The potential of volatile organic compounds for the detection of active disease in patients with ulcerative colitis

• Published in: Alimentary pharmacology & therapeutics Vol. 45; no. 9; pp. 1244 - 1254
• Main Authors: Smolinska, A., Bodelier, A. G. L., Dallinga, J. W., Masclee, A. A. M., Jonkers, D. M., Schooten, F.‐J., Pierik, M. J.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.05.2017
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers - analysis; Breath Tests; C-reactive protein; C-Reactive Protein - analysis; Colitis - blood; Colitis - diagnosis; Colon; Crohn's disease; Cross-Sectional Studies; Feces - chemistry; Female; Gas chromatography; Gas Chromatography-Mass Spectrometry; Humans; Inflammatory bowel disease; Leukocyte L1 Antigen Complex - analysis; Male; Mass spectrometry; Mass spectroscopy; Middle Aged; Mucosa; Organic compounds; Outpatients; Principal components analysis; Remission; Sensitivity and Specificity; Ulcerative colitis; VOCs; Volatile organic compounds; Volatile Organic Compounds - analysis
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.14004

Summary Background To optimise treatment of ulcerative colitis (UC), patients need repeated assessment of mucosal inflammation. Current non‐invasive biomarkers and clinical activity indices do not accurately reflect disease activity in all patients and cannot discriminate UC from non‐UC colitis. Volatile organic compounds (VOCs) in exhaled air could be predictive of active disease or remission in Crohn's disease. Aim To investigate whether VOCs are able to differentiate between active UC, UC in remission and non‐UC colitis. Methods UC patients participated in a 1‐year study. Clinical activity index, blood, faecal and breath samples were collected at each out‐patient visit. Patients with clear defined active faecal calprotectin >250 μg/g and inactive disease (Simple Clinical Colitis Activity Index <3, C‐reactive protein <5 mg/L and faecal calprotectin <100 μg/g) were included for cross‐sectional analysis. Non‐UC colitis was confirmed by stool culture or radiological evaluation. Breath samples were analysed by gas chromatography time‐of‐flight mass spectrometry and kernel‐based method to identify discriminating VOCs. Results In total, 72 UC (132 breath samples; 62 active; 70 remission) and 22 non‐UC‐colitis patients (22 samples) were included. Eleven VOCs predicted active vs. inactive UC in an independent internal validation set with 92% sensitivity and 77% specificity (AUC 0.94). Non‐UC colitis patients could be clearly separated from active and inactive UC patients with principal component analysis. Conclusions Volatile organic compounds can accurately distinguish active disease from remission in UC and profiles in UC are clearly different from profiles in non‐UC colitis patients. VOCs have demonstrated potential as new non‐invasive biomarker to monitor inflammation in UC. Linked ContentThis article is linked to Smolinska and van Schooten, and Williams and Orchard papers. To view these articles visit https://doi.org/10.1111/apt.14163 and https://doi.org/10.1111/apt.14135.