Breath biomarkers of liver cirrhosis

Abstract

The diagnosis of asymptomatic cirrhosis in patients with liver disease is of importance to start screening for complications in due time. Liver biopsy is neither sensitive nor practical enough to be used as a frequent follow-up test in patients with chronic liver disease. The volatile organic compounds present in exhaled breath offer the possibility of exploring internal physiologic and pathologic process in a non invasive way. This study examined whether a specific pattern of biomarkers can be found in breath samples of patients with cirrhosis. To this aim samples of alveolar breath from patients with cirrhosis and healthy volunteers were analyzed using gas chromatography-mass spectrometry. When linear discriminant analysis was used to search for a model(s)/pattern of compounds characteristic for liver cirrhosis, 24 models of 8 independent compounds could distinguish between the groups. The sensitivity and specificity (between 82% and 88%, and 96% and 100%, respectively) of the models suggest that a specific pattern of breath biomarkers can be found in patients with cirrhosis, which may allow detecting this complication of chronic liver disease in an early stage.

Volatile organic compounds in bile for early diagnosis of cholangiocarcinoma in patients with primary sclerosing cholangitis: a pilot study

“…16,19 In our study, the levels of carbon disulfide and dimethyl sulfide were significantly elevated in PSC patients (irrespective of the presence or absence of cirrhosis) when compared to patients with CCA.…”

Breath‐print analysis by e‐nose may refine risk stratification for adverse outcomes in cirrhotic patients

“…Accordingly, it has been shown that the exhaled breath of cirrhotic patients is enriched of alkanes, alkenes, terpenes, ketones and S‐compounds compared to healthy controls . An impaired liver metabolism is certainly involved, and these compounds are likely the result of oxidative stress and of altered hepatic cytochrome P450 enzyme activity . Furthermore, S‐compounds may be generated by incomplete metabolism of methionine in the transamination pathway, as well ketones could be expression either of an increased insulin resistance in cirrhotic patients—which favours lipolysis and free fatty acid beta‐oxidation—or of glycogen exhaustion and gluconeogenesis impairment in the late phases of hepatocellular failure .…”

Investigation of Volatile Organic Compounds Emitted from Faeces for the Diagnosis of Giardiasis

“…Alkanes are known to be produced by oxidative stress [17] and fatty acid metabolism. Giardia has developed elaborate sequences of adaptive mechanisms to maintain oxygen homeostasis and equilibrium [18].…”