Gouveia Liana Ribeiro, Santos Joelma Carvalho, Silva Ronaldo Dionísio, Batista Andrea Dória, Domingues Ana Lúcia Coutinho, Lopes Edmundo Pessoa de Almeida, Silva Ricardo Oliveira
Postgraduate Program in Chemistry, Fundamental Chemistry Department, Center for Exact and Natural Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil.
Postgraduate Program in Tropical Medicine, Center for Health Sciences, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil.
PLoS One. 2017 Aug 1;12(8):e0182196. doi: 10.1371/journal.pone.0182196. eCollection 2017.
Diagnosis of liver involvement due to schistosomiasis in asymptomatic patients from endemic areas previously diagnosed with chronic hepatitis B (HBV) or C (HCV) and periportal fibrosis is challenging. H-1 Nuclear Magnetic Resonance (NMR)-based metabonomics strategy is a powerful tool for providing a profile of endogenous metabolites of low molecular weight in biofluids in a non-invasive way. The aim of this study was to diagnose periportal fibrosis due to schistosomiasis mansoni in patients with chronic HBV or HCV infection through NMR-based metabonomics models.
METHODOLOGY/PRINCIPAL FINDINGS: The study included 40 patients divided into two groups: (i) 18 coinfected patients with schistosomiasis mansoni and HBV or HCV; and (ii) 22 HBV or HCV monoinfected patients. The serum samples were analyzed through H-1 NMR spectroscopy and the models were based on Principal Component Analysis (PCA) and Partial Least Squares-Discriminant Analysis (PLS-DA). Ultrasonography examination was used to ascertain the diagnosis of periportal fibrosis. Exploratory analysis showed a clear separation between coinfected and monoinfected samples. The supervised model built from PLS-DA showed accuracy, R2 and Q2 values equal to 100%, 98.1% and 97.5%, respectively. According to the variable importance in the projection plot, lactate serum levels were higher in the coinfected group, while the signals attributed to HDL serum cholesterol were more intense in the monoinfected group.
CONCLUSIONS/SIGNIFICANCE: The metabonomics models constructed in this study are promising as an alternative tool for diagnosis of periportal fibrosis by schistosomiasis in patients with chronic HBV or HCV infection from endemic areas for Schistosoma mansoni.
对于来自流行地区、先前已诊断为慢性乙型肝炎(HBV)或丙型肝炎(HCV)且伴有门静脉周围纤维化的无症状患者,诊断血吸虫病所致的肝脏受累具有挑战性。基于氢-1核磁共振(NMR)的代谢组学策略是一种强大的工具,可通过非侵入性方式提供生物流体中低分子量内源性代谢物的概况。本研究的目的是通过基于NMR的代谢组学模型诊断慢性HBV或HCV感染患者中曼氏血吸虫病所致的门静脉周围纤维化。
方法/主要发现:该研究纳入了40名患者,分为两组:(i)18名曼氏血吸虫病与HBV或HCV合并感染的患者;以及(ii)22名单纯HBV或HCV感染的患者。通过氢-1核磁共振波谱分析血清样本,模型基于主成分分析(PCA)和偏最小二乘判别分析(PLS-DA)。采用超声检查确定门静脉周围纤维化的诊断。探索性分析显示合并感染组和单纯感染组样本之间有明显区分。由PLS-DA构建的监督模型显示准确率、R2和Q2值分别为100%、98.1%和97.5%。根据投影图中的变量重要性,合并感染组的血清乳酸水平较高,而单纯感染组中归因于高密度脂蛋白血清胆固醇的信号更强。
结论/意义:本研究构建的代谢组学模型有望成为诊断来自曼氏血吸虫病流行地区慢性HBV或HCV感染患者血吸虫病所致门静脉周围纤维化的替代工具。