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Changes in urinary metabolomic profile during relapsing renal vasculitis
Bahjat Al-Ani1, Martin Fitzpatrick2, Hamad Al-Nuaimi1
1Renal Immunobiology Group, School of Infection, Immunology and Inflammation, University of Birmingham, UK.
Scientific Reports
|December 2, 2016
Summary
New urinary biomarkers, including trimethylamine N-oxide (TMAO), citrate, and myo-inositol, show promise for detecting early renal vasculitis flares. These findings could lead to more sensitive diagnostic tools for anti-neutrophil cytoplasmic antibody (ANCA) vasculitis.
Area of Science:
- Nephrology
- Immunology
- Metabolomics
Background:
- Current biomarkers for renal vasculitis lack predictive value and sensitivity for early damage.
- Systemic vasculitis, particularly anti-neutrophil cytoplasmic antibody (ANCA) vasculitis, can cause severe renal damage.
- Novel biomarkers are needed for early detection and monitoring of renal vasculitis flares.
Purpose of the Study:
- To identify novel urinary biomarkers for early detection of renal vasculitis flares.
- To analyze the longitudinal urinary metabolomic profile in a rat model of ANCA vasculitis.
- To validate identified biomarkers in a human patient cohort.
Main Methods:
- Longitudinal urinary metabolomic profiling using Nuclear Magnetic Resonance (NMR) spectroscopy in a rat model of ANCA vasculitis.
- Analysis of metabolite data using Partial Least Squares Discriminant Analysis (PLS-DA) and Partial Least Squares Regression (PLS-R).
- Validation of key urinary metabolites in patients using Liquid Chromatography-Mass Spectrometry (LC-MS).
Main Results:
- Distinct urinary metabolite profiles were observed in rats with vasculitis compared to controls.
- Trimethylamine N-oxide (TMAO), citrate, and 2-oxoglutarate were significantly altered in active or relapsing vasculitis.
- Elevated urinary myo-inositol and hypocitraturia, along with a high myo-inositol:citrate ratio, correlated with active renal vasculitis in both rats and patients.
Conclusions:
- Urinary trimethylamine N-oxide (TMAO), citrate, and myo-inositol are potential novel biomarkers for renal vasculitis flares.
- The urinary myo-inositol:citrate ratio shows strong correlation with active renal vasculitis.
- These findings may improve early diagnosis and monitoring of renal vasculitis.
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