Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Center for Clinical and Molecular Nutrition, Emory University, Atlanta, GA, USA.
Crit Care Med. 2011 Oct;39(10):2308-13. doi: 10.1097/CCM.0b013e31822571ce.
Improved means to monitor and guide interventions could be useful in the intensive care unit. Metabolomic analysis with bioinformatics is used to understand mechanisms and identify biomarkers of disease development and progression. This pilot study evaluated plasma proton nuclear magnetic resonance spectroscopy as a means to monitor metabolism following albumin administration in acute lung injury patients.
This study was conducted on plasma samples from six albumin-treated and six saline-treated patients from a larger double-blind trial. The albumin group was administered 25 g of 25% human albumin in 0.9% saline every 8 hrs for a total of nine doses over 72 hrs. A 0.9% concentration of saline was used as a placebo. Blood samples were collected immediately before, 1 hr after, and 4 hrs after the albumin/saline administration for the first, fourth, and seventh doses (first dose of each day for 3 days). Samples were analyzed by proton nuclear magnetic resonance spectroscopy, and spectra were analyzed by principal component analysis and biostatistical methods.
None.
After 1 day of albumin therapy, changes in small molecules, including amino acids and plasma lipids, were evident with principal component analysis. Differences remained 3 days after the last albumin administration. Analysis of data along with spectra from healthy controls showed that spectra for patients receiving albumin had a trajectory toward the spectra observed for healthy individuals while those of the placebo controls did not.
The data suggest that metabolic changes detected by proton nuclear magnetic resonance spectroscopy and the bioinformatics tool may be a useful approach to clinical research, especially in acute lung injury.
改进监测和指导干预的手段可能对重症监护病房有用。代谢组学分析与生物信息学用于了解机制和识别疾病发展和进展的生物标志物。这项初步研究评估了血浆质子磁共振波谱作为监测急性肺损伤患者白蛋白给药后代谢的一种手段。
本研究在来自一项更大的双盲试验的六名白蛋白治疗患者和六名生理盐水治疗患者的血浆样本上进行。白蛋白组每 8 小时接受 25%人白蛋白 25g 加 0.9%生理盐水，72 小时内共接受九剂。0.9%生理盐水用作安慰剂。在白蛋白/生理盐水给药前、给药后 1 小时和 4 小时采集血液样本，用于第一、第四和第七剂量（第一天每天一次，共 3 天）。样品通过质子磁共振波谱进行分析，通过主成分分析和生物统计学方法对光谱进行分析。
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白蛋白治疗 1 天后，通过主成分分析可以明显看出包括氨基酸和血浆脂质在内的小分子的变化。最后一次白蛋白给药后 3 天仍有差异。对数据的分析以及与健康对照者的光谱比较表明，接受白蛋白治疗的患者的光谱具有向健康个体观察到的光谱发展的轨迹，而安慰剂对照组的光谱则没有。
数据表明，质子磁共振波谱和生物信息学工具检测到的代谢变化可能是一种有用的临床研究方法，特别是在急性肺损伤中。
