A metabonomic approach to early prognostic evaluation of experimental sepsis by <sup>1</sup>H NMR and pattern recognition

Lin, Zhongying; Xu, Pingbo; Yan, Shaomin; Meng, Haibing; Yang, Guanhu; Dai, Weixing; Liu, Xin-ru; Li, Jinbao; Deng, Xiaoming; Zhang, Wei‐Dong

doi:10.1002/nbm.1373

Cited by 58 publications

(48 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both septic shock serum samples and SIRS/ICU control serum samples were collected within 24 h of admission to the PICU, allowing for early diagnostic and prognostic evaluation of the disease. Metabolomics has previously been suggested as a potential technique for early diagnosis of sepsis (17)(18)(19), but our research appears to be the first study that uses serum metabolomics to evaluate septic shock in a pediatric population. It is certainly the largest pediatric metabolomics study to date.…”

Section: Discussionmentioning

confidence: 99%

“…It has been described that metabolomics is a very efficient tool for discovering biomarkers of various infectious diseases, such as severe childhood pneumonia (15) or hepatitis C virus infection (16). So far, most of metabolomics studies associated with sepsis have been reported for animal models (17)(18)(19), and there have been no published metabolomics studies of pediatric septic shock. In the present study we used 1 H NMR and computational analysis to detect and measure concentrations of different metabolites in pediatric serum samples (see Figure E1 in the online supplement).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Mickiewicz

Vogel²,

Wong³

et al. 2013

Am J Respir Crit Care Med

167

175

View full text Add to dashboard Cite

Rationale: Septic shock is a significant cause of morbidity and mortality in the pediatric population. Early recognition of septic shock and appropriate treatment increase survival rate; thus, developing new diagnostic tools may improve patients' outcomes. Objectives: To determine whether a metabolomics approach could be useful in the diagnosis and prognosis of septic shock in pediatric intensive care unit (PICUs). Methods: Serum samples were collected from 60 patients with septic shock, 40 PICU patients with systemic inflammatory response syndrome (not suspected of having an infection), and 40 healthy children. Proton nuclear magnetic resonance spectroscopy spectra were analyzed and quantified using targeted profiling methodology. Measurements and Main Results: Multivariate statistical analysis was applied to detect specific patterns in metabolic profiles and to highlight differences between patient samples. Supervised analysis afforded good predictive models and managed to separate patient populations. Some of the metabolite concentrations identified in serum samples changed markedly, indicating their influence on the separation between patient groups. These metabolites represent a composite biopattern of the pediatric metabolic response to septic shock and might be considered as the basis for a biomarker panel for the diagnosis of septic shock and its mortality in PICU. Conclusions: Our results indicate that nuclear magnetic resonance metabolite profiling might serve as a promising approach for the diagnosis and prediction of mortality in septic shock in a pediatric population and that quantitative metabolomics methods can be applied in the clinical evaluations of pediatric septic shock.Keywords: pediatric septic shock; biomarkers; metabolomics; proton nuclear magnetic resonance spectroscopy; mortalityIn the 1980s the death rate from septic shock in children was around 50% (1, 2), but over the past few decades with better early diagnosis and therapy it has decreased to approximately 10% (3, 4). Unfortunately, in third world countries the mortality rate is still extremely high (5, 6). Moreover, every hour of septic shock without appropriate resuscitation and restoration of blood pressure increases mortality risk by 40% (7). Septic shock is a very dynamic process, and the clinical status of a child can deteriorate quickly (8). The first hours after the diagnosis are called the "golden hours" for a patient's survival; therefore, aggressive and goal-directed treatment should be initiated as quickly as possible (9). It is reported that those children in whom septic shock is recognized early and properly treated have a much higher survival rate than children who were diagnosed later (10-12). Thus, developing diagnostic approaches that might accelerate disease recognition is extremely important to improve patient outcomes and decrease mortality.In this study we investigated whether we could use a metabolomics approach for the diagnosis and prognosis of pediatric septic shock. Metabolomics is defined as "the quantita...

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Mickiewicz

Vogel²,

Wong³

et al. 2013

Am J Respir Crit Care Med

167

175

View full text Add to dashboard Cite

show abstract

“…Several studies have shown that for every hour of delay in administration of an appropriate antibiotic therapy there is a 7% increase in mortality [9]. The need for a highly sensitive and predictive test in the neonatal period for identifying and correctly classifying the maximum number of septic neonates makes metabolomics a method of great diagnostic potential.…”

Section: Discussionmentioning

confidence: 99%

Urinary 1H-NMR and GC-MS metabolomics predicts early and late onset neonatal sepsis

Fanos¹,

Caboni²,

Corsello³

et al. 2014

Early Human Development

View full text Add to dashboard Cite

The purpose of this article is to study one of the most significant causes of neonatal morbidity and mortality: neonatal sepsis. This pathology is due to a bacterial or fungal infection acquired during the perinatal period. Neonatal sepsis has been categorized into two groups: early onset if it occurs within 3-6 days and late onset after 4-7 days. Due to the not-specific clinical signs, along with the inaccuracy of available biomarkers, the diagnosis is still a major challenge. In this regard, the use of a combined approach based on both nuclear magnetic resonance ( 1 H-NMR) and gas-chromatography-mass spectrometry (GC-MS) techniques, coupled with a multivariate statistical analysis, may help to uncover features of the disease that are still hidden. The objective of our study was to evaluate the capability of the metabolomics approach to identify a potential metabolic profile related to the neonatal septic condition. The study population included 25 neonates (15 males and 10 females): 9 (6 males and 3 females) patients had a diagnosis of sepsis and 16 were healthy controls (9 males and 7 females). This study showed a unique metabolic profile of the patients affected by sepsis compared to non-affected ones with a statistically significant difference between the two groups (p = 0.05).

show abstract

“…To date, most metabolomic data have been generated in experimental models, including sepsis (24,40,41) and inflammatory lung injury (42)(43)(44). These preclinical animal data provide clear Figure 4.…”

Section: Clinical Application Of Nmr-based Blood Quantitative Metabolmentioning

confidence: 99%

The Emerging Field of Quantitative Blood Metabolomics for Biomarker Discovery in Critical Illnesses

Serkova

Standiford²,

Stringer

2011

Am J Respir Crit Care Med

166

124

View full text Add to dashboard Cite

Metabolomics, a science of systems biology, is the global assessment of endogenous metabolites within a biologic system and represents a "snapshot" reading of gene function, enzyme activity, and the physiological landscape. Metabolite detection, either individual or grouped as a metabolomic profile, is usually performed in cells, tissues, or biofluids by either nuclear magnetic resonance spectroscopy or mass spectrometry followed by sophisticated multivariate data analysis. Because loss of metabolic homeostasis is common in critical illness, the metabolome could have many applications, including biomarker and drug target identification. Metabolomics could also significantly advance our understanding of the complex pathophysiology of acute illnesses, such as sepsis and acute lung injury/acute respiratory distress syndrome. Despite this potential, the clinical community is largely unfamiliar with the field of metabolomics, including the methodologies involved, technical challenges, and, most importantly, clinical uses. Although there is evidence of successful preclinical applications, the clinical usefulness and application of metabolomics in critical illness is just beginning to emerge, the advancement of which hinges on linking metabolite data to known and validated clinically relevant indices. In addition, other important aspects, such as patient selection, sample collection, and processing, as well as the needed multivariate data analysis, have to be taken into consideration before this innovative approach to biomarker discovery can become a reliable tool in the intensive care unit. The purpose of this review is to begin to familiarize clinicians with the field of metabolomics and its application for biomarker discovery in critical illnesses such as sepsis.

show abstract

A metabonomic approach to early prognostic evaluation of experimental sepsis by ¹H NMR and pattern recognition

Cited by 58 publications

References 48 publications

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Urinary 1H-NMR and GC-MS metabolomics predicts early and late onset neonatal sepsis

The Emerging Field of Quantitative Blood Metabolomics for Biomarker Discovery in Critical Illnesses

Contact Info

Product

Resources

About

A metabonomic approach to early prognostic evaluation of experimental sepsis by 1H NMR and pattern recognition

Cited by 58 publications

References 48 publications

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Urinary 1H-NMR and GC-MS metabolomics predicts early and late onset neonatal sepsis

The Emerging Field of Quantitative Blood Metabolomics for Biomarker Discovery in Critical Illnesses

Contact Info

Product

Resources

About

A metabonomic approach to early prognostic evaluation of experimental sepsis by ¹H NMR and pattern recognition