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Hernandez-Leyva AJ, Berna AZ, Liu Y, Rosen AL, Lint MA, Whiteside SA, Jaeger N, McDonough RT, Joardar N, Santiago-Borges J, Tomera CP, Luo W, John ARO, Kau AL. The breath volatilome is shaped by the gut microbiota. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.02.24311413. [PMID: 39132488 PMCID: PMC11312666 DOI: 10.1101/2024.08.02.24311413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
The gut microbiota is widely implicated in host health and disease, inspiring translational efforts to implement our growing body of knowledge in clinical settings. However, the need to characterize gut microbiota by its genomic content limits the feasibility of rapid, point-of-care diagnostics. The microbiota produces a diverse array of xenobiotic metabolites that disseminate into tissues, including volatile organic compounds (VOCs) that may be excreted in breath. We hypothesize that breath contains gut microbe-derived VOCs that inform the composition and metabolic state of the microbiota. To explore this idea, we compared the breath volatilome and fecal gut microbiomes of 27 healthy children and found that breath VOC composition is correlated with gut microbiomes. To experimentally interrogate this finding, we devised a method for capturing exhaled breath from gnotobiotic mice. Breath volatiles are then profiled by gas-chromatography mass-spectrometry (GC-MS). Using this novel methodology, we found that the murine breath profile is markedly shaped by the composition of the gut microbiota. We also find that VOCs produced by gut microbes in pure culture can be identified in vivo in the breath of mice monocolonized with the same bacteria. Altogether, our studies identify microbe-derived VOCs excreted in breath and support a mechanism by which gut bacterial metabolism directly contributes to the mammalian breath VOC profiles.
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Affiliation(s)
- Ariel J. Hernandez-Leyva
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Amalia Z. Berna
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Yang Liu
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Anne L. Rosen
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Michael A. Lint
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Samantha A. Whiteside
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Natalia Jaeger
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Current address: Department of Immunology, Augusta University, Augusta, GA 30912, USA
| | - Ryan T. McDonough
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Nikhilesh Joardar
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Jesús Santiago-Borges
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Christopher P. Tomera
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Wentai Luo
- Department of Chemistry, Portland State University, Portland, OR 97201, USA
| | - Audrey R. Odom John
- Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Andrew L. Kau
- Division of Allergy and Immunology, Department of Medicine and Center for Women’s Infectious Disease Research, Washington University School of Medicine, St. Louis, MO, 63110, USA
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Sergi CM. NAFLD (MASLD)/NASH (MASH): Does It Bother to Label at All? A Comprehensive Narrative Review. Int J Mol Sci 2024; 25:8462. [PMID: 39126031 PMCID: PMC11313354 DOI: 10.3390/ijms25158462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/29/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), or metabolic dysfunction-associated steatotic liver disease (MASLD), is a liver condition that is linked to overweight, obesity, diabetes mellitus, and metabolic syndrome. Nonalcoholic steatohepatitis (NASH), or metabolic dysfunction-associated steatohepatitis (MASH), is a form of NAFLD/MASLD that progresses over time. While steatosis is a prominent histological characteristic and recognizable grossly and microscopically, liver biopsies of individuals with NASH/MASH may exhibit several other abnormalities, such as mononuclear inflammation in the portal and lobular regions, hepatocellular damage characterized by ballooning and programmed cell death (apoptosis), misfolded hepatocytic protein inclusions (Mallory-Denk bodies, MDBs), megamitochondria as hyaline inclusions, and fibrosis. Ballooning hepatocellular damage remains the defining feature of NASH/MASH. The fibrosis pattern is characterized by the initial expression of perisinusoidal fibrosis ("chicken wire") and fibrosis surrounding the central veins. Children may have an alternative form of progressive NAFLD/MASLD characterized by steatosis, inflammation, and fibrosis, mainly in Rappaport zone 1 of the liver acinus. To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using a score for evaluating NAFLD/MASLD in a comprehensive narrative review. The search for articles was conducted between 1 January 2000 and 31 December 2023, on the PubMed/MEDLINE, Scopus, Web of Science, and Cochrane databases. This search was complemented by a gray search, including internet browsers (e.g., Google) and textbooks. The following research question guided the study: "What are the basic data on using a score for evaluating NAFLD/MASLD?" All stages of the selection process were carried out by the single author. Of the 1783 articles found, 75 were included in the sample for analysis, which was implemented with an additional 25 articles from references and gray literature. The studies analyzed indicated the beneficial effects of scoring liver biopsies. Although similarity between alcoholic steatohepatitis (ASH) and NASH/MASH occurs, some patterns of hepatocellular damage seen in alcoholic disease of the liver do not happen in NASH/MASH, including cholestatic featuring steatohepatitis, alcoholic foamy degeneration, and sclerosing predominant hyaline necrosis. Generally, neutrophilic-rich cellular infiltrates, prominent hyaline inclusions and MDBs, cholestasis, and obvious pericellular sinusoidal fibrosis should favor the diagnosis of alcohol-induced hepatocellular injury over NASH/MASH. Multiple grading and staging methods are available for implementation in investigations and clinical trials, each possessing merits and drawbacks. The systems primarily used are the Brunt, the NASH CRN (NASH Clinical Research Network), and the SAF (steatosis, activity, and fibrosis) systems. Clinical investigations have utilized several approaches to link laboratory and demographic observations with histology findings with optimal platforms for clinical trials of rapidly commercialized drugs. It is promising that machine learning procedures (artificial intelligence) may be critical for developing new platforms to evaluate the benefits of current and future drug formulations.
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Affiliation(s)
- Consolato M. Sergi
- Department of Laboratory Medicine, University of Alberta, Edmonton, AB T6G 2B7, Canada; ; Tel.: +1-613-737-7600 (ext. 2427); Fax: +1-613-738-4837
- Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1, Canada
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Chou H, Godbeer L, Allsworth M, Boyle B, Ball ML. Progress and challenges of developing volatile metabolites from exhaled breath as a biomarker platform. Metabolomics 2024; 20:72. [PMID: 38977623 PMCID: PMC11230972 DOI: 10.1007/s11306-024-02142-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/13/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND The multitude of metabolites generated by physiological processes in the body can serve as valuable biomarkers for many clinical purposes. They can provide a window into relevant metabolic pathways for health and disease, as well as be candidate therapeutic targets. A subset of these metabolites generated in the human body are volatile, known as volatile organic compounds (VOCs), which can be detected in exhaled breath. These can diffuse from their point of origin throughout the body into the bloodstream and exchange into the air in the lungs. For this reason, breath VOC analysis has become a focus of biomedical research hoping to translate new useful biomarkers by taking advantage of the non-invasive nature of breath sampling, as well as the rapid rate of collection over short periods of time that can occur. Despite the promise of breath analysis as an additional platform for metabolomic analysis, no VOC breath biomarkers have successfully been implemented into a clinical setting as of the time of this review. AIM OF REVIEW This review aims to summarize the progress made to address the major methodological challenges, including standardization, that have historically limited the translation of breath VOC biomarkers into the clinic. We highlight what steps can be taken to improve these issues within new and ongoing breath research to promote the successful development of the VOCs in breath as a robust source of candidate biomarkers. We also highlight key recent papers across select fields, critically reviewing the progress made in the past few years to advance breath research. KEY SCIENTIFIC CONCEPTS OF REVIEW VOCs are a set of metabolites that can be sampled in exhaled breath to act as advantageous biomarkers in a variety of clinical contexts.
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Ferrandino G, Ricciardi F, Murgia A, Banda I, Manhota M, Ahmed Y, Sweeney K, Nicholson-Scott L, McConville L, Gandelman O, Allsworth M, Boyle B, Smolinska A, Ginesta Frings CA, Contreras J, Asenjo-Lobos C, Barrientos V, Clavo N, Novoa A, Riviotta A, Jerez M, Méndez L. Exogenous Volatile Organic Compound (EVOC ®) Breath Testing Maximizes Classification Performance for Subjects with Cirrhosis and Reveals Signs of Portal Hypertension. Biomedicines 2023; 11:2957. [PMID: 38001958 PMCID: PMC10669625 DOI: 10.3390/biomedicines11112957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Background: Cirrhosis detection in primary care relies on low-performing biomarkers. Consequently, up to 75% of subjects with cirrhosis receive their first diagnosis with decompensation when causal treatments are less effective at preserving liver function. We investigated an unprecedented approach to cirrhosis detection based on dynamic breath testing. Methods: We enrolled 29 subjects with cirrhosis (Child-Pugh A and B), and 29 controls. All subjects fasted overnight. Breath samples were taken using Breath Biopsy® before and at different time points after the administration of 100 mg limonene. Absolute limonene breath levels were measured using gas chromatography-mass spectrometry. Results: All subjects showed a >100-fold limonene spike in breath after administration compared to baseline. Limonene breath kinetics showed first-order decay in >90% of the participants, with higher bioavailability in the cirrhosis group. At the Youden index, baseline limonene levels showed classification performance with an area under the roc curve (AUROC) of 0.83 ± 0.012, sensitivity of 0.66 ± 0.09, and specificity of 0.83 ± 0.07. The best performing timepoint post-administration was 60 min, with an AUROC of 0.91, sensitivity of 0.83 ± 0.07, and specificity of 0.9 ± 0.06. In the cirrhosis group, limonene bioavailability showed a correlation with MELD and fibrosis indicators, and was associated with signs of portal hypertension. Conclusions: Dynamic limonene breath testing enhances diagnostic performance for cirrhosis compared to static testing. The correlation with disease severity suggests potential for monitoring therapeutic interventions. Given the non-invasive nature of breath collection, a dynamic limonene breath test could be implemented in primary care.
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Affiliation(s)
- Giuseppe Ferrandino
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Federico Ricciardi
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Antonio Murgia
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Iris Banda
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Menisha Manhota
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Yusuf Ahmed
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Kelly Sweeney
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | | | - Lucinda McConville
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Olga Gandelman
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Max Allsworth
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Billy Boyle
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
| | - Agnieszka Smolinska
- Owlstone Medical, 183 Cambridge Science Park, Milton Road, Cambridge CB4 0GJ, UK
- Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
| | - Carmen A. Ginesta Frings
- Unidad de Gastroenterología y Endoscopía, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad de Desarrollo, Santiago 7650568, Chile
- Unidad de Endoscopia, Hospital Padre Hurtado, Santiago 8880465, Chile
| | - Jorge Contreras
- Unidad de Gastroenterología y Endoscopía, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad de Desarrollo, Santiago 7650568, Chile
| | - Claudia Asenjo-Lobos
- Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610315, Chile
| | | | - Nataly Clavo
- Unidad de Endoscopia, Hospital Padre Hurtado, Santiago 8880465, Chile
| | - Angela Novoa
- Laboratorio de Fisiología Digestiva, Clínica Alemana, Santiago 7650568, Chile
| | - Amy Riviotta
- Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago 7610315, Chile
| | - Melissa Jerez
- Nursing School, Universidad de Las Américas, Santiago 8242125, Chile
| | - Luis Méndez
- Unidad de Gastroenterología y Endoscopía, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad de Desarrollo, Santiago 7650568, Chile
- Unidad de Endoscopia, Hospital Padre Hurtado, Santiago 8880465, Chile
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Brebu M, Simion VE, Andronie V, Jaimes-Mogollón AL, Beleño-Sáenz KDJ, Ionescu F, Welearegay TG, Suschinel R, de Lema JB, Ionescu R. Putative volatile biomarkers of bovine tuberculosis infection in breath, skin and feces of cattle. Mol Cell Biochem 2023; 478:2473-2480. [PMID: 36840799 DOI: 10.1007/s11010-023-04676-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 02/09/2023] [Indexed: 02/26/2023]
Abstract
Bovine tuberculosis (bTB) is an infectious disease with significant impact on animal health, public health and international trade. Standard bTB screening in live cattle consists in injecting tuberculin and measuring the swelling at the place of injection few days later. This procedure is expensive, time-consuming, logistically challenging, and is not conclusive before performing confirmatory tests and additional analysis. The analysis of the volatile organic compounds (VOCs) emitted by non-invasive biological samples can provide an alternative diagnostic approach suitable for bTB screening. In the present study, we analyzed VOC samples emitted through the breath, feces and skin of 18 cows diagnosed with bTB from three farms from Romania, as well as of 27 negative cows for bTB from the same farms. Analytical studies employing gas chromatography coupled to mass spectrometry revealed 80 VOCs emitted through the breath, 200 VOCs released by feces, and 80 VOCs emitted through the skin. Statistical analysis of these compounds allowed the identification of 3 tentative breath VOC biomarkers (acetone; 4-methyldecane; D-limonene), 9 tentative feces VOC biomarkers (toluene; [(1,1-dimethylethyl)thio]acetic acid; alpha-thujene; camphene; phenol; o-cymene; 3-(1,1-dimethylethyl)-2,2,4,4-tetramethyl-3-pentanol; 2,5-dimethylhexane-2,5-dihydroperoxide; 2,4-di-tert-butylphenol), and 3 tentative skin VOC biomarkers (ammonia; 1-methoxy-2-propanol; toluene). The possible pathway of these volatile biomarkers is discussed.
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Affiliation(s)
- Mihai Brebu
- "Petru Poni" Institute of Macromolecular Chemistry, Aleea Grigore Ghica Voda 41A, 700487, Iasi, Romania
| | - Violeta Elena Simion
- Faculty of Veterinary Medicine, Spiru Haret University, Bd. Basarabia 256, 030171, Bucharest, Romania
| | - Viorel Andronie
- Faculty of Veterinary Medicine, Spiru Haret University, Bd. Basarabia 256, 030171, Bucharest, Romania
| | - Aylen Lisset Jaimes-Mogollón
- GISM Group, Faculty of Engineering and Architecture, University of Pamplona, Ciudad Universitaria, Via Bucaramanga Km 1, 543050, Pamplona, Colombia
| | - Kelvin de Jesús Beleño-Sáenz
- GISM Group, Faculty of Engineering and Architecture, University of Pamplona, Ciudad Universitaria, Via Bucaramanga Km 1, 543050, Pamplona, Colombia
- Department of Mechatronics Engineering, Universidad Autónoma del Caribe, Calle 90 #46-112, 080020, Barranquilla, Colombia
| | - Florina Ionescu
- The Ångström Laboratory, Department of Materials Science and Engineering, Uppsala University, P.O. Box 35, 75103, Uppsala, Sweden
| | - Tesfalem Geremariam Welearegay
- The Ångström Laboratory, Department of Materials Science and Engineering, Uppsala University, P.O. Box 35, 75103, Uppsala, Sweden
| | - Raluca Suschinel
- Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences, Kreutzwaldi 62, 51006, Tartu, Estonia
| | - Jose Bruno de Lema
- Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences, Kreutzwaldi 62, 51006, Tartu, Estonia
- D Asociation, Paseo de la Montaña 14, 08402, Granollers, Barcelona, Spain
| | - Radu Ionescu
- D Asociation, Paseo de la Montaña 14, 08402, Granollers, Barcelona, Spain.
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Ferrandino G, De Palo G, Murgia A, Birch O, Tawfike A, Smith R, Debiram-Beecham I, Gandelman O, Kibble G, Lydon AM, Groves A, Smolinska A, Allsworth M, Boyle B, van der Schee MP, Allison M, Fitzgerald RC, Hoare M, Snowdon VK. Breath Biopsy ® to Identify Exhaled Volatile Organic Compounds Biomarkers for Liver Cirrhosis Detection. J Clin Transl Hepatol 2023; 11:638-648. [PMID: 36969895 PMCID: PMC10037526 DOI: 10.14218/jcth.2022.00309] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/30/2022] [Accepted: 11/01/2022] [Indexed: 03/29/2023] Open
Abstract
Background and Aims The prevalence of chronic liver disease in adults exceeds 30% in some countries and there is significant interest in developing tests and treatments to help control disease progression and reduce healthcare burden. Breath is a rich sampling matrix that offers non-invasive solutions suitable for early-stage detection and disease monitoring. Having previously investigated targeted analysis of a single biomarker, here we investigated a multiparametric approach to breath testing that would provide more robust and reliable results for clinical use. Methods To identify candidate biomarkers we compared 46 breath samples from cirrhosis patients and 42 from controls. Collection and analysis used Breath Biopsy OMNI™, maximizing signal and contrast to background to provide high confidence biomarker detection based upon gas chromatography mass spectrometry (GC-MS). Blank samples were also analyzed to provide detailed information on background volatile organic compounds (VOCs) levels. Results A set of 29 breath VOCs differed significantly between cirrhosis and controls. A classification model based on these VOCs had an area under the curve (AUC) of 0.95±0.04 in cross-validated test sets. The seven best performing VOCs were sufficient to maximize classification performance. A subset of 11 VOCs was correlated with blood metrics of liver function (bilirubin, albumin, prothrombin time) and separated patients by cirrhosis severity using principal component analysis. Conclusions A set of seven VOCs consisting of previously reported and novel candidates show promise as a panel for liver disease detection and monitoring, showing correlation to disease severity and serum biomarkers at late stage.
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Affiliation(s)
| | | | | | | | | | | | - Irene Debiram-Beecham
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK
| | | | - Graham Kibble
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK
| | - Anne Marie Lydon
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK
| | - Alice Groves
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK
| | - Agnieszka Smolinska
- Owlstone Medical, Cambridge, UK
- Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands
| | | | | | | | - Michael Allison
- Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
- Addenbrookes Hepatology and Liver Transplantation Unit, Addenbrookes Hospital, Cambridge, UK
| | - Rebecca C. Fitzgerald
- MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge, UK
| | - Matthew Hoare
- Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
- Addenbrookes Hepatology and Liver Transplantation Unit, Addenbrookes Hospital, Cambridge, UK
- CRUK Cambridge Institute, Cambridge, UK
| | - Victoria K. Snowdon
- Addenbrookes Hepatology and Liver Transplantation Unit, Addenbrookes Hospital, Cambridge, UK
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Nguyen HD, Kim MS. Effects of chemical mixtures on liver function biomarkers in the Korean adult population: thresholds and molecular mechanisms for non-alcoholic fatty liver disease involved. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:78555-78587. [PMID: 35696061 DOI: 10.1007/s11356-022-21090-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/21/2022] [Indexed: 06/15/2023]
Abstract
There is a scarcity of research on the effects of a mixture of chemicals on liver function biomarkers and non-alcoholic fatty liver disease (NAFLD) indices, including FSI, HIS, and FBI-4. Thus, we aimed to explore whether there is an association between chemical mixtures, including 26 chemicals found in blood and urine, liver function biomarkers, and non-alcoholic fatty liver disease (NAFLD) indices in Korean adults. The effects of exposure to chemical mixtures on liver function biomarkers and NAFLD indices were investigated using linear regression models, weighted quantile sum (WQS) regression, quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR) among 3669 adults. In silico toxicogenomic data-mining, we evaluated molecular mechanisms associated with NAFLD, including pathways, diseases, genes, miRNAs, and biological processes. The linear regression models showed blood or urine Hg levels were the most important factors associated with AST, ALT, GGT, FSI, and HSI levels, and significant trends were observed for these chemical quartiles (p < 0.01). The WQS index was significantly associated with ALT, GGT, FSI, and HSI. The qgcomp index also found an association between chemicals and AST, ALT, GGT, and FSI. In the BKMR model, the overall effect of the mixture was significantly related to ALT, GGT, FSI, and HSI. In silico analysis, we found mixed chemicals interacted with the CYP1A2 gene and were associated with NAFLD. Seventy-eight percent of interactions were identified as physical interactions in the CYP1A2 gene related to NAFLD. Transcription factor regulation in adipogenesis and lipid metabolic processes are fundamental molecular mechanisms that could be influenced by NAFLD-related mixed chemicals. Cutoff thresholds for chemical exposure levels associated with liver function indicators and NAFLD indices were also reported. The strongest interactions and expression of miRNAs involved in NAFLD development were also identified.
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Affiliation(s)
- Hai Duc Nguyen
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, 57922, Republic of Korea
| | - Min-Sun Kim
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Sunchon, Jeonnam, 57922, Republic of Korea.
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8
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Wieczorek M, Weston A, Ledenko M, Thomas JN, Carter R, Patel T. A deep learning approach for detecting liver cirrhosis from volatolomic analysis of exhaled breath. Front Med (Lausanne) 2022; 9:992703. [PMID: 36250077 PMCID: PMC9556819 DOI: 10.3389/fmed.2022.992703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/08/2022] [Indexed: 11/21/2022] Open
Abstract
Liver disease such as cirrhosis is known to cause changes in the composition of volatile organic compounds (VOC) present in patient breath samples. Previous studies have demonstrated the diagnosis of liver cirrhosis from these breath samples, but studies are limited to a handful of discrete, well-characterized compounds. We utilized VOC profiles from breath samples from 46 individuals, 35 with cirrhosis and 11 healthy controls. A deep-neural network was optimized to discriminate between healthy controls and individuals with cirrhosis. A 1D convolutional neural network (CNN) was accurate in predicting which patients had cirrhosis with an AUC of 0.90 (95% CI: 0.75, 0.99). Shapley Additive Explanations characterized the presence of discrete, observable peaks which were implicated in prediction, and the top peaks (based on the average SHAP profiles on the test dataset) were noted. CNNs demonstrate the ability to predict the presence of cirrhosis based on a full volatolomics profile of patient breath samples. SHAP values indicate the presence of discrete, detectable peaks in the VOC signal.
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Affiliation(s)
- Mikolaj Wieczorek
- Digital Innovation Lab, Mayo Clinic, Jacksonville, FL, United States
| | - Alexander Weston
- Digital Innovation Lab, Mayo Clinic, Jacksonville, FL, United States
| | - Matthew Ledenko
- Department of Transplant, Mayo Clinic, Jacksonville, FL, United States
| | | | - Rickey Carter
- Digital Innovation Lab, Mayo Clinic, Jacksonville, FL, United States
| | - Tushar Patel
- Department of Transplant, Mayo Clinic, Jacksonville, FL, United States
- *Correspondence: Tushar Patel,
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Ogbodo JO, Arazu AV, Iguh TC, Onwodi NJ, Ezike TC. Volatile organic compounds: A proinflammatory activator in autoimmune diseases. Front Immunol 2022; 13:928379. [PMID: 35967306 PMCID: PMC9373925 DOI: 10.3389/fimmu.2022.928379] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
The etiopathogenesis of inflammatory and autoimmune diseases, including pulmonary disease, atherosclerosis, and rheumatoid arthritis, has been linked to human exposure to volatile organic compounds (VOC) present in the environment. Chronic inflammation due to immune breakdown and malfunctioning of the immune system has been projected to play a major role in the initiation and progression of autoimmune disorders. Macrophages, major phagocytes involved in the regulation of chronic inflammation, are a major target of VOC. Excessive and prolonged activation of immune cells (T and B lymphocytes) and overexpression of the master pro-inflammatory constituents [cytokine and tumor necrosis factor-alpha, together with other mediators (interleukin-6, interleukin-1, and interferon-gamma)] have been shown to play a central role in the pathogenesis of autoimmune inflammatory responses. The function and efficiency of the immune system resulting in immunostimulation and immunosuppression are a result of exogenous and endogenous factors. An autoimmune disorder is a by-product of the overproduction of these inflammatory mediators. Additionally, an excess of these toxicants helps in promoting autoimmunity through alterations in DNA methylation in CD4 T cells. The purpose of this review is to shed light on the possible role of VOC exposure in the onset and progression of autoimmune diseases.
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Affiliation(s)
- John Onyebuchi Ogbodo
- Department of Science Laboratory Technology, University of Nigeria, Nsukkagu, Enugu State, Nigeria
| | - Amarachukwu Vivan Arazu
- Department of Science Laboratory Technology, University of Nigeria, Nsukkagu, Enugu State, Nigeria
| | - Tochukwu Chisom Iguh
- Department of Plant Science and Biotechnology, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Ngozichukwuka Julie Onwodi
- Department of Pharmaceutical Technology and Industrial Pharmacy, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Tobechukwu Christian Ezike
- Department of Biochemistry, University of Nigeria, Nsukka, Enugu State, Nigeria
- *Correspondence: Tobechukwu Christian Ezike,
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10
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Dai B, Zhou R, Ping J, Ying Y, Xie L. Recent advances in carbon nanotube-based biosensors for biomolecular detection. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Sukaram T, Tansawat R, Apiparakoon T, Tiyarattanachai T, Marukatat S, Rerknimitr R, Chaiteerakij R. Exhaled volatile organic compounds for diagnosis of hepatocellular carcinoma. Sci Rep 2022; 12:5326. [PMID: 35351916 PMCID: PMC8964758 DOI: 10.1038/s41598-022-08678-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 03/03/2022] [Indexed: 12/19/2022] Open
Abstract
Volatile organic compounds (VOCs) profile for diagnosis and monitoring therapeutic response of hepatocellular carcinoma (HCC) has not been well studied. We determined VOCs profile in exhaled breath of 97 HCC patients and 111 controls using gas chromatography–mass spectrometry and Support Vector Machine algorithm. The combination of acetone, 1,4-pentadiene, methylene chloride, benzene, phenol and allyl methyl sulfide provided the highest accuracy of 79.6%, with 76.5% sensitivity and 82.7% specificity in the training set; and 55.4% accuracy, 44.0% sensitivity, and 75.0% specificity in the test set. This combination was correlated with the HCC stages demonstrating by the increased distance from the classification boundary when the stage advanced. For early HCC detection, d-limonene provided a 62.8% sensitivity, 51.8% specificity and 54.9% accuracy. The levels of acetone, butane and dimethyl sulfide were significantly altered after treatment. Patients with complete response had a greater decreased acetone level than those with remaining tumor post-treatment (73.38 ± 56.76 vs. 17.11 ± 58.86 (× 106 AU, p = 0.006). Using a cutoff of 35.9 × 106 AU, the reduction in acetone level predicted treatment response with 77.3% sensitivity, 83.3% specificity, 79.4%, accuracy, and AUC of 0.784. This study demonstrates the feasibility of exhaled VOCs as a non-invasive tool for diagnosis, monitoring of HCC progression and treatment response.
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Affiliation(s)
- Thanikan Sukaram
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Rossarin Tansawat
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology, Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Terapap Apiparakoon
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | | | - Sanparith Marukatat
- Image Processing and Understanding Team, Artificial Intelligence Research Group, National Electronics and Computer Technology Center (NECTEC), Bangkok, Thailand
| | - Rungsun Rerknimitr
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology, Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Roongruedee Chaiteerakij
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. .,Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology, Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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12
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Haworth JJ, Pitcher CK, Ferrandino G, Hobson AR, Pappan KL, Lawson JLD. Breathing new life into clinical testing and diagnostics: perspectives on volatile biomarkers from breath. Crit Rev Clin Lab Sci 2022; 59:353-372. [PMID: 35188863 DOI: 10.1080/10408363.2022.2038075] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Human breath offers several benefits for diagnostic applications, including simple, noninvasive collection. Breath is a rich source of clinically-relevant biological information; this includes a volatile fraction, where greater than 1,000 volatile organic compounds (VOCs) have been described so far, and breath aerosols that carry nucleic acids, proteins, signaling molecules, and pathogens. Many of these factors, especially VOCs, are delivered to the lung by the systemic circulation, and diffusion of candidate biomarkers from blood into breath allows systematic profiling of organismal health. Biomarkers on breath offer the capability to advance early detection and precision medicine in areas of global clinical need. Breath tests are noninvasive and can be performed at home or in a primary care setting, which makes them well-suited for the kind of public screening program that could dramatically improve the early detection of conditions such as lung cancer. Since measurements of VOCs on breath largely report on metabolic changes, this too aids in the early detection of a broader range of illnesses and can be used to detect metabolic shifts that could be targeted through precision medicine. Furthermore, the ability to perform frequent sampling has envisioned applications in monitoring treatment responses. Breath has been investigated in respiratory, liver, gut, and neurological diseases and in contexts as diverse as infectious diseases and cancer. Preclinical research studies using breath have been ongoing for some time, yet only a few breath-based diagnostics tests are currently available and in widespread clinical use. Most recently, tests assessing the gut microbiome using hydrogen and methane on breath, in addition to tests using urea to detect Helicobacter pylori infections have been released, yet there are many more applications of breath tests still to be realized. Here, we discuss the strengths of breath as a clinical sampling matrix and the technical challenges to be addressed in developing it for clinical use. Historically, a lack of standardized methodologies has delayed the discovery and validation of biomarker candidates, resulting in a proliferation of early-stage pilot studies. We will explore how advancements in breath collection and analysis are in the process of driving renewed progress in the field, particularly in the context of gastrointestinal and chronic liver disease. Finally, we will provide a forward-looking outlook for developing the next generation of clinically relevant breath tests and how they may emerge into clinical practice.
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13
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Breath-Taking Perspectives and Preliminary Data toward Early Detection of Chronic Liver Diseases. Biomedicines 2021; 9:biomedicines9111563. [PMID: 34829792 PMCID: PMC8615034 DOI: 10.3390/biomedicines9111563] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 12/17/2022] Open
Abstract
The gold standard method for chronic liver diseases diagnosis and staging remains liver biopsy, despite the spread of less invasive surrogate modalities based on imaging and blood biomarkers. Still, more than 50% of chronic liver disease cases are detected at later stages when patients exhibit episodes of liver decompensation. Breath analysis represents an attractive means for the development of non-invasive tests for several pathologies, including chronic liver diseases. In this perspective review, we summarize the main findings of studies that compared the breath of patients with chronic liver diseases against that of control subjects and found candidate biomarkers for a potential breath test. Interestingly, identified compounds with best classification performance are of exogenous origin and used as flavoring agents in food. Therefore, random dietary exposure of the general population to these compounds prevents the establishment of threshold levels for the identification of disease subjects. To overcome this limitation, we propose the exogenous volatile organic compounds (EVOCs) probe approach, where one or multiple of these flavoring agent(s) are administered at a standard dose and liver dysfunction associated with chronic liver diseases is evaluated as a washout of ingested compound(s). We report preliminary results in healthy subjects in support of the potential of the EVOC Probe approach.
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14
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Hershberger CE, Rodarte AI, Siddiqi S, Moro A, Acevedo-Moreno LA, Brown JM, Allende DS, Aucejo F, Rotroff DM. Salivary Metabolites are Promising Non-Invasive Biomarkers of Hepatocellular Carcinoma and Chronic Liver Disease. ACTA ACUST UNITED AC 2021; 2:33-44. [PMID: 34541549 DOI: 10.1002/lci2.25] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Hepatocellular carcinoma (HCC) is a leading causes of cancer mortality worldwide. Improved tools are needed for detecting HCC so that treatment can begin as early as possible. Current diagnostic approaches and existing biomarkers, such as alpha-fetoprotein (AFP) lack sensitivity, resulting in too many false negative diagnoses. Machine-learning may be able to identify combinations of biomarkers that provide more robust predictions and improve sensitivity for detecting HCC. We sought to evaluate whether metabolites in patient saliva could distinguish those with HCC, cirrhosis, and those with no documented liver disease. Methods and Results We tested 125 salivary metabolites from 110 individuals (43 healthy, 37 HCC, 30 cirrhosis) and identified 4 metabolites that displayed significantly different abundance between groups (FDR P <.2). We also developed four tree-based, machine-learning models, optimized to include different numbers of metabolites, that were trained using cross-validation on 99 patients and validated on a withheld test set of 11 patients. A model using 12 metabolites -octadecanol, acetophenone, lauric acid, 1-monopalmitin, dodecanol, salicylaldehyde, glycyl-proline, 1-monostearin, creatinine, glutamine, serine and 4-hydroxybutyric acid- had a cross-validated sensitivity of 84.8%, specificity of 92.4% and correctly classified 90% of the HCC patients in the test cohort. This model outperformed previously reported sensitivities and specificities for AFP (20-100ng/ml) (61%, 86%) and AFP plus ultrasound (62%, 88%). Conclusions and Impact Metabolites detectable in saliva may represent products of disease pathology or a breakdown in liver function. Notably, combinations of salivary metabolites derived from machine-learning may serve as promising non-invasive biomarkers for the detection of HCC.
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Affiliation(s)
- Courtney E Hershberger
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, OH, USA
| | | | - Shirin Siddiqi
- Department of General Surgery, Cleveland Clinic, OH, USA
| | - Amika Moro
- Department of General Surgery, Cleveland Clinic, OH, USA
| | | | - J Mark Brown
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, OH, USA.,Center for Microbiome and Human Health, Cleveland Clinic, OH, USA
| | | | | | - Daniel M Rotroff
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, OH, USA
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15
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Liver Impairment-The Potential Application of Volatile Organic Compounds in Hepatology. Metabolites 2021; 11:metabo11090618. [PMID: 34564434 PMCID: PMC8471934 DOI: 10.3390/metabo11090618] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 12/20/2022] Open
Abstract
Liver diseases are currently diagnosed through liver biopsy. Its invasiveness, costs, and relatively low diagnostic accuracy require new techniques to be sought. Analysis of volatile organic compounds (VOCs) in human bio-matrices has received a lot of attention. It is known that a musty odour characterises liver impairment, resulting in the elucidation of volatile chemicals in the breath and other body fluids such as urine and stool, which may serve as biomarkers of a disease. Aims: This study aims to review all the studies found in the literature regarding VOCs in liver diseases, and to summarise all the identified compounds that could be used as diagnostic or prognostic biomarkers. The literature search was conducted on ScienceDirect and PubMed, and each eligible publication was qualitatively assessed by two independent evaluators using the SANRA critical appraisal tool. Results: In the search, 58 publications were found, and 28 were kept for inclusion: 23 were about VOCs in the breath, one in the bile, three in urine, and one in faeces. Each publication was graded from zero to ten. A graphical summary of the metabolic pathways showcasing the known liver disease-related VOCs and suggestions on how VOC analysis on liver impairment could be applied in clinical practice are given.
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16
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Lawson J, Beauchamp J. Pursuing breath research in unprecedented circumstances-report from the Breath Biopsy Conference 2020. J Breath Res 2021; 15. [PMID: 34107459 DOI: 10.1088/1752-7163/ac09d3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/09/2021] [Indexed: 12/17/2022]
Abstract
The global outbreak of Sars-CoV-2 commencing early in 2020 had a dramatic impact on breath research, imposing abrupt restrictions but also presenting unforeseen opportunities. Taking place against the background of the COVID-19 pandemic, the 2020 Breath Biopsy Conference provided the breath research community with a platform to showcase and discuss the latest findings, including COVID-19 related research. As with most conferences under the present circumstance, it differed from its predecessor meetings by shifting to a virtual format, but retained its broad scope and interactive nature. The conference centred on four key themes, featuring applications of volatile organic compounds, breath biomarkers for liver disease, study design and data analytics, and, notably this year, breath-based endeavours to detect COVID-19 infection. This meeting report summarizes the events of the conference and spotlights selected contributions.
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Affiliation(s)
- Jonathan Lawson
- Owlstone Medical Ltd, 183 Cambridge Science Park, Milton Road, Cambridge, CB4 0GJ, United Kingdom
| | - Jonathan Beauchamp
- Fraunhofer Institute for Process Engineering and Packaging IVV, Freising, Germany
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17
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Neuberger J, Cain O. The Need for Alternatives to Liver Biopsies: Non-Invasive Analytics and Diagnostics. Hepat Med 2021; 13:59-69. [PMID: 34163263 PMCID: PMC8214024 DOI: 10.2147/hmer.s278076] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/19/2021] [Indexed: 12/15/2022] Open
Abstract
Histology remains essential for the diagnosis and management of many disorders affecting the liver. However, the biopsy procedure itself is associated with a low risk of harm to the patient and cost to the health services; samples may not be adequate and are subject to sampling variation. Furthermore, interpretation often depends on the skill of the pathologist. Increasingly, new techniques are becoming available that are altering the indications for liver biopsy. Many diseases of the liver can be diagnosed and managed using serological and radiological techniques; the degree of fibrosis and fat can often be assessed by serological or imaging techniques and the nature of space occupying lesions defined by serology, imaging and use of liquid biopsy. However, these techniques, too, are subject to limitations: sensitivity and specificity is not always adequate for diagnosis or management; some techniques are expensive and often also require expert interpretation. Although there may be less need for liver biopsy today, histology remains the gold standard as well as an essential tool for the diagnosis and management of many conditions, especially where there are multiple pathologies, or where a diagnosis cannot or has not been made by alternative approaches. Until less invasive techniques become more reliable and accessible, liver histology will remain a key investigation.
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Affiliation(s)
- James Neuberger
- Liver Unit, Queen Elizabeth Hospital, Birmingham, B15 2TH, UK
| | - Owen Cain
- Department of Cellular Pathology, Queen Elizabeth Hospital, Birmingham, B15 2TH, UK
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18
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Comprehensive Two-Dimensional Gas Chromatography-Mass Spectrometry Analysis of Exhaled Breath Compounds after Whole Grain Diets. Molecules 2021; 26:molecules26092667. [PMID: 34063191 PMCID: PMC8125105 DOI: 10.3390/molecules26092667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/26/2021] [Accepted: 04/30/2021] [Indexed: 12/18/2022] Open
Abstract
Exhaled breath is a potential noninvasive matrix to give new information about metabolic effects of diets. In this pilot study, non-targeted analysis of exhaled breath volatile organic compounds (VOCs) was made by comprehensive two-dimensional gas chromatography-mass spectrometry (GCxGC-MS) to explore compounds relating to whole grain (WG) diets. Nine healthy subjects participated in the dietary intervention with parallel crossover design, consisting of two high-fiber diets containing whole grain rye bread (WGR) or whole grain wheat bread (WGW) and 1-week control diets with refined wheat bread (WW) before both diet periods. Large interindividual differences were detected in the VOC composition. About 260 VOCs were detected from exhaled breath samples, in which 40 of the compounds were present in more than half of the samples. Various derivatives of benzoic acid and phenolic compounds, as well as some furanones existed in exhaled breath samples only after the WG diets, making them interesting compounds to study further.
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19
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Schwabe RF. Regenerating research and life. JHEP Rep 2020; 2:100172. [PMID: 32838248 PMCID: PMC7434622 DOI: 10.1016/j.jhepr.2020.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 08/17/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Robert F. Schwabe
- Department of Medicine, Columbia University Irving Medical Center, Columbia University, New York, United States
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20
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Ferrandino G, Orf I, Smith R, Calcagno M, Thind AK, Debiram-Beecham I, Williams M, Gandelman O, de Saedeleer A, Kibble G, Lydon AM, Mayhew CA, Allsworth M, Boyle B, van der Schee MP, Allison M, Hoare M, Snowdon VK. Breath Biopsy Assessment of Liver Disease Using an Exogenous Volatile Organic Compound-Toward Improved Detection of Liver Impairment. Clin Transl Gastroenterol 2020; 11:e00239. [PMID: 33094960 PMCID: PMC7498135 DOI: 10.14309/ctg.0000000000000239] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/21/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Liver cirrhosis and its complication - hepatocellular carcinoma (HCC) - have been associated with increased exhaled limonene. It is currently unclear whether this increase is more strongly associated with the presence of HCC or with the severity of liver dysfunction. METHODS We compared the exhaled breath of 40 controls, 32 cirrhotic patients, and 12 cirrhotic patients with HCC using the Breath Biopsy platform. Breath samples were analyzed by thermal desorption-gas chromatography-mass spectrometry. Limonene levels were compared between the groups and correlated to bilirubin, albumin, prothrombin time international normalized ratio, and alanine aminotransferase. RESULTS Breath limonene concentration was significantly elevated in subjects with cirrhosis-induced HCC (M: 82.1 ng/L, interquartile range [IQR]: 16.33-199.32 ng/L) and cirrhosis (M: 32.6 ng/L, IQR: 6.55-123.07 ng/L) compared with controls (M: 6.2 ng/L, IQR: 2.62-9.57 ng/L) (P value = 0.0005 and 0.0001, respectively) with no significant difference between 2 diseased groups (P value = 0.37). Levels of exhaled limonene correlated with serum bilirubin (R = 0.25, P value = 0.0016, r = 0.51), albumin (R = 0.58, P value = 5.3e-8, r = -0.76), and international normalized ratio (R = 0.29, P value = 0.0003, r = 0.51), but not with alanine aminotransferase (R = 0.01, P value = 0.36, r = 0.19). DISCUSSION Exhaled limonene levels are primarily affected by the presence of cirrhosis through reduced liver functional capacity, as indicated by limonene correlation with blood metrics of impaired hepatic clearance and protein synthesis capacity, without further alterations observed in subjects with HCC. This suggests that exhaled limonene is a potential non-invasive marker of liver metabolic capacity (see Visual abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A388).
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Affiliation(s)
| | - Isabel Orf
- Owlstone Medical, Cambridge, UK
- Current affiliation: Human Metabolome Technologies, Leiden, the Netherlands
| | | | | | | | - Irene Debiram-Beecham
- Department of Oncology, Hutchison/MRC Research Centre, University of Cambridge, Cambridge, UK
| | | | | | | | - Graham Kibble
- Department of Oncology, Hutchison/MRC Research Centre, University of Cambridge, Cambridge, UK
| | - Anne Marie Lydon
- Department of Oncology, Hutchison/MRC Research Centre, University of Cambridge, Cambridge, UK
| | - Chris A. Mayhew
- Institute for Breath Research, Leopold-Franzens-Universität Innsbruck, Dornbirn, Austria
- Molecular Physics Group, School of Physics and Astronomy, University of Birmingham, Birmingham, UK
| | | | | | | | - Michael Allison
- Department of Medicine, Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Addenbrooke's Hepatology and Liver Transplantation Unit, Addenbrooke's Hospital, Cambridge, UK
| | - Matthew Hoare
- Addenbrooke's Hepatology and Liver Transplantation Unit, Addenbrooke's Hospital, Cambridge, UK
- CRUK Cambridge Institute, Cambridge, UK
- Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Victoria K. Snowdon
- Addenbrooke's Hepatology and Liver Transplantation Unit, Addenbrooke's Hospital, Cambridge, UK
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