Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangdong, Guangdong, P.R. China.
Clinic Laboratory, Zhuzhou Central Hospital, Hunan, China.
Rheumatology (Oxford). 2021 Feb 1;60(2):598-606. doi: 10.1093/rheumatology/keaa126.
The spectrum of clinical manifestations and serological phenomena of SLE is heterogeneous among patients and even changes over time unpredictably in individual patients. For this reason, clinical diagnosis especially in complicated or atypical cases is often difficult or delayed leading to poor prognosis. Despite the medical progress nowadays in the understanding of SLE pathogenesis, disease-specific biomarkers for SLE remain an outstanding challenge. Therefore, we undertook this study to investigate potential biomarkers for SLE diagnosis.
Serum samples from 32 patients with SLE and 25 gender-matched healthy controls (HCs) were analysed by metabolic profiling based on liquid chromatography-tandem mass spectrometry metabolomics platform. The further validation for the potential biomarker was performed in an independent set consisting of 36 SLE patients and 30 HCs.
The metabolite profiles of serum samples allowed differentiation of SLE patients from HCs. The levels of arachidonic acid, sphingomyelin (SM) 24:1, monoacylglycerol (MG) 17:0, lysophosphatidyl ethanolamine (lysoPE) 18:0, lysoPE 16:0, lysophosphatidyl choline (lysoPC) 20:0, lysoPC 18:0 and adenosine were significantly decreased in SLE patients, and the MG 20:2 and L-pyroglutamic acid were significantly increased in SLE group. In addition, L-pyroglutamic acid achieved an area under the receiver-operating characteristic curve of 0.955 with high sensitivity (97.22%) and specificity (83.33%) at the cut-off of 61.54 μM in the further targeted metabolism, indicating diagnostic potential.
Serum metabolic profiling is differential between SLE patients and HCs and depicts increased L-pyroglutamic acid as a promising bitformatomarker for SLE.
SLE 患者的临床表现和血清现象谱在患者之间存在异质性,甚至在个体患者中随时间变化不可预测。因此,临床诊断,特别是在复杂或非典型病例中,往往较为困难或延迟,导致预后不良。尽管目前在理解 SLE 发病机制方面取得了医学进展,但 SLE 的疾病特异性生物标志物仍然是一个突出的挑战。因此,我们进行了这项研究,以探讨 SLE 诊断的潜在生物标志物。
采用基于液相色谱-串联质谱代谢组学平台的代谢组学方法分析 32 例 SLE 患者和 25 名性别匹配的健康对照者(HCs)的血清样本。在由 36 例 SLE 患者和 30 名 HCs 组成的独立样本中对潜在生物标志物进行了进一步验证。
血清样本的代谢谱可区分 SLE 患者和 HCs。SLE 患者血清中花生四烯酸、神经鞘磷脂(SM)24:1、单酰基甘油(MG)17:0、溶血磷脂酰乙醇胺(lysoPE)18:0、溶血磷脂酰胆碱(lysoPC)20:0、lysoPC 18:0 和腺苷水平显著降低,MG20:2 和 L-焦谷氨酸水平显著升高。此外,L-焦谷氨酸在进一步的靶向代谢中,当截止值为 61.54μM 时,获得了 0.955 的受试者工作特征曲线下面积,具有较高的敏感性(97.22%)和特异性(83.33%),表明其具有诊断潜力。
SLE 患者与 HCs 的血清代谢谱存在差异,提示 L-焦谷氨酸升高可能是 SLE 的一种有前途的生物标志物。