Differentiation Between Pediatric Irritable Bowel Syndrome and Inflammatory Bowel Disease Based on Fecal Scent: Proof of Principle Study

Bosch, Sofie; Gaal, Nora van; Zuurbier, Roy P; Covington, James A.; Wicaksono, Alfian; Biezeveld, Maarten H.; Benninga, Marc A.; Mulder, Chris J.; Boer, Nanne K. H. de; Meij, Tim G. J. de

doi:10.1093/ibd/izy151

Cited by 23 publications

(27 citation statements)

References 22 publications

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“…Hypothetically, minor differences in VOC profiles as measured by an eNose device may induce significant differences, whereas these differences are not (significantly) detected by FAIMS, and vice versa. Recently, Bosch et al published a study comparing fecal VOC patterns of 15 pediatric IBS patients with 30 de novo, treatment naïve IBD patients and 30 HC by means of FAIMS [40]. In line with previous results, IBD could be distinguished from HC with a high diagnostic accuracy.…”

Section: Inflammatory Bowel Disease and Irritable Bowel Syndromementioning

confidence: 70%

Application of Fecal Volatile Organic Compound Analysis in Clinical Practice: Current State and Future Perspectives

et al. 2018

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Abstract:Increasing interest is noticed in the potential of volatile organic compound (VOC) analysis as non-invasive diagnostic biomarker in clinical medical practice. The spectrum of VOCs, originating from (patho)physiological metabolic processes in the human body and detectable in bodily excrements, such as exhaled breath, urine and feces, harbors a magnificent source of information. Thus far, the majority of studies have focused on VOC analysis in exhaled breath, aiming at identification of disease-specific VOC profiles. Recently, an increasing number of studies have evaluated the usability of VOC present in the headspace of feces in the diagnostic work-up of a wide range of gastrointestinal diseases. Promising results have been demonstrated particularly in those diseases in which microbiota alterations are considered to play a significant etiological role, such as colorectal carcinoma, inflammatory bowel disease, irritable bowel syndrome, celiac disease and infectious bowel diseases. In addition, fecal VOC analysis seems to have potential as a diagnostic biomarker for extra-intestinal diseases, including bronchopulmonary dysplasia and sepsis. Different methods for VOC analysis have been used in medical studies, such as gas-chromatography mass spectrometry, selected-ion flow tube-mass spectrometry, ion-mobility spectrometry, and electronic nose devices. In this review, the available literature on the potential of fecal VOCs as diagnostic biomarker, including an overview of relevant VOC detection techniques, is discussed. In addition, future hurdles, which need to be taken prior to implementation of VOC analysis in daily clinical practice, are outlined.

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Section: Inflammatory Bowel Disease and Irritable Bowel Syndromementioning

confidence: 70%

Application of Fecal Volatile Organic Compound Analysis in Clinical Practice: Current State and Future Perspectives

et al. 2018

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“…Metabolomics offer the potential to look for a “metabolic IBS profile” which could provide insights into pathophysiology and/or provide biomarkers for subsets of patients 58 . Although a number of studies have shown metabolomic analyses to differentiate IBS from HC, 26,27,33,36,37,40,41,43‐45,51,59,60 a common metabolic profile has not been identified 30,39,61 (Table 1) 2,33,36,37,39,40,43,44 (Table 2,3). These discrepancies are likely due to multiple factors as previously discussed, but two seem to be particularly important.…”

Section: Analysis Of Ibs Metabolomic Studiesmentioning

confidence: 99%

“…The first is the use of different technologies. GC‐MS was most commonly used but other studies employed LC‐MS, 36,41,44,59 1 H‐NMR, 30,33 multisegment injection‐capillary electrophoresis‐MS (MSI‐CE‐MS), 27 and field asymmetric ion mobility spectrometry (FAIMS) 61 (Table 1). The second factor was the use of different biofluids.…”

Section: Analysis Of Ibs Metabolomic Studiesmentioning

confidence: 99%

“…A small number of studies (Table 2) have compared metabolites between IBS and inflammatory bowel disease (IBD) patients but results are conflicting, demonstrating either different 38,44,51,61 or similar 30,39 profiles. Interestingly, L‐histidine, a bacterial substrate for histamine and pro‐inflammatory amines regulating physiological function in the gut, was demonstrated to be significantly higher in IBS compared with ulcerative colitis 44 (Table 2).…”

Section: Analysis Of Ibs Metabolomic Studiesmentioning

confidence: 99%

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Application of metabolomics to the study of irritable bowel syndrome

Bennet

Keshteli

Berčík

et al. 2020

Neurogastroenterology Motil

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Irritable bowel syndrome (IBS) is diagnosed based on symptoms 1 and is the most commonly diagnosed bowel disorder. 2 While this symptom-based approach has the advantage of limiting unnecessary testing 3 compared with a "diagnosis of exclusion" approach, the gastrointestinal tract has a limited symptom repertoire. Consequently, this symptom-based diagnosis captures a large but heterogeneous patient population, with multiple pathophysiological mechanisms underlying symptoms. 4 Using the Rome IV criteria, IBS subgroups are based on the predominant bowel habit, that is, IBS with constipation predominance (IBS-C), with diarrhea predominance (IBS-D), a mix between constipation and diarrhea (IBS-M) and unclassified (IBS-U). This method of classification of IBS is useful for clinical management; however, these subtypes may not reflect underlying pathophysiology. 5 While preclinical models have provided important insights, the complexity of IBS is notoriously difficult to model and mechanistic studies in humans are challenging due to their potentially invasive requirements. Therefore, new approaches are needed that might enable non-invasive studies with sufficient sensitivity and specificity to advance the field. In this issue of the journal, Lee et al focused on IBS-D patients and aimed to characterize fecal metabolite profiles of patients compared with healthy controls as well as to determine if diarrhea in and of itself can impact fecal metabolite composition. 6 This review will focus on the use of metabolomics to study IBS patients highlighting key methodological issues underlying the interpretation of these studies, whether identified molecules provide novel insights into Abstract The pathophysiology of irritable bowel syndrome and the detection of biomarkers of specific mechanisms and/or predictors of therapeutic response remain elusive. This roadblock reflects, in large part, the complexity and heterogeneity of the disorder. Recently, there has been growing evidence of a dietary and/or microbiome interaction with the host that may trigger symptoms in a subset of patients. While a number of techniques are available to examine these potential interactions, "omic" approaches such as metabolomics are becoming more widely used. Metabolomics measures hundreds and potentially thousands of known and unknown small molecule chemicals (metabolites) to provide a unique look into mechanisms that underlie symptom generation and potential predictors of therapeutic response. In this issue of the journal, Lee et al use nuclear magnetic resonance (NMR) to demonstrate the value of this approach to study IBS. This review examines the use of metabolomics to better understand IBS, focusing on what has been learned to date, practical and technical considerations, its potential for future research and how the study by Lee et al have contributed to these concepts. K E Y W O R D S irritable bowel syndrome, mass spectometry, metabolites, metabolomics, microbiota, nuclear magnetic resonance

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“…Therefore, fecal VOCs might be a useful group among intestinal metabolites in the regulation of metabolic homeostasis. Interestingly, fecal VOC analysis was performed to evaluate the pathological features of gastrointestinal diseases [18][19][20] including inflammatory bowel disease (IBD) [21][22][23] , irritable bowel syndrome 21,24 , Crohn's disease 25 , colorectal cancer (CRC) 26,27 , and necrotizing enterocolitis 28,29 , as well as infectious diseases including paratuberculosis [30][31][32][33][34] , sepsis 35 , giardiasis 36 , and Clostridium difficile infection 37 . However, it is difficult to handle intestinal microbial VOCs, because of their unpleasant odor, gaseous form, and low boiling point resulting in their loss when using general sample preparation methods including evaporation or concentration.…”

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confidence: 99%

Elevated levels of proinflammatory volatile metabolites in feces of high fat diet fed KK-Ay mice

Uchikawa¹,

Kato

Nagata

et al. 2020

Sci Rep

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When the microfloral composition deteriorates, it triggers low-level chronic inflammation associated with several lifestyle-related diseases including obesity and diabetic mellitus. Fecal volatile organic compounds (VOCs) have been found to differ in gastrointestinal diseases as well as intestinal infection. In this study, to evaluate a potential association between the pathogenesis of lifestyle-related diseases and VOCs in the intestinal tract, fecal VOCs from obese/diabetic KK-A y mice (KK) or controls (C57BL/6J mice; BL) fed a normal or high fat diet (NFD or HFD) were investigated using headspace sampler-GC-EI-MS. Principal component analysis (PCA) of fecal VOC profiles clearly separated the experimental groups depending on the mouse lineage (KK vs BL) and the diet type (NFD vs HFD). 16 s rRNA sequencing revealed that the PCA distribution of VOCs was in parallel with the microfloral composition. We identified that some volatile metabolites including n-alkanals (nonanal and octanal), acetone and phenol were significantly increased in the HFD and/or KK groups. Additionally, these volatile metabolites induced proinflammatory activity in the RAW264 murine macrophage cell line indicating these bioactive metabolites might trigger low-level chronic inflammation. These results suggest that proinflammatory VOCs detected in HFD-fed and/or diabetic model mice might be novel noninvasive diagnosis biomarkers for diabetes.

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Differentiation Between Pediatric Irritable Bowel Syndrome and Inflammatory Bowel Disease Based on Fecal Scent: Proof of Principle Study

Cited by 23 publications

References 22 publications

Application of Fecal Volatile Organic Compound Analysis in Clinical Practice: Current State and Future Perspectives

Application of Fecal Volatile Organic Compound Analysis in Clinical Practice: Current State and Future Perspectives

Application of metabolomics to the study of irritable bowel syndrome

Elevated levels of proinflammatory volatile metabolites in feces of high fat diet fed KK-Ay mice

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