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Mass Spectrometry

Characterization of Liver Failure by the Analysis of Exhaled Breath by Extractive Electrospray Ionization Mass Spectrometry (EESI-MS): A Pilot Study

, , , , , , , , & show all
Pages 1038-1054 | Received 09 Apr 2020, Accepted 06 Jul 2020, Published online: 16 Jul 2020
 

Abstract

Progression of liver failure to coma is a dynamic process. Its prognosis depends primarily on early diagnosis, real-time monitoring of the disease, and appropriate therapy. Current detection methods and repeated blood sampling do not effortlessly meet the clinical requirements. This pilot study aimed to assess the potential of exhaled breath analysis by extractive electrospray ionization mass spectrometry (EESI-MS) as a noninvasive clinical tool to diagnose and provide real-time monitoring of liver failure. A total of 24 healthy controls, 20 chronic hepatitis B patients, and 20 liver failure patients were enrolled in this study. Patients were diagnosed prior to exhaled breath collection; serological biochemical indicators and clinical characteristics were recorded. Exhaled breath samples were detected by EESI-MS; principal component analysis and partial least square discriminant analysis was used to process the final data. Twenty-two mass-to-charge ratio (m/z) values differed significantly between liver failure patients and healthy controls (variable importance plot (VIP)>3.5, P<0.001), and eight metabolites were identified to be 1-butylene, acetone, glycolaldehyde, isoprene, butanone, 2-ethylacrylic acid, ethylmethylacetic acid, and 2,3-octanedione. Four m/z values differed significantly between liver failure and chronic hepatitis B patients (VIP > 3.5, P<0.001) and 2 metabolites were identified to be isoprene and glycolaldehyde. Exhaled breath analysis may be valuable as a noninvasive clinical tool to diagnose and provide real-time monitoring of liver failure.

Acknowledgments

We would like to thank our patients and the volunteers for their altruistic support.

Conflicts of interest

There are no conflicts of interest to report.

Additional information

Funding

The work was funded by the National Natural Science Foundation of China [21665015, 81760115].

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