Abstract
Early diagnosis of inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), remains a clinical challenge with current tests being invasive and costly. The analysis of volatile organic compounds (VOCs) in exhaled breath and biomarkers in stool (faecal calprotectin (FCP)) show increasing potential as non-invasive diagnostic tools. The aim of this pilot study is to evaluate the efficacy of breath analysis and determine if FCP can be used as an additional non-invasive parameter to supplement breath results, for the diagnosis of IBD. Thirty-nine subjects were recruited (14 CD, 16 UC, 9 controls). Breath samples were analysed using an in-house built electronic nose (Wolf eNose) and commercial gas chromatograph–ion mobility spectrometer (G.A.S. BreathSpec GC-IMS). Both technologies could consistently separate IBD and controls [AUC ± 95%, sensitivity, specificity], eNose: [0.81, 0.67, 0.89]; GC-IMS: [0.93, 0.87, 0.89]. Furthermore, we could separate CD from UC, eNose: [0.88, 0.71, 0.88]; GC-IMS: [0.71, 0.86, 0.62]. Including FCP did not improve distinction between CD vs. UC; eNose: [0.74, 1.00, 0.56], but rather, improved separation of CD vs. controls and UC vs. controls; eNose: [0.77, 0.55, 1.00] and [0.72, 0.89, 0.67] without FCP, [0.81, 0.73, 0.78] and [0.90, 1.00, 0.78] with FCP, respectively. These results confirm the utility of breath analysis to distinguish between IBD-related diagnostic groups. FCP does not add significant diagnostic value to breath analysis within this study.
Highlights
Inflammatory bowel disease (IBD) is a chronic condition of unknown aetiology, which includesCrohn’s disease (CD) and ulcerative colitis (UC) [1]
BreathSpec Gas Chromatography—Ion Mobility Spectrometry (GC-IMS) is better suited towards distinguishing between inflammatory bowel disease (IBD) and controls, while the Wolf electronic nose (eNose) can better separate between CD and UC
To the best of our knowledge, this study was the first breath-based investigation of IBD utilising GC-IMS and eNose technology. Both technologies consistently showed the ability to separate those with IBD and controls [area under curve (AUC) ± 95%, sensitivity, specificity], eNose: [0.81 (0.66–0.96), 0.67, 0.89] and GC-IMS: [0.93 (0.85–1.00), 0.87, 0.89]
Summary
Inflammatory bowel disease (IBD) is a chronic condition of unknown aetiology, which includes. Crohn’s disease (CD) and ulcerative colitis (UC) [1]. Both conditions involve inflammation of the gut and are unpleasant. IBD is a common condition in the Western world, affecting over 250,000 people in the UK and 28 million worldwide [3]. €30,000 with an average of 20% loss of working productivity [1,4]. This is due to the relapsing nature of the disease—there may be times when the symptoms are severe (flare-ups), followed by long periods when there are few or no symptoms at Biosensors 2019, 9, 55; doi:10.3390/bios9020055 www.mdpi.com/journal/biosensors
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