Department of Critical Care Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Oxid Med Cell Longev. 2021 Apr 23;2021:6628847. doi: 10.1155/2021/6628847. eCollection 2021.
Sepsis-induced acute kidney injury (SI-AKI) is a serious condition in critically ill patients. Currently, the diagnosis is based on either elevated serum creatinine levels or oliguria, which partially contribute to delayed recognition of AKI. Metabolomics is a potential approach for identifying small molecule biomarkers of kidney diseases. Here, we studied serum metabolomics alterations in rats with sepsis to identify early biomarkers of sepsis and SI-AKI. A rat model of SI-AKI was established by intraperitoneal injection of lipopolysaccharide (LPS). Thirty Sprague-Dawley (SD) rats were randomly divided into the control (CT) group and groups treated for 2 hours (LPS2) and 6 hours (LPS6) with LPS (10 rats per group). Nontargeted metabolomics screening was performed on the serum samples from the control and SI-AKI groups. Combined multivariate and univariate analysis was used for pairwise comparison of all groups to identify significantly altered serum metabolite levels in early-stage AKI in rats with sepsis. Orthogonal partial least squares discriminant analysis (OPLS-DA) showed obvious separation between the CT and LPS2 groups, CT and LPS6 groups, and LPS2 and LPS6 groups. All comparisons of the groups identified a series of differential metabolites according to the threshold defined for potential biomarkers. Intersections and summaries of these differential metabolites were used for pathway enrichment analysis. The results suggested that sepsis can cause an increase in systemic aerobic and anaerobic metabolism, an impairment of the oxygen supply, and uptake and abnormal fatty acid metabolism. Changes in the levels of malic acid, methionine sulfoxide, and petroselinic acid were consistently measured during the progression of sepsis. The development of sepsis was accompanied by the development of AKI, and these metabolic disorders are directly or indirectly related to the development of SI-AKI.
脓毒症相关性急性肾损伤(SI-AKI)是危重症患者的一种严重情况。目前,其诊断基于血清肌酐水平升高或少尿,这部分导致 AKI 的识别延迟。代谢组学是一种鉴定肾脏疾病小分子生物标志物的潜在方法。在这里,我们研究了脓毒症大鼠的血清代谢组学改变,以鉴定脓毒症和 SI-AKI 的早期生物标志物。通过腹腔内注射脂多糖(LPS)建立 SI-AKI 大鼠模型。30 只 Sprague-Dawley(SD)大鼠随机分为对照组(CT)和 LPS2 组(LPS 处理 2 小时,n=10)和 LPS6 组(LPS 处理 6 小时,n=10)。对对照组和 SI-AKI 组的血清样本进行非靶向代谢组学筛选。采用多元和单变量分析相结合的方法对所有组进行两两比较,以鉴定脓毒症大鼠早期 AKI 中血清代谢物水平的显著变化。正交偏最小二乘判别分析(OPLS-DA)显示 CT 和 LPS2 组、CT 和 LPS6 组以及 LPS2 和 LPS6 组之间有明显的分离。所有组间比较均根据潜在生物标志物的阈值确定了一系列差异代谢物。对这些差异代谢物进行交集和总结,并进行通路富集分析。结果表明,脓毒症可引起全身需氧和厌氧代谢增加、氧供和摄取受损以及脂肪酸代谢异常。在脓毒症的进展过程中,苹果酸、甲硫氨酸亚砜和牛蒡烯酸的水平持续变化。脓毒症的发生伴随着 AKI 的发生,这些代谢紊乱与 SI-AKI 的发生直接或间接相关。