Simultaneous Assessment of Urinary and Fecal Volatile Organic Compound Analysis in De Novo Pediatric IBD

Abstract

Endoscopic evaluation is mandatory in establishing the diagnosis of pediatric inflammatory bowel disease (IBD), but unfortunately carries a high burden on patients. Volatile organic compounds (VOC) have been proposed as alternative, noninvasive diagnostic biomarkers for IBD. The current study aimed to assess and compare the potential of fecal and urinary VOC as diagnostic biomarkers for pediatric IBD in an intention-to-diagnose cohort. In this cohort study, patients aged 4–17 years, referred to the outpatient clinic of a tertiary referral center under suspicion of IBD, were eligible to participate. The diagnosis was established by endoscopic and histopathologic assessment, participants who did not meet the criteria of IBD were allocated to the control group. Participants were instructed to concurrently collect a fecal and urinary sample prior to bowel lavage. Samples were analyzed by means of gas chromatography–ion mobility spectrometry. In total, five ulcerative colitis patients, five Crohn’s disease patients, and ten age and gender matched controls were included. A significant difference was demonstrated for both fecal (p-value, area under the curve; 0.038, 0.73) and urinary (0.028, 0.78) VOC profiles between IBD and controls. Analysis of both fecal and urinary VOC behold equal potential as noninvasive biomarkers for pediatric IBD diagnosis.

Are Volatile Organic Compounds Accurate Markers in the Assessment of Colorectal Cancer and Inflammatory Bowel Diseases? A Review

“…The diagnostic accuracy was slightly varied with the different techniques used or differing study groups ( Table 6 ) [ 68 ].…”

“…GC-IMS detected significantly different VOC profiles in 10 IBD patients vs. 10 controls ( p = 0.028, AUC = 0.78) [ 68 ]. This small study reported better performance of urinary-compared to fecal VOCs, as far as sensitivity was concerned (80% vs. 70%), but not for specificity (70% vs. 90%).…”

“…Both technologies were able to separate IBD patients from controls with 88% and 75% accuracy, respectively (p < 0.001), and active from the inactive disease [72]. GC-IMS detected significantly different VOC profiles in 10 IBD patients vs. 10 controls (p = 0.028, AUC = 0.78) [68]. This small study reported better performance of urinarycompared to fecal VOCs, as far as sensitivity was concerned (80% vs. 70%), but not for specificity (70% vs. 90%).…”

New Metabolic and Genetic Biomarkers for Diagnosis of Ulcerative Colitis

“…Also, as the urine collecting method can be faster and more easily accepted by the patients, this type of establishing a preliminary diagnosis can accelerate the process. The distinction between the two methods is that analyses of fecal VOCs is believed to reflect the gut microbiota composition and local inflammatory processes, on the contrary, urinary VOCs associated with IBD are more likely to be a combination of compounds that diffused from the intestine into the bloodstream and VOCs that are associated with general inflammation [40]. Bosch et al previously used field asymmetric ion mobility spectrometry (FAIMS) to analyze fecal VOC composition as a potential tool in differentiating two gastro-intestinal conditions relying on the accessibility of the process in pediatric patients, achieving similar diagnostic accuracies [41].…”

Labordiagnostik bei chronisch‑entzündlichen Darmerkrankungen

“…Die VOC-Profile sowohl aus dem Stuhl (p-Wert 0,038; AUC 0,73) wie auch aus dem Harn (0,028, AUC 0,78) divergierten signifikant zwischen CED-Patienten und Kontrollprobanden. Die Profile wurden daher, ungeachtet der beiden Medien, aus denen sie analysiert wurden, hinsichtlich des Potenzials eines noninvasiven Biomarkers als für die pädiatrische CED-Diagnostik gleich gut eingestuft [23].…”