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Breath Biopsy Assessment of Liver Disease Using an Exogenous Volatile Organic Compound-Toward Improved Detection of Liver Impairment.
- Source :
-
Clinical and translational gastroenterology [Clin Transl Gastroenterol] 2020 Sep; Vol. 11 (9), pp. e00239. - Publication Year :
- 2020
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Abstract
- Introduction: Liver cirrhosis and its complication - hepatocellular carcinoma (HCC) - have been associated with increased exhaled limonene. It is currently unclear whether this increase is more strongly associated with the presence of HCC or with the severity of liver dysfunction.<br />Methods: We compared the exhaled breath of 40 controls, 32 cirrhotic patients, and 12 cirrhotic patients with HCC using the Breath Biopsy platform. Breath samples were analyzed by thermal desorption-gas chromatography-mass spectrometry. Limonene levels were compared between the groups and correlated to bilirubin, albumin, prothrombin time international normalized ratio, and alanine aminotransferase.<br />Results: Breath limonene concentration was significantly elevated in subjects with cirrhosis-induced HCC (M: 82.1 ng/L, interquartile range [IQR]: 16.33-199.32 ng/L) and cirrhosis (M: 32.6 ng/L, IQR: 6.55-123.07 ng/L) compared with controls (M: 6.2 ng/L, IQR: 2.62-9.57 ng/L) (P value = 0.0005 and 0.0001, respectively) with no significant difference between 2 diseased groups (P value = 0.37). Levels of exhaled limonene correlated with serum bilirubin (R = 0.25, P value = 0.0016, r = 0.51), albumin (R = 0.58, P value = 5.3e-8, r = -0.76), and international normalized ratio (R = 0.29, P value = 0.0003, r = 0.51), but not with alanine aminotransferase (R = 0.01, P value = 0.36, r = 0.19).<br />Discussion: Exhaled limonene levels are primarily affected by the presence of cirrhosis through reduced liver functional capacity, as indicated by limonene correlation with blood metrics of impaired hepatic clearance and protein synthesis capacity, without further alterations observed in subjects with HCC. This suggests that exhaled limonene is a potential non-invasive marker of liver metabolic capacity (see Visual abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A388).
- Subjects :
- Adult
Aged
Aged, 80 and over
Biomarkers analysis
Breath Tests
Carcinoma, Hepatocellular pathology
Carcinoma, Hepatocellular physiopathology
Case-Control Studies
Cross-Sectional Studies
Female
Humans
Liver pathology
Liver physiopathology
Liver Cirrhosis pathology
Liver Cirrhosis physiopathology
Liver Function Tests methods
Liver Neoplasms pathology
Liver Neoplasms physiopathology
Male
Middle Aged
Prospective Studies
Severity of Illness Index
Carcinoma, Hepatocellular diagnosis
Limonene analysis
Liver Cirrhosis diagnosis
Liver Neoplasms diagnosis
Volatile Organic Compounds analysis
Subjects
Details
- Language :
- English
- ISSN :
- 2155-384X
- Volume :
- 11
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Clinical and translational gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 33094960
- Full Text :
- https://doi.org/10.14309/ctg.0000000000000239