Exhaled Air Metabolome Analysis for Pulmonary Arterial Hypertension Fingerprints Identification—The Preliminary Study

Abstract

Pulmonary arterial hypertension (PAH) is a rare disease with a serious prognosis. The aim of this study was to identify biomarkers for PAH in the breath phase and to prepare an automatic classification method to determine the changing metabolome trends and molecular mapping. A group of 37 patients (F/M: 8/29 women, mean age 60.4 ± 10.9 years, BMI 27.6 ± 6.0 kg/m2) with diagnosed PAH were enrolled in the study. The breath phase of all the patients was collected on a highly porous septic material using a special patented holder PL230578, OHIM 002890789-0001. The collected air was then examined with gas chromatography coupled with mass spectrometry (GC/MS). The algorithms of Spectral Clustering, KMeans, DBSCAN, and hierarchical clustering methods were used to perform the cluster analysis. The identification of the changes in the ratio of the whole spectra of biomarkers allowed us to obtain a multidimensional pathway for PAH characteristics and showed the metabolome differences in the four subgroups divided by the cluster analysis. The use of GC/MS, supported with novel porous polymeric materials, for the breath phase analysis seems to be a useful tool in selecting bio-fingerprints in patients with PAH. The four metabolome classes which were obtained constitute novel data in the PAH population.

Plasma untargeted metabolomics with proteinase K discloses phospholipid signature associated with pulmonary arterial hypertension

“…The evaluation of metabolic features and biochemical pathways associated with PAH can provide a holistic insight into the molecular mechanisms, improve the current diagnostic or treatment schedules, identify subphenotypes of the disease and propose new therapeutic targets. The results of recently published studies have confirmed that metabolic dysregulation is a common feature of various clinical types of PAH 8 , 11 , 12 , 17 – 20 . Herein, a global plasma untargeted metabolomics with the use of the LC–MS technique was applied to characterize the metabolic phenotype of PAH patients.…”

“…Additionally, most of the recent metabolomics-based studies of PH in the human population have considered different etiologies of the disease 11 , 12 or were focused on the analysis of lung tissue samples 13 , 14 . Evaluation of the tissue metabolic signature provides a specific insight into the molecular mechanisms of PAH, however, it is invasive and limited by the number and amount of samples available for analysis.…”

Metabolomics in Pulmonary Hypertension—A Useful Tool to Provide Insights into the Dark Side of a Tricky Pathology

“…Similar findings were obtained from the metabolomics analysis of exhaled breath. The latter was tested with gas chromatography associated with mass spectrometry [43].…”