Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath Samples
Background: The burden of liver disease in the UK has risen dramatically and there is a need for improved diagnostics. Aims: To determine which breath volatiles are associated with the cirrhotic liver and hence diagnostically useful. Methods: A two-stage biomarker discovery procedure was used. Alveo...
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| Format: | Article |
| Language: | English |
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Elsevier
2015-09-01
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| Series: | EBioMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396415300797 |
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| author | R. Fernández del Río M.E. O'Hara A. Holt P. Pemberton T. Shah T. Whitehouse C.A. Mayhew |
| author_facet | R. Fernández del Río M.E. O'Hara A. Holt P. Pemberton T. Shah T. Whitehouse C.A. Mayhew |
| author_sort | R. Fernández del Río |
| collection | DOAJ |
| description | Background: The burden of liver disease in the UK has risen dramatically and there is a need for improved diagnostics.
Aims: To determine which breath volatiles are associated with the cirrhotic liver and hence diagnostically useful.
Methods: A two-stage biomarker discovery procedure was used. Alveolar breath samples of 31 patients with cirrhosis and 30 healthy controls were mass spectrometrically analysed and compared (stage 1). 12 of these patients had their breath analysed after liver transplant (stage 2). Five patients were followed longitudinally as in-patients in the post-transplant period.
Results: Seven volatiles were elevated in the breath of patients versus controls. Of these, five showed statistically significant decrease post-transplant: limonene, methanol, 2-pentanone, 2-butanone and carbon disulfide. On an individual basis limonene has the best diagnostic capability (the area under a receiver operating characteristic curve (AUROC) is 0.91), but this is improved by combining methanol, 2-pentanone and limonene (AUROC curve 0.95). Following transplant, limonene shows wash-out characteristics.
Conclusions: Limonene, methanol and 2-pentanone are breath markers for a cirrhotic liver. This study raises the potential to investigate these volatiles as markers for early-stage liver disease. By monitoring the wash-out of limonene following transplant, graft liver function can be non-invasively assessed. |
| first_indexed | 2024-12-11T22:18:47Z |
| format | Article |
| id | doaj.art-340d07401d8c462cb56548429c729d35 |
| institution | Directory Open Access Journal |
| issn | 2352-3964 |
| language | English |
| last_indexed | 2024-12-11T22:18:47Z |
| publishDate | 2015-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EBioMedicine |
| spelling | doaj.art-340d07401d8c462cb56548429c729d352022-12-22T00:48:31ZengElsevierEBioMedicine2352-39642015-09-01291243125010.1016/j.ebiom.2015.07.027Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath SamplesR. Fernández del Río0M.E. O'Hara1A. Holt2P. Pemberton3T. Shah4T. Whitehouse5C.A. Mayhew6School of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT, UKSchool of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT, UKDepartment of Hepatology, University Hospital Birmingham NHS Trust, Birmingham B15 2TH, UKCritical Care and Anaesthesia, University Hospital Birmingham NHS Trust, Birmingham B15 2TH, UKDepartment of Hepatology, University Hospital Birmingham NHS Trust, Birmingham B15 2TH, UKCritical Care and Anaesthesia, University Hospital Birmingham NHS Trust, Birmingham B15 2TH, UKSchool of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT, UKBackground: The burden of liver disease in the UK has risen dramatically and there is a need for improved diagnostics. Aims: To determine which breath volatiles are associated with the cirrhotic liver and hence diagnostically useful. Methods: A two-stage biomarker discovery procedure was used. Alveolar breath samples of 31 patients with cirrhosis and 30 healthy controls were mass spectrometrically analysed and compared (stage 1). 12 of these patients had their breath analysed after liver transplant (stage 2). Five patients were followed longitudinally as in-patients in the post-transplant period. Results: Seven volatiles were elevated in the breath of patients versus controls. Of these, five showed statistically significant decrease post-transplant: limonene, methanol, 2-pentanone, 2-butanone and carbon disulfide. On an individual basis limonene has the best diagnostic capability (the area under a receiver operating characteristic curve (AUROC) is 0.91), but this is improved by combining methanol, 2-pentanone and limonene (AUROC curve 0.95). Following transplant, limonene shows wash-out characteristics. Conclusions: Limonene, methanol and 2-pentanone are breath markers for a cirrhotic liver. This study raises the potential to investigate these volatiles as markers for early-stage liver disease. By monitoring the wash-out of limonene following transplant, graft liver function can be non-invasively assessed.http://www.sciencedirect.com/science/article/pii/S2352396415300797Breath analysisCirrhosisDiagnosis limoneneLiver transplantPTR-MSVolatile organic compounds |
| spellingShingle | R. Fernández del Río M.E. O'Hara A. Holt P. Pemberton T. Shah T. Whitehouse C.A. Mayhew Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath Samples EBioMedicine Breath analysis Cirrhosis Diagnosis limonene Liver transplant PTR-MS Volatile organic compounds |
| title | Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath Samples |
| title_full | Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath Samples |
| title_fullStr | Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath Samples |
| title_full_unstemmed | Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath Samples |
| title_short | Volatile Biomarkers in Breath Associated With Liver Cirrhosis — Comparisons of Pre- and Post-liver Transplant Breath Samples |
| title_sort | volatile biomarkers in breath associated with liver cirrhosis comparisons of pre and post liver transplant breath samples |
| topic | Breath analysis Cirrhosis Diagnosis limonene Liver transplant PTR-MS Volatile organic compounds |
| url | http://www.sciencedirect.com/science/article/pii/S2352396415300797 |
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