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The potential of volatile organic compounds for the detection of active disease in patients with ulcerative colitis
Author(s) -
Smolinska A.,
Bodelier A. G. L.,
Dallinga J. W.,
Masclee A. A. M.,
Jonkers D. M.,
Schooten F.J.,
Pierik M. J.
Publication year - 2017
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14004
Subject(s) - ulcerative colitis , medicine , gastroenterology , calprotectin , colitis , inflammatory bowel disease , area under the curve , disease
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 ( VOC s) in exhaled air could be predictive of active disease or remission in Crohn's disease. Aim To investigate whether VOC s 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 VOC s. Results In total, 72 UC (132 breath samples; 62 active; 70 remission) and 22 non‐ UC ‐colitis patients (22 samples) were included. Eleven VOC s 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. VOC s have demonstrated potential as new non‐invasive biomarker to monitor inflammation in UC .