NMR-Based Serum Metabolomics Discriminates Takayasu Arteritis from Healthy Individuals: A Proof-of-Principle Study

Abstract

Takayasu arteritis (TA) is a debilitating, systemic disease that involves the aorta and large arteries in a chronic inflammatory process that leads to vessel stenosis. Initially, the disease remains clinically silent (or remains undetected) until the patients present with vascular occlusion. Therefore, new methods for appropriate and timely diagnosis of TA cases are needed to start proper therapy on time and also to monitor the patient's response to the given treatment. In this context, NMR-based serum metabolomic profiling has been explored in this proof-of-principle study for the first time to determine characteristic metabolites that could be potentially helpful for diagnosis and prognosis of TA. Serum metabolic profiling of TA patients (n = 29) and healthy controls (n = 30) was performed using 1D (1)H NMR spectroscopy, and possible biomarker metabolites were identified. Using projection to least-squares discriminant analysis, we could distinguish TA patients from healthy controls. Compared to healthy controls, TA patients had (a) increased serum levels of choline metabolites, LDL cholesterol, N-acetyl glycoproteins (NAGs), and glucose and (b) decreased serum levels of lactate, lipids, HDL cholesterol, and glucogenic amino acids. The results of this study are preliminary and need to be confirmed in a prospective study.

Clinical study of children with Takayasu arteritis: a retrospective study from a single center in China

“…Also, dyslipidemia is suggestive of disease activity [23]. Here, dyslipidemia was identified in 60% (3/5) of cases, similar to that reported previously [22]; however, the disease activity scores for children with and without dyslipidemia were not statistically different. Also, blood lipids do not correlate with CRP and ESR.…”

“…Some adult TA patients showed dyslipidemia, which may be a risk factor for complicating atherosclerosis [22]. Also, dyslipidemia is suggestive of disease activity [23].…”

Monitoring of Heart Ischemia in Blood Serum

“…Increased blood serum phenylalanine is also a manifestation of the inflammatory states [6]. The primary response to counter-act this effect and maintain physiological homeostasis is increasing serum level of N-acetyl glycoproteins due to their anti-inflammatory and antioxidant activity [7] [8]. On the other hand, glycine has been reported to be elevated in heart failure patients [9] and glycine treatment in ischemia-reperfusion injury rats reduced the infarct size by 21% compared to vehicle-treated AMI rats [10].…”

“…The alternative energy substrates, such as amino acids increases and contribute to acidosis by anaerobic oxidation and decrease blood serum concentration of amino acids [11]. The low blood serum concentration of amino acids results in protein-energy wasting, inflammation and oxidative stress [7] [12]. Oxidative stress is the state of increased production of reactive oxygen species (ROS) which lead to oxidative modification of proteins and lipoproteins [13].…”

New Advances in Fast Methods of 2D NMR Experiments

“…More importantly, NMR has the ability to evaluate information about the environment of each atom and their neighbor's nuclei (both through space and through bond), allowing researchers to differentiate the unique magnetic environments of the same nuclei in different positions of a single molecule. Thus, NMR spectroscopy is extensively used for the identification and in the structural elucidation in a wide Nuclear Magnetic Resonance 2 range of applications in gas [2,3], liquid [4][5][6][7][8][9][10][11][12][13][14][15][16], and solid-state samples [17][18][19][20][21][22][23][24][25][26][27][28]. Nowadays, NMR spectroscopy is one of the most important analytical tools that has been used in several fields.…”