Gemelli Biotech has launched Trio-SmartTM, a novel breath test developed to measure levels of hydrogen, methane, and hydrogen sulfide in patients’ breath after lactulose or glucose consumption.1 To date, breath tests have been limited to hydrogen and methane, which signal small intestinal bacterial overgrowth and intestinal methanogenic overgrowth, respectively.1,2
Trio-Smart, a laboratory-developed test conducted at a Clinical Laboratory Improvement Amendments-certified laboratory, expands breath screening capacity by capturing hydrogen sulfide, a fermentable gas that is expressed in the instance of gastrointestinal (GI) tract issues or in the presence of bacteria in the gut.1,3 Although hydrogen sulfide, which correlates with diarrhea, is known to have toxicity at elevated levels, a lack of modalities able to assess the fermentable gas has stymied its detection.1,2 Consequently, patients with serious GI symptoms may have historically appeared “normal” on hydrogen and methane breath tests.1
“An estimated 25% of patients who appear normal on hydrogen and methane tests could have elevated hydrogen sulfide levels and associated GI complications. These patients were being unrecognized by previous tests that did not measure hydrogen sulfide,” said Mark Pimentel, MD, executive director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai Medical Center in Los Angeles, California.1
MAST researchers are responsible for developing the technology to facilitate the identification of hydrogen sulfide in patients’ breath. The patent rights to the technology are owned by MAST, but have been exclusively licensed to Gemelli Biotech.1
Measuring hydrogen, methane, and hydrogen sulfide is imperative to identifying patients with levels symptomatic of GI complications because the organisms that produce the gases do not act discretely in the microbiome. “Therefore, it is impossible to get a full picture of a patient’s fermented gas profile without measuring all 3 gases,” added Pimentel, who also serves as the head of the Pimentel Laboratory at Cedars-Sinai. Trio-Smart is available as a mail-in, kit-based test that can be ordered directly from the test’s website.1
1. Gemelli Biotech launches novel breath test measuring hydrogen, methane and hydrogen sulfide. News release. Business Wire. October 27, 2020. Accessed October 28, 2020.
2. trio-smart. trio-smart breath test. Accessed October 28, 2020.
3. Wallace JL, Motta JP, Buret AG. Hydrogen sulfide: an agent of stability of the microbiome-mucosa interface. Am J Physiol Gastrointest Liver Physiol. 2018;314(2):G143-G149. doi: 10.1152/ajpgi.00249.2017