Летучие органические соединения выдыхаемого воздуха, фекалий и мочи как биомаркеры в диагностике воспалительных заболеваний кишечника

Цель: проанализировать результаты исследований, изучавших летучие органические соединения различных аналитов (выдыхаемый воздух, фекалии, моча) с целью диагностики воспалительных заболеваний кишечника.

Материалы и методы. Проведен систематический электронный поиск литературы (без ограничений по языку или типу публикации) с использованием баз данных Medline/PubMed, Embase, Scopus и Web of Science с применением ключевых слов. В процессе анализа опубликованных статей оценивалось качество созданных диагностических моделей.

Результаты. Для изучения летучих органических соединений используются метаболомные методы, предполагающие количественное определение соединений, и так называемые «электронные носы» — различные типы сенсоров для создания «паттерна» метаболитов. Показано, что определение летучих органических соединений в выдыхаемом воздухе, фекалиях, моче является недорогим, доступным, приемлемым для пациентов и врачей, обладает высокой диагностической точностью, позволяя различать пациентов с воспалительными заболеваниями кишечника от здоровых лиц, дифференцировать нозологические формы —  язвенный колит и болезнь Крона, активность заболевания, мониторировать характер его течения. Показатели чувствительности и специфичности при решении разных диагностических задач варьируют в зависимости от используемого метода (совокупная чувствительность и специфичность летучих органических соединений в качестве биомаркеров для различения пациентов с воспалительными заболеваниями кишечника от здоровых лиц составили 87 % (95%-ный доверительный интервал (95% ДИ): 0,79–0,92) и 83 % (95% ДИ: 0,73–0,90) соответственно с AUC 0,92), исследуемого аналита, количества анализируемых летучих органических соединений, числа обследованных пациентов, учета влияющих факторов.

Заключение. Исследование летучих органических соединений демонстрирует большой потенциал в качестве неинвазивного биомаркера воспалительных заболеваний кишечника. В дальнейшем необходимы более масштабные многоцентровые проспективные исследования для разработки оптимальных подходов к отбору проб, стандартизации анализа и интерпретации данных по летучим органическим соединениям при решении разных диагностических задач у пациентов с воспалительными заболеваниями кишечника.

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