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Published on: June 1, 2022
Faecal volatile organic compounds analysis using field asymmetric ion mobility spectrometry: non-invasive diagnostics
Nora van Gaal1, Rozanne Lakenman2, James Covington3
1Department of Gastroenterology and Hepatology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Insights
Faecal volatile organic compounds (VOCs) can non-invasively diagnose paediatric inflammatory bowel disease (IBD) in children. This breath test shows promise in distinguishing IBD patients from healthy controls, potentially reducing the need for invasive procedures.
Area of Science:
- Gastroenterology
- Clinical Diagnostics
- Microbiome Research
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), presents diagnostic challenges, particularly in pediatric populations.
- Current diagnostic methods often involve invasive endoscopic procedures, imposing a significant burden on young patients.
- Alterations in intestinal microbiota composition are linked to IBD, and fecal volatile organic compounds (VOCs) are recognized as indicators of this gut microbial state.
Purpose of the Study:
- To evaluate the diagnostic accuracy of fecal volatile organic compound (VOC) profiling as a non-invasive biomarker for pediatric IBD.
- To determine if fecal VOC analysis can differentiate between children with newly diagnosed IBD and healthy controls.
Main Methods:
- A diagnostic accuracy study was conducted in two Dutch tertiary centers.
- Fecal VOC profiles were analyzed using field asymmetric ion-spectrum spectrometry (FAIMS) in 36 treatment-naïve pediatric IBD patients (23 CD, 13 UC) and 24 healthy controls.
- The study focused on de novo patients to assess initial diagnostic potential.
Main Results:
- Fecal VOC profiling successfully differentiated de novo pediatric IBD patients from healthy controls with an area under the curve (AUC) of 0.76 (79% sensitivity, 78% specificity).
- Discrimination was significant for both Crohn's disease (AUC 0.90) and ulcerative colitis (AUC 0.74) compared to controls.
- However, VOC profiles could not reliably distinguish between UC and CD (AUC 0.67).
Conclusions:
- Fecal VOC analysis using FAIMS demonstrates potential as a non-invasive diagnostic biomarker for pediatric IBD.
- This approach may serve as a valuable complementary tool, potentially reducing the number of endoscopies required for children suspected of having IBD.
- Further validation is warranted to refine its role in the diagnostic pathway.
Background And Objectives:
Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), remains challenging to diagnose. Diagnostic work-up carries a high burden, especially in paediatric patients, due to invasive endoscopic procedures. IBD is associated with alterations in intestinal microbiota composition. Faecal volatile organic compounds (VOCs) reflect gut microbiota composition. The aim of this study was to assess the diagnostic accuracy of faecal VOC profiling as a non-invasive diagnostic biomarker for paediatric IBD.
Methods:
In this diagnostic accuracy study performed in two tertiary centres in the Netherlands, faecal VOC profiles of 36 de novo, treatment-naïve paediatric IBD patients (23 CD, 13 UC), and 24 healthy, matched controls were measured by field asymmetric ion mobility spectrometry (Owlstone Ltd, Lonestar®, UK).
Results:
Faecal VOC profiles of de novo paediatric IBD patients could be differentiated from healthy controls (AUC ± 95% CI, p-value, sensitivity, specificity; 0.76 ± 0.14, p < 0.001, 79%, 78%). This discrimination from controls was observed in both CD (0.90 ± 0.10, p < 0.0001, 83%, 83%) and UC (0.74 ± 0.19, p = 0.02, 77%, 75%). VOC profiles from UC could not be discriminated from CD (0.67 ± 0.19, p = 0.0996, 65%, 62%).
Conclusion:
Field asymmetric ion mobility spectrometry allowed for discrimination between faecal VOC profiles of de novo paediatric IBD patients and healthy controls, confirming the potential of faecal VOC analysis as a non-invasive diagnostic biomarker for paediatric IBD. This method may serve as a complementary, non-invasive technique in the diagnosis of IBD, possibly limiting the number of endoscopies needed in children suspected for IBD.
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