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Faecal volatile organic compounds differ according to inflammatory bowel disease sub-type, severity, and response to
Salma Belnour1, Rachael Slater2, Kukatharmini Tharmaratnam3
1Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
Insights
Faecal volatile organic compounds (VOCs) in children with inflammatory bowel disease (IBD) showed distinct patterns related to disease type and severity. These patterns persisted despite treatment, indicating ongoing gut dysbiosis in pediatric IBD patients.
Area of Science:
- Gastroenterology
- Microbiome Research
- Biochemistry
Background:
- Faecal volatile organic compounds (VOCs) are known to vary with disease subtype and activity in adults with inflammatory bowel disease (IBD).
- Understanding these variations in children is crucial for early diagnosis and management of pediatric IBD.
Purpose of the Study:
- To characterize faecal VOC patterns in children newly diagnosed with IBD.
- To correlate these patterns with disease subtype, severity, and treatment response.
Main Methods:
- Recruitment of children with suspected IBD from three UK hospitals.
- Matching IBD patients with non-IBD controls by age, sex, and recruitment site.
- Faecal VOC analysis using gas chromatography-mass spectrometry at presentation and 3 months post-treatment.
Main Results:
- Significant differences in faecal VOC abundance were observed between IBD patients and controls, with 27 out of 62 VOCs showing altered levels.
- Ketones, diketones, fatty acids, and alcohols were particularly affected, with reductions noted in Crohn's disease (CD) and ulcerative colitis (UC).
- Severe colitis showed marked reductions in short-chain, medium-chain, and branched-chain fatty acids. Despite clinical improvement, VOC profiles largely persisted, suggesting persistent dysbiosis. Specific VOCs like Oct-1-en-3-ol, propan-1-ol, and phenol showed significant changes related to disease type and treatment response.
Conclusions:
- Faecal VOC profiling in pediatric IBD reveals distinct patterns associated with diagnosis, disease activity, and extent.
- These findings highlight the potential of VOCs as biomarkers for IBD in children.
- Further research is warranted to explore the relationship between VOCs, the gut microbiome, and their utility in IBD diagnosis and monitoring.
Background:
Faecal volatile organic compounds (VOCs) differ with disease sub-type and activity in adults with established inflammatory bowel disease (IBD) taking therapy.
Objective:
To describe patterns of faecal VOCs in children newly presented with IBD according to disease sub-type, severity, and response to treatment.
Methods:
Children presenting with suspected IBD were recruited from three UK hospitals. Children in whom IBD was diagnosed were matched with a non-IBD child for age, sex, and recruitment site. Faecal VOCs were characterised by gas chromatography-mass spectrometry at presentation and 3 months later in children with IBD.
Results:
In 132 case/control pairs, median (inter-quartile range) age in IBD was 13.3 years (10.2-14.7) and 38.6% were female. Compared with controls, the mean abundance of 27/62 (43.6%) faecal VOCs was statistically significantly decreased in Crohn's disease (CD), ulcerative colitis (UC) or both especially amongst ketones/diketones, fatty acids, and alcohols (p < 0.05). Short-chain, medium chain, and branched chain fatty acids were markedly reduced in severe colitis (p < 0.05). Despite clinical improvement in many children with IBD, the number and abundance of almost all VOCs did not increase following treatment, suggesting persistent dysbiosis. Oct-1-en-3-ol was increased in CD (p = 0.001) and UC (p = 0.012) compared with controls and decreased following treatment in UC (p = 0.01). In CD, propan-1-ol was significantly greater than controls (p < 0.001) and extensive colitis (p = 0.001) and fell with treatment (p = 0.05). Phenol was significantly greater in CD (p < 0.001) and fell with treatment in both CD (p = 0.02) and UC (p = 0.01).
Conclusion:
Characterisation of faecal VOCs in an inception cohort of children with IBD reveals patterns associated with diagnosis, disease activity, and extent. Further work should investigate the relationship between VOCs and the microbiome in IBD and their role in diagnosis and disease monitoring.
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