Breath biomarkers for detection of human liver diseases: preliminary study

Chronic liver disease is initially occult, has multiple aetiologies, involves complex diagnostic questions, and requires follow-up because progression is likely. Blood tests and biopsies are generally used, but have disadvantages. We have developed a new test for liver disease based on abnormal concentrations of metabolic products detected in exhaled breath. This test can be used, in conjunction with other clinically accepted diagnostic protocols, to detect and classify chronic liver diseases. Samples of breath collected from spontaneously breathing human subjects (86 patients presenting with 13 liver diseases and 109 subjects with normal liver function) were concentrated cryogenically and analysed by wide-bore capillary gas chromatography using various detectors. The concentrations of various molecules in exhaled breath were examined for potential use as biomarkers of liver function. Subjects with chronic liver diseases could be differentiated from those with normal liver function by comparing levels of breath carbonyl sulphide, carbon disulphide and isoprene; these differences were confirmed and correlated by comparing the levels with standard clinical blood markers of liver damage. The presence of chronic liver failure can thus be detected with sensitivity and specificity by quantifying sulphur-containing compounds arising from the abnormal metabolism associated with liver disease. The breath test we have developed appears to distinguish between hepatocellular and biliary tract aetiologies, and allows staging for severity. This approach may provide the clinician with a simple, non-invasive technique for use in the screening of large populations and follow-up for patients with chronic liver disease.     

The Prevalence of Euthyroid Hypertriiodothyroninemia in Newly Diagnosed Multiple Myeloma and its Clinical Characteristics

ObjectiveTo evaluate the prevalence of euthyroid hypertriiodothyroninemia and/or hyperthyroxinemia and its clinical characteristics in multiple myeloma (MM) patients.MethodsPreviously untreated, newly diagnosed patients with MM were enrolled at the Beijing Chao-yang Hospital between January 2016 and December 2019. Thyroid function and clinical characteristics were analyzed.ResultsA total of 105 patients were enrolled in this study. Thirteen (12.38%) patients exhibited euthyroid hypertriiodothyroninemia with strikingly elevated total triiodothyronine (TT3) levels (>8 ng/mL). Among these 13 patients, 12 patients were immunoglobulin (Ig) G type (92.31%), and 1 patient was light-chain κ type (7.69%). Compared with other patients with MM, patients with hypertriiodothyroninemia were more likely to be IgG type and had higher serum globulin and lower albumin levels and more advanced International Staging System stage (all P < .05). Among the 13 euthyroid hypertriiodothyroninemia patients, 8 patients have been followed up and checked for thyroid function. The TT3 levels in all 8 patients were normalized to the reference range after antimyeloma chemotherapy.ConclusionAbout 12% of patients with MM had euthyroid hypertriiodothyroninemia. Their strikingly elevated TT3 was normalized after chemotherapy. Clinicians should be aware of the possibility of high TT3 levels in euthyroid patients with MM and the potential risk of MM in patients with strikingly elevated TT3.     

A silvering index for the Japanese eel <Emphasis Type="Italic">Anguilla japonica</Emphasis>

To establish a simple and reliable index for determining silvering stages of the Japanese eel, Anguilla japonica, we observed the colorations of various body parts and biological characteristics of the eels collected in a coastal area of Japan (Mikawa Bay). The four silvering stages are characterized by the colorations of pectoral fins and ventral skin as follows: (1) Y1, yellow eel without a metallic hue at the base of pectoral fins, (2) Y2, late yellow eel with a metallic hue at the base of the pectoral fins but without melanization at the tip of pectoral fins, (3) S1, silver eel with complete melanization at the tip of pectoral fins but without full pigmented belly in black or dark brown, and (4) S2, late silver eel with black or dark brown belly. The body size, eye diameter and sexual maturity of each stage increased in the order of Y1, Y2, S1 and S2 stages, whereas the digestive tract degenerated in the same order, suggesting a sequential development of these ontogenetic stages identified in the study. The Y1, Y2 and S1 stages could be also distinguished by canonical discriminant function analysis using three internal (gonad-somatic index, GSI; hepato-somatic index, HIS; and gut index) and two morphometric (condition factor and eye index) parameters, supporting the significance of these stages. This method of staging for the silvering process of the Japanese eel appeared to be applicable to all specimens of this species, since this index used only simple external characteristics that would be easy to observe during field surveys.