Discriminant biomarkers of acute respiratory distress syndrome associated to H1N1 influenza identified by metabolomics HPLC‐QTOF‐MS/MS platform

Abstract

Acute respiratory distress syndrome (ARDS) is a serious complication of influenza A (H1N1) virus infection. Its pathogenesis is unknown and biomarkers are lacking. Untargeted metabolomics allows the analysis of the whole metabolome in a biological compartment, identifying patterns associated with specific conditions. We hypothesized that LC-MS could help identify discriminant metabolites able to define the metabolic alterations occurring in patients with influenza A (H1N1) virus infection that developed ARDS. Serum samples from patients diagnosed with 2009 influenza A (H1N1) virus infection with (n = 25) or without (n = 32) ARDS were obtained on the day of hospital admission and analyzed by LC-MS/MS. Metabolite identification was determined by MS/MS analysis and analysis of standards. The specificity of the patterns identified was confirmed in patients without 2009 influenza A(H1N1) virus pneumonia (15 without and 17 with ARDS). Twenty-three candidate biomarkers were found to be significantly different between the two groups, including lysophospholipids and sphingolipids related to inflammation; bile acids, tryptophan metabolites, and thyroxine, related to the metabolism of the gut microflora. Confirmation results demonstrated the specificity of major alterations occurring in ARDS patients with influenza A (H1N1) virus infection.

Fatty Acid Metabolism is Associated With Disease Severity After H7N9 Infection

“…Therapeutic-intervention-related factors included intubation, MV, ECMO, and variable treatments with antiviral options or different steroids with variable doses and durations. Lastly, the biomarkers identified in the present study, including palmitic acid, erucic acid, and phytal, may not be specific to H7N9 infection, unlike in the case of serum metabolomic analysis of infections with other respiratory viruses including the respiratory syncytial virus and H1N1 virus ([ 46 ]; Ferrarini et al, [ 14 ]; [ 10 , 47 ]; Chen et al, [ 6 , 7 ]). Future re-evaluation will also be needed because all four patients recruited in this study were at the severe end stage of the disease, while those in the control groups were not.…”

Metabolites of microbiota response to tryptophan and intestinal mucosal immunity: A therapeutic target to control intestinal inflammation

“…Most microbiota, except for virus and archaea, can metabolize tryptophan via different pathways to produce bioactive molecules 6,8,10,22 . Virus cannot metabolize anything and there is also lacking details to illustrate the tryptophan metabolism process of archaea 23 . Thus, these results about Trp‐derived microbial metabolites that come from bacteria, fungi and protozoa will be more representative.…”

“…In brief, a normal level of 5‐HT (10 −11 to 10 −9 M) contributes to a healthy microenvironment in the gut to balance the level of cytokines 138 . Besides, interestingly, 5‐HT has reported to stimulate the growth of E. coli, Enterococcus faecalis , and Rhodospirillum rubrum in culture 23,139 . Whether some microbial members can alter biosynthesis of host 5‐HT to support their colonization, growth or resilience of some microbiota is an exciting question for future study.…”

Auxiliary role of mesenchymal stem cells as regenerative medicine soldiers to attenuate inflammatory processes of severe acute respiratory infections caused by COVID-19

“…The most common cause of pediatric ARDS is primary infection with or without systemic infection and seasonal viruses such as RSV, non-pandemic influenza, RVs, parainfluenza, adenovirus, CoVs, and HMPV (Nye et al 2016). ARDS is an important and serious complication in patients infected by H1N1 virus (Ferrarini et al 2017). Therefore, influenza infection could be followed by lower respiratory tract infections and even ARDS especially in adult immunocompromised hosts (Dioverti et al 2016).…”