Department of Paediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria.
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria.
Pediatr Res. 2018 Jul;84(1):66-70. doi: 10.1038/s41390-018-0007-y. Epub 2018 May 23.
We investigated 'rare' bile acids (BA) as potential markers in septic neonates.
'Rare' (C-6 hydroxylated BA) and 'classical' BA were determined in 102 neonates using high-performance liquid chromatography-high-resolution mass spectrometry (HPLC-HRMS). Four groups according to maturity (full term, FT vs. preterm, PT) and septic status (early-onset neonatal sepsis, EOS vs. CTR; non-septic controls) were formed: FT-CTR; (n = 47), PT-CTR (n = 22), FT-EOS (n = 20), PT-EOS (n = 13).
Firstly, FT-CTR had a significant higher amount of 'rare' BA than PT (FT-CTR: 0.5 µmol/L, IQR: 0.3-1.3 vs. PT-CTR: 0.01 µmol/L, IQR 0.01-0.2; p < 0.01). The most common 'rare' BA in FT-CTR were tauro-γ- (TGMCA) and tauro-α-muricholic acid (TAMCA). Secondly, in EOS, absolute 'rare' BA levels were comparable in both gestational age groups (FT-EOS: 0.6 µmol/L, IQR: 0.1-1.6 and PT-EOS: 0.6 µmol/L, IQR: 0.2-1.5). Therefore, EOS had significantly higher median 'rare' BA values than non-septic PT neonates (p < 0.01). In PT and term neonates, the relative amount of tauro-ω-muricholic acid (TOMCA) within the 'rare' BA pool was significantly higher in EOS than in controls (FT-CTR vs. "FT-EOS and PT-CTR vs. PT-EOS; p < 0.01). It was hence the predominant 'rare' BA in EOS.
TOMCA is an independent factor associated with EOS. It has diagnostic potential.
我们研究了“罕见”胆汁酸（BA）作为脓毒症新生儿的潜在标志物。
采用高效液相色谱-高分辨质谱（HPLC-HRMS）法测定 102 例新生儿的“罕见”（C-6 羟化 BA）和“经典”BA。根据成熟度（足月、FT 与早产、PT）和脓毒症状态（早发性新生儿败血症、EOS 与对照组、CTRL）将患儿分为四组：FT-CRT（n=47）、PT-CRT（n=22）、FT-EOS（n=20）、PT-EOS（n=13）。
首先，FT-CRT 的“罕见”BA 含量明显高于 PT（FT-CRT：0.5μmol/L，IQR：0.3-1.3 比 PT-CRT：0.01μmol/L，IQR：0.01-0.2；p<0.01）。FT-CRT 中最常见的“罕见”BA 是牛磺-γ-（TGMCA）和牛磺-α-鼠胆酸（TAMCA）。其次，在 EOS 中，两个胎龄组的绝对“罕见”BA 水平相当（FT-EOS：0.6μmol/L，IQR：0.1-1.6 和 PT-EOS：0.6μmol/L，IQR：0.2-1.5）。因此，EOS 的“罕见”BA 值中位数明显高于非脓毒症 PT 新生儿（p<0.01）。在 PT 和足月新生儿中，EOS 中“罕见”BA 池内的牛磺-ω-鼠胆酸（TOMCA）相对含量明显高于对照组（FT-CRT 比 FT-EOS 和 PT-CRT 比 PT-EOS；p<0.01）。因此，TOMCA 是 EOS 的一个独立危险因素，具有诊断潜力。
TOMCA 是与 EOS 相关的独立因素，具有诊断潜力。
