Commentary
Metabolic dysfunction in liver disease is reflected in the biocomposition of exhaled breath. Analysis of volatile organic compounds (VOCs) in exhaled breath, ‘volatomics’, provides opportunities for non-invasive biomarker discovery and novel mechanistic insights into a variety of diseases. The purpose of this pilot study by R. Sinha et al. (Liver Unit, The Royal Infirmary and The University of Edinburgh, United Kingdom) was to compare breath VOCs in an initial cohort of patients with NAFLD and healthy controls.
Terpinene, dimethyl sulfide, and D-limonene provided the highest predictive accuracy to discriminate between study groups. Combining dimethyl sulfide with D-limonene led to even better discrimination of patients with NAFLD cirrhosis from healthy volunteers and patients with NAFLD cirrhosis from those with non-cirrhotic NAFLD. Breath terpinene concentrations discriminated between patients with non-cirrhotic NAFLD and healthy volunteers.