PDF(Pubmed)
Abstract：
UNASSIGNED: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by progressive inflammation and fibrosis of the bile ducts. PSC is a complex disease of largely unknown aetiology that is strongly associated with inflammatory bowel disease (IBD). Diagnosis, especially at an early stage, is difficult and to date there is no diagnostic biomarker. The present study aimed to assess the diagnostic potential of volatile organic compounds (VOCs) in exhaled breath to detect (early) PSC in an IBD population.
UNASSIGNED: Breath samples were obtained from 16 patients with PSC alone, 47 with PSC and IBD, and 53 with IBD alone during outpatient clinic visits. Breath sampling was performed using the ReCIVA breath sampler and subsequently analysed by gas chromatography mass spectrometry. Random forest modelling was performed to find discriminatory VOCs and create a predictive model that was tested using an independent test set.
UNASSIGNED: The final model to discriminate patients with PSC, with or without IBD, from patients with IBD alone included twenty VOCs and achieved a sensitivity, specificity, and area under the receiver-operating curve on the test set of 77%, 83%, and 0.84 respectively. Three VOCs (isoprene, 2-octanone and undecane) together correlated significantly with the Amsterdam-Oxford score for PSC disease prognosis. A sensitivity analysis showed stable results across early-stage PSC, including in those with normal alkaline phosphatase levels, as well as further progressed PSC.
UNASSIGNED: The present study demonstrates that exhaled breath can distinguish PSC cases from IBD and has potential as a non-invasive clinical breath test for (early) PSC.
UNASSIGNED: Primary sclerosing cholangitis is a complex chronic liver disease, which ultimately results in cirrhosis, liver failure, and death. Detection, especially in early disease stages, can be challenging, and therefore therapy typically starts when there is already some irreversible damage. The current study shows that metabolites in exhaled breath, so called volatile organic compounds, hold promise to non-invasively detect primary sclerosing cholangitis, including at early disease stages.
UNASSIGNED: Breath samples were obtained from 16 patients with PSC alone, 47 with PSC and IBD, and 53 with IBD alone during outpatient clinic visits. Breath sampling was performed using the ReCIVA breath sampler and subsequently analysed by gas chromatography mass spectrometry. Random forest modelling was performed to find discriminatory VOCs and create a predictive model that was tested using an independent test set.
UNASSIGNED: The final model to discriminate patients with PSC, with or without IBD, from patients with IBD alone included twenty VOCs and achieved a sensitivity, specificity, and area under the receiver-operating curve on the test set of 77%, 83%, and 0.84 respectively. Three VOCs (isoprene, 2-octanone and undecane) together correlated significantly with the Amsterdam-Oxford score for PSC disease prognosis. A sensitivity analysis showed stable results across early-stage PSC, including in those with normal alkaline phosphatase levels, as well as further progressed PSC.
UNASSIGNED: The present study demonstrates that exhaled breath can distinguish PSC cases from IBD and has potential as a non-invasive clinical breath test for (early) PSC.
UNASSIGNED: Primary sclerosing cholangitis is a complex chronic liver disease, which ultimately results in cirrhosis, liver failure, and death. Detection, especially in early disease stages, can be challenging, and therefore therapy typically starts when there is already some irreversible damage. The current study shows that metabolites in exhaled breath, so called volatile organic compounds, hold promise to non-invasively detect primary sclerosing cholangitis, including at early disease stages.
摘要：
■原发性硬化性胆管炎（PSC）是一种慢性胆汁淤积性肝病，其特征是胆管进行性炎症和纤维化。PSC是一种病因不明的复杂疾病，与炎症性肠病（IBD）密切相关。诊断,尤其是在早期阶段，是困难的，迄今为止没有诊断生物标志物。本研究旨在评估呼出气中挥发性有机化合物（VOC）的诊断潜力，以检测IBD人群中的（早期）PSC。
■呼吸样本来自16例单独的PSC患者，47与PSC和IBD，在门诊就诊期间仅有53例IBD。使用ReCIVA呼吸采样器进行呼吸采样,随后通过气相色谱质谱法进行分析。进行随机森林建模以找到歧视性VOC并创建使用独立测试集进行测试的预测模型。
■区分PSC患者的最终模型，有或没有IBD，从单独的IBD患者中包括20种挥发性有机化合物，并获得了敏感性，特异性，和受试者-工作曲线下的面积在77%的测试集上，83%,分别为0.84。三种VOCs（异戊二烯，2-辛酮和十一烷）与PSC疾病预后的阿姆斯特丹-牛津评分显着相关。敏感性分析显示，整个早期PSC的结果稳定，包括那些碱性磷酸酶水平正常的人，以及PSC的进一步发展。
■本研究表明，呼出气可以将PSC病例与IBD区分开，并且具有作为（早期）PSC的非侵入性临床呼气测试的潜力。
■原发性硬化性胆管炎是一种复杂的慢性肝病，最终导致肝硬化，肝功能衰竭,和死亡。检测,尤其是在疾病的早期阶段，可能是具有挑战性的，因此，治疗通常在已经有一些不可逆转的损害时开始。目前的研究表明，呼气中的代谢物，所谓的挥发性有机化合物，持有非侵入性检测原发性硬化性胆管炎的承诺，包括在疾病的早期阶段。
■呼吸样本来自16例单独的PSC患者，47与PSC和IBD，在门诊就诊期间仅有53例IBD。使用ReCIVA呼吸采样器进行呼吸采样,随后通过气相色谱质谱法进行分析。进行随机森林建模以找到歧视性VOC并创建使用独立测试集进行测试的预测模型。
■区分PSC患者的最终模型，有或没有IBD，从单独的IBD患者中包括20种挥发性有机化合物，并获得了敏感性，特异性，和受试者-工作曲线下的面积在77%的测试集上，83%,分别为0.84。三种VOCs（异戊二烯，2-辛酮和十一烷）与PSC疾病预后的阿姆斯特丹-牛津评分显着相关。敏感性分析显示，整个早期PSC的结果稳定，包括那些碱性磷酸酶水平正常的人，以及PSC的进一步发展。
■本研究表明，呼出气可以将PSC病例与IBD区分开，并且具有作为（早期）PSC的非侵入性临床呼气测试的潜力。
■原发性硬化性胆管炎是一种复杂的慢性肝病，最终导致肝硬化，肝功能衰竭,和死亡。检测,尤其是在疾病的早期阶段，可能是具有挑战性的，因此，治疗通常在已经有一些不可逆转的损害时开始。目前的研究表明，呼气中的代谢物，所谓的挥发性有机化合物，持有非侵入性检测原发性硬化性胆管炎的承诺，包括在疾病的早期阶段。
