Blood bile acid profiles in chronic inflammatory demyelinating polyneuropathy

Area of Science:

• Biochemistry
• Immunology
• Neurology

Background:

• Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy lacking specific diagnostic blood biomarkers.
• Bile acids (BA), known for immune-modulatory properties, are investigated as potential novel markers.
• Early diagnosis and monitoring of CIDP require improved diagnostic tools.

Purpose of the Study:

• To investigate plasma bile acid profiles in patients with CIDP.
• To evaluate the potential of bile acid profiles as diagnostic biomarkers for CIDP.
• To differentiate CIDP from Guillain-Barré syndrome (GBS) and healthy controls (HCs) using bile acid profiles.

Main Methods:

• Plasma bile acid profiles were analyzed in treatment-naïve CIDP patients, GBS patients, and HCs using liquid chromatography-mass spectrometry.
• A supervised machine learning model (support vector machine) was employed to assess discriminatory power.
• A simplified tree-based algorithm was developed using key bile acid features for classification.

Main Results:

• CIDP patients exhibited significantly elevated levels of glycochenodeoxycholic acid (GCDCA) and glycohyocholic acid (GHCA) compared to HCs.
• Elevated GCDCA and cholenic acid levels were observed in CIDP patients compared to GBS patients.
• Machine learning models, particularly a simplified tree-based algorithm, demonstrated high accuracy (AUROC: 0.929) in differentiating CIDP, GBS, and HCs based on BA profiles.

Conclusions:

• Plasma bile acid profiles hold significant potential as diagnostic biomarkers for CIDP.
• These findings suggest that bile acid analysis can aid in precise and timely patient management for CIDP.
• Further research into bile acid profiles may lead to improved diagnostic strategies for immune-mediated neuropathies.