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Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
11:02

Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics

Published on: November 29, 2024

684

Systemic inflammation and metabolic disturbances underlie inpatient mortality among ill children with severe

Bijun Wen1,2, James M Njunge3,4, Celine Bourdon2,3

  • 1Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.

Science Advances
|February 16, 2022
PubMed

Insights

Children with complicated severe malnutrition (CSM) face high mortality risks. Biomolecular profiles reveal systemic inflammation and bioenergetic deficits as key factors, offering targets for improved survival in this vulnerable group.

Area of Science:

  • Biochemistry
  • Immunology
  • Pediatrics

Background:

  • Children with acute illness and complicated severe malnutrition (CSM) have a high risk of hospital mortality.
  • The underlying biological mechanisms of mortality in CSM are not well understood.

Purpose of the Study:

  • To investigate the blood metabolomic and proteomic profiles of children with CSM who died versus those who survived.
  • To identify specific biomolecular disturbances associated with CSM mortality.

Main Methods:

  • A case-control study was conducted within a multicenter randomized controlled trial.
  • Blood samples from children with CSM in Kenya and Malawi were analyzed for metabolomic and proteomic profiles.
  • Cases were children who died (n=92) and controls were those who survived (n=92).

Main Results:

  • Metabolomic and proteomic profiles significantly differentiated between children who died and those who survived.
  • Fatalities were characterized by increased energetic substrates (TCA cycle metabolites), microbial metabolites (propionate, isobutyrate), acute phase proteins (calprotectin, CRP), and inflammatory markers (IL-8, TNF-α).
  • These findings indicate disruptions in mitochondria-related bioenergetic pathways and sepsis-like responses.

Conclusions:

  • Specific biomolecular disturbances are associated with mortality in children with complicated severe malnutrition.
  • Systemic inflammation and bioenergetic deficits are identified as targetable pathophysiological processes.
  • These insights may lead to improved survival strategies for this vulnerable pediatric population.

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