Table_1_Volatile organic compound profiling as a potential biomarker in irritable bowel syndrome: A feasibility study.DOCX

BackgroundIrritable bowel syndrome (IBS) is a chronic gastrointestinal disorder for which no diagnostic tools are currently available. Patients are diagnosed using the Rome IV criteria and subtyped into a diarrhea, constipation, or mixed phenotype based on their dominant stool pattern. A recent development in the biomarker area is the analysis of volatile organic compounds (VOCs). The aim of this study was to evaluate the potential of VOCs as diagnostic and phenotypic biomarkers for IBS in breath and fecal samples.
Materials and methodsBreath and fecal samples from IBS patients and healthy asymptomatic controls (HC) were analyzed with multicapillary column/ion mobility spectrometry (MCC/IMS) and classification models were created based upon VOCs and clinical characteristics.
DiscussionIrritable bowel syndrome patients were differentiated from HC by means of volatile profiling in both breath and fecal samples with area under the curve (AUCs) of respectively 0.62 and 0.80. Patient subtypes could also be differentiated from each other with AUCs ranging between 0.65 and 0.78. Furthermore, VOC models could differentiate IBS patients based on clinical characteristics like psychological comorbidities and microbiota-influencing therapies.
ConclusionThis study is the first to demonstrate the use of VOC profiling with the help of MCC/IMS to differentiate IBS patients. Furthermore, the importance of clinical characteristics beside the dominant stool pattern in the differentiation of IBS patients was emphasized.

背景 肠易激综合征（Irritable bowel syndrome, IBS）是一种目前尚无有效诊断手段的慢性胃肠道疾病。临床需通过罗马IV标准（Rome IV criteria）对患者进行确诊，并依据其主导粪便类型将其划分为腹泻型、便秘型或混合型表型。近年来生物标志物领域的一项新兴研究方向为挥发性有机化合物（volatile organic compounds, VOCs）分析。本研究旨在评估呼气与粪便样本中的VOCs作为IBS诊断及表型分型生物标志物的潜力。
材料与方法 本研究采集肠易激综合征患者与健康无症状对照（healthy asymptomatic controls, HC）的呼气及粪便样本，采用多毛细管柱/离子迁移谱（multicapillary column/ion mobility spectrometry, MCC/IMS）进行检测，并基于VOCs与临床特征构建分类模型。
讨论 本研究通过呼气与粪便样本的挥发性物质谱分析，可将肠易激综合征患者与健康对照区分开来，对应的曲线下面积（area under the curve, AUCs）分别为0.62与0.80。患者各亚型之间同样可实现有效区分，曲线下面积介于0.65至0.78之间。此外，基于VOCs的分类模型还可依据心理共病、影响菌群的治疗方案等临床特征对肠易激综合征患者进行区分。
结论 本研究首次证实了借助多毛细管柱/离子迁移谱进行VOC谱分析可用于区分肠易激综合征患者。同时，本研究还强调了除主导粪便类型外，临床特征在肠易激综合征患者分型中的重要价值。