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Gas Chromatography-Sensor System Aids Diagnosis of Inflammatory Bowel Disease, and Separates Crohn's from Ulcerative
Rachael Slater1, Kukatharmini Tharmaratnam2, Salma Belnour3
1Department of Molecular & Clinical Cancer Medicine, Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3GE, UK.
Insights
Diagnosing pediatric inflammatory bowel disease (IBD) can be invasive. A novel breath test using fecal volatile organic compounds (VOCs) shows promise in distinguishing Crohn's disease from ulcerative colitis in children.
Area of Science:
- Gastroenterology
- Biomarkers
- Pediatric Medicine
Background:
- Diagnosing pediatric inflammatory bowel disease (IBD) often involves lengthy and invasive procedures.
- There is a need for non-invasive, rapid, and cost-effective diagnostic tools for IBD in children.
- Faecal volatile organic compounds (VOCs) have shown potential as distinctive biomarkers in IBD.
Purpose of the Study:
- To compare the diagnostic accuracy of a novel fecal volatile organic compound (VOC) sensor (OdoReader©) with fecal calprotectin (FCP) for diagnosing IBD in children.
- To evaluate the ability of the OdoReader© to differentiate between Crohn's disease (CD) and ulcerative colitis (UC) in pediatric patients.
Main Methods:
- An inception cohort of children with suspected IBD was studied.
- Faecal samples were analyzed using the OdoReader© for VOC profiles.
- Diagnostic performance was compared between OdoReader© and FCP, with subgroup analysis for CD vs. UC.
Main Results:
- The OdoReader© showed 82% sensitivity and 71% specificity for IBD diagnosis, not outperforming FCP (93% sensitivity, 86% specificity).
- However, the OdoReader© demonstrated significant ability to distinguish pediatric CD from UC (up to 88% sensitivity, 80% specificity).
- This VOC-based approach offers potential for non-invasive subtyping of IBD in children.
Conclusions:
- While not superior to FCP for general IBD diagnosis, the OdoReader© shows promise for non-invasively differentiating pediatric Crohn's disease from ulcerative colitis.
- Further validation in larger studies is warranted for this VOC-based diagnostic technology.
- This approach could help streamline diagnostic pathways and reduce the need for invasive procedures in children with suspected IBD.
Abstract:
The diagnosis of inflammatory bowel disease (IBD) in children and the need to distinguish between subtypes (Crohn's disease (CD) and ulcerative colitis (UC)) requires lengthy investigative and invasive procedures. Non-invasive, rapid, and cost-effective tests to support these diagnoses are needed. Faecal volatile organic compounds (VOCs) are distinctive in IBD. VOC profiles can be rapidly determined using a gas chromatography-sensor device (OdoReader©). In an inception-cohort of children presenting with suspected IBD, we directly compared the diagnostic fidelity of faecal calprotectin (FCP, a non-specific protein marker of intestinal inflammation) with OdoReader© VOC profiles of children subsequently diagnosed with IBD with matched controls diagnosed with other gastrointestinal conditions. The OdoReader© was 82% (95% confidence interval 75-89%) sensitive and 71% (61-80%) specific but did not outperform FCP (sensitivity 93% (77-99%) and specificity 86% (67-96%); 250 µg/g FCP cut off) in the diagnosis of IBD from other gastrointestinal conditions when validated in a separate sample from the same cohort. However, unlike FCP and better than other similar technologies, the OdoReader© could distinguish paediatric CD from UC (up to 88% (82-93%) sensitivity and 80% (71-89%) specificity in the validation set) and justifies further validation in larger studies. A non-invasive test based on VOCs could help streamline and limit invasive investigations in children.
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