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Xiong W, Yeo T, May JTM, Demmers T, Ceronie B, Ramesh A, McGinty RN, Michael S, Torzillo E, Sen A, Anthony DC, Irani SR, Probert F. Distinct plasma metabolomic signatures differentiate autoimmune encephalitis from drug-resistant epilepsy. Ann Clin Transl Neurol 2024; 11:1897-1908. [PMID: 39012808 PMCID: PMC11251473 DOI: 10.1002/acn3.52112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/24/2024] [Accepted: 05/17/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVE Differentiating forms of autoimmune encephalitis (AE) from other causes of seizures helps expedite immunotherapies in AE patients and informs studies regarding their contrasting pathophysiology. We aimed to investigate whether and how Nuclear Magnetic Resonance (NMR)-based metabolomics could differentiate AE from drug-resistant epilepsy (DRE), and stratify AE subtypes. METHODS This study recruited 238 patients: 162 with DRE and 76 AE, including 27 with contactin-associated protein-like 2 (CASPR2), 29 with leucine-rich glioma inactivated 1 (LGI1) and 20 with N-methyl-d-aspartate receptor (NMDAR) antibodies. Plasma samples across the groups were analyzed using NMR spectroscopy and compared with multivariate statistical techniques, such as orthogonal partial least squares discriminant analysis (OPLS-DA). RESULTS The OPLS-DA model successfully distinguished AE from DRE patients with a high predictive accuracy of 87.0 ± 3.1% (87.9 ± 3.4% sensitivity and 86.3 ± 3.6% specificity). Further, pairwise OPLS-DA models were able to stratify the three AE subtypes. Plasma metabolomic signatures of AE included decreased high-density lipoprotein (HDL, -(CH2)n-, -CH3), phosphatidylcholine and albumin (lysyl moiety). AE subtype-specific metabolomic signatures were also observed, with increased lactate in CASPR2, increased lactate, glucose, and decreased unsaturated fatty acids (UFA, -CH2CH=) in LGI1, and increased glycoprotein A (GlycA) in NMDAR-antibody patients. INTERPRETATION This study presents the first non-antibody-based biomarker for differentiating DRE, AE and AE subtypes. These metabolomics signatures underscore the potential relevance of lipid metabolism and glucose regulation in these neurological disorders, offering a promising adjunct to facilitate the diagnosis and therapeutics.
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Affiliation(s)
- Wenzheng Xiong
- Department of ChemistryUniversity of OxfordOxfordUK
- Department of Pharmacology, Medical Sciences DivisionUniversity of OxfordOxfordUK
| | - Tianrong Yeo
- Department of Pharmacology, Medical Sciences DivisionUniversity of OxfordOxfordUK
- Department of NeurologyNational Neuroscience InstituteSingaporeSingapore
- Duke‐NUS Medical SchoolSingaporeSingapore
- Lee Kong Chian School of MedicineNanyang Technological UniversitySingaporeSingapore
| | - Jeanne Tan May May
- Department of NeurologyNational Neuroscience InstituteSingaporeSingapore
- Duke‐NUS Medical SchoolSingaporeSingapore
| | - Tor Demmers
- Department of Pharmacology, Medical Sciences DivisionUniversity of OxfordOxfordUK
| | - Bryan Ceronie
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Archana Ramesh
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Ronan N. McGinty
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Sophia Michael
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Emma Torzillo
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Arjune Sen
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Daniel C. Anthony
- Department of Pharmacology, Medical Sciences DivisionUniversity of OxfordOxfordUK
| | - Sarosh R. Irani
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Department of NeurologyJohn Radcliffe Hospital, Oxford University HospitalsOxfordUK
- Departments of Neurology and NeurosciencesMayo ClinicJacksonvilleFloridaUSA
| | - Fay Probert
- Department of ChemistryUniversity of OxfordOxfordUK
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Roberts J, Whiley L, Gray N, Gay M, Nitschke P, Masuda R, Holmes E, Nicholson JK, Wist J, Lawler NG. Rapid and Self-Administrable Capillary Blood Microsampling Demonstrates Statistical Equivalence with Standard Venous Collections in NMR-Based Lipoprotein Analysis. Anal Chem 2024; 96:4505-4513. [PMID: 38372289 PMCID: PMC10955515 DOI: 10.1021/acs.analchem.3c05152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/20/2024]
Abstract
We investigated plasma and serum blood derivatives from capillary blood microsamples (500 μL, MiniCollect tubes) and corresponding venous blood (10 mL vacutainers). Samples from 20 healthy participants were analyzed by 1H NMR, and 112 lipoprotein subfraction parameters; 3 supramolecular phospholipid composite (SPC) parameters from SPC1, SPC2, and SPC3 subfractions; 2 N-acetyl signals from α-1-acid glycoprotein (Glyc), GlycA, and GlycB; and 3 calculated parameters, SPC (total), SPC3/SPC2, and Glyc (total) were assessed. Using linear regression between capillary and venous collection sites, we explained that agreement (Adj. R2 ≥ 0.8, p < 0.001) was witnessed for 86% of plasma parameters (103/120) and 88% of serum parameters (106/120), indicating that capillary lipoprotein, SPC, and Glyc concentrations follow changes in venous concentrations. These results indicate that capillary blood microsamples are suitable for sampling in remote areas and for high-frequency longitudinal sampling of the majority of lipoproteins, SPCs, and Glycs.
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Affiliation(s)
- Jayden
Lee Roberts
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
| | - Luke Whiley
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
| | - Nicola Gray
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
| | - Melvin Gay
- Bruker
Pty Ltd., Preston, VIC 3072, Australia
| | - Philipp Nitschke
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
| | - Reika Masuda
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
| | - Elaine Holmes
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Department
of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London SW7 2AZ, U.K.
| | - Jeremy K. Nicholson
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Department
of Cardiology, Fiona Stanley Hospital, Medical School, University of Western Australia, Murdoch, WA 6150, Australia
- Institute
of Global Health Innovation, Faculty of Medicine, Imperial College London, Level 1, Faculty Building, South Kensington, London SW7 2NA, U.K.
| | - Julien Wist
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Faculty
of Medicine, Department of Metabolism, Digestion and Reproduction,
Division of Digestive Diseases, Imperial
College, London SW7 2AZ, United Kingdom
- Chemistry
Department, Universidad del Valle, Melendez 76001, Cali, Colombia
| | - Nathan G. Lawler
- Australian
National Phenome Centre, Health Futures Institute, Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
- Centre
for Computational and Systems Medicine, Health Futures Institute,
Harry Perkins Institute, Murdoch University, 5 Robin Warren Drive, Murdoch, WA 6150, Australia
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Rowley CE, Lodge S, Egan S, Itsiopoulos C, Christophersen CT, Silva D, Kicic-Starcevich E, O’Sullivan TA, Wist J, Nicholson J, Frost G, Holmes E, D’Vaz N. Altered dietary behaviour during pregnancy impacts systemic metabolic phenotypes. Front Nutr 2023; 10:1230480. [PMID: 38111603 PMCID: PMC10725961 DOI: 10.3389/fnut.2023.1230480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/25/2023] [Indexed: 12/20/2023] Open
Abstract
Rationale Evidence suggests consumption of a Mediterranean diet (MD) can positively impact both maternal and offspring health, potentially mediated by a beneficial effect on inflammatory pathways. We aimed to apply metabolic profiling of serum and urine samples to assess differences between women who were stratified into high and low alignment to a MD throughout pregnancy and investigate the relationship of the diet to inflammatory markers. Methods From the ORIGINS cohort, 51 pregnant women were stratified for persistent high and low alignment to a MD, based on validated MD questionnaires. 1H Nuclear Magnetic Resonance (NMR) spectroscopy was used to investigate the urine and serum metabolite profiles of these women at 36 weeks of pregnancy. The relationship between diet, metabolite profile and inflammatory status was investigated. Results There were clear differences in both the food choice and metabolic profiles of women who self-reported concordance to a high (HMDA) and low (LMDA) Mediterranean diet, indicating that alignment with the MD was associated with a specific metabolic phenotype during pregnancy. Reduced meat intake and higher vegetable intake in the HMDA group was supported by increased levels of urinary hippurate (p = 0.044) and lower creatine (p = 0.047) levels. Serum concentrations of the NMR spectroscopic inflammatory biomarkers GlycA (p = 0.020) and GlycB (p = 0.016) were significantly lower in the HDMA group and were negatively associated with serum acetate, histidine and isoleucine (p < 0.05) suggesting a greater level of plant-based nutrients in the diet. Serum branched chain and aromatic amino acids were positively associated with the HMDA group while both urinary and serum creatine, urine creatinine and dimethylamine were positively associated with the LMDA group. Conclusion Metabolic phenotypes of pregnant women who had a high alignment with the MD were significantly different from pregnant women who had a poor alignment with the MD. The metabolite profiles aligned with reported food intake. Differences were most significant biomarkers of systemic inflammation and selected gut-microbial metabolites. This research expands our understanding of the mechanisms driving health outcomes during the perinatal period and provides additional biomarkers for investigation in pregnant women to assess potential health risks.
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Affiliation(s)
- Charlotte E. Rowley
- Australian National Phenome Centre, and Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Samantha Lodge
- Australian National Phenome Centre, and Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Siobhon Egan
- Australian National Phenome Centre, and Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
| | | | - Claus T. Christophersen
- WA Human Microbiome Collaboration Centre, Curtin University, Bentley, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Desiree Silva
- Telethon Kids Institute, Perth Children’s Hospital, Nedlands, WA, Australia
- Joondalup Health Campus, Joondalup, WA, Australia
| | | | - Therese A. O’Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Julien Wist
- Australian National Phenome Centre, and Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
- Chemistry Department, Universidad del Valle, Cali, Colombia
| | - Jeremy Nicholson
- Australian National Phenome Centre, and Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
- Faculty of Medicine, Imperial College London, Institute of Global Health Innovation, London, United Kingdom
- Section of Nutrition Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Gary Frost
- Australian National Phenome Centre, and Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
- Section of Nutrition Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Elaine Holmes
- Australian National Phenome Centre, and Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia
- Faculty of Medicine, Imperial College London, Institute of Global Health Innovation, London, United Kingdom
- Section of Nutrition Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Nina D’Vaz
- Telethon Kids Institute, Perth Children’s Hospital, Nedlands, WA, Australia
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Stadler JT, Habisch H, Prüller F, Mangge H, Bärnthaler T, Kargl J, Pammer A, Holzer M, Meissl S, Rani A, Madl T, Marsche G. HDL-Related Parameters and COVID-19 Mortality: The Importance of HDL Function. Antioxidants (Basel) 2023; 12:2009. [PMID: 38001862 PMCID: PMC10669705 DOI: 10.3390/antiox12112009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/03/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
COVID-19, caused by the SARS-CoV-2 coronavirus, emerged as a global pandemic in late 2019, resulting in significant global public health challenges. The emerging evidence suggests that diminished high-density lipoprotein (HDL) cholesterol levels are associated with the severity of COVID-19, beyond inflammation and oxidative stress. Here, we used nuclear magnetic resonance spectroscopy to compare the lipoprotein and metabolic profiles of COVID-19-infected patients with non-COVID-19 pneumonia. We compared the control group and the COVID-19 group using inflammatory markers to ensure that the differences in lipoprotein levels were due to COVID-19 infection. Our analyses revealed supramolecular phospholipid composite (SPC), phenylalanine, and HDL-related parameters as key discriminators between COVID-19-positive and non-COVID-19 pneumonia patients. More specifically, the levels of HDL parameters, including apolipoprotein A-I (ApoA-I), ApoA-II, HDL cholesterol, and HDL phospholipids, were significantly different. These findings underscore the potential impact of HDL-related factors in patients with COVID-19. Significantly, among the HDL-related metrics, the cholesterol efflux capacity (CEC) displayed the strongest negative association with COVID-19 mortality. CEC is a measure of how well HDL removes cholesterol from cells, which may affect the way SARS-CoV-2 enters cells. In summary, this study validates previously established markers of COVID-19 infection and further highlights the potential significance of HDL functionality in the context of COVID-19 mortality.
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Affiliation(s)
- Julia T. Stadler
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (J.T.S.); (T.B.); (J.K.); (A.P.); (M.H.); (S.M.); (A.R.)
| | - Hansjörg Habisch
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Molecular Biology and Biochemistry, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (H.H.); (T.M.)
| | - Florian Prüller
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria;
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria;
| | - Thomas Bärnthaler
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (J.T.S.); (T.B.); (J.K.); (A.P.); (M.H.); (S.M.); (A.R.)
| | - Julia Kargl
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (J.T.S.); (T.B.); (J.K.); (A.P.); (M.H.); (S.M.); (A.R.)
- BioTechMed Graz, 8010 Graz, Austria
| | - Anja Pammer
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (J.T.S.); (T.B.); (J.K.); (A.P.); (M.H.); (S.M.); (A.R.)
| | - Michael Holzer
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (J.T.S.); (T.B.); (J.K.); (A.P.); (M.H.); (S.M.); (A.R.)
| | - Sabine Meissl
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (J.T.S.); (T.B.); (J.K.); (A.P.); (M.H.); (S.M.); (A.R.)
| | - Alankrita Rani
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (J.T.S.); (T.B.); (J.K.); (A.P.); (M.H.); (S.M.); (A.R.)
| | - Tobias Madl
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Molecular Biology and Biochemistry, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (H.H.); (T.M.)
- BioTechMed Graz, 8010 Graz, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria; (J.T.S.); (T.B.); (J.K.); (A.P.); (M.H.); (S.M.); (A.R.)
- BioTechMed Graz, 8010 Graz, Austria
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