Non-Invasive Monitoring of Inflammation in Inflammatory Bowel Disease Patients during Prolonged Exercise via Exhaled Breath Volatile Organic Compounds.

Ben Henderson,Jeroen J Jansen,Simona M Cristescu,Coen C W G Bongers,Carlijn R Lamers,Maria T E Hopman,Rupert Holzinger,Dušan Materić,Carlo G Bertinetto,Guilherme Lopes Batista,Joris Meurs,Frans J M Harren

doi:10.3390/metabo12030224

Abstract

The aim of this study was to investigate volatile organic compounds (VOCs) in exhaled breath as possible non-invasive markers to monitor the inflammatory response in inflammatory bowel disease (IBD) patients as a result of repeated and prolonged moderate-intensity exercise. We included 18 IBD patients and 19 non-IBD individuals who each completed a 30, 40, or 50 km walking exercise over three consecutive days. Breath and blood samples were taken before the start of the exercise event and every day post-exercise to assess changes in the VOC profiles and cytokine concentrations. Proton transfer reaction time-of-flight mass spectrometry (PTR-ToF-MS) was used to measure exhaled breath VOCs. Multivariate analysis, particularly ANOVA-simultaneous component analysis (ASCA), was employed to extract relevant ions related to exercise and IBD. Prolonged exercise induces a similar response in breath butanoic acid and plasma cytokines for participants with or without IBD. Butanoic acid showed a significant correlation with the cytokine IL-6, indicating that butanoic acid could be a potential non-invasive marker for exercise-induced inflammation. The findings are relevant in monitoring personalized IBD management.

Highlights

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a condition that is characterized by chronic inflammation of the gastrointestinal tract [1]
Identification of Breath volatile organic compounds (VOCs) Affected by Prolonged Exercise and inflammatory bowel disease (IBD) Condition
The results showed that breath VOC profiles of participants were affected by exercise and IBD condition (p < 0.001)

Summary

Introduction

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a condition that is characterized by chronic inflammation of the gastrointestinal tract [1]. Many patients still experience symptoms such as fatigue despite being in remission with medication. They look for supportive and adjunctive or even alternative therapies [2–4]. The general concern that exercise may exacerbate symptoms in IBD patients seems to depend on the amount and intensity of exercise. In the case of repetitive prolonged moderate-intensity exercise, the exercise-induced increase in the concentration of inflammation markers in healthy individuals gradually decreases after consecutive days of exercise, indicating an adaptive response [8]. It has been demonstrated that cytokine concentrations of IBD patients were comparable to non-IBD controls after prolonged moderate-intensity exercise (walking), indicating that this type of exercise can be performed safely without significant exacerbation of inflammation [9]

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Conclusion