| Title: | The breathprints in patients with liver disease identify novel breath biomarkers in alcoholic hepatitis |
| Author(s): | Hanouneh IA; Zein NN; Cikach F; Dababneh L; Grove D; Alkhouri N; Lopez R; Dweik RA; |
| Address: | "Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio. Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio. Department of Quantitative Health Science, Cleveland Clinic, Cleveland, Ohio. Department of Pulmonary, Allergy, and Critical Care Medicine/Respiratory Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: DWEIKR@ccf.org" |
| Journal Title: | Clin Gastroenterol Hepatol |
| DOI: | 10.1016/j.cgh.2013.08.048 |
| ISSN/ISBN: | 1542-7714 (Electronic) 1542-3565 (Print) 1542-3565 (Linking) |
| Abstract: | "BACKGROUND & AIMS: Selected-ion flow-tube mass spectrometry can precisely identify trace gases in the human breath, in the parts-per-billion range. We investigated whether concentrations of volatile compounds in breath samples correlate with the diagnosis of alcoholic hepatitis (AH) and the severity of liver disease in patients with AH. METHODS: We recruited patients with liver disease from a single tertiary care center. The study population was divided between those with AH with cirrhosis (n = 40) and those with cirrhosis with acute decompensation from etiologies other than alcohol (n = 40); individuals without liver disease served as control subjects (n = 43). We used selected-ion flow-tube mass spectrometry to identify and measure 14 volatile compounds in breath samples from fasted subjects. We used various statistical analyses to compare clinical characteristics and breath levels of compounds among groups and to test the correlation between levels of compounds and severity of liver disease. Logistic regression analysis was performed to build a predictive model for AH. RESULTS: We identified 6 compounds (2-propanol, acetaldehyde, acetone, ethanol, pentane, and trimethylamine [TMA]) whose levels were increased in patients with liver disease compared with control subjects. Mean concentrations of TMA and pentane (TAP) were particularly high in breath samples from patients with AH, compared with those with acute decompensation or control subjects (for both, P < .001). Using receiver operating characteristic curve analysis, we developed a model for the diagnosis of AH based on breath levels of TAP. TAP scores of 36 or higher identified the patients with AH (area under the receiver operating characteristic curves = 0.92) with 90% sensitivity and 80% specificity. The levels of exhaled TMA had a low level of correlation with the severity of AH based on model for end-stage liver disease score (r = 0.38; 95% confidence interval, 0.07-0.69; P = .018). CONCLUSIONS: Based on levels of volatile compounds in breath samples, we can identify patients with AH vs patients with acute decompensation or individuals without liver disease. Levels of exhaled TMA moderately correlate with the severity of AH. These findings might be used in diagnosis of AH or in determining patient prognosis" |
| Keywords: | "Adult Aged Biomarkers/*analysis Breath Tests/*methods Female Hepatitis, Alcoholic/*diagnosis Humans Male Mass Spectrometry/methods Middle Aged Severity of Illness Index Tertiary Care Centers Volatile Organic Compounds/*analysis Alcohol Consumption Liver D;" |
| Notes: | "MedlineHanouneh, Ibrahim A Zein, Nizar N Cikach, Frank Dababneh, Luma Grove, David Alkhouri, Naim Lopez, Rocio Dweik, Raed A eng P01 HL107147/HL/NHLBI NIH HHS/ RR026231/RR/NCRR NIH HHS/ P01 HL081064/HL/NHLBI NIH HHS/ HL081064/HL/NHLBI NIH HHS/ HL107147/HL/NHLBI NIH HHS/ HL103453/HL/NHLBI NIH HHS/ P01 HL103453/HL/NHLBI NIH HHS/ HL109250/HL/NHLBI NIH HHS/ Evaluation Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2013/09/17 Clin Gastroenterol Hepatol. 2014 Mar; 12(3):516-23. doi: 10.1016/j.cgh.2013.08.048. Epub 2013 Sep 10" |
