Scientists from the University of Birmingham have discovered that three breath volatiles have excellent capabilities to diagnose liver disease. Methanol, 2-pentanone and limonene levels are higher in cirrhotic patients. The use of an IONICON PTR-MS (Proton Transfer Reaction – Mass Spectrometry) allowed to perform successful, non-invasive breath tests in patients and controls. The results, published in Ebiomedicine, also show that limonene accumulates in the body, probably because the cirrhotic liver fails to metabolise dietary limonene.
Liver disease levels have risen dramatically in the last years, and is the third biggest cause of premature mortality in the UK. Patients do not often present with symptoms until the disease is advanced, so a fast, reliable and cheap diagnosis tool would be very useful. Breath gas analysis is a non-invasive method that monitors the concentration of the volatile organic compounds (VOCs) present in the exhaled breath, which correlate to their concentrations in blood. Previous studies have tried to identify breath volatiles that indicate liver disease. However, results were unclear and contradictory. Dr. Mayhew and coworkers decided to carry out a new study, measuring breath samples in patients, controls and patients after transplant. The researchers compared alveolar breath samples of 31 patients with cirrhosis and 30 healthy controls by mass spectrometry. 12 of these patients had their breath analysed after liver transplant. Seven volatiles were elevated in the breath of patients versus controls, but the best diagnostic capability was obtained by combining the measurement of three: methanol, 2-pentanone and limonene.
IONICON PTR instruments have become the reference method
In addition to its non-invasive character, breath analysis is particularly interesting, since it can be performed “online”: The exhaled breath is directly analysed with immediate results. For such real-time breath analysis, IONICON PTR-TOF (Proton Transfer Reaction – Time of Flight) instruments have become the reference method.
IONICON also provides an optimized inlet systems for PTR-MS (BET-med, Buffered End-Tidal breath sampling inlet), for real-time breath analysis. Safety of patients has become an increasing focus, and even devices for non-invasive breath analysis have to comply with international regulations. The IONICON BET-med system has been certified for clinical use, which allows real-time breath analysis of patients.