A Novel Tool for Noninvasive Diagnosis and Tracking of Patients with Inflammatory Bowel Disease
A Novel Tool for Noninvasive Diagnosis and Tracking of Patients with Inflammatory Bowel Disease
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DOI：
10.1097/mib.0b013e3182802b26
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发表时间：
2013-04-01
影响因子：
4.9
通讯作者：
Covington, James A.
中科院分区：
文献类型：
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作者：
Arasaradnam, Ramesh P.;Ouaret, Nathalie;Covington, James A.
背景：炎症性肠病的发病机制涉及细菌的作用。这些细菌发酵结肠中的非淀粉多糖，通过改变肠道通透性，可以在尿液中追踪到发酵过程。我们建议使用非侵入性实时工具，特别是电子鼻和场不对称离子迁移率光谱仪(FAIMS)仪器来跟踪尿液中产生的挥发性有机化合物或气体。本研究的目的是确定电子鼻和FAIMS仪器在检测和跟踪IBD患者发酵过程中的作用。方法：62例IBD患者，48例IBD患者(分别为24例克罗恩病和溃疡性结肠炎)和14例正常对照。记录疾病活跃度，采集尿样。结果：通过(1)主成分分析(无分类)和(2)判别函数分析(样本预先分类)进行电子鼻数据分析。FAIMS数据用Fisher‘s判别分析(预先分类[临床分组])处理。这两项技术始终显示出能够以75%的准确率将炎症性肠病患者和对照组区分开来，P<；0.001。在一个较小的亚组(n=24)中，我们还证明了电子鼻和FAIMS仪器可以区分活动期和缓解期的疾病。结论：IBD患者的发酵谱或发酵组与对照组相比存在差异，反映了健康和疾病中细菌的多样性。随着疾病的缓解，这种情况也会发生变化(并被跟踪)。因此，电子鼻和FAIMS仪器为临床使用的非侵入性实时诊断工具提供了潜力。
Background: The pathogenesis of inflammatory bowel disease (IBD) involves the role of bacteria. These bacteria ferment nonstarch polysaccharides in the colon producing a fermentation profile that through altered gut permeability can be traced in urine. We proposed to track the resultant volatile organic compounds or gases that emanate from urine using noninvasive real-time tools, specifically by electronic nose and Field Asymmetric Ion Mobility Spectrometer (FAIMS) instruments. The aim of this study was to determine the utility of electronic nose and FAIMS instruments to detect and track the fermentation profile of patients with IBD.Methods: Sixty-two individuals were recruited, 48 individuals with IBD (24 with Crohn's disease and ulcerative colitis, respectively) and 14 controls. The disease activity was recorded, and urine samples were collected. The headspace (the air above the sample) was analyzed using the electronic nose and FAIMS instruments.Results: Electronic nose data analysis was conducted through (1) Principal Component Analysis (data were analyzed together without previous categorization); and (2) Discriminant Function Analysis (samples were precategorized [clinical groups]). The FAIMS data were processed by Fisher's Discriminant Analysis (precategorized [clinical groups]). Both technologies consistently showed the ability to separate those with IBD and controls with a > 75% accuracy; P < 0.001. In a smaller subgroup (n = 24), we also demonstrated that the electronic nose and FAIMS instruments can distinguish between active disease and those in remission.Conclusions: The fermentation profile or fermentome is disparate in those with IBD compared with controls-a reflection of the bacterial diversity in health and disease. This profile also changes (and was tracked) as the disease is induced into remission. Thus, the electronic nose and FAIMS instruments offer the potential of a noninvasive real-time diagnostic tool for point of care clinical use.