Breathomics—exhaled volatile organic compound analysis to detect hepatic encephalopathy : a pilot study

Article English OPEN
Arasaradnam, Ramesh P. ; McFarlane, M. ; Ling, K. ; Wurie, S. ; O’Connell, N. ; Nwokolo, Chuka U. ; Bardhan, Karna Dev ; Skinner, J. ; Savage, Richard S. ; Covington, James A. (2016)

he current diagnostic challenge with diagnosing hepatic encephalopathy (HE) is identifying those with minimal HE as opposed to the more clinically apparent covert/overt HE. Rifaximin, is an effective therapy but earlier identification and treatment of HE could prevent liver disease progression and hospitalization. Our pilot study aimed to analyse breath samples of patients with different HE grades, and controls, using a portable electronic (e) nose. 42 patients were enrolled; 22 with HE and 20 controls. Bedside breath samples were captured and analysed using an uvFAIMS machine (portable e-nose). West Haven criteria applied and MELD scores calculated. We classify HE patients from controls with a sensitivity and specificity of 0.88 (0.73-0.95) and 0.68 (0.51-0.81) respectively, AUROC 0.84 (0.75-0.93). Minimal HE was distinguishable from covert/overt HE with sensitivity of 0.79 and specificity of 0.5, AUROC 0.71 (0.57-0.84). This pilot study has highlighted the potential of breathomics to identify VOCs signatures in HE patients for diagnostic purposes. Importantly this was performed utilizing a non-invasive, portable bedside device and holds potential for future early HE diagnosis.
  • References (33)
    33 references, page 1 of 4

    [1] Waghray A, Waghray N and Mullen K 2015 Management of covert hepatic encephalopathy J. Clin. Exp. Hepatol. 5 S75-81

    [2] Bajaj J S, Cordoba J, Mullen K D, Amodio P, Shawcross D L, Butterworth R F and Morgan M Y (International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN)) 2011 Review article: the design of clinical trials in hepatic encephalopathy-an International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) consensus statement Aliment. Pharmacol. Ther. 33 739-47

    [3] Stewart C A, Malinchoc M, Kim W R and Kamath P S 2007 Hepatic encephalopathy as a predictor of survival in patients with end-stage liver disease Liver Transpl. 13 1366-71

    [4] Blei A T and Córdoba J 2001 Practice Parameters Committee of the American College of Gastroenterology. Hepatic encephalopathy Am. J. Gastroenterol. 96 1968-76

    [5] Jiang Q, Jiang X H, Zheng M H, Jiang L M, Chen Y P and Wang L 2008 Rifaximin versus nonabsorbable disaccharides in the management of hepatic encephalopathy: a meta-analysis Eur. J. Gastroenterol. Hepatol. 20 1064-70

    [6] Sharma B C, Sharma P, Lunia M K, Srivastava S, Goyal R and Sarin S K 2013 A randomized, double-blind, controlled trial comparing rifaximin plus lactulose with lactulose alone in treatment of overt hepatic encephalopathy Am. J. Gastroenterol. 108 1458-63

    [7] Sidhu S S, Goyal O, Mishra B P, Sood A, Chhina R S and Soni R K 2011 Rifaximin improves psychometric performance and health-related quality of life in patients with minimal hepatic encephalopathy (the RIME Trial) Am. J. Gastroenterol. 106 307-16

    [8] Bajaj J S, Heuman D M and Wade J B 2011 Rifaximin improves driving simulator performance in a randomized trial of patients with minimal hepatic encephalopathy Gastroenterology 140 478-87

    [9] Arasaradnam R P et al 2014 Next generation diagnostic modalities in gastroenterology-gas phase volatile compound biomarker Aliment. Pharmacol. Ther. 39 780-9

    [10] Peng G et al 2010 Detection of lung, breast, colorectal, and prostate cancers from exhaled breath using a single array of nanosensors Br. J. Cancer 10 542-51

  • Metrics
    views in OpenAIRE
    views in local repository
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    Warwick Research Archives Portal Repository - IRUS-UK 0 30
Share - Bookmark