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Abstract：
BACKGROUND: Faecal volatile organic compounds (VOCs) differ with disease sub-type and activity in adults with established inflammatory bowel disease (IBD) taking therapy.
OBJECTIVE: To describe patterns of faecal VOCs in children newly presented with IBD according to disease sub-type, severity, and response to treatment.
METHODS: Children presenting with suspected IBD were recruited from three UK hospitals. Children in whom IBD was diagnosed were matched with a non-IBD child for age, sex, and recruitment site. Faecal VOCs were characterised by gas chromatography-mass spectrometry at presentation and 3 months later in children with IBD.
RESULTS: In 132 case/control pairs, median (inter-quartile range) age in IBD was 13.3 years (10.2-14.7) and 38.6% were female. Compared with controls, the mean abundance of 27/62 (43.6%) faecal VOCs was statistically significantly decreased in Crohn\'s disease (CD), ulcerative colitis (UC) or both especially amongst ketones/diketones, fatty acids, and alcohols (p < 0.05). Short-chain, medium chain, and branched chain fatty acids were markedly reduced in severe colitis (p < 0.05). Despite clinical improvement in many children with IBD, the number and abundance of almost all VOCs did not increase following treatment, suggesting persistent dysbiosis. Oct-1-en-3-ol was increased in CD (p = 0.001) and UC (p = 0.012) compared with controls and decreased following treatment in UC (p = 0.01). In CD, propan-1-ol was significantly greater than controls (p < 0.001) and extensive colitis (p = 0.001) and fell with treatment (p = 0.05). Phenol was significantly greater in CD (p < 0.001) and fell with treatment in both CD (p = 0.02) and UC (p = 0.01).
CONCLUSIONS: Characterisation of faecal VOCs in an inception cohort of children with IBD reveals patterns associated with diagnosis, disease activity, and extent. Further work should investigate the relationship between VOCs and the microbiome in IBD and their role in diagnosis and disease monitoring.
OBJECTIVE: To describe patterns of faecal VOCs in children newly presented with IBD according to disease sub-type, severity, and response to treatment.
METHODS: Children presenting with suspected IBD were recruited from three UK hospitals. Children in whom IBD was diagnosed were matched with a non-IBD child for age, sex, and recruitment site. Faecal VOCs were characterised by gas chromatography-mass spectrometry at presentation and 3 months later in children with IBD.
RESULTS: In 132 case/control pairs, median (inter-quartile range) age in IBD was 13.3 years (10.2-14.7) and 38.6% were female. Compared with controls, the mean abundance of 27/62 (43.6%) faecal VOCs was statistically significantly decreased in Crohn\'s disease (CD), ulcerative colitis (UC) or both especially amongst ketones/diketones, fatty acids, and alcohols (p < 0.05). Short-chain, medium chain, and branched chain fatty acids were markedly reduced in severe colitis (p < 0.05). Despite clinical improvement in many children with IBD, the number and abundance of almost all VOCs did not increase following treatment, suggesting persistent dysbiosis. Oct-1-en-3-ol was increased in CD (p = 0.001) and UC (p = 0.012) compared with controls and decreased following treatment in UC (p = 0.01). In CD, propan-1-ol was significantly greater than controls (p < 0.001) and extensive colitis (p = 0.001) and fell with treatment (p = 0.05). Phenol was significantly greater in CD (p < 0.001) and fell with treatment in both CD (p = 0.02) and UC (p = 0.01).
CONCLUSIONS: Characterisation of faecal VOCs in an inception cohort of children with IBD reveals patterns associated with diagnosis, disease activity, and extent. Further work should investigate the relationship between VOCs and the microbiome in IBD and their role in diagnosis and disease monitoring.
摘要：
背景：在已确诊的炎症性肠病（IBD）患者中，粪便挥发性有机化合物（VOCs）因疾病亚型和活动而异。
目的：根据疾病亚型描述新出现的IBD儿童的粪便VOCs模式，严重程度,以及对治疗的反应。
方法：从英国三家医院招募疑似IBD患儿。诊断为IBD的儿童与非IBD儿童的年龄相匹配，性别,招聘网站。在IBD患儿出现时和3个月后，通过气相色谱-质谱法对粪便VOCs进行了表征。
结果：在132个病例/对照对中，IBD的中位(四分位数间)年龄为13.3岁(10.2~14.7岁),38.6%为女性.与对照组相比，在克罗恩病（CD）中，27/62（43.6％）粪便VOCs的平均丰度显着降低，溃疡性结肠炎（UC）或两者，尤其是酮/二酮，脂肪酸，和醇(p<0.05)。短链,中链,和支链脂肪酸在严重结肠炎中显著降低(p<0.05)。尽管许多IBD患儿的临床改善，治疗后几乎所有挥发性有机化合物的数量和丰度都没有增加，表明持续的生态失调。与对照组相比，Oct-1-en-3-ol在CD（p=0.001）和UC（p=0.012）中增加，在UC中治疗后降低（p=0.01）。在CD中,丙-1-醇显著高于对照组(p<0.001)和广泛性结肠炎(p=0.001),且随治疗而下降(p=0.05).CD中的苯酚显著增加(p<0.001),并且在CD(p=0.02)和UC(p=0.01)中随着处理而下降。
结论：在IBD患儿的初始队列中，粪便VOCs的特征揭示了与诊断相关的模式，疾病活动,和程度。进一步的工作应研究IBD中VOCs与微生物组之间的关系及其在诊断和疾病监测中的作用。
目的：根据疾病亚型描述新出现的IBD儿童的粪便VOCs模式，严重程度,以及对治疗的反应。
方法：从英国三家医院招募疑似IBD患儿。诊断为IBD的儿童与非IBD儿童的年龄相匹配，性别,招聘网站。在IBD患儿出现时和3个月后，通过气相色谱-质谱法对粪便VOCs进行了表征。
结果：在132个病例/对照对中，IBD的中位(四分位数间)年龄为13.3岁(10.2~14.7岁),38.6%为女性.与对照组相比，在克罗恩病（CD）中，27/62（43.6％）粪便VOCs的平均丰度显着降低，溃疡性结肠炎（UC）或两者，尤其是酮/二酮，脂肪酸，和醇(p<0.05)。短链,中链,和支链脂肪酸在严重结肠炎中显著降低(p<0.05)。尽管许多IBD患儿的临床改善，治疗后几乎所有挥发性有机化合物的数量和丰度都没有增加，表明持续的生态失调。与对照组相比，Oct-1-en-3-ol在CD（p=0.001）和UC（p=0.012）中增加，在UC中治疗后降低（p=0.01）。在CD中,丙-1-醇显著高于对照组(p<0.001)和广泛性结肠炎(p=0.001),且随治疗而下降(p=0.05).CD中的苯酚显著增加(p<0.001),并且在CD(p=0.02)和UC(p=0.01)中随着处理而下降。
结论：在IBD患儿的初始队列中，粪便VOCs的特征揭示了与诊断相关的模式，疾病活动,和程度。进一步的工作应研究IBD中VOCs与微生物组之间的关系及其在诊断和疾病监测中的作用。
