Title: | Volatile Biomarkers in Breath Associated With Liver Cirrhosis - Comparisons of Pre- and Post-liver Transplant Breath Samples |
Author(s): | Fernandez Del Rio R; O'Hara ME; Holt A; Pemberton P; Shah T; Whitehouse T; Mayhew CA; |
Address: | "School of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT, UK. Department of Hepatology, University Hospital Birmingham NHS Trust, Birmingham B15 2TH, UK. Critical Care and Anaesthesia, University Hospital Birmingham NHS Trust, Birmingham B15 2TH, UK" |
DOI: | 10.1016/j.ebiom.2015.07.027 |
ISSN/ISBN: | 2352-3964 (Print) 2352-3964 (Electronic) 2352-3964 (Linking) |
Abstract: | "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" |
Keywords: | "Adult Aged Biomarkers/*analysis Breath Tests/*methods Cyclohexenes/analysis Female Humans Limonene Liver Cirrhosis/*diagnosis *Liver Transplantation Male Methanol/analysis Middle Aged Pentanones/analysis ROC Curve Terpenes/analysis Volatilization AID, aut;" |
Notes: | "MedlineFernandez Del Rio, R O'Hara, M E Holt, A Pemberton, P Shah, T Whitehouse, T Mayhew, C A eng 097825/Z/11/B/Wellcome Trust/United Kingdom Comparative Study Research Support, Non-U.S. Gov't Netherlands 2015/10/27 EBioMedicine. 2015 Jul 26; 2(9):1243-50. doi: 10.1016/j.ebiom.2015.07.027. eCollection 2015 Sep" |