Outsourcing Pharma: Breath test can reveal signs of liver cirrhosis and portal hypertension

Owlstone Medical’s exegenous volatile organic compound (EVOC) breath test can reveal signs of liver cirrhosis and portal hypertension, a study has found. 

The leader in the breath biopsy field announced on Thursday last week (9 Nov) the results of a peer-reviewed study in the journal Biomedicines called ‘Exogenous Volatile Organic Compound (EVOC) Breath Testing Maximizes Classification Performance for Subjects with Cirrhosis and Reveals Signs of Portal Hypertension’.

The study enrolled 29 ultrasound-confirmed cirrhosis cases and 29 healthy controls to access the performance of Owlstone’s EVOC limonene breath test in cirrhosis detection.

Owlstone found that the food manufacturing industry used limonene. It is deemed a safe chemical ingested mainly through the diet and accumulates in the liver with a small amount excreted in the breath following elevated exposure. In the study, all subjects showed a greater than 100-fold limonene spike in breath after administration of the limonene EVOC probe, with significantly higher bioavailability seen in the cirrhosis group.

Optimal test performance for detecting cirrhosis was seen at 60 minutes post-administration, a performance that suggests it has utility for screening.

The company is developing non-invasive, easy-to-use, breath tests for liver disease, including for the early detection of cirrhosis. This test is planning to be used in primary care to screen individuals at high risk of having liver cirrhosis, with administration of the ECOV probe and collection of the sample to be performed in-clinic and analysed in a Breath Biopsy laboratory. Individuals with a positive test would then be expected to undergo further clinical diagnostic testing in line with the current clinical care pathway for formal diagnosis.