Urine metabolome profiling of immune-mediated inflammatory diseases


Por: Alonso, A, Julia, A, Vinaixa, M, Domenech, E, Fernandez-Nebro, A, Canete, J, Ferrandiz, C, Tornero, J, Gisbert, J, Nos, P, Gutierrez Casbas, A, Puig, L, Gonzalez-Alvaro, I, Pinto-Tasende, J, Blanco, R, Rodriguez, M, Beltran, A, Correig, X, Marsal, S and IMID Consortium

Publicada: 8 sep 2016
Categoría: Medicine (miscellaneous)

Resumen:
Background: Immune-mediated inflammatory diseases (IMIDs) are a group of complex and prevalent diseases where disease diagnostic and activity monitoring is highly challenging. The determination of the metabolite profiles of biological samples is becoming a powerful approach to identify new biomarkers of clinical utility. In order to identify new metabolite biomarkers of diagnosis and disease activity, we have performed the first large-scale profiling of the urine metabolome of the six most prevalent IMIDs: rheumatoid arthritis, psoriatic arthritis, psoriasis, systemic lupus erythematosus, Crohn's disease, and ulcerative colitis. Methods: Using nuclear magnetic resonance, we analyzed the urine metabolome in a discovery cohort of 1210 patients and 100 controls. Within each IMID, two patient subgroups were recruited representing extreme disease activity (very high vs. very low). Metabolite association analysis with disease diagnosis and disease activity was performed using multivariate linear regression in order to control for the effects of clinical, epidemiological, or technical variability. After multiple test correction, the most significant metabolite biomarkers were validated in an independent cohort of 1200 patients and 200 controls. Results: In the discovery cohort, we identified 28 significant associations between urine metabolite levels and disease diagnosis and three significant metabolite associations with disease activity (P-FDR < 0.05). Using the validation cohort, we validated 26 of the diagnostic associations and all three metabolite associations with disease activity (PFDR < 0.05). Combining all diagnostic biomarkers using multivariate classifiers we obtained a good disease prediction accuracy in all IMIDs and particularly high in inflammatory bowel diseases. Several of the associated metabolites were found to be commonly altered in multiple IMIDs, some of which can be considered as hub biomarkers. The analysis of the metabolic reactions connecting the IMID-associated metabolites showed an overrepresentation of citric acid cycle, phenylalanine, and glycine-serine metabolism pathways. Conclusions: This study shows that urine is a source of biomarkers of clinical utility in IMIDs. We have found that IMIDs show similar metabolic changes, particularly between clinically similar diseases and we have found, for the first time, the presence of hub metabolites. These findings represent an important step in the development of more efficient and less invasive diagnostic and disease monitoring methods in IMIDs.

Filiaciones:
Alonso, A:
 Vall dHebron Hosp, Res Inst, Rheumatol Res Grp, Barcelona, Spain

Julia, A:
 Vall dHebron Hosp, Res Inst, Rheumatol Res Grp, Barcelona, Spain

Vinaixa, M:
 COS DEEEA URV IISPV, Centre Omic Sci, Reus, Spain

 CIBERDEM, Metab Platform, Reus, Spain

Domenech, E:
 Hosp Badalona Germans Trias & Pujol, Badalona, Spain

 CIBERehd, Madrid, Spain

Fernandez-Nebro, A:
 Univ Malaga, Hosp Reg Univ Malaga, Inst Investi Biomed IBIMA, UGC Reumatol, Malaga, Spain

Canete, J:
 Hosp Clin Barcelona, Barcelona, Spain

 IDIBAPS, Barcelona, Spain

Ferrandiz, C:
 Hosp Badalona Germans Trias & Pujol, Badalona, Spain

Tornero, J:
 Hosp Univ Guadalajara, Guadalajara, Spain

Gisbert, J:
 CIBERehd, Madrid, Spain

 Hosp Univ Princesa, Madrid, Spain

 IIS IP, Madrid, Spain

Nos, P:
 CIBERehd, Madrid, Spain

 Hosp La Fe, Valencia, Spain

:
 CIBERehd, Madrid, Spain

 Hosp Gen Alicante, Alicante, Spain

Puig, L:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Pinto-Tasende, J:
 INIBIC, Complejo Hosp Juan Canalejo, La Coruna, Spain

Blanco, R:
 Hosp Univ Marques Valdecilla, Santander, Spain

Rodriguez, M:
 COS DEEEA URV IISPV, Centre Omic Sci, Reus, Spain

 CIBERDEM, Metab Platform, Reus, Spain

Beltran, A:
 COS DEEEA URV IISPV, Centre Omic Sci, Reus, Spain

 CIBERDEM, Metab Platform, Reus, Spain

Correig, X:
 COS DEEEA URV IISPV, Centre Omic Sci, Reus, Spain

 CIBERDEM, Metab Platform, Reus, Spain

Marsal, S:
 Vall dHebron Hosp, Res Inst, Rheumatol Res Grp, Barcelona, Spain
ISSN: 17417015





BMC MEDICINE
Editorial
BIOMED CENTRAL LTD, 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 14 Número:
Páginas:
WOS Id: 000382736600001
ID de PubMed: 27609333

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