Early detection of any chronic disease is critical for providing the best outcomes for patients. Earlier disease detection will allow for an immediate impact on patients’ lives by starting them on potentially lifesaving therapies sooner, and could allow for successful treatments for diseases such as Alzheimer’s disease or cancer. Measuring the chemical makeup of exhaled breath by quantifying volatile organic compounds (VOCs) is one promising new method of detecting disease before symptoms appear.
VOCs are gaseous molecules that can be sampled quickly and non-invasively from exhaled breath. Compounds are produced as the end product of metabolic processes within the body, with the underlying changes in metabolic activity potentially producing patterns of VOCs that are characteristic of specific diseases. Cleveland Clinic researchers have previously linked VOCs to acute alcoholic hepatitis, diabetes, acute decompensated heart failure (ADHF), pulmonary arterial hypertension, C. diff infection and liver disease. In many cases these VOCs show promise for providing better diagnosis of disease than the accepted gold standard used currently to diagnose the specific disease. Much of these efforts have been led by Dr. Raed Dweik, head of the Respiratory Institute and one of the early adoptors and a world leader in the diagnostic use of VOCs.
A new center is being established to investigate the use of measuring VOCs in exhaled breath, in combination with other non-invasive biomarkers from other bodily fluids such as saliva and blood, for the early detection of multiple diseases from chronic conditions to cancer. There are a number of detection systems available to collect and identify the breath metabolites. One focus of the Center will be to compare the value of various collection and identification systems. The Center’s first project will focus on the discovery of breath-based biomarkers for chronic liver diseases and liver-related cancers. In this project, the Center for Early Disease Detection will collaborate with Owlstone Medical, a company that has a patient friendly collection system.
Tony Giordano, Innovation Manager, Cleveland Clinic Innovations said: “At Cleveland Clinic, we are committed to providing our patients with the best care available and this starts with accurately diagnosing disease as early as possible. Breath is emerging as a promising approach to early disease detection based on its ease of sample collection and potential to offer high levels of sensitivity, we are very pleased to collaborate with Owlstone Medical, as we work to establish the Center for Early Disease Detection.”
The Center’s first study will focus on identifying volatile organic compounds (VOCs) in breath that can be utilized as biomarkers for the early detection of multiple forms of liver disease and to distinguish between them. The study will involve patients with hepatocellular carcinoma, colorectal liver metastases, and patients with cirrhosis but no malignancies, and is expected to run for approximately 12 months. The study is being co-led by Dr. Federico Aucejo from the Digestive Disease & Surgery Institute and Dr. Daniel Rotroff of the Department of Quantitative Health Sciences in Lerner Research Institute.
VOCs originating from all parts of the body are captured in breath, making this assay applicable to a wide range of diseases including cancer, inflammatory disease, infectious disease, metabolic disease, cardiovascular disease and respiratory disease. The nature of VOC biomarkers make them well suited to address two of the major challenges of healthcare today: early detection and precision medicine.