Volatile sulfur compounds as a predictor for esophagogastroduodenal mucosal injury.
OBJECTIVE
Halitosis is a symptom that bothers patients more socially than medically and its pathogenic mechanisms are unclear and treatment armamenterium is limited. Clinicians generally ignored active interventions. Since halitosis is closely associated with volatile sulfur compounds (VSCs), we used a Halimeter and gas chromatography to measure VSCs in patients with Helicobacter-pylori (H. pylori)-associated gastric diseases.


METHODS
We categorized 72 patients with H. pylori infection into two groups based on their endoscopic findings: a non-erosive mucosal group (NE, n=24) and an erosive mucosal group (E, n=48). Halitosis was objectively assessed by applying either a Halimeter to breath air or gas chromatography to gastric juice. Simultaneously, the expression of VSC-generating enzyme was measured with reverse-transcriptase PCR using mRNA isolated from biopsy tissues.


RESULTS
The levels of VSCs in exhaled breaths or aspirated gastric juices differed significantly between the NE and E groups (p<0.00001), suggesting that VSCs might reflect eroded epithelial damage induced by H. pylori infection. The expressions of cystathionine beta-synthase (CBS) and cystathionine gamma-lyase (CSE) were broadly consistent with the degree of mucosal injury.


CONCLUSIONS
Erosive changes in esophagogastroduodenal mucosa were strongly correlated with increased VSC levels, suggesting that halitosis might result from H. pylori-associated erosive lesions.
Yoo
Seung Hee
SH
Digestive Disease Center, Daejin Medical Center Jesaeng Hospital at Bundang, Seongnam, Korea.
Jung
Hyeon Sik
HS
Sohn
Wee Sik
WS
Kim
Bong Hwan
BH
Ku
Bon Ho
BH
Kim
Young Saeng
YS
Park
Sang Woon
SW
Hahm
Ki-Baik
KB