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Burghelea D, Moisoiu T, Ivan C, Elec A, Munteanu A, Iancu ȘD, Truta A, Kacso TP, Antal O, Socaciu C, Elec FI, Kacso IM. The Use of Machine Learning Algorithms and the Mass Spectrometry Lipidomic Profile of Serum for the Evaluation of Tacrolimus Exposure and Toxicity in Kidney Transplant Recipients. Biomedicines 2022; 10:biomedicines10051157. [PMID: 35625894 PMCID: PMC9138871 DOI: 10.3390/biomedicines10051157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 12/10/2022] Open
Abstract
Tacrolimus has a narrow therapeutic window; a whole-blood trough target concentration of between 5 and 8 ng/mL is considered a safe level for stable kidney transplant recipients. Tacrolimus serum levels must be closely monitored to obtain a balance between maximizing efficacy and minimizing dose-related toxic effects. Currently, there is no specific tacrolimus toxicity biomarker except a graft biopsy. Our study aimed to identify specific serum metabolites correlated with tacrolinemia levels using serum high-precision liquid chromatography–mass spectrometry and standard laboratory evaluation. Three machine learning algorithms were used (Naïve Bayes, logistic regression, and Random Forest) in 19 patients with high tacrolinemia (8 ng/mL) and 23 patients with low tacrolinemia (5 ng/mL). Using a selected panel of five lipid metabolites (phosphatidylserine, phosphatidylglycerol, phosphatidylethanolamine, arachidyl palmitoleate, and ceramide), Mg2+, and uric acid, all three machine learning algorithms yielded excellent classification accuracies between the two groups. The highest classification accuracy was obtained by Naïve Bayes, with an area under the curve of 0.799 and a classification accuracy of 0.756. Our results show that using our identified five lipid metabolites combined with Mg2+ and uric acid serum levels may provide a novel tool for diagnosing tacrolimus toxicity in kidney transplant recipients. Further validation with targeted MS and biopsy-proven TAC toxicity is needed.
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Affiliation(s)
- Dan Burghelea
- Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania; (D.B.); (T.M.); (A.E.); (A.M.); (O.A.)
- Department of Urology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
| | - Tudor Moisoiu
- Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania; (D.B.); (T.M.); (A.E.); (A.M.); (O.A.)
- Department of Urology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- Biomed Data Analytics SRL, 400696 Cluj-Napoca, Romania
| | - Cristina Ivan
- “Regina Maria” Hospital, 400117 Cluj-Napoca, Romania;
| | - Alina Elec
- Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania; (D.B.); (T.M.); (A.E.); (A.M.); (O.A.)
| | - Adriana Munteanu
- Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania; (D.B.); (T.M.); (A.E.); (A.M.); (O.A.)
| | - Ștefania D. Iancu
- Faculty of Physics, Babeș-Bolyai University, 400084 Cluj-Napoca, Romania;
| | - Anamaria Truta
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400337 Cluj-Napoca, Romania;
| | - Teodor Paul Kacso
- Department of Nephrology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania; (T.P.K.); (I.M.K.)
| | - Oana Antal
- Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania; (D.B.); (T.M.); (A.E.); (A.M.); (O.A.)
- Department of Anesthesiology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
| | - Carmen Socaciu
- Faculty of Food Science and Technology, University of Agricultural Science and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3–5, 400372 Cluj-Napoca, Romania;
| | - Florin Ioan Elec
- Clinical Institute of Urology and Renal Transplantation, 400006 Cluj-Napoca, Romania; (D.B.); (T.M.); (A.E.); (A.M.); (O.A.)
- Department of Urology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-756285972
| | - Ina Maria Kacso
- Department of Nephrology, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania; (T.P.K.); (I.M.K.)
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