Minimal Gluten Exposure Alters Urinary Volatile Organic Compounds in Stable Coeliac Disease

Michael McFarlane, Ramesh P Arasaradnam, Beryl Reed, Emma Daulton, Alfian Wicaksono, Heena Tyagi, James A Covington, Chuka Nwokolo

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Coeliac disease (CD) patients are distinguishable from healthy individuals via urinary volatile organic compounds (VOCs) analysis. We exposed 20 stable CD patients on gluten-free diet (GFDs) to a 14-day, 3 g/day gluten challenge (GCh), and assessed urinary VOC changes. A control cohort of 20 patients continued on GFD. Urine samples from Days 0, 7, 14, 28 and 56 were analysed using Lonestar FAIMS and Markes Gas Chromatography-Time of Flight-Mass Spectrometer (GC-TOF-MS). VOC signatures on D (day) 7-56 were compared with D0. Statistical analysis was performed using R. In GCh patients, FAIMS revealed significant VOC differences for all time points compared to D0. GC-TOF-MS revealed significant changes at D7 and D14 only. In control samples, FAIMS revealed significant differences at D7 only. GC-TOF-MS detected no significant differences. Chemical analysis via GC-MS-TOF revealed 12 chemicals with significantly altered intensities at D7 vs. D0 for GCh patients. The alterations persisted for six chemicals at D14 and one (N-methyltaurine) remained altered after D14. This low-dose, short-duration challenge was well tolerated. FAIMS and GC-TOF-MS detected VOC signature changes in CD patients when undergoing a minimal GCh. These findings suggest urinary VOCs could have a role in monitoring dietary compliance in CD patients.
Original languageEnglish
Article number1290
Number of pages12
Issue number3
Publication statusPublished - 8 Feb 2022

Bibliographical note

Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// 4.0/).


  • gluten free diet
  • Humans
  • Glutens
  • Celiac Disease - diagnosis
  • coeliac disease
  • Volatile Organic Compounds - analysis
  • Gas Chromatography-Mass Spectrometry
  • Mass Spectrometry
  • VOCs
  • gluten challenge


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