University Clinic for Visceral Surgery and Medicine, Inselspital Bern, Bern, Switzerland.
J Surg Res. 2012 Dec;178(2):879-87. doi: 10.1016/j.jss.2012.08.011. Epub 2012 Aug 25.
Diagnosis of intestinal ischemia remains a clinical challenge. The aim of the present study was to use a metabolomic protocol to identify upregulated and downregulated small molecules (M(r) < 500) in the serum of mice with intestinal ischemia. Such molecules could have clinical utility when evaluated as biomarkers in human studies.
A mouse model for intestinal ischemia was established and validated using histology and serum tumor necrosis factor α concentrations. A second mouse model of peritoneal sepsis was used as a positive control. Serial serum samples were collected from these and from sham-operated animals. Sera were analyzed by gas chromatography-mass spectrometry for 40 small molecules as their trimethylsilyl and O-methyloxime derivatives. Peak areas were normalized against an internal standard and resultant peak area ratios subjected to multivariate data analysis using unsupervised principal components analysis and supervised orthogonal projection to latent structures-discriminant analysis. Upregulated and downregulated serum molecules were identified from their correlation to the orthogonal projection to latent structures-discriminant analysis model.
Three highly significantly upregulated (fold-change) serum molecules in intestinal ischemia were inorganic phosphate (2.4), urea (4.3), and threonic acid (2.9). Five highly significantly downregulated (fold-change) serum molecules were stearic acid (1.7), arabinose (2.7), xylose (1.6), glucose (1.4), and ribose (2.2). Lactic acid remained unchanged in intestinal ischemia.
Distinct molecular changes are reported here for the first time in intestinal ischemia. They reveal impairments of gut microbiota metabolism, intestinal absorption, and renal function, together with increased oxidative stress. In contrast to other reports, lactic acid was not significantly changed. These molecular signatures may now be evaluated in clinical studies.
肠缺血的诊断仍然是临床挑战。本研究旨在使用代谢组学方案来鉴定肠缺血小鼠血清中上调和下调的小分子(Mr <500)。当作为人类研究中的生物标志物进行评估时,这些分子可能具有临床实用性。
使用组织学和血清肿瘤坏死因子 α 浓度建立和验证了肠缺血的小鼠模型。使用腹膜脓毒症的第二个小鼠模型作为阳性对照。从这些模型和假手术动物中采集连续的血清样本。用气相色谱-质谱法对 40 种小分子进行分析,作为它们的三甲基硅烷基和 O-甲氧基肟衍生物。将峰面积与内标归一化,并将所得峰面积比通过无监督主成分分析和有监督正交投影到潜在结构-判别分析进行多变量数据分析。通过与正交投影到潜在结构-判别分析模型的相关性鉴定上调和下调的血清分子。
肠缺血中三种高度上调(倍数变化)的血清分子是无机磷酸盐(2.4)、尿素(4.3)和苏糖醇(2.9)。五种高度下调(倍数变化)的血清分子是硬脂酸(1.7)、阿拉伯糖(2.7)、木糖(1.6)、葡萄糖(1.4)和核糖(2.2)。乳酸在肠缺血中保持不变。
本文首次报道了肠缺血的独特分子变化。它们揭示了肠道微生物群代谢、肠道吸收和肾功能受损,以及氧化应激增加。与其他报告不同,乳酸没有明显变化。这些分子特征现在可以在临床研究中进行评估。