Breath Biopsy ® to Identify Exhaled Volatile Organic Compounds Biomarkers for Liver Cirrhosis Detection

Journal of Clinical and Translational Hepatology · 19 authors, 7 centres

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TL;DR

This study analyzed breath from 46 cirrhosis patients and 42 controls to find volatile organic compound (VOC) biomarkers. A panel of 29 VOCs discriminated between the groups, and a classification model using seven key VOCs achieved an area under the curve of 0.95.

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This cross-sectional pilot study used Breath Biopsy to analyze exhaled VOCs from 46 patients with liver cirrhosis and 42 controls. Breath samples were collected and analyzed using gas chromatography-mass spectrometry. The analysis identified 29 VOCs that significantly differed between groups. A classification model based on these VOCs achieved an area under the curve of 0.95±0.04 in cross-validation. A subset of 11 VOCs correlated with blood liver function markers (bilirubin, albumin, prothrombin time) and separated patients by cirrhosis severity. The study had limitations, including limited characterization of the control group and unstandardized dietary intake. The findings suggest a breath-based VOC panel could serve as a non-invasive tool for detecting and monitoring liver disease progression.

STUDY TYPE

cohort

SPECIALTY

gastroenterology

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AI pipeline

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ORIGINAL PAPER

PMC10037526

Breath Biopsy ® to Identify Exhaled Volatile Organic Compounds Biomarkers for Liver Cirrhosis Detection

Journal of Clinical and Translational Hepatology

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ABSTRACT

Abstract Background and Aims The prevalence of chronic liver disease in adults exceeds 30% in some countries and there is significant interest in developing tests and treatments to help control disease progression and reduce healthcare burden. Breath is a rich sampling matrix that offers non-invasive solutions suitable for early-stage detection and disease monitoring. Having previously investigated targeted analysis of a single biomarker, here we investigated a multiparametric approach to breath testing that would provide more robust and reliable results for clinical use. Methods To identify candidate biomarkers we compared 46 breath samples from cirrhosis patients and 42 from controls. Collection and analysis used Breath Biopsy OMNI™, maximizing signal and contrast to background to provide high confidence biomarker detection based upon gas chromatography mass spectrometry (GC-MS). Blank samples were also analyzed to provide detailed information on background volatile organic compounds (VOCs) levels. Results A set of 29 breath VOCs differed significantly between cirrhosis and controls. A classification model based on these VOCs had an area under the curve (AUC) of 0.95±0.04 in cross-validated test sets. The seven best performing VOCs were sufficient to maximize classification performance. A subset of 11 VOCs was correlated with blood metrics of liver function (bilirubin, albumin, prothrombin time) and separated patients by cirrhosis severity using principal component analysis. Conclusions A set of seven VOCs consisting of previously reported and novel candidates show promise as a panel for liver disease detection and monitoring, showing correlation to disease severity and serum biomarkers at late stage. Keywords: Breath Biopsy, Non-invasive, Biomarker, Cirrhosis, Liver function test

CITATION EXPORT

Giuseppe Ferrandino, Giovanna De Palo, Antonio Murgia et al.. Breath Biopsy® to Identify Exhaled Volatile Organic Compounds Biomarkers for Liver Cirrhosis Detection. Journal of Clinical and Translational Hepatology. (2023). https://doi.org/10.14218/JCTH.2022.00309

AUTHORS

19 · 7 CENTRES

Giuseppe Ferrandino, Giovanna De Palo, Antonio Murgia, Owen Birch, Ahmed Tawfike, Rob Smith, Irene Debiram-Beecham, Olga Gandelman, Graham Kibble, Anne Marie Lydon, Alice Groves, Agnieszka Smolinska, Max Allsworth, Billy Boyle, Marc P van der Schee, Michael Allison, Rebecca C Fitzgerald, Matthew Hoare, Victoria K Snowdon

1Owlstone Medical, Cambridge, UK
2Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK
3Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, the Netherlands
4Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
5Addenbrookes Hepatology and Liver Transplantation Unit, Addenbrookes Hospital, Cambridge, UK
6MRC Cancer Unit, Hutchison/MRC Research Centre, University of Cambridge, Cambridge, UK
7CRUK Cambridge Institute, Cambridge, UK