Rapid “Breath-Print” of Liver Cirrhosis by Proton Transfer Reaction Time-of-Flight Mass Spectrometry. A Pilot Study.
Open Access
- 3 April 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (4), e59658
- https://doi.org/10.1371/journal.pone.0059658
Abstract
The aim of the present work was to test the potential of Proton Transfer Reaction Time-of-Flight Mass Spectrometry (PTR-ToF-MS) in the diagnosis of liver cirrhosis and the assessment of disease severity by direct analysis of exhaled breath. Twenty-six volunteers have been enrolled in this study: 12 patients (M/F 8/4, mean age 70.5 years, min-max 42–80 years) with liver cirrhosis of different etiologies and at different severity of disease and 14 healthy subjects (M/F 5/9, mean age 52.3 years, min-max 35–77 years). Real time breath analysis was performed on fasting subjects using a buffered end-tidal on-line sampler directly coupled to a PTR-ToF-MS. Twelve volatile organic compounds (VOCs) resulted significantly differently in cirrhotic patients (CP) compared to healthy controls (CTRL): four ketones (2-butanone, 2- or 3- pentanone, C8-ketone, C9-ketone), two terpenes (monoterpene, monoterpene related), four sulphur or nitrogen compounds (sulfoxide-compound, S-compound, NS-compound, N-compound) and two alcohols (heptadienol, methanol). Seven VOCs (2-butanone, C8-ketone, a monoterpene, 2,4-heptadienol and three compounds containing N, S or NS) resulted significantly differently in compensate cirrhotic patients (Child-Pugh A; CP-A) and decompensated cirrhotic subjects (Child-Pugh B+C; CP-B+C). ROC (Receiver Operating Characteristic) analysis was performed considering three contrast groups: CP vs CTRL, CP-A vs CTRL and CP-A vs CP-B+C. In these comparisons monoterpene and N-compound showed the best diagnostic performance. Breath analysis by PTR-ToF-MS was able to distinguish cirrhotic patients from healthy subjects and to discriminate those with well compensated liver disease from those at more advanced severity stage. A breath-print of liver cirrhosis was assessed for the first time.This publication has 36 references indexed in Scilit:
- Direct-injection mass spectrometry adds the time dimension to (B)VOC analysisTrAC Trends in Analytical Chemistry, 2011
- Effects of GLUT4 expression on insulin resistance in patients with advanced liver cirrhosisJournal of Zhejiang University-SCIENCE B, 2011
- On-line breath analysis with PTR-TOFJournal of Breath Research, 2009
- Proton-Transfer Reaction Mass SpectrometryChemical Reviews, 2009
- On the use of Tedlar® bags for breath-gas sampling and analysisJournal of Breath Research, 2008
- Metabolic Significance of Nonalcoholic Fatty Liver Disease in Nonobese, Nondiabetic AdultsArchives of Internal Medicine, 2004
- Diagnostic potential of breath analysis—focus on volatile organic compoundsClinica Chimica Acta; International Journal of Clinical Chemistry, 2004
- On-line monitoring of volatile organic compounds at pptv levels by means of proton-transfer-reaction mass spectrometry (PTR-MS) medical applications, food control and environmental researchInternational Journal of Mass Spectrometry and Ion Processes, 1998
- Do Endogenous Volatile Organic Chemicals Measured in Breath Reflect and Maintain CYP2E1 Levelsin Vivo?Toxicology and Applied Pharmacology, 1997
- Limonene in expired lung air of patients with liver diseaseDigestive Diseases and Sciences, 1994