1. Identifiction of IBD using an electronic e-nose Gastroenterology: Arasaradnam RP 1,2 - r.arasaradnam@warwick.ac.uk Engineering: Covington JA 3, - 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, 11 th BROAD Meeting, Los Angeles – March 2013 1

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

3. ‘Smell’ @ Warwick 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… Life in ‘Smell’ Persaud & Dodd Nature 1982

4. 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

5. Study design 62 subjects – 3 groups Urine collected and analysed using E-nose and FAIMS Data analysed using Principal Component analysis Crohns Remission UC Remission Crohns Flare UC Flare Controls Number20 4414 Mean Age (sd) 50 (11.4)56 (15.8)39 (10.3)42 (16.6)32 (8.2) Sex: M/F12:810:103:14:05/9 Mean BMI (sd) 25 (5.9)28 (4.3)22 (4.2)25 (3.6) Arasaradnam et al 2013

6. E-nose sensor response Arasaradnam et al 2013

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

8. 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