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John TM, Shrestha N, Hasan L, Pappan K, Birch O, Grove DE, Boyle B, Allsworth M, Shrestha P, Procop G, Dweik RA. Detection of Clostridioides difficileinfection by assessment of exhaled breath volatile organic compounds. J Breath Res 2024. [PMID: 38502958 DOI: 10.1088/1752-7163/ad3572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Clostridioides difficileinfection (CDI) is the leading cause of hospital-acquired infective diarrhea. Current methods for diagnosing CDI have limitations; enzyme immunoassays for toxin have low sensitivity andClostridioides difficilePCR cannot differentiate infection from colonization. An ideal diagnostic test that incorporates microbial factors, host factors, and host-microbe interaction might characterize true infection. Assessing volatile organic compounds (VOCs) in exhaled breath may be a useful test for identifying CDI. To identify a wide selection of VOCs in exhaled breath, we used thermal desorption-gas chromatography-mass spectrometry to study breath samples from 17 patients with CDI. Age- and sex-matched patients with diarrhea and negative C.difficile testing (no CDI) were used as controls. Of the 65 VOCs tested, 9 were used to build a quadratic discriminant model that showed a final cross-validated accuracy of 74%, a sensitivity of 71%, a specificity of 76%, and a receiver operating characteristic area under the curve of 0.72. If these findings are proven by larger studies, breath VOC analysis may be a helpful adjunctive diagnostic test for CDI.
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Affiliation(s)
- Teny M John
- Infectious Diseases, UH MD Anderson Library, 1515 Holcombe Blvd, Houston, Texas, 77204-2000, UNITED STATES
| | - Nabin Shrestha
- Infectious Disease/Medicine Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA, Cleveland, 44195, UNITED STATES
| | - Leen Hasan
- Medicine, Columbia University Irving Medical Center, New York, New York, New York, 10032-3784, UNITED STATES
| | - Kirk Pappan
- Acclivity technology, 6135 Park South Drive Ste 510, Charlotte, NC, Charlotte, 28210, UNITED STATES
| | - Owen Birch
- Owlstone Medical Ltd, 183 Cambridge Science Park, Cambridge, CB4 0GJ, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - David E Grove
- Inflammation and Immunity, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA, Cleveland , Ohio, 44195, UNITED STATES
| | - Billy Boyle
- Owlstone Ltd, Owlstone Inc., Cambridge, Cambridgeshire, CB4 0GJ, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Max Allsworth
- Owlstone Ltd, 183 Cambridge Science Park Milton Road Cambridge, Cambridge, Cambridgeshire, CB4 0GJ, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Priyanka Shrestha
- Computer Science, Stanford University, Stanford, California, Stanford, California, 94305-6104, UNITED STATES
| | - Gary Procop
- The American Board of Pathology, Tampa Florida, Tampa, Florida, 33609-2571, UNITED STATES
| | - Raed A Dweik
- Departments of Pulmonary and Critical Care Medicine / Respiratory Institute, and Pathobiology / Lerner Research Institute, Cleveland Clinic Foundation, Director, Cleveland Clinic, Cleveland, Ohio, 44195, cleveland, Ohio, 44195, UNITED STATES
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Broda P, MacDonald M, Raeder U, Liwicki R, Haylock R, McCarthy A, Paterson A, Birch O, Peace E, Ramsey L, Cookson I. Genetic methods for studying lignin degradation. Appl Biochem Biotechnol 1984. [DOI: 10.1007/bf02798956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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