Urinary excretion of 2,3-butanediol and acetoin by babies on a special care unit

Metabolic insights into HIV/TB co-infection: an untargeted urinary metabolomics approach

INTRODUCTION

Amid the global health crisis, HIV/TB co-infection presents significant challenges, amplifying the burden on patients and healthcare systems alike. Metabolomics offers an innovative window into the metabolic disruptions caused by co-infection, potentially improving diagnosis and treatment monitoring.

AIM

This study uses untargeted metabolomics to investigate the urinary metabolic signature of HIV/TB co-infection, enhancing understanding of the metabolic interplay between these infections.

METHODS

Urine samples from South African adults, categorised into four groups - healthy controls, TB-positive, HIV-positive, and HIV/TB co-infected - were analysed using GCxGC-TOFMS. Metabolites showing significant differences among groups were identified through Kruskal-Wallis and Wilcoxon rank sum tests.

RESULTS

Various metabolites (n = 23) were modulated across the spectrum of health and disease states represented in the cohorts. The metabolomic profiles reflect a pronounced disruption in biochemical pathways involved in energy production, amino acid metabolism, gut microbiome, and the immune response, suggesting a bidirectional exacerbation between HIV and TB. While both diseases independently perturb the host's metabolism, their co-infection leads to a unique metabolic phenotype, indicative of an intricate interplay rather than a simple additive effect.

CONCLUSION

Metabolic profiling revealed a unique metabolic landscape shaped by HIV/TB co-infection. The findings highlight the potential of urinary differential metabolites for co-infection, offering a non-invasive tool for enhancing diagnostic precision and tailoring therapeutic interventions. Future research should focus on expanding sample sizes and integrating longitudinal analyses to build upon these foundational insights, paving the way for metabolomic applications in combating these concurrent pandemics.

Molecular cloning and characterization of a cDNA encoding a bovine butanediol dehydrogenase

Using a polyclonal antibody against a bovine brain 30-kDa protein (p30), we isolated from a lambda gt11 bovine brain expression library a cDNA that codifies a protein with an apparent molecular mass of 30 kDa. The cDNA nucleotide sequence contained a unique open reading frame encoding a 26.7 kDa polypeptide. The 257 amino acids deduced sequence showed a significant homology with several dehydrogenases, mainly with a bacterial acetoin reductase (62%). The cloned cDNA identity was confirmed by the determination of acetoin reductase activity in lysogens of lambda phage constructions containing the full length cDNA. The results described in this report are to our knowledge the first molecular characterization of a 2,3-butanediol dehydrogenase in mammals.

Simple and sensitive determination of 2,3-butanediol in biological samples by gas chromatography with electron-capture detection

2,3-Butanediol was quantitatively oxidized into diacetyl by reaction with MnO4- at 20 degrees C for 30 min under neutral conditions. The reaction of diacetyl with 4,5-dichloro-1,2-diaminobenzene afforded 6,7-dichloro-2,3-dimethyl-quinoxaline (DCDMQ), which was extracted with n-hexane and determined by gas chromatography with electron-capture detection. As an internal standard 1,2-cyclohexanediol was used. The detection limit of DCDMQ (or 2,3-butanediol) was 10 fmol/microliter in the extract, and the determination limit of DCDMQ (or 2,3-butanediol) was at least from 50 fmol/microliter to 20 pmol/microliter in the extract. Recoveries from normal rat urine and rat liver homogenate were 97.8 +/- 3.4% and 98.4 +/- 2.9%, respectively. The method is very simple and sensitive and is applicable to the determination of 2,3-butanediol in normal rat tissues.

Simple and sensitive determination of diacetyl and acetoin in biological samples and alcoholic drinks by gas chromatography with electron-capture detection

Acetoin was quantitatively oxidized into diacetyl by Fe3+ in 1 M perchloric acid. The reaction of diacetyl with 4,5-dichloro-1,2-diaminobenzene afforded 6,7-dichloro-2,3-dimethylquinoxaline (DCDMQ), which was extracted by benzene containing aldrin (25 ng/ml) as an internal standard, and determined by gas chromatography with electron-capture detection. The method is very simple and sensitive. The detection limit of DCDMQ (either diacetyl or acetoin) was 10 fmol/microliters of the benzene extract, and the determination limit of DCDMQ (either diacetyl or acetoin) was 50 fmol/microliters of the extract. Both acetoin and diacetyl could be determined in 0.1 ml of normal human urine or blood, and both were found in rat liver, kidney and brain. The method was also applied to the determination of acetoin and diacetyl in alcoholic drinks.

Short chain diol metabolism in human disease states

Recent clinical studies have shown the presence of two short chain diols, meso-2,3-butanediol and D/L-2,3-butanediol, and in most cases 1,2-propanediol in either serum or urine collected from humans in several apparently unrelated disease states: congenital propionic and methylmalonic acidemia, premature infants, and alcoholics both in the presence and absence of ethanol. In addition 1,2-propanediol has been shown in patients during prolonged starvation, and in patients with diabetic keto-acidosis. No common defect is known to exist in these metabolic states. Understanding how these compounds are produced in clinically well-defined diseases such as methyl malonic and propionic aciduria, however, may help explain how and why these compounds are produced in alcoholics.

Carbohydrate fermentation by gut microflora in preterm neonates

To study organic acid excretion, urine was collected from 52 preterm infants at weekly intervals and analysed by capillary gas chromatography-mass spectrometry. Twelve of 22 babies born before 33 weeks' gestation excreted 2,3-butanediol, as did six born between 33 and 36 weeks. Six very immature babies also excreted acetoin, the metabolic precursor of the diol. Other products derived from carbohydrate included methylmalonic and ethylmalonic acids in one baby, and D-lactic acid in five. Acetoin has never been found in urine before, and the other four acids have been found only rarely. Excretion of these metabolites by preterm babies can be explained by increased intestinal permeability, unabsorbed lactose in the colon, and colonisation with certain opportunistic micro-organisms prevalent in neonatal units, including klebsiella, serratia, and enterobacter. The findings support evidence from breath hydrogen analysis that carbohydrate fermentation takes place in the gut of preterm infants.

3-Methylisoxazol-5-one, an artefact from acetoacetic acid formed during urinary organic acid analysis

During the analysis of urine for organic acids for suspected metabolic disorders by solvent extraction, derivatisation and capillary gas chromatography, unaccountably large lactic acid peaks were observed in some samples containing large amounts of acetoacetic acid. Electron impact mass spectrometry showed that this was due to two unknown compounds coeluting with lactic acid. These were found to be two trimethylsilyl derivatives of 3-methylisoxazol-5-one, produced from acetoacetic acid during oximation with hydroxylamine hydrochloride, by a cyclisation reaction. Awareness of the formation of this previously unreported artefact is important to laboratories employing a similar profiling procedure.