Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710048, China.
Cardiology Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710048, China.
Sci Rep. 2020 Mar 10;10(1):4436. doi: 10.1038/s41598-020-61290-x.
Despite the utilization of various biochemical markers and probability calculation algorithms based on clinical studies of community-acquired pneumonia (CAP), more specific and practical biochemical markers remain to be found for improved diagnosis and prognosis. In this study, we aimed to detect the alteration of metabolite profiles, explore the correlation between serum metabolites and inflammatory markers, and seek potential biomarkers for young adults with CAP. 13 Eligible young mild CAP patients between the ages of 18 and 30 years old with CURB65 = 0 admitted to the respiratory medical department were enrolled, along with 36 healthy participants as control. Untargeted metabolomics profiling was performed and metabolites including alcohols, amino acids, carbohydrates, fatty acids, etc. were detected. A total of 227 serum metabolites were detected. L-Alanine, 2-Hydroxybutyric acid, Methylcysteine, L-Phenylalanine, Aminoadipic acid, L-Tryptophan, Rhamnose, Palmitoleic acid, Decanoylcarnitine, 2-Hydroxy-3-methylbutyric acid and Oxoglutaric acid were found to be significantly altered, which were enriched mainly in propanoate and tryptophan metabolism, as well as antibiotic-associated pathways. Aminoadipic acid was found to be significantly correlated with CRP levels and 2-Hydroxy-3-methylbutyric acid and Palmitoleic acid with PCT levels. The top 3 metabolites of diagnostic values are 2-Hydroxybutyric acid(AUC = 0.90), Methylcysteine(AUC = 0.85), and L-Alanine(AUC = 0.84). The AUC for CRP and PCT are 0.93 and 0.91 respectively. Altered metabolites were correlated with inflammation severity and were of great diagnostic value for CAP.
尽管在社区获得性肺炎(CAP)的临床研究中已经利用了各种生化标志物和基于概率计算的算法,但仍需要找到更特异和实用的生化标志物来改善诊断和预后。在本研究中,我们旨在检测代谢物谱的变化,探讨血清代谢物与炎症标志物之间的相关性,并寻找 CAP 年轻患者的潜在生物标志物。
共纳入 13 例年龄在 18 至 30 岁之间、CURB65=0 的符合条件的年轻轻症 CAP 患者,以及 36 例健康参与者作为对照。对非靶向代谢组学进行了分析,检测到包括醇类、氨基酸、碳水化合物、脂肪酸等在内的代谢物。共检测到 227 种血清代谢物。L-丙氨酸、2-羟基丁酸、甲基半胱氨酸、L-苯丙氨酸、氨己二酸、L-色氨酸、鼠李糖、棕榈油酸、癸酰肉碱、2-羟基-3-甲基丁酸和草酰乙酸显著改变,主要富集在丙酸盐和色氨酸代谢以及抗生素相关途径中。氨己二酸与 CRP 水平显著相关,2-羟基-3-甲基丁酸和棕榈油酸与 PCT 水平显著相关。诊断价值最高的 3 种代谢物是 2-羟基丁酸(AUC=0.90)、甲基半胱氨酸(AUC=0.85)和 L-丙氨酸(AUC=0.84)。CRP 和 PCT 的 AUC 分别为 0.93 和 0.91。改变的代谢物与炎症严重程度相关,对 CAP 具有很高的诊断价值。