title: Geographical variation in the exhaled volatile organic compounds.
abstract: Breath-gas analysis has demonstrated that concentration profiles of volatile organic compounds (VOCs) could be used for detecting a variety of diseases, among them gastric cancer (GC) and peptic ulcer disease (PUD). Here, we explore how geographical variation affects the disease-specific changes in the chemical composition of breath samples, as compared to control states (less severe gastric conditions). Alveolar exhaled breath samples from 260 patients were collected at two remotely different geographic locations (China and Latvia), following similar breath-collection protocols. Each cohort included 130 patients that were matched in terms of diagnosis (37 GC/32 PUD/61 controls), average age, gender ratio and smoking habits. Helicobacter Pylori infection, which is a major cause for GC and PUD, was found in part of the patients, as well as in part of the controls, at both locations. The breath samples were analyzed by gas chromatography/mass spectrometry, using the same equipment and protocol-of-experiment. We observed similar characteristic differences in the chemical composition of the breath samples between the study groups at the two locations, even though the exact composition of the breath samples differed. Both in China and Latvia, the GC patients and controls could be distinguished by differences in the average levels of 6-methyl-5-hepten-2-one; PUD patients were distinguished from controls by the levels of aromatic compounds and alcohols; GC and PUD patients could not be distinguished at either site. This pilot study indicates the limitations of chemical breath-gas analysis alone for identifying gastric diseases based on the concentration profiles of separate VOCs in international patient cohorts. We assume that these limitations would apply to other diseases as well. The presented data could potentially be useful for developing an alternative, universally applicable diagnostic method that relies on the detection of changes in the collective patterns of the disease-specific classes of exhaled VOCs.
authors.affiliation: Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel.
authors.forename: Haitham
authors.initials: H
authors.lastname: Amal
authors.forename: Marcis
authors.initials: M
authors.lastname: Leja
authors.forename: Yoav Y
authors.initials: YY
authors.lastname: Broza
authors.forename: Ulrike
authors.initials: U
authors.lastname: Tisch
authors.forename: Konrads
authors.initials: K
authors.lastname: Funka
authors.forename: Inta
authors.initials: I
authors.lastname: Liepniece-Karele
authors.forename: Roberts
authors.initials: R
authors.lastname: Skapars
authors.forename: Zhen-Qin
authors.initials: ZQ
authors.lastname: Xu
authors.forename: Hu
authors.initials: H
authors.lastname: Liu
authors.forename: Hossam
authors.initials: H
authors.lastname: Haick
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests / Q000379:methods*; D002681:China / Q000453:epidemiology; D045853:Exhalation; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007844:Latvia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D017678:Sex Distribution; D013272:Stomach Diseases / Q000175:diagnosis* / Q000453:epidemiology; D055549:Volatile Organic Compounds / Q000032:analysis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D055549:Volatile Organic Compounds