PDF(Pubmed)
Abstract：
Up to 5% of inflammatory bowel disease patients may at some point develop primary sclerosing cholangitis (PSC). PSC is a rare liver disease that ultimately results in liver damage, cirrhosis and liver failure. It typically remains subclinical until irreversible damage has been inflicted. Hence, it is crucial to screen IBD patients for PSC, but its early detection is challenging, and the disease\'s etiology is not well understood. This current study aimed at the early detection of PSC in an IBD population using Volatile Organic Compounds in fecal headspace and exhaled breath. To this aim, fecal material and exhaled breath were collected from 73 patients (n = 16 PSC/IBD; n = 8 PSC; n = 49 IBD), and their volatile profile were analyzed using Gas Chromatography-Mass Spectrometry. Using the most discriminatory features, PSC detection resulted in areas under the ROC curve (AUCs) of 0.83 and 0.84 based on fecal headspace and exhaled breath, respectively. Upon data fusion, the predictive performance increased to AUC 0.92. The observed features in the fecal headspace relate to detrimental microbial dysbiosis and exogenous exposure. Future research should aim for the early detection of PSC in a prospective study design.
摘要：
多达5%的炎症性肠病患者可能在某些时候发展为原发性硬化性胆管炎(PSC)。PSC是一种罕见的肝脏疾病，最终导致肝脏损伤，肝硬化和肝功能衰竭。它通常保持亚临床，直到造成不可逆转的损害。因此，筛查IBD患者的PSC至关重要，但是它的早期发现具有挑战性，和疾病的病因没有很好的理解。这项当前的研究旨在使用粪便顶部空间和呼气中的挥发性有机化合物在IBD人群中早期检测PSC。为了这个目标,收集73例患者（n=16PSC/IBD；n=8PSC；n=49IBD）的粪便和呼出气，并使用气相色谱-质谱法分析了它们的挥发性分布。使用最具歧视性的特征，PSC检测导致基于粪便顶部空间和呼气的ROC曲线下面积（AUC）为0.83和0.84，分别。数据融合后，预测性能增加到AUC0.92。粪便顶部空间中观察到的特征与有害的微生物菌群失调和外源暴露有关。未来的研究应旨在在前瞻性研究设计中早期发现PSC。
