Published February 1, 2021 | Version v1
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NMR based clinical metabolomics revealed distinctive serum metabolic profiles in patients with Spondyloarthritis

  • 1. Department of Clinical Immunology and Rheumatology, SGPGIMS, Raebareli Road, Lucknow-226014, India
  • 2. Centre of Biomedical Research, SGPGIMS Campus, Lucknow-226014, India
  • 3. Centre of Biomedical Research, SGPGIMS Campus, Lucknow-226014, Uttar Pradesh, India

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  • 1. Centre of Biomedical Research, SGPGIMS Campus, Lucknow-226014, Uttar Pradesh, India
  • 2. Department of Clinical Immunology and Rheumatology, SGPGIMS, Raebareli Road, Lucknow-226014, India
  • 3. Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

Description

Spondyloarthritis (SpA) is an umbrella term for autoimmune rheumatic diseases that can affect the back, pelvis, neck and some larger joints, as well as internal organs, like the intestines and eyes. The most common of these diseases is ankylosing spondylitis (ASp) which predominantly affects the spine and sacroiliac joints causing characteristic inflammatory back pain (IBP) and severe spine stiffness. In addition, AsP may involve peripheral joints causing asymmetrical peripheral oligo-arthritis often associated with extra-articular symptoms such as acute anterior uveitis (iritis), psoriasis, enthesitis, dactylitis and chronic inflammatory bowel disease (IBD). These clinical features adversely affect the quality of life in ASp patients owing to restricted spinal/hip mobility, pain, fatigue, disease flares and depression. The clinical management of SpA is marred by delay in diagnosis, and paucity of biomarkers of disease activity. The present study aimed to explore the potential of serum metabolic profiling of patients with SpA to identify biomarker for the diagnosis and assessment of disease activity. The serum metabolic profiles of 81 patients with SpA were compared with that of 86 healthy controls (HC) using nuclear magnetic resonance (NMR) based metabolomics approach. Seventeen patients were followed-up after 3 months of standard treatment and paired sera were analyzed for effects of therapy. Comparisons were done using the multivariate partial least-squares discriminant analysis (PLS-DA) and the discriminatory metabolic entities were identified based on variable importance in projection (VIP) statistics and further evaluated for statistical significance (p-value<0.05). We found that the serum metabolic profiles differed significantly in SpA as compared with healthy controls. Compared to HC, the SpA patients were characterized by increased serum levels of amino-acids, acetate, choline, N-acetyl glycoproteins, N-alpha-acetyllysine, creatine/creatinine etc. and decreased levels of low/very-low density lipoproteins, and poly-unsaturated lipids. PLS-DA analysis also revealed metabolic differences between axial and peripheral SpA patients. Further metabolite profiles were found to differ with disease activity and treatment in responding patients. The results presented in this study demonstrate the potential of serum metabolic profiling of SpA as a useful tool for diagnosis, prediction of peripheral disease, assessment of disease activity, and treatment response.

Notes

The decreased circulatory levels of glutamine were found to be associated with SpA disease activity.

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References

  • Latika Gupta, Anupam Guleria, Atul Rawat, Dinesh Kumar* and Amita Aggarwal*, "NMR based clinical metabolomics revealed distinctive serum metabolic profiles in patients with Spondyloarthritis", Magnetic Resonance in Chemistry (2021), 59(2), 85-98.