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Danlos FX, Grajeda-Iglesias C, Durand S, Sauvat A, Roumier M, Cantin D, Colomba E, Rohmer J, Pommeret F, Baciarello G, Willekens C, Vasse M, Griscelli F, Fahrner JE, Goubet AG, Dubuisson A, Derosa L, Nirmalathasan N, Bredel D, Mouraud S, Pradon C, Stoclin A, Rozenberg F, Duchemin J, Jourdi G, Ellouze S, Levavasseur F, Albigès L, Soria JC, Barlesi F, Solary E, André F, Pène F, Ackerman F, Mouthon L, Zitvogel L, Marabelle A, Michot JM, Fontenay M, Kroemer G. Metabolomic analyses of COVID-19 patients unravel stage-dependent and prognostic biomarkers. Cell Death Dis 2021; 12:258. [PMID: 33707411 PMCID: PMC7948172 DOI: 10.1038/s41419-021-03540-y] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 02/07/2023]
Abstract
The circulating metabolome provides a snapshot of the physiological state of the organism responding to pathogenic challenges. Here we report alterations in the plasma metabolome reflecting the clinical presentation of COVID-19 patients with mild (ambulatory) diseases, moderate disease (radiologically confirmed pneumonitis, hospitalization and oxygen therapy), and critical disease (in intensive care). This analysis revealed major disease- and stage-associated shifts in the metabolome, meaning that at least 77 metabolites including amino acids, lipids, polyamines and sugars, as well as their derivatives, were altered in critical COVID-19 patient's plasma as compared to mild COVID-19 patients. Among a uniformly moderate cohort of patients who received tocilizumab, only 10 metabolites were different among individuals with a favorable evolution as compared to those who required transfer into the intensive care unit. The elevation of one single metabolite, anthranilic acid, had a poor prognostic value, correlating with the maintenance of high interleukin-10 and -18 levels. Given that products of the kynurenine pathway including anthranilic acid have immunosuppressive properties, we speculate on the therapeutic utility to inhibit the rate-limiting enzymes of this pathway including indoleamine 2,3-dioxygenase and tryptophan 2,3-dioxygenase.
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Affiliation(s)
- François-Xavier Danlos
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Université Paris Saclay, Faculté de Médecine, 94270, Le Kremlin-Bicêtre, France
| | - Claudia Grajeda-Iglesias
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- INSERM U1138, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Sylvère Durand
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Allan Sauvat
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Mathilde Roumier
- Service de Médecine Interne, Hôpital Foch, 92150, Suresnes, France
| | - Delphine Cantin
- Service d'Accueil des Urgences, AP-HP, Hôpital Hôtel-Dieu, 75004, Paris, France
| | - Emeline Colomba
- Département d'Oncologie Médicale, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Julien Rohmer
- Service de Médecine Interne, Hôpital Foch, 92150, Suresnes, France
| | - Fanny Pommeret
- Département d'Oncologie Médicale, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Giulia Baciarello
- Département d'Oncologie Médicale, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Christophe Willekens
- Département d'Hématologie, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Marc Vasse
- Service de biologie clinique, Hôpital Foch, 92150, Suresnes, France
| | - Frank Griscelli
- Service de virologie, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Jean-Eudes Fahrner
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Université Paris Saclay, Faculté de Médecine, 94270, Le Kremlin-Bicêtre, France
| | - Anne-Gaëlle Goubet
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Université Paris Saclay, Faculté de Médecine, 94270, Le Kremlin-Bicêtre, France
| | - Agathe Dubuisson
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Université Paris Saclay, Faculté de Médecine, 94270, Le Kremlin-Bicêtre, France
| | - Lisa Derosa
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Département d'Oncologie Médicale, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Centre d'Investigation Clinique - Biothérapie, INSERM CICBT1428, 94800, Villejuif, France
| | | | - Delphine Bredel
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Séverine Mouraud
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Caroline Pradon
- Département de Biologie Médicale, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Annabelle Stoclin
- Département de Réanimation, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Flore Rozenberg
- Service de Virologie, AP-HP. Centre-Université de Paris, Hôpital Cochin, Paris, France
| | - Jérôme Duchemin
- Service d'Hématologie Biologique, AP-HP, Centre-Université de Paris, Hôpital Cochin, 75014, Paris, France
| | - Georges Jourdi
- Service d'Hématologie Biologique, AP-HP, Centre-Université de Paris, Hôpital Cochin, 75014, Paris, France
- Université de Paris, Innovative Therapies in Haemostasis, INSERM 1140, F-75006, Paris, France
| | - Syrine Ellouze
- Service d'Hématologie Biologique, AP-HP, Centre-Université de Paris, Hôpital Cochin, 75014, Paris, France
| | - Françoise Levavasseur
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016, 75006, Paris, France
| | - Laurence Albigès
- Département d'Oncologie Médicale, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | | | - Fabrice Barlesi
- Département d'Oncologie Médicale, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France
| | - Eric Solary
- Université Paris Saclay, Faculté de Médecine, 94270, Le Kremlin-Bicêtre, France
- Département d'Hématologie, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- INSERM U1287, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Fabrice André
- Université Paris Saclay, Faculté de Médecine, 94270, Le Kremlin-Bicêtre, France
- Département d'Oncologie Médicale, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- INSERM U981, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Frédéric Pène
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016, 75006, Paris, France
- Service de Médecine Intensive et Réanimation, AP-HP, Hôpital Cochin, 75014, Paris, France
| | - Félix Ackerman
- Service de Médecine Interne, Hôpital Foch, 92150, Suresnes, France
| | - Luc Mouthon
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016, 75006, Paris, France
- Service de Médecine Interne, AP-HP, Hôpital Cochin, 75014, Paris, France
| | - Laurence Zitvogel
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Université Paris Saclay, Faculté de Médecine, 94270, Le Kremlin-Bicêtre, France
- Centre d'Investigation Clinique - Biothérapie, INSERM CICBT1428, 94800, Villejuif, France
| | - Aurélien Marabelle
- INSERM U1015, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Université Paris Saclay, Faculté de Médecine, 94270, Le Kremlin-Bicêtre, France
- Centre d'Investigation Clinique - Biothérapie, INSERM CICBT1428, 94800, Villejuif, France
- Département d'Innovation Thérapeutique et des Essais Précoces, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Jean-Marie Michot
- Département d'Hématologie, Gustave Roussy Cancer Campus, 94800, Villejuif, France
- Département d'Innovation Thérapeutique et des Essais Précoces, Gustave Roussy Cancer Campus, 94800, Villejuif, France
| | - Michaela Fontenay
- Service d'Hématologie Biologique, AP-HP, Centre-Université de Paris, Hôpital Cochin, 75014, Paris, France
- Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016, 75006, Paris, France
| | - Guido Kroemer
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, 94800, Villejuif, France.
- Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Institut Universitaire de France, Paris, France.
- Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, 75015, Paris, France.
- Suzhou Institute for Systems Biology, Chinese Academy of Sciences, Suzhou, China.
- Department of Women's and Children's Health, Karolinska University Hospital, 17176, Stockholm, Sweden.
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