Volatile organic compounds (VOCs) and lactoferrin have been studied as potential faecal biomarkers for ISO. Changes in VOC patterns in stool reflect both physiological and pathological processes within the gut. Lactoferrin, a protein present in neutrophils can be quantified in stool. This thesis studies the potential and efficacy of both urine and faecal VOCs and the efficacy of lactoferrin in differentiating ISO from ISS and healthy controls. CD was best differentiated from those with IBS by presence or absence of urine VOCs when compared to UC. Active UC versus IBS comparison, using the presence or absence of urine VOCs, yielded a higher sensitivity and specificity than when inactive UC was compared with ISS (Inactive UC vs ISS: 54.2%, 30.4% and Active uC vs IBS: 86%, 77% respectively). Active and inactive UC comparisons with IBS groups, based on peak area, resulted in significant urine VOCs with high sensitivity but moderate specificity (Inactive UC vs ISS: 83%, 52% and Active UC vs ISS: 100%, 78% respectively). Moderate sensitivity and specificity were recorded for faecal VOCs with comparisons based on peak area measures for inactive CD versus IBS (67%; 77%) and inactive UC versus ISS (100%; 59%). Faecal vacs in the active CD and ISS comparison recorded the be.st sensitivity and specificity (92%; 74%). Faecal vac profiles were better than urine for the group separation of active disease. Correct classification was much improved with peak area measure than the presence or absence of volatiles: Lactoferrin levels were considerably higher in 180 patients than those with IBS, while in IBS and healthy controls were similar. Lactoferrin levels were lower in inactive UC when compared with active UC. No such statistical difference was noted when active and inactive CD were compared. Lactoferrin levels in inactive IBD groups were higher compared to the healthy controls. Faecal and urinary biomarkers have potential to enhance management of patients with IBS and IBD.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:617931 |
| Date | January 2013 |
| Creators | Jayasena, Demuni Hiruni |
| Publisher | University of Bristol |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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