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Nash PS, Fandler-Höfler S, Ambler G, Zhang W, Ozkan H, Locatelli M, Du Y, Obergottsberger L, Wünsch G, Jäger HR, Enzinger C, Wheeler DC, Simister RJ, Gattringer T, Werring DJ. Associations of Cerebral Small Vessel Disease and Chronic Kidney Disease in Patients With Acute Intracerebral Hemorrhage: A Cross-Sectional Study. Neurology 2024; 103:e209540. [PMID: 38889380 PMCID: PMC11254447 DOI: 10.1212/wnl.0000000000209540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/15/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic kidney disease (CKD) may be associated with the pathogenesis and phenotype of cerebral small vessel disease (SVD), which is the commonest cause of intracerebral hemorrhage (ICH). The purpose of this study was to investigate the associations of CKD with ICH neuroimaging phenotype, volume, and location, total burden of small vessel disease, and its individual components. METHODS In 2 cohorts of consecutive patients with ICH evaluated with MRI, we investigated the frequency and severity of CKD based on established Kidney Disease Improving Global Outcomes criteria, requiring estimated glomerular filtration rate (eGFR) measurements <60 mL/min/1.732 ≥ 3 months apart to define CKD. MRI scans were rated for ICH neuroimaging phenotype (arteriolosclerosis, cerebral amyloid angiopathy, mixed location SVD, or cryptogenic ICH) and the presence of markers of SVD (white matter hyperintensities [WMHs], cerebral microbleeds [CMBs], lacunes, and enlarged perivascular spaces, defined according to the STandards for ReportIng Vascular changes on nEuroimaging criteria). We used multinomial, binomial logistic, and ordinal logistic regression models adjusted for age, sex, hypertension, and diabetes to account for possible confounding caused by shared risk factors of CKD and SVD. RESULTS Of 875 patients (mean age 66 years, 42% female), 146 (16.7%) had CKD. After adjusting for age, sex, and comorbidities, patients with CKD had higher rates of mixed SVD than those with eGFR >60 (relative risk ratio 2.39, 95% CI 1.16-4.94, p = 0.019). Severe WMHs, deep microbleeds, and lacunes were more frequent in patients with CKD, as was a higher overall SVD burden score (odds ratio 1.83 for each point on the ordinal scale, 95% CI 1.31-2.56, p < 0.001). Patients with eGFR ≤30 had more CMBs (median 7 [interquartile range 1-23] vs 2 [0-8] for those with eGFR >30, p = 0.007). DISCUSSION In patients with ICH, CKD was associated with SVD burden, a mixed SVD phenotype, and markers of arteriolosclerosis. Our findings indicate that CKD might independently contribute to the pathogenesis of arteriolosclerosis and mixed SVD, although we could not definitively account for the severity of shared risk factors. Longitudinal and experimental studies are, therefore, needed to investigate causal associations. Nevertheless, stroke clinicians should be aware of CKD as a potentially independent and modifiable risk factor of SVD.
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Affiliation(s)
- Philip S Nash
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Simon Fandler-Höfler
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Gareth Ambler
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Wenpeng Zhang
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Hatice Ozkan
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Martina Locatelli
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Yang Du
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Lena Obergottsberger
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Gerit Wünsch
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Hans Rolf Jäger
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Christian Enzinger
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - David C Wheeler
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Robert J Simister
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Thomas Gattringer
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - David J Werring
- From the UCL Stroke Research Centre (P.S.N., S.F.-H., W.Z., H.O., M.L., Y.D., R.J.S., D.J.W.), Department of Brain Repair and Rehabilitation, and Comprehensive Stroke Service (P.S.N., H.O., R.J.S., D.J.W.), National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology (S.F.-H., L.O., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Institute for Medical Informatics (G.W.), Statistics and Documentation, Medical University of Graz, Austria; Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology; Department of Renal Medicine (D.C.W.), University College London, United Kingdom; and Division of Neuroradiology (T.G.), Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
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Hanin A, Chollet C, Demeret S, Di Meglio L, Castelli F, Navarro V. Metabolomic changes in adults with status epilepticus: A human case-control study. Epilepsia 2024; 65:929-943. [PMID: 38339978 DOI: 10.1111/epi.17899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Status epilepticus (SE) is a life-threatening prolonged epileptic seizure that affects ~40 per 100 000 people yearly worldwide. The persistence of seizures may lead to excitotoxic processes, neuronal loss, and neuroinflammation, resulting in long-term neurocognitive and functional disabilities. A better understanding of the pathophysiological mechanisms underlying SE consequences is crucial for improving SE management and preventing secondary neuronal injury. METHODS We conducted a comprehensive untargeted metabolomic analysis, using liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS), on plasma and cerebrospinal fluid (CSF) samples from 78 adult patients with SE and 107 control patients without SE, including 29 with CSF for both groups. The metabolomic fingerprints were compared between patients with SE and controls. Metabolites with differences in relative abundances that could not be attributed to treatment or nutrition provided in the intensive care unit were isolated. Enrichment analysis was performed on these metabolites to identify the most affected pathways. RESULTS We identified 76 metabolites in the plasma and 37 in the CSF that exhibited differential expression in patients with SE compared to controls. The enrichment analysis revealed that metabolic dysregulations in patients with SE affected primarily amino acid metabolism (including glutamate, alanine, tryptophan, glycine, and serine metabolism), pyrimidine metabolism, and lipid homeostasis. Specifically, patients with SE had elevated levels of pyruvate, quinolinic acid, and keto butyric acid levels, along with lower levels of arginine, N-acetylaspartylglutamate (NAAG), tryptophan, uracil, and uridine. The tryptophan kynurenine pathway was identified as the most significantly altered in SE, resulting in the overproduction of quinolinic acid, an N-methyl-d-aspartate (NMDA) receptor agonist with pro-inflammatory properties. SIGNIFICANCE This study has identified several pathways that may play pivotal roles in SE consequences, such as the tryptophan kynurenine pathway. These findings offer novel perspectives for the development of neuroprotective therapeutics.
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Affiliation(s)
- Aurélie Hanin
- Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié-Salpêtrière, Paris, France
- AP-HP, Epilepsy Unit and Clinical Neurophysiology Department, DMU Neurosciences, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Céline Chollet
- Université Paris Saclay, CEA, INRAE, Médicaments et Technologies pour la Santé (MTS), MetaboHUB, Gif-sur-Yvette, France
| | - Sophie Demeret
- AP-HP, Neuro-Intensive Care Unit, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Lucas Di Meglio
- AP-HP, Neuro-Intensive Care Unit, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Florence Castelli
- Université Paris Saclay, CEA, INRAE, Médicaments et Technologies pour la Santé (MTS), MetaboHUB, Gif-sur-Yvette, France
| | - Vincent Navarro
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié-Salpêtrière, Paris, France
- AP-HP, Epilepsy Unit and Clinical Neurophysiology Department, DMU Neurosciences, Hôpital de la Pitié-Salpêtrière, Paris, France
- Center of Reference for Rare Epilepsies, Epicare, Hôpital de la Pitié-Salpêtrière, Paris, France
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Wang T, Li C, Ma Y, Zhou H, Du X, Li Y, Long S, Ding Y, Lu G, Chen W, Zhou Y, Yu L, Wang J, Wang Y. Metabolomics of cerebrospinal fluid reveals prognostic biomarkers in pediatric status epilepticus. CNS Neurosci Ther 2023; 29:3925-3934. [PMID: 37381696 PMCID: PMC10651953 DOI: 10.1111/cns.14312] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023] Open
Abstract
AIMS Status epilepticus (SE) is the most common neurological emergency in pediatric patients. This study aimed to screen for prognostic biomarkers of SE in the cerebrospinal fluid (CSF) using metabolomics. METHODS Ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry (UPLC-QTOF-MS) was conducted to identify prognostic biomarkers in CSF metabolomics by comparing the poor outcome group (N = 13) with the good outcome group (N = 15) of children with SE. Differentially expressed metabolites were identified using Mann-Whitney U test corrected by Benjamini-Hochberg and partial least squares discriminant analysis (PLS-DA). RESULTS The PLS-DA model identified and validated significant metabolic differences between the poor and good outcome groups of children with SE (PLS-DA with R2 Y = 0.992 and Q2 = 0.798). A total of 49 prognosis-related metabolites were identified. Of these metabolites, 20 including glutamyl-glutamine, 3-iodothyronamine, and L-fucose had an area under the curve (AUC) ≥ 80% in prognostic prediction of SE. The logistic regression model combining glutamyl-glutamine and 3-iodothyronamine produced an AUC value of 0.976, with a sensitivity of 0.863 and specificity of 0.956. Pathway analysis revealed that dysregulation of the citrate cycle (TCA) and arginine biosynthesis may contribute to poor SE prognosis. CONCLUSIONS This study highlighted the prognosis-related metabolomic disturbances in the CSF of children with SE and identified potential prognostic biomarkers. A prognostic prediction model combining glutamyl-glutamine and 3-iodothyronamine with high predictive value was established.
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Affiliation(s)
- Tianqi Wang
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Chunpei Li
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Yu Ma
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Hao Zhou
- Department of Developmental Behavioral Pediatrics, Guizhou Provincial People's HospitalMedical College of Guizhou UniversityGuiyangChina
| | - Xiaonan Du
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Yingfeng Li
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Shasha Long
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Yifeng Ding
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Guoping Lu
- Pediatric Intensive Care Unit, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Weiming Chen
- Pediatric Intensive Care Unit, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Yuanfeng Zhou
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Lifei Yu
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Ji Wang
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
| | - Yi Wang
- Department of Neurology, National Children's Medical CenterChildren's Hospital of Fudan UniversityShanghaiChina
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Huang Y, Li Q, Huang G, Pei X, Chen Z, Tang X, Zhang R, Zhao SW, Liu Z, Sun J, Guo T, Liang FR. Immediate analgesic effect of acupuncture intervention within 10 min during acute migraine attacks: protocol of a randomised controlled trial. BMJ Open 2023; 13:e075715. [PMID: 37723105 PMCID: PMC10510906 DOI: 10.1136/bmjopen-2023-075715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023] Open
Abstract
INTRODUCTION Migraine is a widespread neurological disorder characterised by recurrent moderate-to-severe headaches. These headaches can seriously affect patients' daily life and work, especially during acute attacks when patients often need immediate pain relief. This study aims to assess the immediate analgesic effect of acupuncture for 10 min during acute migraine attacks. METHODS AND ANALYSIS The study will randomly divide 80 participants into either the acupuncture group or the sham acupuncture group with an allocation ratio of 1:1. Each group will receive 10 min of treatment, and the post-treatment evaluation will be performed after 0, 0-2, 4, 6, 8 and 10 min of acupuncture. The primary outcome is the pain Visual Analogue Scale (VAS) score assessed before and after treatment at 10 min. Additionally, secondary outcomes include the pain VAS score assessed at 0-2, 4, 6 and 8 min, blinding assessment and treatment effectiveness expectations scale. Data will be collected at baseline time and the end of treatment (after 10 min). Adverse events during each treatment period will be collected and recorded. ETHICS AND DISSEMINATION Ethics approval was obtained from the Ethics Committee of the Second Affiliated Hospital of Yunnan University of Chinese Medicine (2022-008). All participants will provide written informed consent before randomisation. The results of this study will be published in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registration Center (ChiCTR2200066976).
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Affiliation(s)
- Ya Huang
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Qifu Li
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Gaoyangzi Huang
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Xianmei Pei
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Ziwen Chen
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xing Tang
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Renrui Zhang
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Si-Wen Zhao
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Zili Liu
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Jinbo Sun
- School of Life Science and Technology, Xidian University, Xian, Shanxi, China
| | - Taipin Guo
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Fan-Rong Liang
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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5
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Osredkar J, Baškovič BŽ, Finderle P, Bobrowska-Korczak B, Gątarek P, Rosiak A, Giebułtowicz J, Vrhovšek MJ, Kałużna-Czaplińska J. Relationship between Excreted Uremic Toxins and Degree of Disorder of Children with ASD. Int J Mol Sci 2023; 24:7078. [PMID: 37108238 PMCID: PMC10138607 DOI: 10.3390/ijms24087078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is a complex developmental disorder in which communication and behavior are affected. A number of studies have investigated potential biomarkers, including uremic toxins. The aim of our study was to determine uremic toxins in the urine of children with ASD (143) and compare the results with healthy children (48). Uremic toxins were determined with a validated high-performance liquid chromatography coupled to mass spectrometry (LC-MS/MS) method. We observed higher levels of p-cresyl sulphate (pCS) and indoxyl sulphate (IS) in the ASD group compared to the controls. Moreover, the toxin levels of trimethylamine N-oxide (TMAO), symmetric dimethylarginine (SDMA), and asymmetric dimethylarginine (ADMA) were lower in ASD patients. Similarly, for pCS and IS in children classified, according to the intensity of their symptoms, into mild, moderate, and severe, elevated levels of these compounds were observed. For mild severity of the disorder, elevated levels of TMAO and comparable levels of SDMA and ADMA for ASD children as compared to the controls were observed in the urine. For moderate severity of ASD, significantly elevated levels of TMAO but reduced levels of SDMA and ADMA were observed in the urine of ASD children as compared to the controls. When the results obtained for severe ASD severity were considered, reduced levels of TMAO and comparable levels of SDMA and ADMA were observed in ASD children.
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Affiliation(s)
- Joško Osredkar
- Institute of Clinical Chemistry and Biochemistry, University Medical Center Ljubljana, Njegoseva 4, 1000 Ljubljana, Slovenia; (B.Ž.B.); (P.F.)
- Faculty of Pharmacy, University of Ljubljana, Aškerčeva Cesta 7, 1000 Ljubljana, Slovenia
| | - Barbara Žvar Baškovič
- Institute of Clinical Chemistry and Biochemistry, University Medical Center Ljubljana, Njegoseva 4, 1000 Ljubljana, Slovenia; (B.Ž.B.); (P.F.)
| | - Petra Finderle
- Institute of Clinical Chemistry and Biochemistry, University Medical Center Ljubljana, Njegoseva 4, 1000 Ljubljana, Slovenia; (B.Ž.B.); (P.F.)
| | - Barbara Bobrowska-Korczak
- Department of Toxicology and Food Science, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland;
| | - Paulina Gątarek
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (P.G.); (A.R.)
- CONEM Poland Chemistry and Nutrition Research Group, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland
| | - Angelina Rosiak
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (P.G.); (A.R.)
- CONEM Poland Chemistry and Nutrition Research Group, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland
| | - Joanna Giebułtowicz
- Department of Bioanalysis and Drug Analysis, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland;
| | - Maja Jekovec Vrhovšek
- Center for Autism, Unit of Child Psychiatry, University Children’s Hospital, University Medical Centre Ljubljana, Zaloška c.002, 1000 Ljubljana, Slovenia;
| | - Joanna Kałużna-Czaplińska
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (P.G.); (A.R.)
- CONEM Poland Chemistry and Nutrition Research Group, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland
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6
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Alimajstorovic Z, Mollan SP, Grech O, Mitchell JL, Yiangou A, Thaller M, Lyons H, Sassani M, Seneviratne S, Hancox T, Jankevics A, Najdekr L, Dunn W, Sinclair AJ. Dysregulation of Amino Acid, Lipid, and Acylpyruvate Metabolism in Idiopathic Intracranial Hypertension: A Non-targeted Case Control and Longitudinal Metabolomic Study. J Proteome Res 2022; 22:1127-1137. [PMID: 36534069 PMCID: PMC10088035 DOI: 10.1021/acs.jproteome.2c00449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure occurring predominantly in women with obesity. The pathogenesis is not understood. We have applied untargeted metabolomic analysis using ultrahigh-performance liquid chromatography-mass spectrometry to characterize the cerebrospinal fluid (CSF) and serum in IIH compared to control subjects. Methods and findings: Samples were collected from IIH patients (n = 66) with active disease at baseline and again at 12 months following therapeutic weight loss. Control samples were collected from gender- and weight-matched healthy controls (n = 20). We identified annotated metabolites in CSF, formylpyruvate and maleylpyruvate/fumarylpyruvate, which were present at lower concentrations in IIH compared to control subjects and returned to values observed in controls following weight loss. These metabolites showed the opposite trend in serum at baseline. Multiple amino acid metabolic pathways and lipid classes were perturbed in serum and CSF in IIH alone. Serum lipid metabolite pathways were significantly increased in IIH. Conclusions: We observed a number of differential metabolic pathways related to amino acid, lipid, and acylpyruvate metabolism, in IIH compared to controls. These pathways were associated with clinical measures and normalized with disease remission. Perturbation of these metabolic pathways provides initial understanding of disease dysregulation in IIH.
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Affiliation(s)
- Zerin Alimajstorovic
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
| | - Susan P. Mollan
- Birmingham Neuro-Ophthalmology, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham B15 2WB, U.K
| | - Olivia Grech
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
| | - James L. Mitchell
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
- Department of Neurology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, U.K
| | - Andreas Yiangou
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
- Department of Neurology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, U.K
| | - Mark Thaller
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
- Department of Neurology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, U.K
| | - Hannah Lyons
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
- Department of Neurology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, U.K
| | - Matilde Sassani
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
- Department of Neurology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, U.K
| | - Senali Seneviratne
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
| | - Thomas Hancox
- School of Biosciences, University of Birmingham, Birmingham B15 2TT, U.K
| | - Andris Jankevics
- School of Biosciences, University of Birmingham, Birmingham B15 2TT, U.K
- Phenome Centre Birmingham, University of Birmingham, Birmingham B15 2TT, U.K
| | - Lukáš Najdekr
- School of Biosciences, University of Birmingham, Birmingham B15 2TT, U.K
- Phenome Centre Birmingham, University of Birmingham, Birmingham B15 2TT, U.K
- Institute of Molecular and Translational Medicine, Palacký University Olomouc, Hněvotínská 5, Olomouc 77900, Czech Republic
| | - Warwick Dunn
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
- School of Biosciences, University of Birmingham, Birmingham B15 2TT, U.K
- Phenome Centre Birmingham, University of Birmingham, Birmingham B15 2TT, U.K
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool L69 7ZB, U.K
| | - Alexandra J. Sinclair
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, U.K
- Department of Neurology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, U.K
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham B15 2TT, U.K
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7
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Onderwater GLJ, van Dongen RM, Harms AC, Zielman R, van Oosterhout WPJ, van Klinken JB, Goeman JJ, Terwindt GM, van den Maagdenberg AMJM, Hankemeier T, Ferrari MD. Cerebrospinal Fluid and Plasma Amine Profiles in Interictal Migraine. Ann Neurol 2022; 93:715-728. [PMID: 36511835 DOI: 10.1002/ana.26576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 11/18/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Impaired amine metabolism has been associated with the etiology of migraine, that is, why patients continue to get migraine attacks. However, evidence from cerebrospinal fluid (CSF) is lacking. Here, we evaluated individual amine levels, global amine profiles, and amine pathways in CSF and plasma of interictal migraine patients and healthy controls. METHODS CSF and plasma were sampled between 8:30 am and 1:00 pm, randomly and interchangeably over the time span to avoid any diurnal and seasonal influences, from healthy volunteers and interictal migraine patients, matched for age, sex, and sampling time. The study was approved by the local medical ethics committee. Individual amines (n = 31), global amine profiles, and specific amine pathways were analyzed using a validated ultraperformance liquid chromatography mass spectrometry platform. RESULTS We analyzed n = 99 participants with migraine with aura, n = 98 with migraine without aura, and n = 96 healthy volunteers. Univariate analysis with Bonferroni correction indicated that CSF L-arginine was reduced in migraine with aura (10.4%, p < 0.001) and without aura (5.0%, p = 0.03). False discovery rate-corrected CSF L-phenylalanine was also lower in migraine with aura (6.9%, p = 0.011) and without aura (8.1%, p = 0.001), p = 0.088 after Bonferroni correction. Multivariate analysis revealed that CSF global amine profiles were similar for both types of migraine (p = 0.64), but distinct from controls (p = 0.009). Global profile analyses were similar in plasma. The strongest associated pathways with migraine were related to L-arginine metabolism. INTERPRETATION L-Arginine was decreased in the CSF (but not in plasma) of interictal patients with migraine with or without aura, and associated pathways were altered. This suggests that dysfunction of nitric oxide signaling is involved in susceptibility to getting migraine attacks. ANN NEUROL 2023.
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Affiliation(s)
| | - Robin M van Dongen
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Amy C Harms
- Division of Analytical Biosciences, Leiden Academic Center for Drug Research, Leiden, the Netherlands
| | - Ronald Zielman
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Jan B van Klinken
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands.,Department of Clinical Chemistry, Laboratory Genetic Metabolic Diseases, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Jelle J Goeman
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Thomas Hankemeier
- Division of Analytical Biosciences, Leiden Academic Center for Drug Research, Leiden, the Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
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8
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Liu L, Li W, Wang L, Gong P, Lyu T, Liu D, Zhang Y, Guo Y, Liu X, Tang M, Hu H, Liu C, Li B. Proteomic and metabolomic profiling of acupuncture for migraine reveals a correlative link via energy metabolism. Front Neurosci 2022; 16:1013328. [PMID: 36248663 PMCID: PMC9557737 DOI: 10.3389/fnins.2022.1013328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
Migraine is a neurovascular disease with a high disability rate. Acupuncture treatment has emerged as a safe and viable alternative prophylactic therapy that can effectively alleviate the duration and frequency of migraine attacks. However, the therapeutic mechanisms underlying the effects of acupuncture are yet to be systematically elucidated. In this study, we enrolled female patients with migraine without aura (n = 20) and healthy controls (n = 10). Patients received acupuncture treatment on DU20, DU24, bilateral GB13, GB8, and GB20, applied three times per week over the course of 4 weeks for 12 sessions in total. Blood samples were collected from the median cubital vein before and after acupuncture treatment. Proteomic and metabolomic profiling was performed using liquid chromatography-mass spectrometry to determine the characteristics of differentially expressed molecules and expression of their corresponding biological pathways as well as to elucidate the pathogenesis of migraine and the biological effects underlying the treatment of migraine with acupuncture. Proteomic and metabolomic profiling of plasma samples from patients with migraine without aura before and after acupuncture treatment revealed enrichment of immune-related pathway functions and the arginine synthesis pathway. Joint pathway analyses revealed significant enrichment of the pentose phosphate and glycolysis/gluconeogenesis pathways in patients with migraine. The glycolysis/gluconeogenesis and riboflavin metabolism pathways were significantly enriched after acupuncture treatment. The expression levels of various key proteins and metabolites, including α-D-glucose, flavin adenine dinucleotide, biliverdin reductase B, and L-glutamate, were significantly differentially expressed before and after acupuncture treatment in patients with migraine without aura. Treatment of migraine with acupuncture was associated with significant changes in key molecules and pathways, indicative of physiological changes in the trigeminovascular system, glutamate neurotoxicity, and other migraine-related physiological changes. Overall, our comprehensive analysis using proteomic and metabolomic profiling demonstrates that energy metabolism may serve as a key correlative link in the occurrence of migraine and the therapeutic effects of acupuncture treatment. Our findings may facilitate the identification of diagnostic and therapeutic modalities in the ongoing search for effective treatments for migraine attacks.
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Affiliation(s)
- Lu Liu
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Weizheng Li
- School of Engineering Medicine & School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Key Laboratory of Big Data-Based Precision Medicine, Beihang University, Ministry of Industry and Information Technology, Beijing, China
| | - Linpeng Wang
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Pengyun Gong
- School of Engineering Medicine & School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Key Laboratory of Big Data-Based Precision Medicine, Beihang University, Ministry of Industry and Information Technology, Beijing, China
| | - Tianli Lyu
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Dapeng Liu
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yajie Zhang
- Shanxi Hospital of Integrated Traditional and Western Medicine, Taiyuan, China
| | - Yijie Guo
- School of Engineering Medicine & School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Key Laboratory of Big Data-Based Precision Medicine, Beihang University, Ministry of Industry and Information Technology, Beijing, China
| | - Xiang Liu
- School of Engineering Medicine & School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Key Laboratory of Big Data-Based Precision Medicine, Beihang University, Ministry of Industry and Information Technology, Beijing, China
| | - Min Tang
- School of Engineering Medicine & School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Key Laboratory of Big Data-Based Precision Medicine, Beihang University, Ministry of Industry and Information Technology, Beijing, China
| | - Hongke Hu
- School of Engineering Medicine & School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Key Laboratory of Big Data-Based Precision Medicine, Beihang University, Ministry of Industry and Information Technology, Beijing, China
| | - Chao Liu
- School of Engineering Medicine & School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Key Laboratory of Big Data-Based Precision Medicine, Beihang University, Ministry of Industry and Information Technology, Beijing, China
- *Correspondence: Chao Liu,
| | - Bin Li
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
- Bin Li,
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9
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Li Q, Feng J, Zhang X, Wang Y, Zhao S, Xing C, Song Y, Zeng X, Kong M, Zheng Y, Zhao L, Guo T. Efficacy of contralateral acupuncture in women with migraine without aura: protocol for a randomised controlled trial. BMJ Open 2022; 12:e061287. [PMID: 35750456 PMCID: PMC9234910 DOI: 10.1136/bmjopen-2022-061287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Migraine is a common neurological disorder with a higher prevalence occurring in women. Migraine without aura (MwoA) is the most common type of migraine. In recent years, the safety and effectiveness of acupuncture for migraines have been internationally recognised. Contralateral acupuncture (CAT) (Jùcì) is an ancient classic acupuncture technique from Huang Di Nei Jing that refers to the acupoints on the right side (healthy side) selected for diseases on the left (affected side) and vice versa. Some studies have shown that efficacy of CAT on the painful disorder is even better than ipsilateral acupuncture (IAT), but there remains a lack of high-quality evidence to support it. METHODS AND ANALYSIS This is a single-centre, randomised and sham-controlled clinical trial in China with three parallel groups that aim to evaluate the efficacy of CAT in women with unilateral MwoA. 243 participants will be randomly divided into the experimental group (CAT group), control group 1 (IAT group) and control group 2 (sham acupuncture group) (1:1:1 allocation ratio). Each group will be given 30-minute treatment sessions, once every other day, approximately three times per week, for a total of 24 treatments and follow-up visits two times. The primary outcome is the changes in days of migraine attacks. The secondary outcomes are frequency of migraine attacks, intensity of migraine, migraine duration, the dose of intake of acute medication, the Migraine-Specific Quality of Life Questionnaire, the Migraine Disability Assessment Score, the Headache Impact Test-6 and the Pittsburgh Sleep Quality Index. The data will be collected at the baseline time (week 0), end of treatment (week 4-8) and the follow-up time (week 12-16). Adverse events will be collected and recorded during each treatment. ETHICS AND DISSEMINATION Ethics approval was obtained from the Ethics Committee of the Sports Trauma Specialist Hospital of Yunnan Province (2021-01). All participants will provide written informed consent before randomisation. The results of this study will be published in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registration Center (ChiCTR2100051479).
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Affiliation(s)
- Qifu Li
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Jialei Feng
- Institute for History of Medicine and Medical Literature, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinghe Zhang
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yanan Wang
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Siwen Zhao
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Chonghui Xing
- The Sports Trauma Specialist Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Yongli Song
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xuanxiang Zeng
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Meng Kong
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yunqiu Zheng
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Ling Zhao
- College of Acupuncture and Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Taipin Guo
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
- Key Laboratory for Acupuncture, Moxibustion and Tuina Prevention and Treatment of Brain Diseases in Yunnan Universities, Kunming, Yunnan, China
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10
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Biringer RG. Migraine signaling pathways: amino acid metabolites that regulate migraine and predispose migraineurs to headache. Mol Cell Biochem 2022; 477:2269-2296. [PMID: 35482233 DOI: 10.1007/s11010-022-04438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
Migraine is a common, debilitating disorder for which attacks typically result in a throbbing, pulsating headache. Although much is known about migraine, its complexity renders understanding the complete etiology currently out of reach. However, two important facts are clear, the brain and the metabolism of the migraineur differ from that of the non-migraineur. This review centers on the altered amino acid metabolism in migraineurs and how it helps define the pathology of migraine.
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Affiliation(s)
- Roger Gregory Biringer
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL, 34211, USA.
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11
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Masood A, Jacob M, Gu X, Abdel Jabar M, Benabdelkamel H, Nizami I, Li L, Dasouki M, Abdel Rahman AM. Distinctive metabolic profiles between Cystic Fibrosis mutational subclasses and lung function. Metabolomics 2021; 17:4. [PMID: 33394183 DOI: 10.1007/s11306-020-01760-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/09/2020] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Cystic fibrosis (CF) is a lethal multisystemic disease of a monogenic origin with numerous mutations. Functional defects in the cystic fibrosis transmembrane conductance receptor (CFTR) protein based on these mutations are categorised into distinct classes having different clinical presentations and disease severity. OBJECTIVES The present study aimed to create a comprehensive metabolomic profile of altered metabolites in patients with CF, among different classes and in relation to lung function. METHODS A chemical isotope labeling liquid chromatography-mass spectrometry metabolomics was used to study the serum metabolic profiles of young and adult CF (n = 39) patients and healthy controls (n = 30). Comparisons were made at three levels, CF vs. controls, among mutational classes of CF, between CF class III and IV, and correlated the lung function findings. RESULTS A distinctive metabolic profile was observed in the three analyses. 78, 20, and 13 significantly differentially dysregulated metabolites were identified in the patients with CF, among the different classes and between class III and IV, respectively. The significantly identified metabolites included amino acids, di-, and tri-peptides, glutathione, glutamine, glutamate, and arginine metabolism. The top significant metabolites include 1-Aminopropan-2-ol, ophthalmate, serotonin, cystathionine, and gamma-glutamylglutamic acid. Lung function represented by an above-average FEV1% level was associated with decreased glutamic acid and increased guanosine levels. CONCLUSION Metabolomic profiling identified alterations in different amino acids and dipeptides, involved in regulating glutathione metabolism. Two metabolites, 3,4-dihydroxymandelate-3-O-sulfate and 5-Aminopentanoic acid, were identified in common between the three anlayses and may represent as highly sensitive biomarkers for CF.
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Affiliation(s)
- Afshan Masood
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, PO. Box 2925 (98), Riyadh, 11461, Saudi Arabia
| | - Minnie Jacob
- Metabolomics Section, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre (KFSHRC), Zahrawi Street, Al Maather, PO. Box 3354, Riyadh, 11211, Saudi Arabia
| | - Xinyun Gu
- Department of Chemistry, University of Alberta, Edmonton, AB, T6G 2R3, Canada
| | - Mai Abdel Jabar
- Department of Chemistry, University of Alberta, Edmonton, AB, T6G 2R3, Canada
| | - Hicham Benabdelkamel
- Proteomics Resource Unit, Obesity Research Center, College of Medicine, King Saud University, PO. Box 2925 (98), Riyadh, 11461, Saudi Arabia
| | - Imran Nizami
- Lung Transplant Section, Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Zahrawi Street, Al Maather, Riyadh, 11211, Saudi Arabia
| | - Liang Li
- Department of Chemistry, University of Alberta, Edmonton, AB, T6G 2R3, Canada
| | - Majed Dasouki
- Metabolomics Section, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre (KFSHRC), Zahrawi Street, Al Maather, PO. Box 3354, Riyadh, 11211, Saudi Arabia
| | - Anas M Abdel Rahman
- Metabolomics Section, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre (KFSHRC), Zahrawi Street, Al Maather, PO. Box 3354, Riyadh, 11211, Saudi Arabia.
- Department of Biochemistry and Molecular Medicine, College of Medicine, Al Faisal University, Riyadh, Saudi Arabia.
- Department of Chemistry, Memorial University of Newfoundland, St. John's, NL, A1B 3X7, Canada.
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12
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Matjuda EN, Engwa GA, Sewani-Rusike CR, Nkeh-Chungag BN. An Overview of Vascular Dysfunction and Determinants: The Case of Children of African Ancestry. Front Pediatr 2021; 9:769589. [PMID: 34956981 PMCID: PMC8709476 DOI: 10.3389/fped.2021.769589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022] Open
Abstract
The balance between dilatory and constrictive factors is important as it keeps blood vessels in a homeostatic state. However, altered physiological processes as a result of obesity, hypertension, oxidative stress, and other cardiovascular risk factors may lead to vascular damage, causing an imbalance of vasoactive factors. Over time, the sustained imbalance of these vasoactive factors may lead to vascular dysfunction, which can be assessed by non-invasive methods, such as flow-mediated dilation, pulse wave velocity, flow-mediated slowing, retinal vessel analysis, peripheral vascular reactivity, and carotid intima-media thickness assessment. Although there is increasing prevalence of cardiovascular risk factors (obesity and hypertension) in children in sub-Saharan Africa, little is known about how this may affect vascular function. This review focuses on vasoactive factors implicated in vascular (dys)function, highlighting the determinants and consequences of vascular dysfunction. It further describes the non-invasive methods used for vascular (dys)function assessments and, last, describes the impact of cardiovascular risk factors on vascular dysfunction in children of African ancestry.
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Affiliation(s)
- Edna N Matjuda
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University PBX1, Mthatha, South Africa
| | - Godwill Azeh Engwa
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, Mthatha, South Africa
| | - Constance R Sewani-Rusike
- Department of Human Biology, Faculty of Health Sciences, Walter Sisulu University PBX1, Mthatha, South Africa
| | - Benedicta N Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, Mthatha, South Africa
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Elevated Levels of ADMA Are Associated with Lower DDAH2 and Higher PRMT1 in LPS-Induced Endometritis Rats. Inflammation 2017; 41:299-306. [DOI: 10.1007/s10753-017-0687-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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