Differentiating coeliac disease from irritable bowel syndrome by urinary volatile organic compound analysis--a pilot study.
Differentiating coeliac disease from irritable bowel syndrome by urinary volatile organic compound analysis--a pilot study.
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DOI：
10.1371/journal.pone.0107312
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Covington JA
中科院分区：
文献类型：
--
作者：
Arasaradnam RP;Westenbrink E;McFarlane MJ;Harbord R;Chambers S;O'Connell N;Bailey C;Nwokolo CU;Bardhan KD;Savage R;Covington JA
乳糜泻（CD）是一种t细胞介导的麸质敏感肠病，影响约1%的英国人口，可呈现广泛的临床特征，常被误认为肠易激综合征（IBS）。提高临床意识和血清学筛查识别潜在乳糜泻患者；经十二指肠活检证实，无麸质饮食可改善症状。诊断的局限性是血清学假阴性和不愿进行活检。肠道微生物群在几种胃肠道疾病中发生改变，导致肠道发酵模式发生改变，这可以通过尿液、呼吸和粪便中的挥发性有机化合物（VOC）分析来识别。我们的目的是确定乳糜泻是否会改变尿液VOC模式，从而将其与肠易激综合征区分开来。招募了47名患者，27名患有乳糜泻，无麸质饮食，20名患有腹泻为主的肠易激综合征（D-IBS）。收集的尿液以10毫升的等量冷冻保存。将样品加热至40±0.1°C，用场不对称离子迁移谱法（FAIMS）分析顶空。采用机器学习算法进行统计评估。样品还使用气相色谱和质谱（GC-MS）进行分析。稀疏logistic回归结果显示，FAIMS区分CD和D-IBS的ROC曲线AUC分别为0.91(0.83-0.99)，灵敏度和特异性分别为85%。GCMS在4 ' 67处有一个独特的峰，仅在CD中发现，而在D-IBS中没有，该峰与化合物1,3,5,7环四烯相关。这项研究表明，FAIMS提供了一种新的、无创的方法来识别可能患有乳糜泻的患者，并将其与D-IBS区分开来。它提供了在家监测无谷蛋白饮食依从性的可能性。环四烯在CD标本中的存在需要进一步验证。
Coeliac disease (CD), a T-cell-mediated gluten sensitive enteropathy, affects ∼1% of the UK population and can present with wide ranging clinical features, often being mistaken for Irritable Bowel Syndrome (IBS). Heightened clinical awareness and serological screening identifies those with potential coeliac disease; the diagnosis is confirmed with duodenal biopsies, and symptom improvement with a gluten-free diet. Limitations to diagnosis are false negative serology and reluctance to undergo biopsy. The gut microbiome is altered in several gastrointestinal disorders, causing altered gut fermentation patterns recognisable by volatile organic compounds (VOC) analysis in urine, breath and faeces. We aimed to determine if CD alters the urinary VOC pattern, distinguishing it from IBS. 47 patients were recruited, 27 with established CD, on gluten free diets, and 20 with diarrhoea-predominant IBS (D-IBS). Collected urine was stored frozen in 10 ml aliquots. For assay, the specimens were heated to 40±0.1°C and the headspace analysed by Field Asymmetric Ion Mobility Spectrometry (FAIMS). Machine learning algorithms were used for statistical evaluation. Samples were also analysed using Gas chromatography and mass spectroscopy (GC-MS). Sparse logistic regression showed that FAIMS distinguishes VOCs in CD vs D-IBS with ROC curve AUC of 0.91 (0.83–0.99), sensitivity and specificity of 85% respectively. GCMS showed a unique peak at 4′67 found only in CD, not D-IBS, which correlated with the compound 1,3,5,7 cyclooctatetraene. This study suggests that FAIMS offers a novel, non-invasive approach to identify those with possible CD, and distinguishes from D-IBS. It offers the potential for monitoring compliance with a gluten-free diet at home. The presence of cyclooctatetraene in CD specimens will need further validation.
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影响因子：
4.9
作者：
Arasaradnam, Ramesh P.;Ouaret, Nathalie;Covington, James A.
通讯作者：
Covington, James A.
影响因子：
4.3
作者：
Benkebil, Faiza;Combescure, Christophe;Schaeppi, Michela G.
通讯作者：
Schaeppi, Michela G.
DOI：
10.3390/s121013002
发表时间：
2012-09-26
期刊：
Sensors (Basel, Switzerland)
影响因子：
--
作者：
Covington JA;Wedlake L;Andreyev J;Ouaret N;Thomas MG;Nwokolo CU;Bardhan KD;Arasaradnam RP
通讯作者：
Arasaradnam RP
影响因子：
12.6
作者：
Hopper, Andrew D.;Hadjivassiliou, Marios;Sanders, David S.
通讯作者：
Sanders, David S.
影响因子：
7.6
作者：
Dahle, C.;Hagman, A.;Strom, M.
通讯作者：
Strom, M.