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Moon K, McKinnon E, Croft K, Mori TA, Simmer K, Patole S, Rao S. Early versus late parenteral nutrition in term and late preterm infants: a randomised controlled trial. BMJ Paediatr Open 2024; 8:e002579. [PMID: 38735834 PMCID: PMC11097870 DOI: 10.1136/bmjpo-2024-002579] [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: 02/15/2024] [Accepted: 04/09/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND There is limited evidence regarding the optimal time to commence parenteral nutrition (PN) in term and late preterm infants. DESIGN Single-centre, non-blinded, exploratory randomised controlled trial. SETTING A level-3 neonatal unit in a stand-alone paediatric hospital. PATIENTS Infants born ≥34 weeks of gestation and ≤28 days, who needed PN. Eligible infants were randomised on day 1 or day 2 of admission. INTERVENTIONS Early (day 1 or day 2 of admission, N=30) or late (day 6 of admission, N=30) PN. MAIN OUTCOME MEASURES Plasma phenylalanine and F2-isoprostane levels on day 4 and day 8 of admission. Secondary outcomes were amino-acid and fatty-acid profiles on day 4 and day 8, and clinical outcomes. RESULTS The postnatal age at randomisation was similar between the groups (2.3 (SD 0.8) vs 2.3 (0.7) days, p=0.90). On day 4, phenylalanine levels in early-PN infants were higher than in late-PN (mean (SD) 62.9 (26.7) vs 45.5 (15.3) µmol/L; baseline-adjusted percentage difference 25.8% (95% CI 11.6% to 39.9%), p<0.001). There was no significant difference in phenylalanine levels between the two groups on day 8. There was no significant difference between the groups for F2-isoprostane levels on day 4 (early-PN mean (SD) 389 (176) vs late-PN 419 (291) pg/mL; baseline-adjusted percentage difference: -4.4% (95% CI -21.5% to 12.8%) p=0.62) and day 8 (mean (SD) 305 (125) vs 354 (113) pg/mL; adjusted mean percentage difference -16.1 (95% CI -34.1 to 1.9) p=0.09).Postnatal growth restriction for weight was less severe in the early-PN group (change in weight z-score from baseline to discharge: -0.6 (0.6) vs -1.0 (0.6); p=0.02). The incidence of hyperglycaemia was greater in the early-PN group (20/30 (66.7%) vs 11/30 (36.7%), p=0.02). CONCLUSIONS The timing of the commencement of PN did not seem to affect the degree of oxidative stress in critically ill term and late preterm infants. The effect of transiently high plasma phenylalanine with early PN on clinical outcomes requires further investigation. TRIAL REGISTRATION NUMBER ACTRN12620000324910.
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Affiliation(s)
- Kwi Moon
- Pharmacy Department, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth McKinnon
- Telethon Institute for Child Health Research, Nedlands, Western Australia, Australia
| | - Kevin Croft
- The University of Western Australia School of Biomedical Sciences, Nedlands, Western Australia, Australia
| | - Trevor A Mori
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Karen Simmer
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Sanjay Patole
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Neonatology, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
| | - Shripada Rao
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Neonatology, Perth Children's Hospital, Nedlands, Western Australia, Australia
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Shevtsova Y, Starodubtseva N, Tokareva A, Goryunov K, Sadekova A, Vedikhina I, Ivanetz T, Ionov O, Frankevich V, Plotnikov E, Sukhikh G, Zorov D, Silachev D. Metabolite Biomarkers for Early Ischemic-Hypoxic Encephalopathy: An Experimental Study Using the NeoBase 2 MSMS Kit in a Rat Model. Int J Mol Sci 2024; 25:2035. [PMID: 38396712 PMCID: PMC10888647 DOI: 10.3390/ijms25042035] [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: 12/04/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Hypoxic-ischemic encephalopathy (HIE) is one of the most common causes of childhood disability. Hypothermic therapy is currently the only approved neuroprotective approach. However, early diagnosis of HIE can be challenging, especially in the first hours after birth when the decision to use hypothermic therapy is critical. Distinguishing HIE from other neonatal conditions, such as sepsis, becomes a significant problem in diagnosis. This study explored the utility of a metabolomic-based approach employing the NeoBase 2 MSMS kit to diagnose HIE using dry blood stains in a Rice-Vannucci model of HIE in rats. We evaluated the diagnostic fidelity of this approach in a range between 3 and 6 h after the onset of HIE, including in the context of systemic inflammation and concomitant hypothermic therapy. Discriminant analysis revealed several metabolite patterns associated with HIE. A logistic regression model using glycine levels achieved high diagnostic fidelity with areas under the receiver operating characteristic curve of 0.94 at 3 h and 0.96 at 6 h after the onset of HIE. In addition, orthogonal partial least squares discriminant analysis, which included five metabolites, achieved 100% sensitivity and 80% specificity within 3 h of HIE. These results highlight the significant potential of the NeoBase 2 MSMS kit for the early diagnosis of HIE and could improve patient management and outcomes in this serious illness.
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Affiliation(s)
- Yulia Shevtsova
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Natalia Starodubtseva
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
- Moscow Institute of Physics and Technology, 141700 Moscow, Russia
| | - Alisa Tokareva
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
| | - Kirill Goryunov
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
| | - Alsu Sadekova
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
| | - Irina Vedikhina
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
| | - Tatiana Ivanetz
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
| | - Oleg Ionov
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
| | - Vladimir Frankevich
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
| | - Egor Plotnikov
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Gennady Sukhikh
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
| | - Dmitry Zorov
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Denis Silachev
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (N.S.); (A.T.); (K.G.); (A.S.); (I.V.); (T.I.); (O.I.); (V.F.); (E.P.); (G.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia
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Liu H, Xie T, Wang J, Wang X, Han J, Huang Z, Jiang L, Nie Z. In situ analysis of metabolic changes under hypoxic-ischemic encephalopathy via MALDI mass spectrometry imaging. Talanta 2024; 268:125306. [PMID: 37839325 DOI: 10.1016/j.talanta.2023.125306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/28/2023] [Accepted: 10/11/2023] [Indexed: 10/17/2023]
Abstract
Hypoxic-ischemic encephalopathy (HIE) is a leading cause of neurological disability and even more serious fetal or neonatal asphyxia death. As the therapeutic time window is limited and timely intervention could have a better prognosis, elucidating the mechanisms underlying HIE and developing novel therapeutic strategies is of great importance. In the present study, 1, 5-Diaminonaphthalene hydrochloride (1, 5-DANHCl) assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) was applied to the neonatal rat model of HIE to investigate metabolic changes during hypoxic-ischemic period. Seventy-three metabolites involved in various metabolic pathways such as glycolysis, tricarboxylic acid (TCA) cycle, nucleoside metabolism, lipid metabolism, oxidative stress and ionic homeostasis demonstrated significant changes. It is worth mentioning that we have detected neutral triglycerides (TGs) that are difficult to ionize and observed their accumulation in the ischemic region, which has been rarely reported in previous studies. The results not only help us discover biomarkers but also provide new insights into its mechanism for us to understand the pathological and physiological processes of the disease.
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Affiliation(s)
- Huihui Liu
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
| | - Ting Xie
- Gannan Medical University, Ganzhou, Jiangxi Province, 341000, China; Gannna Innovation and Translational Medicine Research Institute, Ganzhou, Jiangxi Province, 341000, China
| | - Jiyun Wang
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xiao Wang
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jing Han
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
| | - Zhihua Huang
- Ganzhou Key Laboratory of Neuroinflammation Research, Gannan Medical University, Ganzhou, 341000, China; Gannan Medical University, Ganzhou, Jiangxi Province, 341000, China.
| | - Lixia Jiang
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, 341000, China; Ganzhou Key Laboratory of Neuroinflammation Research, Gannan Medical University, Ganzhou, 341000, China.
| | - Zongxiu Nie
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China; University of Chinese Academy of Sciences, Beijing, 100049, China.
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Shevtsova Y, Eldarov C, Starodubtseva N, Goryunov K, Chagovets V, Ionov O, Plotnikov E, Silachev D. Identification of Metabolomic Signatures for Ischemic Hypoxic Encephalopathy Using a Neonatal Rat Model. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1693. [PMID: 37892356 PMCID: PMC10605414 DOI: 10.3390/children10101693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023]
Abstract
A study was performed to determine early metabolomic markers of ischemic hypoxic encephalopathy (HIE) using a Rice-Vannucci model for newborn rats. Dried blood spots from 7-day-old male and female rat pups, including 10 HIE-affected animals and 16 control animals, were analyzed by liquid chromatography coupled with mass spectrometry (HPLC-MS) in positive and negative ion recording modes. Multivariate statistical analysis revealed two distinct clusters of metabolites in both HPLC-MS modes. Subsequent univariate statistical analysis identified 120 positive and 54 negative molecular ions that exhibited statistically significant change in concentration, with more than a 1.5-fold difference after HIE. In the HIE group, the concentrations of steroid hormones, saturated mono- and triglycerides, and phosphatidylcholines (PCs) were significantly decreased in positive mode. On the contrary, the concentration of unsaturated PCs was increased in the HIE group. Among negatively charged molecular ions, the greatest variations were found in the categories of phosphatidylcholines, phosphatidylinositols, and triglycerides. The major metabolic pathways associated with changed metabolites were analyzed for both modes. Metabolic pathways such as steroid biosynthesis and metabolism fatty acids were most affected. These results underscored the central role of glycerophospholipid metabolism in triggering systemic responses in HIE. Therefore, lipid biomarkers' evaluation by targeted HPLC-MS research could be a promising approach for the early diagnosis of HIE.
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Affiliation(s)
- Yulia Shevtsova
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (C.E.); (N.S.); (K.G.); (V.C.); (O.I.); (E.P.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Chupalav Eldarov
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (C.E.); (N.S.); (K.G.); (V.C.); (O.I.); (E.P.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Natalia Starodubtseva
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (C.E.); (N.S.); (K.G.); (V.C.); (O.I.); (E.P.)
| | - Kirill Goryunov
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (C.E.); (N.S.); (K.G.); (V.C.); (O.I.); (E.P.)
| | - Vitaliy Chagovets
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (C.E.); (N.S.); (K.G.); (V.C.); (O.I.); (E.P.)
| | - Oleg Ionov
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (C.E.); (N.S.); (K.G.); (V.C.); (O.I.); (E.P.)
| | - Egor Plotnikov
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (C.E.); (N.S.); (K.G.); (V.C.); (O.I.); (E.P.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Denis Silachev
- V.I. Kulakov National Medical Research Center for Obstetrics Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia; (Y.S.); (C.E.); (N.S.); (K.G.); (V.C.); (O.I.); (E.P.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119992 Moscow, Russia
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Yip PK, Bremang M, Pike I, Ponnusamy V, Michael-Titus AT, Shah DK. Newborns with Favourable Outcomes after Perinatal Asphyxia Have Upregulated Glucose Metabolism-Related Proteins in Plasma. Biomolecules 2023; 13:1471. [PMID: 37892154 PMCID: PMC10604898 DOI: 10.3390/biom13101471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/17/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
Hypoxic-ischaemic encephalopathy (HIE) is an important cause of morbidity and mortality globally. Although mild therapeutic hypothermia (TH) may improve outcomes in selected babies, the mechanism of action is not fully understood. A proteomics discovery study was carried out to analyse proteins in the plasma of newborns with HIE. Proteomic analysis of plasma from 22 newborns with moderate-severe HIE that had initially undergone TH, and relative controls including 10 newborns with mild HIE who did not warrant TH and also cord blood from 10 normal births (non-HIE) were carried out using the isobaric Tandem Mass Tag (TMT®) 10plexTM labelling with tandem mass spectrometry. A total of 7818 unique peptides were identified in all TMT10plexTM samples, translating to 3457 peptides representing 405 proteins, after applying stringent filter criteria. Apart from the unique protein signature from normal cord blood, unsupervised analysis revealed several significantly regulated proteins in the TH-treated moderate-severe HIE group. GO annotation and functional clustering revealed various proteins associated with glucose metabolism: the enzymes fructose-bisphosphate aldolase A, glyceraldehyde-3-phosphate dehydrogenase, phosphoglycerate mutase 1, phosphoglycerate kinase 1, and pyruvate kinase PKM were upregulated in newborns with favourable (sHIE+) outcomes compared to newborns with unfavourable (sHIE-) outcomes. Those with favourable outcomes had normal MR imaging or mild abnormalities not predictive of adverse outcomes. However, in comparison to mild HIE and the sHIE- groups, the sHIE+ group had the additional glucose metabolism-related enzymes upregulated, including triosephosphate isomerase, α-enolase, 6-phosphogluconate dehydrogenase, transaldolase, and mitochondrial glutathione reductase. In conclusion, our plasma proteomic study demonstrates that TH-treated newborns with favourable outcomes have an upregulation in glucose metabolism. These findings may open new avenues for more effective neuroprotective therapy.
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Affiliation(s)
- Ping K. Yip
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (V.P.); (A.T.M.-T.); (D.K.S.)
| | - Michael Bremang
- Proteome Sciences PLC, Coveham House, Surrey KT11 3EP, UK (I.P.)
| | - Ian Pike
- Proteome Sciences PLC, Coveham House, Surrey KT11 3EP, UK (I.P.)
| | - Vennila Ponnusamy
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (V.P.); (A.T.M.-T.); (D.K.S.)
- St. Peter’s Hospital (Ashford and St. Peter’s Hospitals NHS Foundation Trust), Chertsey KT16 0PZ, UK
| | - Adina T. Michael-Titus
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (V.P.); (A.T.M.-T.); (D.K.S.)
| | - Divyen K. Shah
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (V.P.); (A.T.M.-T.); (D.K.S.)
- Neonatal Unit, Royal London Hospital, Barts Health NHS Trust, London E1 1FR, UK
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Xiao T, Dong X, Lu Y, Zhou W. High-Resolution and Multidimensional Phenotypes Can Complement Genomics Data to Diagnose Diseases in the Neonatal Population. PHENOMICS (CHAM, SWITZERLAND) 2023; 3:204-215. [PMID: 37197647 PMCID: PMC10110825 DOI: 10.1007/s43657-022-00071-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 05/19/2023]
Abstract
Advances in genomic medicine have greatly improved our understanding of human diseases. However, phenome is not well understood. High-resolution and multidimensional phenotypes have shed light on the mechanisms underlying neonatal diseases in greater details and have the potential to optimize clinical strategies. In this review, we first highlight the value of analyzing traditional phenotypes using a data science approach in the neonatal population. We then discuss recent research on high-resolution, multidimensional, and structured phenotypes in neonatal critical diseases. Finally, we briefly introduce current technologies available for the analysis of multidimensional data and the value that can be provided by integrating these data into clinical practice. In summary, a time series of multidimensional phenome can improve our understanding of disease mechanisms and diagnostic decision-making, stratify patients, and provide clinicians with optimized strategies for therapeutic intervention; however, the available technologies for collecting multidimensional data and the best platform for connecting multiple modalities should be considered.
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Affiliation(s)
- Tiantian Xiao
- Division of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, 399 Wanyuan Road, Shanghai, 201102 China
- Department of Neonatology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610000 China
| | - Xinran Dong
- Center for Molecular Medicine, Pediatric Research Institute, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102 China
| | - Yulan Lu
- Center for Molecular Medicine, Pediatric Research Institute, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102 China
| | - Wenhao Zhou
- Division of Neonatology, Children’s Hospital of Fudan University, National Children’s Medical Center, 399 Wanyuan Road, Shanghai, 201102 China
- Center for Molecular Medicine, Pediatric Research Institute, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102 China
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Li S, Wan L, Sun J, Yan W, Wang J, Gao X, Ren C, Hao L. New Insights into Mechanisms of Ferroptosis Associated with Immune Infiltration in Neonatal Hypoxic-Ischemic Brain Damage. Cells 2022; 11:cells11233778. [PMID: 36497037 PMCID: PMC9736049 DOI: 10.3390/cells11233778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The mechanisms underlying ferroptosis in neonatal hypoxic-ischemic brain damage (HIBD) remain unclear. METHOD Four microarray datasets were collected from the GEO database (three mRNA datasets GSE23317, GSE144456, and GSE112137, and one miRNA microarray dataset GSE184939). Weighted gene co-expression network analysis (WGCNA) was used to identify modules of HIBD-related genes. The ferroptosis-related genes were extracted from FerrDb, of which closely correlated to HIBD were obtained after the intersection with existing HIBD's DEGs. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, as well as protein-protein interaction (PPI) network analysis were subsequently conducted. Cytoscape was used to identify central genes. Immune cell infiltration analysis was performed by the CIBERSORT algorithm. RESULT Fifty-six ferroptosis-related differentially expressed genes (FRDEGs) were screened, mainly related to ferroptosis, autophagy, hypoxia response, metabolic pathways, and immune inflammation. The seven optimal hub FRDEGs were obtained by intersecting with key modules of WGCNA. Then, the expression levels of the seven optimal hub FRDEGs were validated in the GSE144456 and GSE112137 datasets, and the ferroptosis-related mRNA-miRNA network was established. In addition, this study revealed immune cell infiltration in the HIBD cerebral cortex and the interaction between immune cells. Moreover, notably, specific FRDEGs were strongly positively correlated with immune function. CONCLUSIONS The mechanism of ferroptosis is intricate and closely related to neonatal HIBD. Therefore, targeting ferroptosis-related gene therapy and immunotherapy may have therapeutic prospects for neonatal HIBD.
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Affiliation(s)
- Shangbin Li
- Department of Pediatrics, First Affiliated Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang 050000, China
| | - Li Wan
- Institute for Epidemic Disease Control, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang 050000, China
| | - Jingfei Sun
- Department of Pediatrics, Zhengding People’s Hospital, Shijiazhuang 050000, China
| | - Weichen Yan
- Department of Pediatrics, First Affiliated Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang 050000, China
| | - Jie Wang
- Department of Pediatrics, First Affiliated Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang 050000, China
| | - Xiong Gao
- Department of Pediatrics, First Affiliated Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang 050000, China
| | - Changjun Ren
- Department of Pediatrics, First Affiliated Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang 050000, China
- Correspondence: (C.R.); (L.H.)
| | - Ling Hao
- Department of Pediatrics, First Affiliated Hospital of Hebei Medical University, Hebei Medical University, Shijiazhuang 050000, China
- Correspondence: (C.R.); (L.H.)
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Rasineni GK, Panigrahy N, Rath SN, Chinnaboina M, Konanki R, Chirla DK, Madduri S. Diagnostic and Therapeutic Roles of the “Omics” in Hypoxic–Ischemic Encephalopathy in Neonates. Bioengineering (Basel) 2022; 9:bioengineering9100498. [PMID: 36290466 PMCID: PMC9598631 DOI: 10.3390/bioengineering9100498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Perinatal asphyxia and neonatal encephalopathy remain major causes of neonatal mortality, despite the improved availability of diagnostic and therapeutic tools, contributing to neurological and intellectual disabilities worldwide. An approach using a combination of clinical data, neuroimaging, and biochemical parameters is the current strategy towards the improved diagnosis and prognosis of the outcome in neonatal hypoxic–ischemic encephalopathy (HIE) using bioengineering methods. Traditional biomarkers are of little use in this multifactorial and variable phenotype-presenting clinical condition. Novel systems of biology-based “omics” approaches (genomics, transcriptome proteomics, and metabolomics) may help to identify biomarkers associated with brain and other tissue injuries, predicting the disease severity in HIE. Biomarker studies using omics technologies will likely be a key feature of future neuroprotective treatment methods and will help to assess the successful treatment and long-term efficacy of the intervention. This article reviews the roles of different omics as biomarkers of HIE and outlines the existing knowledge of our current understanding of the clinical use of different omics molecules as novel neonatal brain injury biomarkers, which may lead to improved interventions related to the diagnostic and therapeutic aspects of HIE.
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Affiliation(s)
- Girish Kumar Rasineni
- LCMS Division, Tenet Medcorp Pvt. Ltd., 54 Kineta Towers Road No 3, Banjara Hills, Hyderabad 500034, India
| | - Nalinikanta Panigrahy
- Department of Neonatology, Rainbow Children’s Hospital, Hyderabad 500034, India
- Correspondence: (N.P.); (S.N.R.)
| | - Subha Narayan Rath
- Regenerative Medicine and Stem Cell Laboratory, Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Telangana 502284, India
- Correspondence: (N.P.); (S.N.R.)
| | - Madhurarekha Chinnaboina
- LCMS Division, Tenet Medcorp Pvt. Ltd., 54 Kineta Towers Road No 3, Banjara Hills, Hyderabad 500034, India
| | - Ramesh Konanki
- Department of Pediatric Neurology, Rainbow Children’s Hospital, Hyderabad 500034, India
| | - Dinesh Kumar Chirla
- Department of Neonatology, Rainbow Children’s Hospital, Hyderabad 500034, India
| | - Srinivas Madduri
- Bioengineering and Regenerative Medicine, Department of Biomedical Engineering, University of Basel, University Hospital Basel, 4001 Basel, Switzerland
- Department of Surgery, Bioengineering and Neuroregeneration, University of Geneva, University Hospital Geneva, 1211 Geneva, Switzerland
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9
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Moon K, Mckinnon E, Croft K, Hendrie D, Patole S, Simmer K, Rao S. Early versus late parenteral nutrition in term and late preterm infants: study protocol for a randomised controlled trial. BMC Pediatr 2022; 22:514. [PMID: 36042439 PMCID: PMC9429301 DOI: 10.1186/s12887-022-03569-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 08/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the wide use of parenteral nutrition (PN) in neonatal intensive care units (NICU), there is limited evidence regarding the optimal time to commence PN in term and late preterm infants. The recommendations from the recently published ESPGHAN/ESPEN/ESPR/CPEN and NICE guidelines are substantially different in this area, and surveys have reported variations in clinical practice. The aim of this randomised controlled trial (RCT) is to evaluate the benefits and risks of early versus late PN in term and late preterm infants. METHODS/DESIGN This study is a single-centre, non-blinded RCT in the NICU of Perth Children's Hospital, Western Australia.A total of 60 infants born ≥34 weeks of gestation who have a high likelihood of intolerance to enteral nutrition (EN) for at least 3-5 days will be randomised to early (day 1 or day 2 of admission) or late commencement (day 6 of admission) of PN after informed parental consent. In both groups, EN will be commenced as early as clinically feasible. Primary outcomes are plasma phenylalanine and plasma F2-isoprostane levels on Day 4 and Day 8 of admission. Secondary outcomes are total and individual plasma amino acid profiles, plasma and red blood cell fatty acid profiles, in-hospital all-cause mortality, hospital-acquired infections, length of hospital/NICU stay, z scores and changes in z scores at discharge for weight, height and head circumference, time to full EN, duration of respiratory (mechanical, non-invasive) support, duration of inotropic support, the incidence of hyper and hypoglycaemia, incidence of metabolic acidosis, liver function, blood urea nitrogen, and C-reactive protein (CRP). DISCUSSION This RCT will examine the effects of early versus late PN in term and late preterm infants by comparing key biochemical and clinical outcomes and has the potential to identify underlying pathways for beneficial or harmful effects related to the timing of commencement of PN in such infants. TRIAL REGISTRATION ANZCTR; ACTRN12620000324910 (3rd March 2020).
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Affiliation(s)
- Kwi Moon
- Pharmacy Department, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia. .,Medical School, The University of Western Australia, Perth, WA, Australia.
| | | | - Kevin Croft
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Delia Hendrie
- School of Public Health Sciences, Curtin University, Perth, WA, Australia
| | - Sanjay Patole
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Neonatology, King Edward Memorial Hospital, Subiaco, WA, Australia
| | - Karen Simmer
- Medical School, The University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Nedlands, WA, Australia
| | - Shripada Rao
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Neonatology, Perth Children's Hospital, Nedlands, WA, Australia
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10
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Valerio E, Mardegan V, Stocchero M, Cavicchiolo ME, Pirillo P, Poloniato G, D’Onofrio G, Bonadies L, Giordano G, Baraldi E. Urinary metabotypes of newborns with perinatal asphyxia undergoing therapeutic hypothermia. PLoS One 2022; 17:e0273175. [PMID: 35972970 PMCID: PMC9380923 DOI: 10.1371/journal.pone.0273175] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022] Open
Abstract
Perinatal asphyxia (PA) still occurs in about three to five per 1,000 deliveries in developed countries; 20% of these infants show hypoxic-ischemic encephalopathy (HIE) on brain magnetic resonance imaging (MRI). The aim of our study was to apply metabolomic analysis to newborns undergoing therapeutic hypothermia (TH) after PA to identify a distinct metabotype associated with the development of HIE on brain MRI. We enrolled 53 infants born at >35 weeks of gestation with PA: 21 of them showed HIE on brain MRI (the “HIE” group), and 32 did not (the “no HIE” group). Urine samples were collected at 24, 48 and 72 hours of TH. Metabolomic data were acquired using high-resolution mass spectrometry and analyzed with univariate and multivariate methods. Considering the first urines collected during TH, untargeted analysis found 111 relevant predictors capable of discriminating between the two groups. Of 35 metabolites showing independent discriminatory power, four have been well characterized: L-alanine, Creatine, L-3-methylhistidine, and L-lysine. The first three relate to cellular energy metabolism; their involvement suggests a multimodal derangement of cellular energy metabolism during PA/HIE. In addition, seven other metabolites with a lower annotation level (proline betaine, L-prolyl-L-phenylalanine, 2-methyl-dodecanedioic acid, S-(2-methylpropionyl)-dihydrolipoamide-E, 2,6 dimethylheptanoyl carnitine, Octanoylglucuronide, 19-hydroxyandrost-4-ene-3,17-dione) showed biological consistency with the clinical picture of PA. Moreover, 4 annotated metabolites (L-lysine, L-3-methylhistidine, 2-methyl-dodecanedioic acid, S-(2-methylpropionyl)-dihydrolipoamide-E) retained a significant difference between the “HIE” and “no HIE” groups during all the TH treatment. Our analysis identified a distinct urinary metabotype associated with pathological findings on MRI, and discovered 2 putative markers (L-lysine, L-3-methylhistidine) which may be useful for identifying neonates at risk of developing HIE after PA.
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Affiliation(s)
- Enrico Valerio
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- * E-mail:
| | - Veronica Mardegan
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
| | - Matteo Stocchero
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Maria Elena Cavicchiolo
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
| | - Paola Pirillo
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Gabriele Poloniato
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Gianluca D’Onofrio
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
| | - Luca Bonadies
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
| | - Giuseppe Giordano
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Eugenio Baraldi
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
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11
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Dave AM, Genaro-Mattos TC, Korade Z, Peeples ES. Neonatal Hypoxic-Ischemic Brain Injury Alters Brain Acylcarnitine Levels in a Mouse Model. Metabolites 2022; 12:metabo12050467. [PMID: 35629971 PMCID: PMC9143624 DOI: 10.3390/metabo12050467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/10/2022] [Accepted: 05/18/2022] [Indexed: 12/10/2022] Open
Abstract
Hypoxic-ischemic brain injury (HIBI) leads to depletion of ATP, mitochondrial dysfunction, and enhanced oxidant formation. Measurement of acylcarnitines may provide insight into mitochondrial dysfunction. Plasma acylcarnitine levels are altered in neonates after an HIBI, but individual acylcarnitine levels in the brain have not been evaluated. Additionally, it is unknown if plasma acylcarnitines reflect brain acylcarnitine changes. In this study, postnatal day 9 CD1 mouse pups were randomized to HIBI induced by carotid artery ligation, followed by 30 min at 8% oxygen, or to sham surgery and normoxia, with subgroups for tissue collection at 30 min, 24 h, or 72 h after injury (12 animals/group). Plasma, liver, muscle, and brain (dissected into the cortex, cerebellum, and striatum/thalamus) tissues were collected for acylcarnitine analysis by LC-MS. At 30 min after HIBI, acylcarnitine levels were significantly increased, but the differences resolved by 24 h. Palmitoylcarnitine was increased in the cortex, muscle, and plasma, and stearoylcarnitine in the cortex, striatum/thalamus, and cerebellum. Other acylcarnitines were elevated only in the muscle and plasma. In conclusion, although plasma acylcarnitine results in this study mimic those seen previously in humans, our data suggest that the plasma acylcarnitine profile was more reflective of muscle changes than brain changes. Acylcarnitine metabolism may be a target for therapeutic intervention after neonatal HIBI, though the lack of change after 30 min suggests a limited therapeutic window.
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Affiliation(s)
- Amanda M. Dave
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA; (A.M.D.); (Z.K.)
- Children’s Hospital & Medical Center, Omaha, NE 68114, USA
- Child Health Research Institute, Omaha, NE 68198, USA;
| | - Thiago C. Genaro-Mattos
- Child Health Research Institute, Omaha, NE 68198, USA;
- Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Zeljka Korade
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA; (A.M.D.); (Z.K.)
- Child Health Research Institute, Omaha, NE 68198, USA;
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Eric S. Peeples
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA; (A.M.D.); (Z.K.)
- Children’s Hospital & Medical Center, Omaha, NE 68114, USA
- Child Health Research Institute, Omaha, NE 68198, USA;
- Correspondence: ; Tel.: +1-402-955-6140; Fax: +1-402-955-3398
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12
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Hartvigsson O, Barman M, Savolainen O, Ross AB, Sandin A, Jacobsson B, Wold AE, Sandberg AS, Brunius C. Differences between Arterial and Venous Umbilical Cord Plasma Metabolome and Association with Parity. Metabolites 2022; 12:metabo12020175. [PMID: 35208249 PMCID: PMC8877791 DOI: 10.3390/metabo12020175] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 02/01/2023] Open
Abstract
Umbilical cord blood is frequently used in health monitoring of the neonate. Results may be affected by the proportion of arterial and venous cord blood, the venous blood coming from the mother to supply oxygen and nutrients to the infant, and the arterial carrying waste products from the fetus. Here, we sampled arterial and venous umbilical cords separately from 48 newly delivered infants and examined plasma metabolomes using GC-MS/MS metabolomics. We investigated differences in metabolomes between arterial and venous blood and their associations with gestational length, birth weight, sex, and whether the baby was the first born or not, as well as maternal age and BMI. Using multilevel random forest analysis, a classification rate of 79% was achieved for arteriovenous differences (p = 0.004). Several monosaccharides had higher concentrations in the arterial cord plasma while amino acids were higher in venous plasma, suggesting that the main differences in the measured arterial and venous plasma metabolomes are related to amino acid and energy metabolism. Venous cord plasma metabolites related to energy metabolism were positively associated with parity (77% classification rate, p = 0.004) while arterial cord plasma metabolites were not. This underlines the importance of defining cord blood type for metabolomic studies.
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Affiliation(s)
- Olle Hartvigsson
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden; (M.B.); (A.-S.S.); (C.B.)
- Correspondence:
| | - Malin Barman
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden; (M.B.); (A.-S.S.); (C.B.)
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Otto Savolainen
- Chalmers Mass Spectrometry Infrastructure, Chalmers University of Technology, 412 96 Göteborg, Sweden;
| | - Alastair B. Ross
- AgResearch, Proteins and Metabolites, Lincoln 7674, New Zealand;
| | - Anna Sandin
- Department of Clinical Science, Pediatrics, Sunderby Research Unit, Umeå University, 901 897 Umeå, Sweden;
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden;
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Agnes E. Wold
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, 413 45 Gothenburg, Sweden;
| | - Ann-Sofie Sandberg
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden; (M.B.); (A.-S.S.); (C.B.)
| | - Carl Brunius
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden; (M.B.); (A.-S.S.); (C.B.)
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13
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Noninvasive monitoring of evolving urinary metabolic patterns in neonatal encephalopathy. Pediatr Res 2022; 91:598-605. [PMID: 33953355 DOI: 10.1038/s41390-021-01553-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 04/08/2021] [Accepted: 04/10/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Infants with moderate and severe neonatal encephalopathy (NE) frequently suffer from long-term adverse outcomes. We hypothesize that the urinary metabolome of newborns with NE reflects the evolution of injury patterns observed with magnetic resonance imaging (MRI). METHODS Eligible patients were newborn infants with perinatal asphyxia evolving to NE and qualifying for therapeutic hypothermia (TH) included in the HYPOTOP trial. MRI was employed for characterizing brain injury. Urine samples of 55 infants were collected before, during, and after TH. Metabolic profiles of samples were recorded employing three complementary mass spectrometry-based assays, and the alteration of detected metabolic features between groups was assessed. RESULTS The longitudinal assessment revealed significant perturbations of the urinary metabolome. After 24 h of TH, a stable disease pattern evolved characterized by the alterations of 4-8% of metabolic features related to lipid metabolism, metabolism of cofactors and vitamins, glycan biosynthesis and metabolism, amino acid metabolism, and nucleotide metabolism. Characteristic metabolomic fingerprints were observed for different MRI injury patterns. CONCLUSIONS This study shows the potential of urinary metabolic profiles for the noninvasive monitoring of brain injury of infants with NE during TH. IMPACT A comprehensive approach for the study of the urinary metabolome was employed involving a semi-targeted capillary electrophoresis-time-of-flight mass spectrometry (TOFMS) assay, an untargeted ultra-performance liquid chromatography (UPLC)-quadrupole TOFMS assay, and a targeted UPLC-tandem MS-based method for the quantification of amino acids. The longitudinal study of the urinary metabolome identified dynamic metabolic changes between birth and until 96 h after the initiation of TH. The identification of altered metabolic pathways in newborns with pathologic MRI outcomes might offer the possibility of developing noninvasive monitoring approaches for personalized adjustment of the treatment and for supporting early outcome prediction.
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14
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Nixon R, Ip THR, Jenkins B, Yip PK, Clarke P, Ponnusamy V, Michael-Titus AT, Koulman A, Shah DK. Lipid Profiles from Dried Blood Spots Reveal Lipidomic Signatures of Newborns Undergoing Mild Therapeutic Hypothermia after Hypoxic-Ischemic Encephalopathy. Nutrients 2021; 13:nu13124301. [PMID: 34959853 PMCID: PMC8703828 DOI: 10.3390/nu13124301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/24/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022] Open
Abstract
Hypoxic-ischemic encephalopathy (HIE) is associated with perinatal brain injury, which may lead to disability or death. As the brain is a lipid-rich organ, various lipid species can be significantly impacted by HIE and these correlate with specific changes to the lipidomic profile in the circulation. Objective: To investigate the peripheral blood lipidomic signature in dried blood spots (DBS) from newborns with HIE. Using univariate analysis, multivariate analysis and sPLS-DA modelling, we show that newborns with moderate-severe HIE (n = 46) who underwent therapeutic hypothermia (TH) displayed a robust peripheral blood lipidomic signature comprising 29 lipid species in four lipid classes; namely phosphatidylcholine (PC), lysophosphatidylcholine (LPC), triglyceride (TG) and sphingomyelin (SM) when compared with newborns with mild HIE (n = 18). In sPLS-DA modelling, the three most discriminant lipid species were TG 50:3, TG 54:5, and PC 36:5. We report a reduction in plasma TG and SM and an increase in plasma PC and LPC species during the course of TH in newborns with moderate-severe HIE, compared to a single specimen from newborns with mild HIE. These findings may guide the research in nutrition-based intervention strategies after HIE in synergy with TH to enhance neuroprotection.
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Affiliation(s)
- Rebekah Nixon
- The Royal London Hospital, Barts Health NHS Trust, London E1 1FR, UK; (R.N.); (T.H.R.I.)
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.K.Y.); (A.T.M.-T.)
| | - Ting Hin Richard Ip
- The Royal London Hospital, Barts Health NHS Trust, London E1 1FR, UK; (R.N.); (T.H.R.I.)
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.K.Y.); (A.T.M.-T.)
| | - Benjamin Jenkins
- NIHR Core Metabolomics and Lipidomics Laboratory, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UK;
| | - Ping K. Yip
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.K.Y.); (A.T.M.-T.)
| | - Paul Clarke
- Neonatal Unit, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich NR4 7UY, UK;
- Norwich Medical School, University of East Anglia, Norwich NR4 7UY, UK
| | - Vennila Ponnusamy
- Ashford and St. Peter’s Hospitals NHS Foundation Trust, Chertsey KT16 0PZ, UK;
| | - Adina T. Michael-Titus
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.K.Y.); (A.T.M.-T.)
| | - Albert Koulman
- NIHR Core Metabolomics and Lipidomics Laboratory, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UK;
- Correspondence: (A.K.); (D.K.S.); Tel.: +44-20-3594-0524 (D.K.S); Fax: +44-20-7882-2180 (D.K.S.)
| | - Divyen K. Shah
- The Royal London Hospital, Barts Health NHS Trust, London E1 1FR, UK; (R.N.); (T.H.R.I.)
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.K.Y.); (A.T.M.-T.)
- Correspondence: (A.K.); (D.K.S.); Tel.: +44-20-3594-0524 (D.K.S); Fax: +44-20-7882-2180 (D.K.S.)
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15
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Solevåg AL, Zykova SN, Thorsby PM, Schmölzer GM. Metabolomics to Diagnose Oxidative Stress in Perinatal Asphyxia: Towards a Non-Invasive Approach. Antioxidants (Basel) 2021; 10:antiox10111753. [PMID: 34829624 PMCID: PMC8615205 DOI: 10.3390/antiox10111753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
There is a need for feasible and non-invasive diagnostics in perinatal asphyxia. Metabolomics is the study of small molecular weight products of cellular metabolism that may, directly and indirectly, reflect the level of oxidative stress. Saliva analysis is a novel approach that has a yet unexplored potential in metabolomics in perinatal asphyxia. The aim of this review was to give an overview of metabolomics studies of oxidative stress in perinatal asphyxia, particularly searching for studies analyzing non-invasively collected biofluids including saliva. We searched the databases PubMed/Medline and included 11 original human and 4 animal studies. In perinatal asphyxia, whole blood, plasma, and urine are the most frequently used biofluids used for metabolomics analyses. Although changes in oxidative stress-related salivary metabolites have been reported in adults, the utility of this approach in perinatal asphyxia has not yet been explored. Human and animal studies indicate that, in addition to antioxidant enzymes, succinate and hypoxanthine, as well acylcarnitines may have discriminatory diagnostic and prognostic properties in perinatal asphyxia. Researchers may utilize the accumulating evidence of discriminatory metabolic patterns in perinatal asphyxia to develop bedside methods to measure oxidative stress metabolites in perinatal asphyxia. Although only supported by indirect evidence, saliva might be a candidate biofluid for such point-of-care diagnostics.
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Affiliation(s)
- Anne Lee Solevåg
- The Department of Paediatric and Adolescent Medicine, Oslo University Hospital, 0424 Nydalen, Norway
- Correspondence: ; Tel.: +47-4146-9314
| | - Svetlana N. Zykova
- Biochemical Endocrinology and Metabolism Research Group, The Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, 0424 Nydalen, Norway; (S.N.Z.); (P.M.T.)
| | - Per Medbøe Thorsby
- Biochemical Endocrinology and Metabolism Research Group, The Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, 0424 Nydalen, Norway; (S.N.Z.); (P.M.T.)
| | - Georg M. Schmölzer
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB 23821, Canada;
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB 23821, Canada
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16
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Ponnusamy V, Ip RTH, Mohamed MAEK, Clarke P, Wozniak E, Mein C, Schwendimann L, Barlas A, Chisholm P, Chakkarapani E, Michael-Titus AT, Gressens P, Yip PK, Shah DK. Neuronal let-7b-5p acts through the Hippo-YAP pathway in neonatal encephalopathy. Commun Biol 2021; 4:1143. [PMID: 34593980 PMCID: PMC8484486 DOI: 10.1038/s42003-021-02672-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022] Open
Abstract
Despite increasing knowledge on microRNAs, their role in the pathogenesis of neonatal encephalopathy remains to be elucidated. Herein, we identify let-7b-5p as a significant microRNA in neonates with moderate to severe encephalopathy from dried blood spots using next generation sequencing. Validation studies using Reverse Transcription and quantitative Polymerase Chain Reaction on 45 neonates showed that let-7b-5p expression was increased on day 1 in neonates with moderate to severe encephalopathy with unfavourable outcome when compared to those with mild encephalopathy. Mechanistic studies performed on glucose deprived cell cultures and the cerebral cortex of two animal models of perinatal brain injury, namely hypoxic-ischaemic and intrauterine inflammation models confirm that let-7b-5p is associated with the apoptotic Hippo pathway. Significant reduction in neuronal let-7b-5p expression corresponded with activated Hippo pathway, with increased neuronal/nuclear ratio of Yes Associated Protein (YAP) and increased neuronal cleaved caspase-3 expression in both animal models. Similar results were noted for let-7b-5p and YAP expression in glucose-deprived cell cultures. Reduced nuclear YAP with decreased intracellular let-7b-5p correlated with neuronal apoptosis in conditions of metabolic stress. This finding of the Hippo-YAP association with let-7b needs validation in larger cohorts to further our knowledge on let-7b-5p as a biomarker for neonatal encephalopathy. Using next generation sequencing of dried blood spots and subsequent validation, Ponnusamy et al identify let-7b-5p as an elevated microRNA in neonates with moderate to severe encephalopathy. Using cell culture and murine models of perinatal brain injury they demonstrate that the effects of let-7b-5p are elicited via the Hippo-YAP pathway, which should be validated in large neonate cohorts to expand our understanding of let-7b-5p as a biomarker for neonatal encephalopathy.
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Affiliation(s)
- Vennila Ponnusamy
- Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, UK.,Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Richard T H Ip
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Moumin A E K Mohamed
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Paul Clarke
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Eva Wozniak
- Genome Centre, Barts and the London School of Medicine and Dentistry, London, UK
| | - Charles Mein
- Genome Centre, Barts and the London School of Medicine and Dentistry, London, UK
| | | | - Akif Barlas
- The Royal London Hospital, Barts Health NHS Trust, London, UK
| | | | - Ela Chakkarapani
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Adina T Michael-Titus
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Pierre Gressens
- Université de Paris, NeuroDiderot, Inserm, 75019, Paris, France.,Centre for the Developing Brain, Kings College London, London, UK
| | - Ping K Yip
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Divyen K Shah
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,The Royal London Hospital, Barts Health NHS Trust, London, UK
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17
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Mooney C, O'Boyle D, Finder M, Hallberg B, Walsh BH, Henshall DC, Boylan GB, Murray DM. Predictive modelling of hypoxic ischaemic encephalopathy risk following perinatal asphyxia. Heliyon 2021; 7:e07411. [PMID: 34278022 PMCID: PMC8261660 DOI: 10.1016/j.heliyon.2021.e07411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/29/2021] [Accepted: 06/23/2021] [Indexed: 01/03/2023] Open
Abstract
Hypoxic Ischemic Encephalopathy (HIE) remains a major cause of neurological disability. Early intervention with therapeutic hypothermia improves outcome, but prediction of HIE is difficult and no single clinical marker is reliable. Machine learning algorithms may allow identification of patterns in clinical data to improve prognostic power. Here we examine the use of a Random Forest machine learning algorithm and five-fold cross-validation to predict the occurrence of HIE in a prospective cohort of infants with perinatal asphyxia. Infants with perinatal asphyxia were recruited at birth and neonatal course was followed for the development of HIE. Clinical variables were recorded for each infant including maternal demographics, delivery details and infant's condition at birth. We found that the strongest predictors of HIE were the infant's condition at birth (as expressed by Apgar score), need for resuscitation, and the first postnatal measures of pH, lactate, and base deficit. Random Forest models combining features including Apgar score, most intensive resuscitation, maternal age and infant birth weight both with and without biochemical markers of pH, lactate, and base deficit resulted in a sensitivity of 56-100% and a specificity of 78-99%. This study presents a dynamic method of rapid classification that has the potential to be easily adapted and implemented in a clinical setting, with and without the availability of blood gas analysis. Our results demonstrate that applying machine learning algorithms to readily available clinical data may support clinicians in the early and accurate identification of infants who will develop HIE. We anticipate our models to be a starting point for the development of a more sophisticated clinical decision support system to help identify which infants will benefit from early therapeutic hypothermia.
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Affiliation(s)
- Catherine Mooney
- School of Computer Science, University College Dublin, Dublin, Ireland.,FutureNeuro SFI Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,INFANT Research Centre, University College Cork, Cork, Ireland
| | - Daragh O'Boyle
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Mikael Finder
- Neonatal Department, Karolinska University Hospital, Stockholm, Sweden.,Division of Paediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden
| | - Boubou Hallberg
- Neonatal Department, Karolinska University Hospital, Stockholm, Sweden.,Division of Paediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden
| | - Brian H Walsh
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.,Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland
| | - David C Henshall
- FutureNeuro SFI Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Geraldine B Boylan
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Deirdre M Murray
- INFANT Research Centre, University College Cork, Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
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18
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Jain PN, Robertson M, Lasa JJ, Shekerdemian L, Guffey D, Zhang Y, Lingappan K, Checchia P, Coarfa C. Altered metabolic and inflammatory transcriptomics after cardiac surgery in neonates with congenital heart disease. Sci Rep 2021; 11:4965. [PMID: 33654130 PMCID: PMC7925649 DOI: 10.1038/s41598-021-83882-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 01/22/2021] [Indexed: 12/20/2022] Open
Abstract
The study examines the whole blood transcriptome profile before and after cardiopulmonary bypass (CPB) in neonates with hypoplastic left heart syndrome (HLHS), a severe form of congenital heart disease, that can develop low cardiac output syndrome (LCOS). Whole blood mRNA transcriptome profiles of 13 neonates with HLHS before and after their first palliative surgery were analyzed to determine differentially expressed genes and pathways. The median age and weight at surgery were 4 days and 3.2 kg, respectively. Of the 13 patients, 8 developed LCOS. There was no significant difference between CPB, aortic cross clamp, deep hypothermic cardiac arrest times between patients that develop LCOS and those that do not. Upon comparing differential gene expression profiles between patients that develop LCOS and those that do not in pre-operative samples, 1 gene was up-regulated and 13 were down regulated. In the post-operative samples, 4 genes were up-regulated, and 4 genes were down regulated when patients that develop LCOS were compared to those that do not. When comparing post-operative samples to pre-operative samples in the patients that do not develop LCOS, 1484 genes were up-regulated, and 1388 genes were down regulated; while patients that developed LCOS had 2423 up-regulated genes, and 2414 down regulated genes for the same pre to post-operative comparison. Pathway analysis revealed differential regulation of inflammatory pathways (IL signaling, PDGF, NOTCH1, NGF, GPCR) and metabolic pathways (heme metabolism, oxidative phosphorylation, protein metabolism including amino acid and derivatives, fatty acid metabolism, TCA cycle and respiratory electron transport chain). By identifying altered transcriptome profiles related to inflammation and metabolism in neonates with HLHS who develop LCOS after CPB, this study opens for exploration novel pathways and potential therapeutic targets to improve outcomes in this high-risk population.
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Affiliation(s)
- Parag N Jain
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
| | | | - Javier J Lasa
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Lara Shekerdemian
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | | | - Yuhao Zhang
- Baylor College of Medicine, Houston, TX, USA
| | - Krithika Lingappan
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Paul Checchia
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
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19
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Improvement in the Prediction of Neonatal Hypoxic-Ischemic Encephalopathy with the Integration of Umbilical Cord Metabolites and Current Clinical Makers. J Pediatr 2021; 229:175-181.e1. [PMID: 33039387 DOI: 10.1016/j.jpeds.2020.09.065] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To validate our previously identified candidate metabolites, and to assess the ability of these metabolites to predict hypoxic-ischemic encephalopathy (HIE) both individually and combined with clinical data. STUDY DESIGN Term neonates with signs of perinatal asphyxia, with and without HIE, and matched controls were recruited prospectively at birth from 2 large maternity units. Umbilical cord blood was collected for later batch metabolomic analysis by mass spectroscopy along with clinical details. The optimum selection of clinical and metabolites features with the ability to predict the development of HIE was determined using logistic regression modelling and machine learning techniques. Outcome of HIE was determined by clinical Sarnat grading and confirmed by electroencephalogram grade at 24 hours. RESULTS Fifteen of 27 candidate metabolites showed significant alteration in infants with perinatal asphyxia or HIE when compared with matched controls. Metabolomic data predicted the development of HIE with an area under the curve of 0.67 (95% CI, 0.62-0.71). Lactic acid and alanine were the primary metabolite predictors for the development of HIE, and when combined with clinical data, gave an area under the curve of 0.96 (95% CI, 0.92-0.95). CONCLUSIONS By combining clinical and metabolic data, accurate identification of infants who will develop HIE is possible shortly after birth, allowing early initiation of therapeutic hypothermia.
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20
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Debuf MJ, Carkeek K, Piersigilli F. A Metabolomic Approach in Search of Neurobiomarkers of Perinatal Asphyxia: A Review of the Current Literature. Front Pediatr 2021; 9:674585. [PMID: 34249811 PMCID: PMC8267248 DOI: 10.3389/fped.2021.674585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Perinatal asphyxia and the possible sequelae of hypoxic-ischemic encephalopathy (HIE), are associated with high morbidity and mortality rates. The use of therapeutic hypothermia (TH) commencing within the first 6 h of life-currently the only treatment validated for the management of HIE-has been proven to reduce the mortality rate and disability seen at follow up at 18 months. Although there have been attempts to identify neurobiomarkers assessing the severity levels in HIE; none have been validated in clinical use to date, and the lack thereof limits the optimal treatment for these vulnerable infants. Metabolomics is a promising field of the "omics technologies" that may: identify neurobiomarkers, help improve diagnosis, identify patients prone to developing HIE, and potentially improve targeted neuroprotection interventions. This review focuses on the current evidence of metabolomics, a novel tool which may prove to be a useful in the diagnosis, management and treatment options for this multifactorial complex disease. Some of the most promising metabolites analyzed are the group of acylcarnitines: Hydroxybutyrylcarnitine (Malonylcarnitine) [C3-DC (C4-OH)], Tetradecanoylcarnitine [C14], L-Palmitoylcarnitine [C16], Hexadecenoylcarnitine [C16:1], Stearoylcarnitine [C18], and Oleoylcarnitine [C18:1]. A metabolomic "fingerprint" or "index," made up of 4 metabolites (succinate × glycerol/(β-hydroxybutyrate × O-phosphocholine)), seems promising in identifying neonates at risk of developing severe HIE.
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Affiliation(s)
- Marie Julie Debuf
- Division of Neonatology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Bruxelles, Belgium
| | - Katherine Carkeek
- Division of Neonatology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Bruxelles, Belgium
| | - Fiammetta Piersigilli
- Division of Neonatology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Bruxelles, Belgium
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21
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Garvey AA, Pavel AM, O’Toole JM, Walsh BH, Korotchikova I, Livingstone V, Dempsey EM, Murray DM, Boylan GB. Multichannel EEG abnormalities during the first 6 hours in infants with mild hypoxic-ischaemic encephalopathy. Pediatr Res 2021; 90:117-124. [PMID: 33879847 PMCID: PMC8370873 DOI: 10.1038/s41390-021-01412-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Infants with mild HIE are at risk of significant disability at follow-up. In the pre-therapeutic hypothermia (TH) era, electroencephalography (EEG) within 6 hours of birth was most predictive of outcome. This study aims to identify and describe features of early EEG and heart rate variability (HRV) (<6 hours of age) in infants with mild HIE compared to healthy term infants. METHODS Infants >36 weeks with mild HIE, not undergoing TH, with EEG before 6 hours of age were identified from 4 prospective cohort studies conducted in the Cork University Maternity Services, Ireland (2003-2019). Control infants were taken from a contemporaneous study examining brain activity in healthy term infants. EEGs were qualitatively analysed by two neonatal neurophysiologists and quantitatively assessed using multiple features of amplitude, spectral shape and inter-hemispheric connectivity. Quantitative features of HRV were assessed in both the groups. RESULTS Fifty-eight infants with mild HIE and sixteen healthy term infants were included. Seventy-two percent of infants with mild HIE had at least one abnormal EEG feature on qualitative analysis and quantitative EEG analysis revealed significant differences in spectral features between the two groups. HRV analysis did not differentiate between the groups. CONCLUSIONS Qualitative and quantitative analysis of the EEG before 6 hours of age identified abnormal EEG features in mild HIE, which could aid in the objective identification of cases for future TH trials in mild HIE. IMPACT Infants with mild HIE currently do not meet selection criteria for TH yet may be at risk of significant disability at follow-up. In the pre-TH era, EEG within 6 hours of birth was most predictive of outcome; however, TH has delayed this predictive value. 72% of infants with mild HIE had at least one abnormal EEG feature in the first 6 hours on qualitative assessment. Quantitative EEG analysis revealed significant differences in spectral features between infants with mild HIE and healthy term infants. Quantitative EEG features may aid in the objective identification of cases for future TH trials in mild HIE.
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Affiliation(s)
- Aisling A. Garvey
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Andreea M. Pavel
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - John M. O’Toole
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Brian H. Walsh
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Irina Korotchikova
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Vicki Livingstone
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Eugene M. Dempsey
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Deirdre M. Murray
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Geraldine B. Boylan
- INFANT Research Centre, Cork, Ireland ,grid.7872.a0000000123318773Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
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22
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Burgess K, Bennett C, Mosnier H, Kwatra N, Bethel F, Jadavji NM. The Antioxidant Role of One-Carbon Metabolism on Stroke. Antioxidants (Basel) 2020; 9:E1141. [PMID: 33212887 PMCID: PMC7698340 DOI: 10.3390/antiox9111141] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 02/07/2023] Open
Abstract
One-carbon (1C) metabolism is a metabolic network that is centered on folate, a B vitamin; it integrates nutritional signals with biosynthesis, redox homeostasis, and epigenetics. This metabolic pathway also reduces levels of homocysteine, a non-protein amino acid. High levels of homocysteine are linked to increased risk of hypoxic events, such as stroke. Several preclinical studies have suggested that 1C metabolism can impact stroke outcome, but the clinical data are unclear. The objective of this paper was to review preclinical and clinical research to determine whether 1C metabolism has an antioxidant role on stroke. To accomplish the objective, we searched for publications using the following medical subject headings (MeSH) keywords: antioxidants, hypoxia, stroke, homocysteine, one-carbon metabolism, folate, methionine, and dietary supplementation of one-carbon metabolism. Both pre-clinical and clinical studies were retrieved and reviewed. Our review of the literature suggests that deficiencies in 1C play an important role in the onset and outcome of stroke. Dietary supplementation of 1C provides beneficial effects on stroke outcome. For stroke-affected patients or individuals at high risk for stroke, the data suggest that nutritional modifications in addition to other therapies could be incorporated into a treatment plan.
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Affiliation(s)
- Kassidy Burgess
- College of Veterinary Medicine, Midwestern University, Glendale, AZ 85308, USA;
- Biomedical Sciences Program, Midwestern University, Glendale, AZ 85308, USA; (C.B.); (N.K.); (F.B.)
| | - Calli Bennett
- Biomedical Sciences Program, Midwestern University, Glendale, AZ 85308, USA; (C.B.); (N.K.); (F.B.)
- College of Osteopathic Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Hannah Mosnier
- School of Medicine, National University of Ireland Galway, H91 TK33, Ireland;
- College of Dental Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Neha Kwatra
- Biomedical Sciences Program, Midwestern University, Glendale, AZ 85308, USA; (C.B.); (N.K.); (F.B.)
- College of Dental Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Forrest Bethel
- Biomedical Sciences Program, Midwestern University, Glendale, AZ 85308, USA; (C.B.); (N.K.); (F.B.)
- College of Osteopathic Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Nafisa M. Jadavji
- College of Veterinary Medicine, Midwestern University, Glendale, AZ 85308, USA;
- Biomedical Sciences Program, Midwestern University, Glendale, AZ 85308, USA; (C.B.); (N.K.); (F.B.)
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
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23
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Abstract
Cerebral palsy (CP), defined as a group of nonprogressive disorders of movement and posture, is the most common cause of severe neurodisability in children. The prevalence of CP is the same across the globe, affecting approximately 17 million people worldwide. Cerebral Palsy is an umbrella term used to describe the disease due to its inherent heterogeneity. For instance, CP has multiple (1) causes; (2) clinical types; (3) patterns of neuropathology on brain imaging and (4) it's associated with several developmental pathologies such as intellectual disability, autism, epilepsy, and visual impairment. Understanding its physiopathology is crucial to developing protective strategies. Despite its importance, there is still insufficient progress in the areas of CP prediction, early diagnosis, treatment, and prevention. Herein we describe the current risk factors and biomarkers used for the diagnosis and prediction of CP. With the advancement in biomarker discovery, we predict that our understanding of the etiopathophysiology of CP will also increase, lending to more opportunities for developing novel treatments and prognosis.
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Affiliation(s)
- Zeynep Alpay Savasan
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Division, Beaumont Health System, Royal Oak, MI, United States; Oakland University-William Beaumont School of Medicine, Beaumont Health, Royal Oak, MI, United States.
| | - Sun Kwon Kim
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Division, Beaumont Health System, Royal Oak, MI, United States; Oakland University-William Beaumont School of Medicine, Beaumont Health, Royal Oak, MI, United States
| | - Kyung Joon Oh
- Beaumont Research Institute, Beaumont Health, Royal Oak, MI, United States; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea; Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea
| | - Stewart F Graham
- Oakland University-William Beaumont School of Medicine, Beaumont Health, Royal Oak, MI, United States; Beaumont Research Institute, Beaumont Health, Royal Oak, MI, United States
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24
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Exploring Perinatal Asphyxia by Metabolomics. Metabolites 2020; 10:metabo10040141. [PMID: 32260446 PMCID: PMC7240960 DOI: 10.3390/metabo10040141] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/25/2020] [Accepted: 04/02/2020] [Indexed: 02/06/2023] Open
Abstract
Brain damage related to perinatal asphyxia is the second cause of neuro-disability worldwide. Its incidence was estimated in 2010 as 8.5 cases per 1000 live births worldwide, with no further recent improvement even in more industrialized countries. If so, hypoxic-ischemic encephalopathy is still an issue of global health concern. It is thought that a consistent number of cases may be avoided, and its sequelae may be preventable by a prompt and efficient physical and therapeutic treatment. The lack of early, reliable, and specific biomarkers has up to now hampered a more effective use of hypothermia, which represents the only validated therapy for this condition. The urge to unravel the biological modifications underlying perinatal asphyxia and hypoxic-ischemic encephalopathy needs new diagnostic and therapeutic tools. Metabolomics for its own features is a powerful approach that may help for the identification of specific metabolic profiles related to the pathological mechanism and foreseeable outcome. The metabolomic profiles of animal and human infants exposed to perinatal asphyxia or developing hypoxic-ischemic encephalopathy have so far been investigated by means of 1H nuclear magnetic resonance spectroscopy and mass spectrometry coupled with gas or liquid chromatography, leading to the identification of promising metabolomic signatures. In this work, an extensive review of the relevant literature was performed.
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25
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Abstract
Hypoxic Ischemic Encephalopathy (HIE) is one of the most deleterious conditions in the perinatal period and the access to small molecule biomarkers aiding accurate diagnosis and disease staging, progress monitoring, and early outcome prognosis could provide relevant advances towards the development of personalized therapies. The emergence of metabolomics, the "omics" technology enabling the holistic study of small molecules, for biomarker discovery employing different analytical platforms, animal models and study populations has drastically increased the number and diversity of small molecules proposed as candidate biomarkers. However, the use of very few compounds has been implemented in clinical guidelines and authorized medical devices. In this work we review different approaches employed for discovering HIE-related small molecule biomarkers. Their role in associated biochemical disease mechanisms as well as the way towards their translation into the clinical practice are discussed.
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26
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Metabolic Phenotypes of Hypoxic-Ischemic Encephalopathy with Normal vs. Pathologic Magnetic Resonance Imaging Outcomes. Metabolites 2020; 10:metabo10030109. [PMID: 32183365 PMCID: PMC7143850 DOI: 10.3390/metabo10030109] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 01/09/2023] Open
Abstract
Hypoxic-Ischemic Encephalopathy (HIE) is one of the most relevant contributors to neurological disability in term infants. We hypothesized that clinical outcomes of newborns with (HIE) can be associated with changes at plasma metabolic level enabling the detection of brain injury. Plasma samples of a cohort of 55 asphyxiated infants who evolved to moderate/severe HIE were collected between birth and completion of therapeutic hypothermia (TH). Samples were analyzed employing a quantitative gas chromatography–mass spectrometry method for the determination of lactate and pyruvate and an untargeted liquid chromatography–time-of-flight mass spectrometry method for metabolic fingerprinting. Brain injury was assessed employing magnetic resonance imaging (MRI). A critical assessment of the usefulness of lactate, pyruvate, and pyruvate/lactate for outcome prediction was carried out. Besides, metabolic fingerprinting identified a dynamic perturbation of eleven metabolic pathways, including amino acid and purine metabolism, and the steroid hormone biosynthesis, in newborns with pathologic MRI outcomes. Although data suggest the usefulness of lactate and pyruvate monitoring during 72 h for discerning outcomes, only the steroid hormone biosynthesis pathway was significantly altered in early plasma samples (i.e., before the initiation of TH). This study highlights pathways that might potentially be targeted for biomarker discovery or adjuvant therapies to be combined with TH.
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27
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Bahado-Singh RO, Turkoglu O, Yilmaz A, Kumar P, Zeb A, Konda S, Sherman E, Kirma J, Allos M, Odibo A, Maulik D, Graham SF. Metabolomic identification of placental alterations in fetal growth restriction. J Matern Fetal Neonatal Med 2020; 35:447-456. [PMID: 32041426 DOI: 10.1080/14767058.2020.1722632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Fetal growth restriction (FGR), viz., birth weight <10th percentile is a common pregnancy complication which increases the risk of adverse fetal and newborn outcomes. The placenta is the key organ for fetal growth as it controls oxygen and nutrient availability. This study aims to elucidate the mechanisms of and identify putative placental biomarkers for FGR using high-resolution metabolomics.Methods: Placenta samples from 19 FGR cases and 30 controls were analyzed using proton magnetic resonance (1H NMR) spectroscopy and direct flow injection mass spectrometry with reverse-phase liquid-chromatography mass spectrometry (DI-LC-MS/MS). Significant concentration differences (p-value <.05) in 179 of the 220 metabolites were measured.Results: Of the 179 metabolites, 176 (98.3%) had reduced placental levels in FGR cases. The best performing metabolite model: 3-hydroxybutyrate, glycine and PCaaC42:0 achieved an AUC (95% CI) = 0.912 (0.814-1.000) with a sensitivity of 86.7% and specificity of 84.2% for FGR detection. Metabolite set enrichment analysis (MSEA) revealed significant (p < .05) perturbation of multiple placental metabolite pathways including urea metabolism, ammonia recycling, porphyrin metabolism, bile acid biosynthesis, galactose metabolism and perturbed protein biosynthesis.Conclusion: The placental metabolic pathway analysis revealed abnormalities that are consistent with fetal hepatic dysfunction in FGR. Near global reduction of metabolite concentrations was found in the placenta from FGR cases and metabolites demonstrated excellent diagnostic accuracy for FGR detection.
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Affiliation(s)
- Ray O Bahado-Singh
- Department of Obstetrics and Gynecology, Beaumont Health, Royal Oak, Michigan, USA
| | - Onur Turkoglu
- Department of Obstetrics and Gynecology, Beaumont Health, Royal Oak, Michigan, USA
| | - Ali Yilmaz
- Department of Obstetrics and Gynecology, Beaumont Health, Royal Oak, Michigan, USA
| | - Praveen Kumar
- Department of Obstetrics and Gynecology, Beaumont Health, Royal Oak, Michigan, USA
| | - Amna Zeb
- Department of Obstetrics and Gynecology, Beaumont Health, Royal Oak, Michigan, USA
| | - Shruti Konda
- Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, USA
| | - Eric Sherman
- University of Michigan, Ann Arbor, Michigan, USA
| | - Joseph Kirma
- Oakland University, William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Mathew Allos
- Oakland University, William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Anthony Odibo
- Morsani College of Medicine, USF Health, Tampa, Florida, USA
| | - Dev Maulik
- Department of Obstetrics and Gynecology, Kansas City School of Medicine, University of Missouri, Kansas City, Missouri, USA
| | - Stewart F Graham
- Department of Obstetrics and Gynecology, Beaumont Health, Royal Oak, Michigan, USA
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Agakidou E, Agakidis C, Gika H, Sarafidis K. Emerging Biomarkers for Prediction and Early Diagnosis of Necrotizing Enterocolitis in the Era of Metabolomics and Proteomics. Front Pediatr 2020; 8:602255. [PMID: 33425815 PMCID: PMC7793899 DOI: 10.3389/fped.2020.602255] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/16/2020] [Indexed: 12/11/2022] Open
Abstract
Necrotizing Enterocolitis (NEC) is a catastrophic disease affecting predominantly premature infants and is characterized by high mortality and serious long-term consequences. Traditionally, diagnosis of NEC is based on clinical and radiological findings, which, however, are non-specific for NEC, thus confusing differential diagnosis of other conditions such as neonatal sepsis and spontaneous intestinal perforation. In addition, by the time clinical and radiological findings become apparent, NEC has already progressed to an advanced stage. During the last three decades, a lot of research has focused on the discovery of biomarkers, which could accurately predict and make an early diagnosis of NEC. Biomarkers used thus far in clinical practice include acute phase proteins, inflammation mediators, and molecules involved in the immune response. However, none has been proven accurate enough to predict and make an early diagnosis of NEC or discriminate clinical from surgical NEC or other non-NEC gastrointestinal diseases. Complexity of mechanisms involved in NEC pathogenesis, which remains largely poorly elucidated, could partly explain the unsatisfactory diagnostic performance of the existing NEC biomarkers. More recently applied technics can provide important insight into the pathophysiological mechanisms underlying NEC but can also aid the detection of potentially predictive, early diagnostic, and prognostic biomarkers. Progress in omics technology has allowed for the simultaneous measurement of a large number of proteins, metabolic products, lipids, and genes, using serum/plasma, urine, feces, tissues, and other biological specimens. This review is an update of current data on emerging NEC biomarkers detected using proteomics and metabolomics, further discussing limitations and future perspectives in prediction and early diagnosis of NEC.
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Affiliation(s)
- Eleni Agakidou
- 1st Department of Neonatology, Faculty of Medicine, Ippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charalampos Agakidis
- 1st Department of Pediatrics, Faculty of Medicine, Ippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Helen Gika
- Laboratory of Forensic Medicine and Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.,BIOMIC_AUTH, Bioanalysis and Omics Laboratory, Centre for Interdisciplinary Research and Innovation, CIRI-AUTH B1.4, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kosmas Sarafidis
- 1st Department of Neonatology, Faculty of Medicine, Ippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ogunade I, Jiang Y, Pech Cervantes A. DI/LC-MS/MS-Based Metabolome Analysis of Plasma Reveals the Effects of Sequestering Agents on the Metabolic Status of Dairy Cows Challenged with Aflatoxin B 1. Toxins (Basel) 2019; 11:toxins11120693. [PMID: 31779109 PMCID: PMC6950757 DOI: 10.3390/toxins11120693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/20/2019] [Accepted: 11/23/2019] [Indexed: 11/16/2022] Open
Abstract
The study applied a targeted metabolomics approach that uses a direct injection and tandem mass spectrometry (DI–MS/MS) coupled with a liquid chromatography–tandem mass spectrometry (LC–MS/MS)-based metabolomics of plasma to evaluate the effects of supplementing clay with or without Saccharomyces cerevisiae fermentation product (SCFP) on the metabolic status of dairy cows challenged with aflatoxin B1. Eight healthy, lactating, multiparous Holstein cows in early lactation (64 ± 11 DIM) were randomly assigned to one of four treatments in a balanced 4 × 4 duplicated Latin square design with four 33 d periods. Treatments were control, toxin (T; 1725 µg aflatoxin B1 (AFB1)/head/day), T with clay (CL; 200 g/head/day), and CL with SCFP (YEA; 35 g of SCFP/head/day). Cows in T, CL, and YEA were dosed with aflatoxin B1 (AFB1) from days 26 to 30. The sequestering agents were top-dressed from day 1 to 33. On day 30 of each period, 15 mL of blood was taken from the coccygeal vessels and plasma samples were obtained from blood by centrifugation and analyzed for metabolites using a kit that combines DI–MS/MS with LC–MS/MS-based metabolomics. The data were analyzed using the GLIMMIX procedure of SAS. The model included the effects of treatment, period, and random effects of cow and square. Significance was declared at p ≤ 0.05. Biomarker profiles for aflatoxin ingestion in dairy cows fed no sequestering agents were determined using receiver–operator characteristic (ROC) curves, as calculated by the ROCCET web server. A total of 127 metabolites such as amino acids, biogenic amines, acylcarnitines, glycerophospholipids, and organic acids were quantified. Compared with the control, T decreased (p < 0.05) plasma concentrations of alanine, leucine, and arginine and tended to decrease that of citrulline. Treatment with CL had no effects on any of the metabolites relative to the control but increased (p ≤ 0.05) concentrations of alanine, leucine, arginine, and that of citrulline (p = 0.07) relative to T. Treatment with YEA resulted in greater (p ≤ 0.05) concentrations of aspartic acid and lysine relative to the control and the highest (p ≤ 0.05) plasma concentrations of alanine, valine, proline, threonine, leucine, isoleucine, glutamic acid, phenylalanine, and arginine compared with other treatments. The results of ROC analysis between C and T groups revealed that the combination of arginine, alanine, methylhistidine, and citrulline had sufficient specificity and sensitivity (area under the curve = 0.986) to be excellent potential biomarkers of aflatoxin ingestion in dairy cows fed no sequestering agents. This study confirmed the protective effects of sequestering agents in dairy cows challenged with aflatoxin B1.
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Affiliation(s)
- Ibukun Ogunade
- College of Agriculture, Communities, and the Environment, Kentucky State University, Frankfort, KY 40601, USA
- Correspondence:
| | - Yun Jiang
- Department of Animal Sciences, University of Florida, Gainesville, FL 32611, USA;
| | - Andres Pech Cervantes
- Agricultural Research Station, Fort Valley State University, Fort Valley, GA 31030, USA;
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30
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Patterson E, Ryan PM, Wiley N, Carafa I, Sherwin E, Moloney G, Franciosi E, Mandal R, Wishart DS, Tuohy K, Ross RP, Cryan JF, Dinan TG, Stanton C. Gamma-aminobutyric acid-producing lactobacilli positively affect metabolism and depressive-like behaviour in a mouse model of metabolic syndrome. Sci Rep 2019; 9:16323. [PMID: 31704943 PMCID: PMC6841999 DOI: 10.1038/s41598-019-51781-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/20/2019] [Indexed: 12/22/2022] Open
Abstract
Metabolic and neuroactive metabolite production represents one of the mechanisms through which the gut microbiota can impact health. One such metabolite, gamma-aminobutyric acid (GABA), can modulate glucose homeostasis and alter behavioural patterns in the host. We previously demonstrated that oral administration of GABA-producing Lactobacillus brevis DPC6108 has the potential to increase levels of circulating insulin in healthy rats. Therefore, the objective of this study was to assess the efficacy of endogenous microbial GABA production in improving metabolic and behavioural outcomes in a mouse model of metabolic dysfunction. Diet-induced obese and metabolically dysfunctional mice received one of two GABA-producing strains, L. brevis DPC6108 or L. brevis DSM32386, daily for 12 weeks. After 8 and 10 weeks of intervention, the behavioural and metabolic profiles of the mice were respectively assessed. Intervention with both L. brevis strains attenuated several abnormalities associated with metabolic dysfunction, causing a reduction in the accumulation of mesenteric adipose tissue, increased insulin secretion following glucose challenge, improved plasma cholesterol clearance and reduced despair-like behaviour and basal corticosterone production during the forced swim test. Taken together, this exploratory dataset indicates that intervention with GABA-producing lactobacilli has the potential to improve metabolic and depressive- like behavioural abnormalities associated with metabolic syndrome in mice.
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Affiliation(s)
- E Patterson
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - P M Ryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - N Wiley
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - I Carafa
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.,Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - E Sherwin
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - G Moloney
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - E Franciosi
- Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - R Mandal
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - D S Wishart
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada.,Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada.,National Institute for Nanotechnology, Edmonton, Alberta, Canada
| | - K Tuohy
- Department of Food Quality and Nutrition, Research and Innovation Centre-Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - R P Ross
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - J F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - T G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - C Stanton
- APC Microbiome Ireland, University College Cork, Cork, Ireland. .,Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland.
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Lee JW, Moen EL, Punshon T, Hoen AG, Stewart D, Li H, Karagas MR, Gui J. An Integrated Gaussian Graphical Model to evaluate the impact of exposures on metabolic networks. Comput Biol Med 2019; 114:103417. [PMID: 31521894 PMCID: PMC6817396 DOI: 10.1016/j.compbiomed.2019.103417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/25/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023]
Abstract
Examining the effects of exogenous exposures on complex metabolic processes poses the unique challenge of identifying interactions among a large number of metabolites. Recent progress in the quantification of the metabolome through mass spectrometry (MS) and nuclear magnetic resonance (NMR) has given rise to high-dimensional biomedical data of specific metabolites that can be leveraged to study their effects in humans. These metabolic interactions can be evaluated using probabilistic graphical models (PGMs), which define conditional dependence and independence between components within and between heterogeneous biomedical datasets. This method allows for the detection and recovery of valuable but latent information that cannot be easily detected by other currently existing methods. Here, we develop a PGM method, referred to as an "Integrated Gaussian Graphical Model (IGGM)", to incorporate exposure concentrations of seven trace elements-arsenic (As), lead (Pb), mercury (Hg), cadmium (Cd), zinc (Zn), selenium (Se) and copper (Cu-into metabolic networks. We first conducted a simulation study demonstrating that the integration of trace elements into metabolomics data can improve the accuracy of detecting latent interactions of metabolites impacted by exposure in the network. We tested parameters such as sample size and the number of neighboring metabolites of a chosen trace element for their impact on the accuracy of detecting metabolite interactions. We then applied this method to measurements of cord blood plasma metabolites and placental trace elements collected from newborns in the New Hampshire Birth Cohort Study (NHBCS). We found that our approach can identify latent interactions among metabolites that are related to trace element concentrations. Application to similarly structured data may contribute to our understanding of the complex interplay between exposure-related metabolic interactions that are important for human health.
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Affiliation(s)
- Jai Woo Lee
- Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, NH, USA
| | - Erika L Moen
- Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA
| | - Tracy Punshon
- Department of Biological Sciences, Dartmouth College, Hanover, NH, USA
| | - Anne G Hoen
- Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA; Department of Epidemiology, Geisel School of Medicine, Lebanon, NH, USA
| | - Delisha Stewart
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hongzhe Li
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadephia, PA, USA
| | | | - Jiang Gui
- Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA.
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Association between newborn screening analytes and hypoxic ischemic encephalopathy. Sci Rep 2019; 9:15704. [PMID: 31673070 PMCID: PMC6823438 DOI: 10.1038/s41598-019-51919-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/10/2019] [Indexed: 01/04/2023] Open
Abstract
Hypoxic ischemic encephalopathy (HIE) is a major cause of neonatal mortality and morbidity. Our study sought to examine whether patterns of newborn screening analytes differed between infants with and without neonatal HIE in order to identify opportunities for potential use of these analytes for diagnosis in routine clinical practice. We linked a population-based newborn screening registry with health databases to identify cases of HIE among term infants (≥37 weeks' gestation) in Ontario from 2010-2015. Correlations between HIE and screening analytes were examined using multivariable logistic regression models containing clinical factors and individual screening analytes (acyl-carnitines, amino acids, fetal-to-adult hemoglobin ratio, endocrine markers, and enzymes). Among 731,841 term infants, 3,010 were diagnosed with HIE during the neonatal period. Multivariable models indicated that clinical variables alone or in combination with hemoglobin values were not associated with HIE diagnosis. Although the model was improved after adding acyl-carnitines and amino acids, the ability of the model to identify infants with HIE was moderate. Our findings indicate that analytes associated with catabolic stress were altered in infants with HIE; however, future research is required to determine whether amino acid and acyl-carnitine profiles could hold clinical utility in the early diagnosis or clinical management of HIE. In particular, further research should examine whether cord blood analyses can be used to identify HIE within a clinically useful timeframe or to guide treatment and predict long-term health outcomes.
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33
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Liu QT, Zhong XY. [Application of metabolomics in neonatal clinical practice]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:942-948. [PMID: 31506158 PMCID: PMC7390243 DOI: 10.7499/j.issn.1008-8830.2019.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/08/2019] [Indexed: 06/10/2023]
Abstract
Metabolomics is an emerging and popular subject in the post-genome era, and a large number of studies have been noted on the application of metabolomics in health evaluation, growth and development evaluation, disease diagnosis, and therapeutic efficacy evaluation. As a special period of life, the neonatal period is characterized by rapid cell renewing, consumption of a lot of energy and materials, and changes in metabolic pathways, all of which affect the level of metabolites. However, there is still no reference standard for metabolic level and profile in neonates. This article reviews the current status of metabolic research on neonatal growth and development and common diseases and related clinical application of metabolomics, so as to provide new ideas for nutrition guidance and evaluation, selection of therapeutic regimens, and new drug research in neonates.
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Affiliation(s)
- Qiu-Tong Liu
- Department of Neonatology, Chongqing Health Center for Children and Women, Chongqing 400000, China.
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Abstract
Hypoxic-ischemic encephalopathy is a subtype of neonatal encephalopathy and a major contributor to global neonatal morbidity and mortality. Despite advances in obstetric and neonatal care there are still challenges in accurate determination of etiology of neonatal encephalopathy. Thus, identification of intrapartum risk factors and comprehensive evaluation of the neonate is important to determine the etiology and severity of neonatal encephalopathy. In developed countries, therapeutic hypothermia as a standard of care therapy for neonates with hypoxic-ischemic encephalopathy has proven to decrease incidence of death and neurodevelopmental disabilities, including cerebral palsy in surviving children. Advances in neuroimaging, brain monitoring modalities, and biomarkers of brain injury have improved the ability to diagnose, monitor, and treat newborns with encephalopathy. However, challenges remain in early identification of neonates at risk for hypoxic-ischemic brain injury, and determination of the timing and extent of brain injury. Using imaging studies such as Neonatal MRI and MR spectroscopy have proven to be most useful in predicting outcomes in infants with encephalopathy within the first week of life, although comprehensive neurodevelopmental assessments still remains the gold standard for determining long term outcomes. Future studies are needed to identify other newborns with encephalopathy that might benefit from therapeutic hypothermia and to determine the efficacy of other adjunctive neuroprotective strategies. This review focuses on newer evidence and advances in diagnoses and management of infants with neonatal encephalopathy, including novel therapies, as well as prognostication of outcomes to childhood.
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Boruczkowski D, Pujal JM, Zdolińska-Malinowska I. Autologous cord blood in children with cerebral palsy: a review. Int J Mol Sci 2019; 20:E2433. [PMID: 31100943 PMCID: PMC6566649 DOI: 10.3390/ijms20102433] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/11/2019] [Accepted: 05/12/2019] [Indexed: 02/07/2023] Open
Abstract
The aim of this narrative review is to report on the current knowledge regarding the clinical use of umbilical cord blood (CB) based on articles from PubMed and clinical trials registered on ClinicalTrials.gov. An increasing amount of evidence suggests that CB may be used for both early diagnostics and treatment of cerebral palsy. The acidity of CB and its biochemical parameters, including dozens of cytokines, growth factors, and other metabolites (such as amino acids, acylcarnitines, phosphatidylcholines, succinate, glycerol, 3-hydroxybutyrate, and O-phosphocholine) are predictors of future neurodevelopment. In addition, several clinical studies confirmed the safety and efficacy of CB administration in both autologous and allogeneic models, including a meta-analysis of five clinical trials involving a total of 328 participants. Currently, nine clinical trials assessing the use of autologous umbilical CB in children diagnosed with hypoxic-ischemic encephalopathy or cerebral palsy are in progress. The total population assessed in these trials exceeds 2500 patients.
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Affiliation(s)
- Dariusz Boruczkowski
- Polski Bank Komórek Macierzystych S.A. (FamiCord Group), Jana Pawła II 29, 00-867 Warsaw, Poland.
| | - Josep-Maria Pujal
- Sevibe Cells, Parc Científic i Tecnològic de la UdG, C/Pic de Peguera No. 11, 17003 Girona, Spain.
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López-Suárez O, Concheiro-Guisán A, Sánchez-Pintos P, Cocho JA, Fernández Lorenzo JR, Couce ML. Acylcarnitine profile in neonatal hypoxic-ischemic encephalopathy: The value of butyrylcarnitine as a prognostic marker. Medicine (Baltimore) 2019; 98:e15221. [PMID: 30985723 PMCID: PMC6485840 DOI: 10.1097/md.0000000000015221] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 03/01/2019] [Accepted: 03/20/2019] [Indexed: 11/26/2022] Open
Abstract
Optimal prognostic markers evaluating early neuroprotective interventions in neonatal hypoxic-ischemic encephalopathy (HIE) are lacking. This study was designed to assess the prognostic value of acylcarnitines in neonatal HIE.An observational cohort study was conducted over 10 years in 67 HIE. Variables analyzed included sex, blood cord pH, Apgar score, hypothermia treatment (yes/no), neuron-specific enolase (NSE) levels, and clinical outcome (neurological examination, brain magnetic resonance imaging [MRI], and electroencephalogram) before discharge and at 6 months. Acylcarnitine profiles were analyzed by tandem-mass spectrometry on dried-blood spots collected on day 3 for newborn screening. A cohort of healthy newborns was used as control group.HIE patients had significantly increased C4, C5, C5:1, C6, C6-OH, C8 levels (all P < .01) and decreased long-chain acylcarnitine levels (P < .03). Hypothermia treatment was associated with a decrease in C4 levels (p = 0.005) and an increase in most long-chain acylcarnitine levels (P < .01). A significant association was found between C4 levels and NSE on day 1 of hypothermia treatment (P = .002) and abnormal brain magnetic resonance imaging (MRI) at discharge (P = .037). In the hypothermia group, C4 levels decreased in patients with favorable outcomes but remained high in those who progressed unfavorably.C4 appears to be a good prognostic marker in HIE, as blood levels correlated with NSE levels and abnormal MRI findings. Furthermore, hypothermia did not lead to decreased levels in patients with adverse outcomes.
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Affiliation(s)
- Olalla López-Suárez
- Neonatal Unit, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela
| | - Ana Concheiro-Guisán
- Neonatal Unit, Pediatric Service, Hospital Alvaro Cunqueiro, Health Research Institute of Vigo (IVI), Vigo
| | - Paula Sánchez-Pintos
- Diagnosis and Treatment of Congenital Metabolic Diseases Unit (UDyTEMC), Department of Pediatrics, Health Research Institute of Santiago (IDIS), CIBERER, Hospital Clínico Universitario de Santiago de Compostela, Spain
| | - Jose A. Cocho
- Diagnosis and Treatment of Congenital Metabolic Diseases Unit (UDyTEMC), Department of Pediatrics, Health Research Institute of Santiago (IDIS), CIBERER, Hospital Clínico Universitario de Santiago de Compostela, Spain
| | - José R. Fernández Lorenzo
- Neonatal Unit, Pediatric Service, Hospital Alvaro Cunqueiro, Health Research Institute of Vigo (IVI), Vigo
| | - María L. Couce
- Neonatal Unit, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela
- Diagnosis and Treatment of Congenital Metabolic Diseases Unit (UDyTEMC), Department of Pediatrics, Health Research Institute of Santiago (IDIS), CIBERER, Hospital Clínico Universitario de Santiago de Compostela, Spain
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Alpay Savasan Z, Yilmaz A, Ugur Z, Aydas B, Bahado-Singh RO, Graham SF. Metabolomic Profiling of Cerebral Palsy Brain Tissue Reveals Novel Central Biomarkers and Biochemical Pathways Associated with the Disease: A Pilot Study. Metabolites 2019; 9:metabo9020027. [PMID: 30717353 PMCID: PMC6409919 DOI: 10.3390/metabo9020027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 12/17/2022] Open
Abstract
Cerebral palsy (CP) is one of the most common causes of motor disability in childhood, with complex and heterogeneous etiopathophysiology and clinical presentation. Understanding the metabolic processes associated with the disease may aid in the discovery of preventive measures and therapy. Tissue samples (caudate nucleus) were obtained from post-mortem CP cases (n = 9) and age- and gender-matched control subjects (n = 11). We employed a targeted metabolomics approach using both 1H NMR and direct injection liquid chromatography-tandem mass spectrometry (DI/LC-MS/MS). We accurately identified and quantified 55 metabolites using 1H NMR and 186 using DI/LC-MS/MS. Among the 222 detected metabolites, 27 showed significant concentration changes between CP cases and controls. Glycerophospholipids and urea were the most commonly selected metabolites used to develop predictive models capable of discriminating between CP and controls. Metabolomics enrichment analysis identified folate, propanoate, and androgen/estrogen metabolism as the top three significantly perturbed pathways. We report for the first time the metabolomic profiling of post-mortem brain tissue from patients who died from cerebral palsy. These findings could help to further investigate the complex etiopathophysiology of CP while identifying predictive, central biomarkers of CP.
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Affiliation(s)
- Zeynep Alpay Savasan
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Division, Beaumont Health System, 3811 W. 13 Mile Road, Royal Oak, MI 48073, USA.
- Oakland University-William Beaumont School of Medicine, Beaumont Health, 3811 W. 13 Mile Road, Royal Oak, MI 48073, USA.
| | - Ali Yilmaz
- Beaumont Research Institute, Beaumont Health, 3811 W. 13 Mile Road, Royal Oak, MI 48073, USA.
| | - Zafer Ugur
- Beaumont Research Institute, Beaumont Health, 3811 W. 13 Mile Road, Royal Oak, MI 48073, USA.
| | - Buket Aydas
- Departments of Mathematics and Computer Sciences, Albion College, 611 E. Porter St., Albion, MI 49224, USA.
| | - Ray O Bahado-Singh
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Division, Beaumont Health System, 3811 W. 13 Mile Road, Royal Oak, MI 48073, USA.
- Oakland University-William Beaumont School of Medicine, Beaumont Health, 3811 W. 13 Mile Road, Royal Oak, MI 48073, USA.
| | - Stewart F Graham
- Oakland University-William Beaumont School of Medicine, Beaumont Health, 3811 W. 13 Mile Road, Royal Oak, MI 48073, USA.
- Beaumont Research Institute, Beaumont Health, 3811 W. 13 Mile Road, Royal Oak, MI 48073, USA.
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Denihan NM, Kirwan JA, Walsh BH, Dunn WB, Broadhurst DI, Boylan GB, Murray DM. Untargeted metabolomic analysis and pathway discovery in perinatal asphyxia and hypoxic-ischaemic encephalopathy. J Cereb Blood Flow Metab 2019; 39:147-162. [PMID: 28840775 PMCID: PMC6311668 DOI: 10.1177/0271678x17726502] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Elucidating metabolic effects of hypoxic-ischaemic encephalopathy (HIE) may reveal early biomarkers of injury and new treatment targets. This study uses untargeted metabolomics to examine early metabolic alterations in a carefully defined neonatal population. Infants with perinatal asphyxia who were resuscitated at birth and recovered (PA group), those who developed HIE (HIE group) and healthy controls were all recruited at birth. Metabolomic analysis of cord blood was performed using direct infusion FT-ICR mass spectrometry. For each reproducibly detected metabolic feature, mean fold differences were calculated HIE vs. controls (ΔHIE) and PA vs. controls (ΔPA). Putative metabolite annotations were assigned and pathway analysis was performed. Twenty-nine putatively annotated metabolic features were significantly different in ΔPA after false discovery correction ( q < 0.05), with eight of these also significantly altered in ΔHIE. Altered putative metabolites included; melatonin, leucine, kynurenine and 3-hydroxydodecanoic acid which differentiated between infant groups (ΔPA and ΔHIE); and D-erythrose-phosphate, acetone, 3-oxotetradecanoic acid and methylglutarylcarnitine which differentiated across severity grades of HIE. Pathway analysis revealed ΔHIE was associated with a 50% and 75% perturbation of tryptophan and pyrimidine metabolism, respectively. We have identified perturbed metabolic pathways and potential biomarkers specific to PA and HIE, which measured at birth, may help direct treatment.
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Affiliation(s)
- Niamh M Denihan
- 1 Neonatal Brain Research Group, University College Cork, Cork, Ireland.,2 Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
| | | | - Brian H Walsh
- 4 Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA.,5 Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Warwick B Dunn
- 3 School of Biosciences, University of Birmingham, Birmingham, UK.,6 Phenome Centre Birmingham, University of Birmingham, Birmingham, UK
| | - David I Broadhurst
- 7 School of Science, Edith Cowan University, Joondalup, Perth, Australia
| | - Geraldine B Boylan
- 1 Neonatal Brain Research Group, University College Cork, Cork, Ireland.,2 Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
| | - Deirdre M Murray
- 1 Neonatal Brain Research Group, University College Cork, Cork, Ireland.,2 Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
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Aslam S, Strickland T, Molloy EJ. Neonatal Encephalopathy: Need for Recognition of Multiple Etiologies for Optimal Management. Front Pediatr 2019; 7:142. [PMID: 31058120 PMCID: PMC6477286 DOI: 10.3389/fped.2019.00142] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/26/2019] [Indexed: 12/18/2022] Open
Abstract
Neonatal encephalopathy (NE) is associated with high mortality and morbidity. Factors predisposing to NE can be antenatal, perinatal, or a combination of both. Antenatal maternal factors, familial factors, genetic predisposition, hypoxic ischemic encephalopathy, infections, placental abnormalities, thrombophilia, coagulation defects, and metabolic disorders all have been implicated in the pathogenesis of NE. At present, therapeutic hypothermia is the only treatment available, regardless of etiology. Recognizing the etiology of NE involved can also guide investigations such as metabolic and sepsis workups to ensure optimal management. Understanding the etiology of NE may allow the development of targeted adjunctive therapies related to the underlying mechanism and develop preventative strategies.
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Affiliation(s)
- Saima Aslam
- Paediatrics, National Maternity Hospital, Dublin, Ireland.,UCD School of Medicine & Medical Sciences, University College Dublin, Dublin, Ireland
| | - Tammy Strickland
- Paediatrics, National Maternity Hospital, Dublin, Ireland.,Trinity College Translational Medicine Institute, Academic Paediatrics, Trinity College Dublin, National Children's Hospital, Dublin, Ireland.,Paediatrics, Coombe Women's and Infant's University Hospital, Dublin, Ireland
| | - Eleanor J Molloy
- Paediatrics, National Maternity Hospital, Dublin, Ireland.,UCD School of Medicine & Medical Sciences, University College Dublin, Dublin, Ireland.,Trinity College Translational Medicine Institute, Academic Paediatrics, Trinity College Dublin, National Children's Hospital, Dublin, Ireland.,Paediatrics, Coombe Women's and Infant's University Hospital, Dublin, Ireland.,Neonatology, Our Lady's Children's Hospital, Drimnagh, Ireland
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Murray DM. Biomarkers in neonatal hypoxic-ischemic encephalopathy-Review of the literature to date and future directions for research. HANDBOOK OF CLINICAL NEUROLOGY 2019; 162:281-293. [PMID: 31324315 DOI: 10.1016/b978-0-444-64029-1.00013-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The widespread introduction of therapeutic hypothermia as a standard of care in hypoxic-ischemic encephalopathy (HIE) has brought increasing pressure on clinicians to make an early and accurate assessment of the degree of hypoxic injury (HI) that has occurred and the severity of the encephalopathy that will ensue. No single blood-based marker is currently robust enough to detect significant HI or predict outcome. However, research in the field has been active in the last 10 years and we know that HIE is associated with predictable alterations in the expression of a number of inflammatory proteins, neuron-specific proteins, metabolite pathways, and microRNA. These alterations evolve quickly over the first hours and days of life. Predictive power varies depending on the timing of measurement of the biomarker, the sample type, and the case mix of the cohort examined. Combining clinical data with biochemical measurements is currently the most likely path toward improved detection and prediction of outcome in neonatal HIE.
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Affiliation(s)
- Deirdre M Murray
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
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Sarafidis K, Begou O, Deda O, Gika H, Agakidis C, Efstathiou N, Theodoridis G. Targeted urine metabolomics in preterm neonates with intraventricular hemorrhage. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1104:240-248. [PMID: 30530117 DOI: 10.1016/j.jchromb.2018.11.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/11/2018] [Accepted: 11/20/2018] [Indexed: 01/21/2023]
Abstract
Intraventricular hemorrhage (IVH) is a major cause of morbidity and mortality in preterm neonates. Elucidation of the mechanisms underlying IVH and/or development of disease biomarkers is essential. The aim of the study was to investigate the urine metabolic profile of preterm neonates (gestational age < 32 weeks) IVH and explore the role of metabolomics in understanding pathophysiological mechanisms of the disease from which novel biomarkers could be derived. In this single-center, prospective, case-control study, urine samples were collected from seven preterm infants with early IVH (IVH group) and from 11 preterm ones without IVH (control group) on days 1, 3 and 9 of life. Urine metabolites were evaluated using targeted liquid chromatography-tandem mass spectrometry. Demographic and perinatal-clinical characteristics were recorded. Univariate and multivariate statistical analyses were performed. Orthogonal Partial Least Squares-Discriminant Analysis showed that the study groups differed significantly due to alternation in 20 out of the 40 metabolites detected in the urine. Elevated differentiated metabolites included energy intermediates and other important compounds, whereas reduced ones various amino acids, hypoxanthine and nicotinamide. A set of metabolites showed high performance as indicators of IVH, especially during day 1. As evidenced by metabolomics, preterm neonates with IVH demonstrate significant metabolism perturbations. Potentially, a selected panel of metabolites could be used as urine biomarkers of IVH development and/or progression in high-risk preterm infants.
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Affiliation(s)
- K Sarafidis
- 1(st) Department of Neonatology, School of Medicine, Aristotle University of Thessaloniki, Hippokrateion General Hospital, Kostantinoupoleos 49, 54642 Thessaloniki, Greece.
| | - O Begou
- Laboratory of Analytical Chemistry, School of Chemistry, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - O Deda
- Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - H Gika
- Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - C Agakidis
- 1(st) Department of Neonatology, School of Medicine, Aristotle University of Thessaloniki, Hippokrateion General Hospital, Kostantinoupoleos 49, 54642 Thessaloniki, Greece
| | - N Efstathiou
- 1(st) Department of Neonatology, School of Medicine, Aristotle University of Thessaloniki, Hippokrateion General Hospital, Kostantinoupoleos 49, 54642 Thessaloniki, Greece
| | - G Theodoridis
- Laboratory of Analytical Chemistry, School of Chemistry, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
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Age-Related Reference Intervals for Blood Amino Acids in Thai Pediatric Population Measured by Liquid Chromatography Tandem Mass Spectrometry. J Nutr Metab 2018; 2018:5124035. [PMID: 29854440 PMCID: PMC5960525 DOI: 10.1155/2018/5124035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 02/19/2018] [Accepted: 02/28/2018] [Indexed: 01/21/2023] Open
Abstract
Background Age, race, and analytic method influence levels of blood amino acids, of which reference intervals are required for the diagnosis and management of inherited metabolic disorders. Objectives To establish age-specific reference intervals for blood amino acids in Thai pediatric population measured by liquid chromatography tandem mass spectrometry (LC-MS/MS). Methods A cross-sectional study of 277 healthy children from birth to 12 years was conducted. Anthropometric, clinical, and dietary information were recorded. Dried blood spots on a filtered paper were used for measurement by derivatized LC-MS/MS. Factors that might affect amino acids such as fasting time and dietary intake were analyzed using quantile regression analysis. Results Levels of thirteen blood amino acids were reported as median and interval from 2.5th–97.5th percentiles. Compared with those of Caucasian, most blood amino acid levels of Thai children were higher. Compared with a previous study using HPLC in Thai children, many amino acid levels are different. Glycine, alanine, leucine/isoleucine, and glutamic acid sharply decreased after birth. Citrulline, arginine, and methionine stayed low from birth throughout childhood, whereas phenylalanine was at middle level and slightly increased during preadolescence. Conclusion Reference intervals of age-specific blood amino acids using LC-MS/MS were established in the Thai pediatric population. They diverge from previous studies, substantiating the recommendation that, for the optimal clinical practice, age-specific reference intervals of amino acids should be designated for the particular population and analysis method.
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Locci E, Noto A, Puddu M, Pomero G, Demontis R, Dalmazzo C, Delogu A, Fanos V, d’Aloja E, Gancia P. A longitudinal 1H-NMR metabolomics analysis of urine from newborns with hypoxic-ischemic encephalopathy undergoing hypothermia therapy. Clinical and medical legal insights. PLoS One 2018; 13:e0194267. [PMID: 29668681 PMCID: PMC5906012 DOI: 10.1371/journal.pone.0194267] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 02/28/2018] [Indexed: 01/21/2023] Open
Abstract
Perinatal asphyxia is an event affecting around four million newborns worldwide. The 0.5 to 2 per 1000 of full term asphyxiated newborns suffer from hypoxic-ischemic encephalopathy (HIE), which is a frequent cause of death or severe disability and, as consequence, the most common birth injury claim for obstetrics, gynaecologists, and paediatricians. Perinatal asphyxia results from a compromised gas exchange that leads to hypoxemia, hypercapnia, and metabolic acidosis. In this work, we applied a metabolomics approach to investigate the metabolic profiles of urine samples collected from full term asphyxiated newborns with HIE undergoing therapeutic hypothermia (TH), with the aim of identifying a pattern of metabolites associated with HIE and to follow their modifications over time. Urine samples were collected from 10 HIE newborns at birth, during hypothermia (48 hours), at the end of the therapeutic treatment (72 hours), at 1 month of life, and compared with a matched control population of 16 healthy full term newborns. The metabolic profiles were investigated by 1H NMR spectroscopy coupled with multivariate statistical methods such as principal component analysis and orthogonal partial least square discriminant analysis. Multivariate analysis indicated significant differences between the urine samples of HIE and healthy newborns at birth. The altered metabolic patterns, mainly originated from the depletion of cellular energy and homeostasis, seem to constitute a characteristic of perinatal asphyxia. The HIE urine metabolome changes over time reflected either the effects of TH and the physiological growth of the newborns. Of interest, the urine metabolic profiles of the HIE non-surviving babies, characterized by the increased excretion of lactate, resulted significantly different from the rest of HIE population.
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Affiliation(s)
- Emanuela Locci
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Noto
- Department of Surgical Sciences, University of Cagliari, and Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, Cagliari, Italy
| | - Melania Puddu
- Department of Surgical Sciences, University of Cagliari, and Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, Cagliari, Italy
| | - Giulia Pomero
- Neonatal Intensive Care, Neonatology, ASO S. Croce e Carle, Cuneo, Italy
| | - Roberto Demontis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Cristina Dalmazzo
- Neonatal Intensive Care, Neonatology, ASO S. Croce e Carle, Cuneo, Italy
| | - Antonio Delogu
- Neonatal Intensive Care, Neonatology, ASO S. Croce e Carle, Cuneo, Italy
| | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari, and Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, Cagliari, Italy
| | - Ernesto d’Aloja
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paolo Gancia
- Neonatal Intensive Care, Neonatology, ASO S. Croce e Carle, Cuneo, Italy
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Robinson O, Keski-Rahkonen P, Chatzi L, Kogevinas M, Nawrot T, Pizzi C, Plusquin M, Richiardi L, Robinot N, Sunyer J, Vermeulen R, Vrijheid M, Vineis P, Scalbert A, Chadeau-Hyam M. Cord Blood Metabolic Signatures of Birth Weight: A Population-Based Study. J Proteome Res 2018; 17:1235-1247. [PMID: 29401400 DOI: 10.1021/acs.jproteome.7b00846] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Birth weight is an important indicator of maternal and fetal health and a predictor of health in later life. However, the determinants of variance in birth weight are still poorly understood. We aimed to identify the biological pathways, which may be perturbed by environmental exposures, that are important in determining birth weight. We applied untargeted mass-spectrometry-based metabolomics to 481 cord blood samples collected at delivery in four birth cohorts from across Europe: ENVIRONAGE (Belgium), INMA (Spain), Piccolipiu (Italy), and Rhea (Greece). We performed a metabolome-wide association scan for birth weight on over 4000 metabolic features, controlling the false discovery rate at 5%. Annotation of compounds was conducted through reference to authentic standards. We identified 68 metabolites significantly associated with birth weight, including vitamin A, progesterone, docosahexaenoic acid, indolelactic acid, and multiple acylcarnitines and phosphatidylcholines. We observed enrichment (p < 0.05) of the tryptophan metabolism, prostaglandin formation, C21-steroid hormone signaling, carnitine shuttle, and glycerophospholipid metabolism pathways. Vitamin A was associated with both maternal smoking and birth weight, suggesting a mediation pathway. Our findings shed new light on the pathways central to fetal growth and will have implications for antenatal and perinatal care and potentially for health in later life.
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Affiliation(s)
- Oliver Robinson
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London , St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom
| | - Pekka Keski-Rahkonen
- International Agency for Research on Cancer (IARC) , 150 Cours Albert Thomas, 69372 Lyon, France
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete , Voutes University Campus, Heraklion, Crete, GR-70013, Greece
- Department of Preventive Medicine, Keck School of Medicine, University of South California , Soto Street Building 2001 N Soto Street, Suite 201-D, Los Angeles, California 90032-3628, United States
- Department of Genetics & Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University , Universiteitssingel 40, 6229 Maastricht, The Netherlands
| | - Manolis Kogevinas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , PRBB, C/ Doctor Aiguader, 88, 08003, Barcelona Spain
- Universitat Pompeu Fabra (UPF) , Plaça de la Mercè, 10, Barcelona 08002, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , PRBB, C/ Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University , Campus Diepenbeek, Agoralaan building D, BE3590 Diepenbeek, Belgium
- Department of Public Health & Primary Care, Leuven University , Oude Markt 13, B-3000 Leuven, Belgium
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte , C.So, Dogliotti, 14, 10126 Turin, Italy
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University , Campus Diepenbeek, Agoralaan building D, BE3590 Diepenbeek, Belgium
- Department of Public Health & Primary Care, Leuven University , Oude Markt 13, B-3000 Leuven, Belgium
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte , C.So, Dogliotti, 14, 10126 Turin, Italy
| | - Nivonirina Robinot
- International Agency for Research on Cancer (IARC) , 150 Cours Albert Thomas, 69372 Lyon, France
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , PRBB, C/ Doctor Aiguader, 88, 08003, Barcelona Spain
- Universitat Pompeu Fabra (UPF) , Plaça de la Mercè, 10, Barcelona 08002, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , PRBB, C/ Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University , POB 80178, Utrecht NL-3508, The Netherlands
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , PRBB, C/ Doctor Aiguader, 88, 08003, Barcelona Spain
- Universitat Pompeu Fabra (UPF) , Plaça de la Mercè, 10, Barcelona 08002, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) , PRBB, C/ Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London , St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom
| | - Augustin Scalbert
- International Agency for Research on Cancer (IARC) , 150 Cours Albert Thomas, 69372 Lyon, France
| | - Marc Chadeau-Hyam
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London , St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom
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Sánchez-Illana Á, Núñez-Ramiro A, Cernada M, Parra-Llorca A, Valverde E, Blanco D, Moral-Pumarega MT, Cabañas F, Boix H, Pavon A, Chaffanel M, Benavente-Fernández I, Tofe I, Loureiro B, Fernández-Lorenzo JR, Fernández-Colomer B, García-Robles A, Kuligowski J, Vento M. Evolution of Energy Related Metabolites in Plasma from Newborns with Hypoxic-Ischemic Encephalopathy during Hypothermia Treatment. Sci Rep 2017; 7:17039. [PMID: 29213095 PMCID: PMC5719006 DOI: 10.1038/s41598-017-17202-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/22/2017] [Indexed: 12/17/2022] Open
Abstract
Therapeutic hypothermia (TH) initiated within 6 h from birth is the most effective therapeutic approach for moderate to severe hypoxic-ischemic encephalopathy (HIE). However, underlying mechanisms and effects on the human metabolism are not yet fully understood. This work aims at studying the evolution of several energy related key metabolites in newborns with HIE undergoing TH employing gas chromatography - mass spectrometry. The method was validated following stringent FDA requirements and applied to 194 samples from a subgroup of newborns with HIE (N = 61) enrolled in a multicenter clinical trial (HYPOTOP) for the determination of lactate, pyruvate, ketone bodies and several Krebs cycle metabolites at different sampling time points. The analysis of plasma samples from newborns with HIE revealed a decrease of lactate, pyruvate and β-hydroxybutyrate concentrations, whereas rising malate concentrations were observed. In healthy control newborns (N = 19) significantly lower levels of pyruvate and lactate were found in comparison to age-matched newborns with HIE undergoing TH, whereas acetoacetate and β-hydroxybutyrate levels were clearly increased. Access to a validated analytical method and a controlled cohort of newborns with HIE undergoing hypothermia treatment for the first time allowed the in-depth study of the evolution of key metabolites of metabolic junctions in this special population.
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Affiliation(s)
- Ángel Sánchez-Illana
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Antonio Núñez-Ramiro
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - María Cernada
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Anna Parra-Llorca
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Eva Valverde
- Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Dorotea Blanco
- Hospital Universitario Gregorio Marañón, C/O'Donnell 48-50, 28009, Madrid, Spain
| | | | - Fernando Cabañas
- Hospital Universitario Quirónsalud Madrid, Calle Diego de Velazquez s/n, 28223, Madrid, Spain
| | - Hector Boix
- Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Antonio Pavon
- Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot, s/n, 41013, Sevilla, Spain
| | - Mercedes Chaffanel
- Hospital Materno Infantil Carlos Haya, Avda. Arroyo de los Angeles s/n, 29011, Málaga, Spain
| | | | - Inés Tofe
- Hospital Universitario Reina Sofía, Avda. Menendez Pidal s/n, 14004, Córdoba, Spain
| | - Begoña Loureiro
- Hospital Universitario Cruces, Plaza Cruces s/n, 48903, Barakaldo, Vizcaya, Spain
| | | | | | - Ana García-Robles
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Julia Kuligowski
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain.
| | - Máximo Vento
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain.
- Division of Neonatology, University & Polytechnic Hospital La Fe, Avda. Fernando Abril Martorell 106, 46026, Valencia, Spain.
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Considine EC, Thomas G, Boulesteix AL, Khashan AS, Kenny LC. Critical review of reporting of the data analysis step in metabolomics. Metabolomics 2017; 14:7. [PMID: 30830321 DOI: 10.1007/s11306-017-1299-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 11/13/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION We present the first study to critically appraise the quality of reporting of the data analysis step in metabolomics studies since the publication of minimum reporting guidelines in 2007. OBJECTIVES The aim of this study was to assess the standard of reporting of the data analysis step in metabolomics biomarker discovery studies and to investigate whether the level of detail supplied allows basic understanding of the steps employed and/or reuse of the protocol. For the purposes of this review we define the data analysis step to include the data pretreatment step and the actual data analysis step, which covers algorithm selection, univariate analysis and multivariate analysis. METHOD We reviewed the literature to identify metabolomic studies of biomarker discovery that were published between January 2008 and December 2014. Studies were examined for completeness in reporting the various steps of the data pretreatment phase and data analysis phase and also for clarity of the workflow of these sections. RESULTS We analysed 27 papers, published anytime in 2008 until the end of 2014 in the area or biomarker discovery in serum metabolomics. The results of this review showed that the data analysis step in metabolomics biomarker discovery studies is plagued by unclear and incomplete reporting. Major omissions and lack of logical flow render the data analysis' workflows in these studies impossible to follow and therefore replicate or even imitate. CONCLUSIONS While we await the holy grail of computational reproducibility in data analysis to become standard, we propose that, at a minimum, the data analysis section of metabolomics studies should be readable and interpretable without omissions such that a data analysis workflow diagram could be extrapolated from the study and therefore the data analysis protocol could be reused by the reader. That inconsistent and patchy reporting obfuscates reproducibility is a given. However even basic understanding and reuses of protocols are hampered by the low level of detail supplied in the data analysis sections of the studies that we reviewed.
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Affiliation(s)
- E C Considine
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland.
| | - G Thomas
- SQU4RE, Sint-Alfonsusstraat 17, 8800, Roeselare, Belgium
| | - A L Boulesteix
- Department of Medical Informatics, Biometry and Epidemiology, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - A S Khashan
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - L C Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
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47
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Efstathiou N, Theodoridis G, Sarafidis K. Understanding neonatal hypoxic-ischemic encephalopathy with metabolomics. Hippokratia 2017; 21:115-123. [PMID: 30479472 PMCID: PMC6248003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Hypoxic-ischemic encephalopathy (HIE), a serious complication of perinatal asphyxia, is commonly associated with an unfavorable outcome. In-depth research is important not only for the interpretation of the underlying biological alternations but may also provide the basis for the development of novel diagnostic and therapeutic tools. The application of metabolomics in perinatal asphyxia/HIE is a relatively new approach. METHODS We performed a narrative, non-systematic review in the literature of metabolomic studies involving newborn animals and humans exposed to hypoxia-ischemia or developing perinatal asphyxia/HIE. RESULTS Fifteen animal studies, nine studies in human neonates, and two review articles were evaluated. Changes in the metabolomic profile of newborn animals exposed to hypoxia-ischemia and of asphyxiated neonates with HIE are presented in relation to the underlying pathophysiology. The clinical relevance of these findings is further discussed in a comprehensible to the bedside clinician manner. CONCLUSIONS Metabolomics may provide an explanation for the various metabolic alternations occurring in perinatal asphyxia/HIE, elucidate the biological background of the applied therapeutic interventions and promote the development of novel diagnostic-prognostic biomarkers of the disease. HIPPOKRATIA 2017, 21(3): 115-123.
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Affiliation(s)
- N Efstathiou
- 1 Department of Neonatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Theodoridis
- School of Chemistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Sarafidis
- 1 Department of Neonatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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El-Farghali OG, El-Chimi MS, El-Abd HS, El-Desouky E. Amino acid and acylcarnitine profiles in perinatal asphyxia: a case-control study. J Matern Fetal Neonatal Med 2017; 31:1462-1469. [PMID: 28412875 DOI: 10.1080/14767058.2017.1319354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To estimate cord blood amino acid and acylcarnitine levels in term newborns exposed to perinatal asphyxia. MATERIALS AND METHODS We studied 45 asphyxiated term newborns (cases) and 20 gestational age-matched healthy newborns (control). 16 cases developed HIE according to clinical scoring and amplitude-integrated electroencephalography. Asphyxiated cases were accordingly subdivided into: HIE group (n = 16) and Asphyxia group (n = 29). Amino acid and acylcarnitine levels were measured in cord blood dried spot samples from all newborns using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Data were analyzed using one-way ANOVA with post hoc test and MetaboAnalyst-2. RESULTS Distinct metabolite alterations were detected in cases versus control, in HIE versus Asphyxia, and in Survivors within HIE group (n = 6) versus nonsurvivors (n = 10). Principal component analysis (PCA) and partial least squares-discriminate analysis (PLS-DA) showed increased levels of methionine and certain acylcarnitines, but reduced levels of ornithine, histidine, and arginine. Metabolite set enrichment analysis (MSEA); compared to KEGG library metabolite sets, identified some disorders with similar metabolomic derangements. CONCLUSIONS We report UPLC-MS detectable alterations of amino acids and acylcarnitines in asphyxiated newborns at birth, that can serve as early diagnostic bedside biomarkers for HIE and predictors for its short-term outcome, and in the near future, as therapeutic targets.
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Affiliation(s)
- Ola Galal El-Farghali
- a Neonatology Division, Department of Pediatrics, Faculty of Medicine , Ain Shams University , Cairo , Egypt
| | - Mohamed Sami El-Chimi
- a Neonatology Division, Department of Pediatrics, Faculty of Medicine , Ain Shams University , Cairo , Egypt
| | - Heba Salah El-Abd
- b Genetics Division, Department of Pediatrics, Faculty of Medicine , Ain Shams University , Cairo , Egypt
| | - Eman El-Desouky
- c Department of Epidemiology and Biostatistics , National Cancer Institute, Cairo University , Cairo , Egypt
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Sarafidis K, Efstathiou N, Begou O, Soubasi V, Agakidou E, Gika E, Theodoridis G, Drossou V. Urine metabolomic profile in neonates with hypoxic-ischemic encephalopa-thy. Hippokratia 2017; 21:80-84. [PMID: 30455560 PMCID: PMC6239088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Metabolomics could provide valuable insights into hypoxemic-ischemic encephalopathy (HIE) revealing new disease-associated biochemical derangements. The study aimed to investigate urine metabolic changes in neonates with HIE compared to healthy controls, using targeted liquid chromatography-tandem mass spectrometry (LC-MS/MS). PATIENTS AND METHODS In this prospective, single-center study we enrolled neonates born at ≥ 36 weeks gestation with HIE (HIE group) and healthy controls (control group). We collected urine samples for metabolomic analysis on days one, three, and nine of life. RESULTS Twenty-one full-term newborns were studied, 13 in the HIE group and eight in the control group. Six of the affected neonates had moderate/severe HIE and seven mild HIE. Therapeutic hypothermia was applied only in four neonates with moderate/severe HIE. Multivariate and univariate statistical analysis showed a clear separation between the HIE and the control groups. Discriminant metabolites involved pyruvic acid, amino acids, acylcarnitines, inositol, kynurenine, hippuric acid, and vitamins. CONCLUSIONS We have identified a specific metabolic profile in neonates with HIE, adding to the existing knowledge on the disease biochemistry that may potentially help in biomarker development. HIPPOKRATIA 2017, 21(2): 80-84.
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Affiliation(s)
- K Sarafidis
- 1 Department of Neonatology, School of Medicine Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N Efstathiou
- 1 Department of Neonatology, School of Medicine Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - O Begou
- School of Chemistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Soubasi
- 1 Department of Neonatology, School of Medicine Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Agakidou
- 1 Department of Neonatology, School of Medicine Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Gika
- Laboratory of Forensic Toxicology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Theodoridis
- School of Chemistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Drossou
- 1 Department of Neonatology, School of Medicine Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ryan PM, London LEE, Bjorndahl TC, Mandal R, Murphy K, Fitzgerald GF, Shanahan F, Ross RP, Wishart DS, Caplice NM, Stanton C. Microbiome and metabolome modifying effects of several cardiovascular disease interventions in apo-E -/- mice. MICROBIOME 2017; 5:30. [PMID: 28285599 PMCID: PMC5346842 DOI: 10.1186/s40168-017-0246-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/23/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND There is strong evidence indicating that gut microbiota have the potential to modify, or be modified by the drugs and nutritional interventions that we rely upon. This study aims to characterize the compositional and functional effects of several nutritional, neutraceutical, and pharmaceutical cardiovascular disease interventions on the gut microbiome, through metagenomic and metabolomic approaches. Apolipoprotein-E-deficient mice were fed for 24 weeks either high-fat/cholesterol diet alone (control, HFC) or high-fat/cholesterol in conjunction with one of three dietary interventions, as follows: plant sterol ester (PSE), oat β-glucan (OBG) and bile salt hydrolase-active Lactobacillus reuteri APC 2587 (BSH), or the drug atorvastatin (STAT). The gut microbiome composition was then investigated, in addition to the host fecal and serum metabolome. RESULTS We observed major shifts in the composition of the gut microbiome of PSE mice, while OBG and BSH mice displayed more modest fluctuations, and STAT showed relatively few alterations. Interestingly, these compositional effects imparted by PSE were coupled with an increase in acetate and reduction in isovalerate (p < 0.05), while OBG promoted n-butyrate synthesis (p < 0.01). In addition, PSE significantly dampened the microbial production of the proatherogenic precursor compound, trimethylamine (p < 0.05), attenuated cholesterol accumulation, and nearly abolished atherogenesis in the model (p < 0.05). However, PSE supplementation produced the heaviest mice with the greatest degree of adiposity (p < 0.05). Finally, PSE, OBG, and STAT all appeared to have considerable impact on the host serum metabolome, including alterations in several acylcarnitines previously associated with a state of metabolic dysfunction (p < 0.05). CONCLUSIONS We observed functional alterations in microbial and host-derived metabolites, which may have important implications for systemic metabolic health, suggesting that cardiovascular disease interventions may have a significant impact on the microbiome composition and functionality. This study indicates that the gut microbiome-modifying effects of novel therapeutics should be considered, in addition to the direct host effects.
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Affiliation(s)
- Paul M. Ryan
- Department of Food Biosciences, Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
- School of Microbiology, University College Cork, Co. Cork, Ireland
| | - Lis E. E. London
- Department of Food Biosciences, Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - Trent C. Bjorndahl
- Department of Biological Sciences, University of Alberta, Edmonton, AB Canada
| | - Rupasri Mandal
- Department of Biological Sciences, University of Alberta, Edmonton, AB Canada
| | - Kiera Murphy
- Department of Food Biosciences, Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - Gerald F. Fitzgerald
- School of Microbiology, University College Cork, Co. Cork, Ireland
- APC Microbiome Institute, Biosciences Institute, University College Cork, Co. Cork, Ireland
| | - Fergus Shanahan
- Department of Medicine, University College Cork, National University of Ireland, Cork, Ireland
- APC Microbiome Institute, Biosciences Institute, University College Cork, Co. Cork, Ireland
| | - R. Paul Ross
- APC Microbiome Institute, Biosciences Institute, University College Cork, Co. Cork, Ireland
- College of Science, Engineering & Food Science, University College Cork, Co. Cork, Ireland
| | - David S. Wishart
- Department of Biological Sciences, University of Alberta, Edmonton, AB Canada
- Department of Computing Science, University of Alberta, Edmonton, AB Canada
- National Institute for Nanotechnology, Edmonton, AB Canada
| | - Noel M. Caplice
- Centre for Research in Vascular Biology, University College Cork, Co. Cork, Ireland
| | - Catherine Stanton
- Department of Food Biosciences, Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
- APC Microbiome Institute, Biosciences Institute, University College Cork, Co. Cork, Ireland
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