Identifiction of IBD using an electronic e-nose

Identifiction of IBD using an electronic e-nose Gastroenterology: Arasaradnam RP1,2 - r.arasaradnam@warwick.ac.uk Engineering: Covington JA3, - j.a.covington@warwick.ac.uk 1University Hospital Coventry & Warwickshire & 2Clinical Sciences Research Institute, Medical School, University of Warwick 3School of Engineering, University of Warwick, 11th BROAD Meeting, Los Angeles – March 2013 1

Distal UC; proximal constipation PL, age 64 11 weeks after PEG: 4 / 20 markers Before PEG: 13 / 20 markers Cow 100% Horse 100% Cow 50% Saw dust 50% --horse-oid! Arasaradnam et al 2009 2

‘Smell’ @ Warwick Life in ‘Smell’ Persaud & Dodd Nature 1982 First research group dedicated to the sense of smell First company making artificial olfaction instruments First commercial products manufactured here… Long history of smell research…

Volatile organic compounds (VOCs) • Disease alters gut flora - altered fermentation patterns which alters the composition of gases emitted from urine • Organic compounds that have high vapour pressure at normal room temperature. • Mainly from colonic fermentation by gut bacteria and partly from physiological metabolic processes • Released in breath, urine, faeces, blood • A potential diagnostic biomarker in IBD

Study design 62 subjects – 3 groups Urine collected and analysed using E-nose and FAIMS Data analysed using Principal Component analysis Arasaradnam et al 2013

E-nose sensor response Arasaradnam et al 2013

Results – E nose Discriminant Function (DF) Analysis of Fox 4000 data Arasaradnam et al 2013

Conclusions Clear disease separation between controls, ulcerative colitis and Crohn’s disease Able to detect between disease flares and remission VOC correlation with GC/MS Potential first line diagnostic modality in patients with suspected IBD Inexpensive novel tool, non invasive and potentially provides point of care diagnosis Arasaradnam et al 2013

Identifiction of IBD using an electronic e-nose