21 pre-selected VOCs correctly classify patients with IBD or as healthy controls; p < 0.0001. Multivariable logistic regression analysis further showed 3 specific VOCs (1-octene, 1-decene, (E)-2-nonene) had excellent accuracy for predicting the presence of IBD with an area under the curve (AUC) of 0.96 (95% CI: 0.93, 0.99). No significant difference in VOCs was found between patients with Crohn's disease or ulcerative colitis and no significant correlation was seen with disease activity. Conclusion This pilot data supports the hypothesis that a unique breathprint potentially exists for pediatric IBD in the exhaled metabolome.

Letter: volatile metabolomics of exhaled breath or faecal gas? – authors' reply

“…We agree that analytical techniques that are able to identify single compounds, such as single ion flow tube mass spectrometry 4,5 are complementary to the electronic nose technology. Examples of this approach include the development of hand held breath sensors for the diagnosis of asthma after identifying the key VOC in single analyte studies.…”

Metabolomics in the Clinical Diagnosis of Inflammatory Bowel Disease

“…Finally, in a pilot study using breath metabolomic analysis, it was demonstrated that children with IBD have a unique breath profile that can separate them from HC children [50] .…”

Novel Methods in Pulmonary Hypertension Phenotyping in the Age of Precision Medicine (2015 Grover Conference Series)

“…With this best-of-both-worlds approach, we are able to identify unique "breathprints" in patients with liver disease ( fetor hepaticus) as well as those for heart and lung disease. 85,88,93,94 We are further able to analyze these patterns to identify single molecules in the breath of these patients and link them to the underlying pathobiology of the disease. 85,86,88,95,96 In a single-center cohort study of PAH patients, we correlated exhaled-breath VOCs with clinical parameters.…”