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Slater R, Tharmaratnam K, Belnour S, Auth MKH, Muhammed R, Spray C, Wang D, de Lacy Costello B, García-Fiñana M, Allen S, Probert C. Gas Chromatography-Sensor System Aids Diagnosis of Inflammatory Bowel Disease, and Separates Crohn's from Ulcerative Colitis, in Children. SENSORS (BASEL, SWITZERLAND) 2024; 24:5079. [PMID: 39124126 PMCID: PMC11314755 DOI: 10.3390/s24155079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024]
Abstract
The diagnosis of inflammatory bowel disease (IBD) in children and the need to distinguish between subtypes (Crohn's disease (CD) and ulcerative colitis (UC)) requires lengthy investigative and invasive procedures. Non-invasive, rapid, and cost-effective tests to support these diagnoses are needed. Faecal volatile organic compounds (VOCs) are distinctive in IBD. VOC profiles can be rapidly determined using a gas chromatography-sensor device (OdoReader©). In an inception-cohort of children presenting with suspected IBD, we directly compared the diagnostic fidelity of faecal calprotectin (FCP, a non-specific protein marker of intestinal inflammation) with OdoReader© VOC profiles of children subsequently diagnosed with IBD with matched controls diagnosed with other gastrointestinal conditions. The OdoReader© was 82% (95% confidence interval 75-89%) sensitive and 71% (61-80%) specific but did not outperform FCP (sensitivity 93% (77-99%) and specificity 86% (67-96%); 250 µg/g FCP cut off) in the diagnosis of IBD from other gastrointestinal conditions when validated in a separate sample from the same cohort. However, unlike FCP and better than other similar technologies, the OdoReader© could distinguish paediatric CD from UC (up to 88% (82-93%) sensitivity and 80% (71-89%) specificity in the validation set) and justifies further validation in larger studies. A non-invasive test based on VOCs could help streamline and limit invasive investigations in children.
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Affiliation(s)
- Rachael Slater
- Department of Molecular & Clinical Cancer Medicine, Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3GE, UK;
| | - Kukatharmini Tharmaratnam
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GF, UK; (K.T.); (M.G.-F.)
| | - Salma Belnour
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 7ZB, UK;
| | - Marcus Karl-Heinz Auth
- Paediatric Gastroenterology, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK; (M.K.-H.A.); (S.A.)
| | - Rafeeq Muhammed
- Gastroenterology and Nutrition, Birmingham Children’s NHS Foundation Trust, Birmingham B4 6NH, UK;
| | - Christine Spray
- Paediatric Gastroenterology, Bristol Children’s NHS Foundation Trust, Bristol BS2 8BJ, UK;
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;
| | - Ben de Lacy Costello
- School of Applied Sciences, University of the West of England, Bristol BS16 1QY, UK;
| | - Marta García-Fiñana
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool L69 3GF, UK; (K.T.); (M.G.-F.)
| | - Stephen Allen
- Paediatric Gastroenterology, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK; (M.K.-H.A.); (S.A.)
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;
| | - Chris Probert
- Department of Molecular & Clinical Cancer Medicine, Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3GE, UK;
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Van Malderen K, Hanning N, Lambrechts H, Haverhals T, Van Marcke S, Ceuleers H, De Man JG, De Winter BY, Lamote K, De Schepper HU. Volatile organic compound profiling as a potential biomarker in irritable bowel syndrome: A feasibility study. Front Med (Lausanne) 2022; 9:960000. [PMID: 35991639 PMCID: PMC9388331 DOI: 10.3389/fmed.2022.960000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder for which no diagnostic tools are currently available. Patients are diagnosed using the Rome IV criteria and subtyped into a diarrhea, constipation, or mixed phenotype based on their dominant stool pattern. A recent development in the biomarker area is the analysis of volatile organic compounds (VOCs). The aim of this study was to evaluate the potential of VOCs as diagnostic and phenotypic biomarkers for IBS in breath and fecal samples. Materials and methods Breath and fecal samples from IBS patients and healthy asymptomatic controls (HC) were analyzed with multicapillary column/ion mobility spectrometry (MCC/IMS) and classification models were created based upon VOCs and clinical characteristics. Discussion Irritable bowel syndrome patients were differentiated from HC by means of volatile profiling in both breath and fecal samples with area under the curve (AUCs) of respectively 0.62 and 0.80. Patient subtypes could also be differentiated from each other with AUCs ranging between 0.65 and 0.78. Furthermore, VOC models could differentiate IBS patients based on clinical characteristics like psychological comorbidities and microbiota-influencing therapies. Conclusion This study is the first to demonstrate the use of VOC profiling with the help of MCC/IMS to differentiate IBS patients. Furthermore, the importance of clinical characteristics beside the dominant stool pattern in the differentiation of IBS patients was emphasized.
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Affiliation(s)
- Kathleen Van Malderen
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
| | - Nikita Hanning
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Helen Lambrechts
- Medical School, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tine Haverhals
- Medical School, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Silke Van Marcke
- Medical School, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hannah Ceuleers
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Joris G. De Man
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Benedicte Y. De Winter
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
| | - Kevin Lamote
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Heiko U. De Schepper
- Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
- *Correspondence: Heiko U. De Schepper,
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Ferrari A, Neefs I, Hoeck S, Peeters M, Van Hal G. Towards Novel Non-Invasive Colorectal Cancer Screening Methods: A Comprehensive Review. Cancers (Basel) 2021; 13:1820. [PMID: 33920293 PMCID: PMC8070308 DOI: 10.3390/cancers13081820] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer (CRC) is one of the leading cancer-related causes of death in the world. Since the 70s, many countries have adopted different CRC screening programs, which has resulted in a decrease in mortality. However, current screening test options still present downsides. The commercialized stool-based tests present high false-positive rates and low sensitivity, which negatively affects the detection of early stage carcinogenesis. The gold standard colonoscopy has low uptake due to its invasiveness and the perception of discomfort and embarrassment that the procedure may bring. In this review, we collected and described the latest data about alternative CRC screening techniques that can overcome these disadvantages. Web of Science and PubMed were employed as search engines for studies reporting on CRC screening tests and future perspectives. The searches generated 555 articles, of which 93 titles were selected. Finally, a total of 50 studies, describing 14 different CRC alternative tests, were included. Among the investigated techniques, the main feature that could have an impact on CRC screening perception and uptake was the ease of sample collection. Urine, exhaled breath, and blood-based tests promise to achieve good diagnostic performance (sensitivity of 63-100%, 90-95%, and 47-97%, respectively) while minimizing stress and discomfort for the patient.
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Affiliation(s)
- Allegra Ferrari
- Social Epidemiology and Health Policy, University of Antwerp, 2610 Antwerpen, Belgium; (S.H.); (G.V.H.)
| | - Isabelle Neefs
- Center for Oncological Research (CORE), University of Antwerp and Antwerp University Hospital, 2610 Antwerpen, Belgium; (I.N.); (M.P.)
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, 2610 Antwerpen, Belgium
| | - Sarah Hoeck
- Social Epidemiology and Health Policy, University of Antwerp, 2610 Antwerpen, Belgium; (S.H.); (G.V.H.)
- Center for Cancer Detection, 8000 Bruges, Belgium
| | - Marc Peeters
- Center for Oncological Research (CORE), University of Antwerp and Antwerp University Hospital, 2610 Antwerpen, Belgium; (I.N.); (M.P.)
- Department of Oncology, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
| | - Guido Van Hal
- Social Epidemiology and Health Policy, University of Antwerp, 2610 Antwerpen, Belgium; (S.H.); (G.V.H.)
- Center for Cancer Detection, 8000 Bruges, Belgium
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El Manouni El Hassani S, Soers RJ, Berkhout DJC, Niemarkt HJ, Weda H, Nijsen T, Benninga MA, de Boer NKH, de Meij TGJ, Knobel HH. Optimized sample preparation for fecal volatile organic compound analysis by gas chromatography-mass spectrometry. Metabolomics 2020; 16:112. [PMID: 33037948 PMCID: PMC7547966 DOI: 10.1007/s11306-020-01735-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/30/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Headspace gas chromatography-mass spectrometry (HS-GC-MS) is widely considered the gold standard of quantitative fecal VOC analysis. However, guidelines providing general recommendations for bioanalytical method application in research and clinical setting are lacking. OBJECTIVES To propose an evidence-based research protocol for fecal VOC analysis by HS-GC-MS, based on extensive testing of instrumental and sampling conditions on detection and quantification limits, linearity, accuracy and repeatability of VOC outcome. METHODS The influence of the following variables were assessed: addition of different salt solutions, injection temperature, injection speed, injection volume, septum use, use of calibration curves and fecal sample mass. Ultimately, the optimal sample preparation was assessed using fecal samples from healthy preterm infants. Fecal VOC analysis in this specific population has potential as diagnostic biomarkers, but available amount of feces is limited here, so optimization of VOC extraction is of importance. RESULTS We demonstrated that addition of lithium chloride enhanced the release of polar compounds (e.g. small alcohols) into the headspace. Second, a linear relationship between injection volume, speed and temperature, and fecal sample mass on the abundance of VOC was demonstrated. Furthermore, the use of a septum preserved 90% of the non-polar compounds. By application of optimal instrumental and sampling conditions, a maximum of 320 unique compounds consisting of 14 different chemical classes could be detected. CONCLUSIONS These findings may contribute to standardized analysis of fecal VOC by HS-GC-MS, facilitating future application of fecal VOC in clinical practice.
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Affiliation(s)
- Sofia El Manouni El Hassani
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Ruud J Soers
- EurofinsEAG, Eurofins Materials Science Netherlands B.V., Eindhoven, The Netherlands
| | - Daniel J C Berkhout
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Hendrik J Niemarkt
- Neonatal Intensive Care Unit, Máxima Medical Center, Veldhoven, the Netherlands
| | | | | | - Marc A Benninga
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nanne K H de Boer
- Department of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tim G J de Meij
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Hugo H Knobel
- EurofinsEAG, Eurofins Materials Science Netherlands B.V., Eindhoven, The Netherlands
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Vossen E, Goethals S, De Vrieze J, Boon N, Van Hecke T, De Smet S. Red and processed meat consumption within two different dietary patterns: Effect on the colon microbial community and volatile metabolites in pigs. Food Res Int 2019; 129:108793. [PMID: 32036914 DOI: 10.1016/j.foodres.2019.108793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 02/07/2023]
Abstract
Pigs were fed either red and processed meat or chicken meat within either a prudent or a Western dietary pattern for four weeks (2 × 2 full factorial design). The colon microbial community and volatile organic compounds were assessed (either quantified or based on their presence). Results show that Lactobacilli were characteristic for the chicken × prudent dietary pattern treatment and Paraprevotella for the red and processed meat × prudent dietary pattern treatment. Enterobacteriaceae and Desulfovibrio were characteristic for the chicken × Western dietary pattern treatment and Butyrivibrio for the red and processed meat × Western dietary pattern treatment. Campylobacter was characteristic for chicken consumption and Clostridium XIVa for red and processed meat, irrespective of the dietary pattern. Ethyl valerate and 1-methylthio-propane were observed more frequently in pigs fed red and processed meat compared to chicken meat. The prevalence of 3-methylbutanal was >80% for pigs receiving a Western dietary pattern, whereas for pigs fed a prudent dietary pattern the prevalence was <35%. The concentration of butanoic acid was significantly higher when the prudent dietary pattern was given, compared to the Western dietary pattern, but no differences for other short chain fatty acids or protein fermentation products were observed.
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Affiliation(s)
- Els Vossen
- Laboratory for Animal Nutrition and Animal Product Quality, Department of Animal Sciences and Aquatic Ecology, Ghent University, Coupure Links 653, Ghent, Belgium
| | - Sophie Goethals
- Laboratory for Animal Nutrition and Animal Product Quality, Department of Animal Sciences and Aquatic Ecology, Ghent University, Coupure Links 653, Ghent, Belgium
| | - Jo De Vrieze
- Center for Microbial Ecology and Technology, Department of Biotechnology, Ghent University, Coupure Links 653, Ghent, Belgium
| | - Nico Boon
- Center for Microbial Ecology and Technology, Department of Biotechnology, Ghent University, Coupure Links 653, Ghent, Belgium
| | - Thomas Van Hecke
- Laboratory for Animal Nutrition and Animal Product Quality, Department of Animal Sciences and Aquatic Ecology, Ghent University, Coupure Links 653, Ghent, Belgium
| | - Stefaan De Smet
- Laboratory for Animal Nutrition and Animal Product Quality, Department of Animal Sciences and Aquatic Ecology, Ghent University, Coupure Links 653, Ghent, Belgium.
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Charles MK, Wang Y, Zurberg T, Kinna J, Bryce E. Detecting Clostridioides (Clostridium) difficile using canine teams: What does the nose know? Infect Prev Pract 2019; 1:100005. [PMID: 34368671 PMCID: PMC8336037 DOI: 10.1016/j.infpip.2019.100005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/03/2019] [Indexed: 11/24/2022] Open
Abstract
Background Trained canines are capable of detecting Clostridioides (Clostridium) difficile (CD) in the environment; however, the primary odour of interest on which the dogs alert is unclear. Aim To evaluate the inter-rater reliability of two canine detection teams for their ability to discriminate between scent pads containing CD-toxin-positive and -negative odours and their ability to discriminate between clostridial strains. Methods During a six-month period, two canine teams were tested weekly for their ability to detect CD-toxin-positive odours and discriminate between these and -negative odours. To further determine the canines' discrimination capability, scent pads impregnated with odours from reference isolates representing common CD toxin types (including toxin-negative CD isolates) or from clinical isolates representing other clostridial species were used. Results A total of 264 samples were tested with an overall sensitivity of 94.7% (Team A) and 86.8% (Team B) and specificities of 96.9% and 98.7%, respectively. Inter-rater reliability was very good (Cohen's kappa 0.87). When challenged with toxin- and non-toxin-producing strains, the teams alerted on 96.3% of all CD isolate odours (including nontoxigenic strains) and 46.7% of closely related species. Conclusions The canine teams exhibited strong inter-rater reliability on both clinical faecal specimens and reference CD isolates (both toxin and non-toxin producing) but were challenged to discriminate between CD and closely related clostridial species. These findings strongly support the development of scent detection programmes provided dogs and their handlers are properly trained and used in the right context.
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Affiliation(s)
- M K Charles
- Division of Medical Microbiology and Infection Prevention, Vancouver Coastal Health and University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Y Wang
- University of British Columbia Undergraduate Integrated Sciences Program, Vancouver, British Columbia, Canada
| | - T Zurberg
- Quality and Patient Safety Department, Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - J Kinna
- Quality and Patient Safety Department, Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - E Bryce
- Division of Medical Microbiology and Infection Prevention, Vancouver Coastal Health and University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
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Abstract
Celiac disease (CD) is a T cell-mediated inflammatory autoimmune disorder of the upper small intestine caused by the ingestion of gluten. It is increasingly recognized as a global problem by experts and societies. The diagnosis of CD is of crucial importance because its delay strongly affects patient's health and quality of life. The diagnosis of CD is, however, complex and requires reliable, sensitive, specific, rapid, simple, and cost-effective, as well-as non-invasive analytical tools. There is also a high demand to develop simple point-of-care (POC) tests for non-specialists at home or in doctors' offices. Analytical techniques are now moving toward the development of fast, more simple, non-invasive, and POC analyses. The present review focuses on recent advances of CD biomarker detection in body fluids, concerning CD specific autoantibody detection in blood and saliva using electrochemical, optic-fiber, and piezoelectric biosensors and POC finger-prick tests, and identifying CD characteristic volatile organic compounds (VOCs) in urine and feces.
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Wilson AD. Application of Electronic-Nose Technologies and VOC-Biomarkers for the Noninvasive Early Diagnosis of Gastrointestinal Diseases †. SENSORS (BASEL, SWITZERLAND) 2018; 18:E2613. [PMID: 30096939 PMCID: PMC6111575 DOI: 10.3390/s18082613] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/03/2018] [Accepted: 08/04/2018] [Indexed: 12/13/2022]
Abstract
Conventional methods utilized for clinical diagnosis of gastrointestinal (GI) diseases have employed invasive medical procedures that cause stress, anxiety and pain to patients. These methods are often expensive, time-consuming, and require sophisticated chemical-analysis instruments and advanced modeling procedures to achieve diagnostic interpretations. This paper reviews recent applications of simpler, electronic-nose (e-nose) devices for the noninvasive early diagnosis of a wide range of GI diseases by collective analysis of headspace volatile organic compound (VOC)-metabolites from clinical samples to produce disease-specific aroma signatures (VOC profiles). A different "metabolomics" approach to GI disease diagnostics, involving identifications and quantifications of disease VOC-metabolites, are compared to the electronic-nose approach based on diagnostic costs, accuracy, advantages and disadvantages. The importance of changes in gut microbiome composition that result from disease are discussed relative to effects on disease detection. A new diagnostic approach, which combines the use of e-nose instruments for early rapid prophylactic disease-screenings with targeted identification of known disease biomarkers, is proposed to yield cheaper, quicker and more dependable diagnostic results. Some priority future research needs and coordination for bringing e-nose instruments into routine clinical practice are summarized.
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Affiliation(s)
- Alphus Dan Wilson
- Pathology Department, Southern Hardwoods Laboratory, Center for Bottomland Hardwoods Research, Southern Research Station, USDA Forest Service, 432 Stoneville Road, Stoneville, MS 38776, USA.
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