Metabolomic Profile of ARDS by Nuclear Magnetic Resonance Spectroscopy in Patients With H1N1 Influenza Virus Pneumonia

Izquierdo-García, José Luis; Nin, Nicolás; Jimenez-Clemente, Jorge; Horcajada, Juan Pablo; Arenas-Miras, Mar; Gea, Joaquim; Esteban, Andrés; Ruíz-Cabello, Jesús; Lorente, José A.

doi:10.1097/shk.0000000000001099

Cited by 26 publications

(25 citation statements)

References 36 publications

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“…Patients with ARDS showed lower serum concentrations of glucose (−41%, p < 0.01), alanine (−45%, p < 0.05), methylhistidine (−47%, p < 0.001), fatty acids (−40%, p < 0.001), citrate (−25%, p < 0.05), creatine (−40%, p < 0.05), creatinine (−20%, p < 0.05) and valine (−20%, p < 0.05), whereas acetone (100%, p < 0.05) concentration increased. These findings are in line with our previous findings in IAP patients with and without ARDS [1], and indicate impairment of normal cell energy production [5].…”

supporting

confidence: 93%

“…When we focused on SPP patients, PCA ( Fig. 1b) provided nearly perfect discrimination between patients with and without ARDS, as we had observed previously in IAP patients [1]. Patients with ARDS showed lower serum concentrations of glucose (−41%, p < 0.01), alanine (−45%, p < 0.05), methylhistidine (−47%, p < 0.001), fatty acids (−40%, p < 0.001), citrate (−25%, p < 0.05), creatine (−40%, p < 0.05), creatinine (−20%, p < 0.05) and valine (−20%, p < 0.05), whereas acetone (100%, p < 0.05) concentration increased.…”

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confidence: 75%

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confidence: 99%

“…Patients with SPP were older (p < 0.05) and presented more often with renal failure (p < 0.05) (Table-S1). Serum samples were obtained within 24 h of presentation to the emergency department, before starting mechanical ventilation, and examined by nuclear magnetic resonance spectroscopy, as previously described [1,3]. We quantified 16 characteristic serum metabolites, and statistical significance was determined using a Bonferroni-corrected Student t test, assuming unequal variance, with p < 0.05 considered significant.Principal component analysis (PCA) [4] ( Fig.…”

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Metabolomic profile of acute respiratory distress syndrome of different etiologies

et al. 2019

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Dear Editor, In a recent study, we reported the metabolic alterations related to acute respiratory distress syndrome (ARDS) in patients with influenza A pneumonia (IAP) [1]. We hypothesized that other types of acute lung injury causing ARDS may share the same metabolic alterations. As proof of concept, we have analyzed the metabolomic profiles of patients with and without ARDS induced by Streptococcus pneumoniae (SPP) (ARDS = 13; no ARDS = 17) or IAP (ARDS = 12; no ARDS = 18). Some of the results of these studies have been previously reported in the form of an abstract [2]. Patients with SPP were older (p < 0.05) and presented more often with renal failure (p < 0.05) (Table-S1). Serum samples were obtained within 24 h of presentation to the emergency department, before starting mechanical ventilation, and examined by nuclear magnetic resonance spectroscopy, as previously described [1,3]. We quantified 16 characteristic serum metabolites, and statistical significance was determined using a Bonferroni-corrected Student t test, assuming unequal variance, with p < 0.05 considered significant.Principal component analysis (PCA) [4] ( Fig. 1a) differentiated patients with and without ARDS, irrespective of the infectious pathogen, indicating that ARDS induces adaptations in similar molecular pathways regardless of the etiology. When we focused on SPP patients, PCA (Fig. 1b) provided nearly perfect discrimination between patients with and without ARDS, as we had observed previously in IAP patients [1]. Patients with ARDS showed lower serum concentrations of glucose (−41%, p < 0.01), alanine (−45%, p < 0.05), methylhistidine (−47%, p < 0.001), fatty acids (−40%, p < 0.001), citrate (−25%, p < 0.05), creatine (−40%, p < 0.05), creatinine (−20%, p < 0.05) and valine (−20%, p < 0.05), whereas acetone (100%, p < 0.05) concentration increased. These findings are in line with our previous findings in IAP patients with and without ARDS [1], and indicate impairment of normal cell energy production [5].Additionally, the metabolomic fingerprints of ARDS patients with IAP or SPP were compared to identify specific metabolic biomarkers of the pathogen responsible for ARDS ( Fig. 1c). Increased levels of glutamine (37%, p < 0.01), methylguanidine (88%, p < 0.001) and phenylalanine (56%, p < 0.01), previously identified as biomarkers of ARDS induced by IAP, may indicate a specific metabolic pattern of this infection. Alterations in lactate (−184%, p < 0.01) and creatine (−43%, p < 0.05) may be considered a metabolic pattern of SPP. We have also detected significant differences in common metabolic alterations, such as glucose (60%, p < 0.01), methylhistidine (29%, p < 0.01) and alanine (−79%, p < 0.05), that may indicate greater inflammatory response and energetic requirements in SPP. The specific metabolic fingerprint was then used to develop a partial least squares model [4] for the identification of the etiological pathogens responsible for ARDS (identification success of 93.0 ± 8.3%, sensitivity 81.1 ± 9.2% and specificity 93.6 ± 7.6%...

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confidence: 75%

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Metabolomic profile of acute respiratory distress syndrome of different etiologies

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“…Third, the present findings are limited to patients without active respiratory infections. Alterations in metabolomic profile with lung infections is well realized [79][80][81]. Since patients with ACO are susceptible to infection [82,83], it would be worthwhile to investigate ACO metabolomic profiles with and without infections.…”

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confidence: 99%

Metabolomic fingerprinting and systemic inflammatory profiling of asthma COPD overlap (ACO)

et al. 2020

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Background: Asthma-COPD overlap (ACO) refers to a group of poorly studied and characterised patients reporting with disease presentations of both asthma and COPD, thereby making both diagnosis and treatment challenging for the clinicians. They exhibit a higher burden in terms of both mortality and morbidity in comparison to patients with only asthma or COPD. The pathophysiology of the disease and its existence as a unique disease entity remains unclear. The present study aims to determine whether ACO has a distinct metabolic and immunological mediator profile in comparison to asthma and COPD. Methods: Global metabolomic profiling using two different groups of patients [discovery (D) and validation (V)] were conducted. Serum samples obtained from moderate and severe asthma [n = 34(D); n = 32(V)], moderate and severe COPD [n = 30(D); 32(V)], ACO patients [n = 35(D); 40(V)] and healthy controls [n = 33(D)] were characterized using gas chromatography mass spectrometry (GC-MS). Multiplexed analysis of 25 immunological markers (IFN-γ (interferon gamma), TNF-α (tumor necrosis factor alpha), IL-12p70 (interleukin 12p70), IL-2, IL-4, IL-5, IL-13, IL-10, IL-1α, IL-1β, TGF-β (transforming growth factor), IL-6, IL-17E, IL-21, IL-23, eotaxin, GM-CSF (granulocyte macrophagecolony stimulating factor), IFN-α (interferon alpha), IL-18, NGAL (neutrophil gelatinase-associated lipocalin), periostin, TSLP (thymic stromal lymphopoietin), MCP-1 (monocyte chemoattractant protein-1), YKL-40 (chitinase 3 like 1) and IL-8) was also performed in the discovery cohort. Results: Eleven metabolites [serine, threonine, ethanolamine, glucose, cholesterol, 2-palmitoylglycerol, stearic acid, lactic acid, linoleic acid, D-mannose and succinic acid] were found to be significantly altered in ACO as compared with asthma and COPD. The levels and expression trends were successfully validated in a fresh cohort of subjects. Thirteen immunological mediators including TNFα, IL-1β, IL-17E, GM-CSF, IL-18, NGAL, IL-5, IL-10, MCP-1, YKL-40, IFNγ, IL-6 and TGF-β showed distinct expression patterns in ACO. These markers and metabolites exhibited significant correlation with each other and also with lung function parameters.

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Precision Medicine in Critical Illness: Sepsis and Acute Respiratory Distress Syndrome

Rogers

Meyer

2020

Precision in Pulmonary, Critical Care, and Sleep Medicine

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Metabolomic Profile of ARDS by Nuclear Magnetic Resonance Spectroscopy in Patients With H1N1 Influenza Virus Pneumonia

Abstract: The serum metabolomic profile is sensitive and specific to identify ARDS in patients with H1N1 influenza A pneumonia. Future studies are needed to determine the role of NMR spectroscopy as a biomarker of ARDS.

Cited by 26 publications

References 36 publications

Metabolomic profile of acute respiratory distress syndrome of different etiologies

Metabolomic profile of acute respiratory distress syndrome of different etiologies

Metabolomic fingerprinting and systemic inflammatory profiling of asthma COPD overlap (ACO)

Precision Medicine in Critical Illness: Sepsis and Acute Respiratory Distress Syndrome

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