Volatile Organic Compounds as Biomarkers of Gastrointestinal Diseases and Nutritional Status.

Mariangela Rondanelli,Clementina Cocuzza,Mara Nichetti,Vittoria Infantino,Simone Perna,Gabriella Peroni,Milena Anna Faliva,Federica Perdoni,Tariq A. Alalwan,Giancarlo Iannello

doi:10.1155/2019/7247802

Abstract

Purpose The purpose of this review was to identify the best solution for rapid and noninvasive diagnosis and long-term monitoring of patients affected by inflammatory gastrointestinal diseases, colon and gastric cancer, obesity in correlation to diet, and breast milk to evaluate exposure to VOCs in women and infants. Methods This review included 20 previously published eligible studies. VOC analysis has allowed us to highlight differences in lifestyles, intestinal microbiota, and metabolism. New innovative methods have been described that allow the detection and quantification of a broad spectrum of metabolites present in exhaled breath even at very low levels, some of which have been shown to be indicators of pathological conditions. Results Five studies were analyzed that involved VOC analysis in relation to type of diet. All of them showed that the type of diet can have an impact on metabolites excreted and therefore can be a useful tool in the nutritional studies related to metabolism and health and disease status. Two studies concerned VOC analysis in inflammatory bowel diseases, and the results showed that VOCs can distinguish active disease from remission; VOC profile is clearly different in patients. In particular, C15H30 1-pentadecene, 3-methyl-1-butanal, octane, acetic acid, alpha-pinene, and m-cymene are elevated in active ulcerative colitis. Four studies examined VOCs in gastric and colorectal tumors showing a change in metabolic biomarkers of cancer patients compared to the control group. Finally, the study of VOCs in breast milk has improved the understanding of the potential health risks of exposure of children to chemical pollutants. Conclusions VOC analysis allowed to highlight differences in behavior, lifestyle, and metabolism of individuals. Analytical methods are continuously developed to allow for better detection and quantification of metabolites, thus enabling the detection of a broader spectrum of pathophysiology and disease biomarkers.

Highlights

Intermediate products of metabolism are considered biomarkers specific to human clinical and nutritional status and can be a useful diagnostic support to monitoring metabolic disease, including chronic inflammatory disease and gastrointestinal disease, using noninvasive methods
Is study describes the development and validation of methods for collecting, storing, and analyzing 36 different volatile organic compounds (VOCs) in breast milk to evaluate the exposure to VOCs of lactating women and nursing infants. e loss of volatile analyzed was minimized by collecting and storing 3 mL samples in small containers resulting in 70% recovery for all 10 VOCs detected in the majority of breast milk samples collected from 12 women
The collection and analysis of milk for these compounds are difficult, and robust methods are needed for accurate assessments of child exposure. e presence of lipids is a characteristic of milk that presents many challenges in ensuring an unbiased analysis of VOCs. e relatively high lipid content compared to other biological matrices means that milk is more susceptible to contamination through contact with air and laboratory materials commonly used for collection, storage, and analysis of samples

Summary

Introduction

Summarizes the recent progress made in noninvasive monitoring of volatile compounds in exhaled breath and above biological liquids, as they are becoming increasingly important in assessing the nutritional and clinical status and beginning to provide support to conventional clinical diagnostics and therapy. E authors concluded that this method can be applied to determine human exposure to HDI, IPDI, BMAA, and carnitine/choline in population-based studies, such as the National Health and Nutritional Examination Survey (NHANES), in addition to other clinical studies that desire noninvasive urine sampling Another similar study was conducted by Alkhouri et al [16] who used SIFT-MS to evaluate exhaled breath VOCs from OW/Ob children compared to lean children. E authors concluded that gastrointestinal interventions, including the use of antibiotics in Helicobacter pylori eradication and bowel cleansing for colonoscopy, could potentially affect the diagnostic accuracy of breath VOCs. e other study by Kumar et al [22] used SIFT-MS to monitor the VOCs in the exhaled breath of 81 patients with esophageal or gastric adenocarcinoma and 129 healthy controls.

Results

Methods