Metabolomic diferences between COVID-19 and H1N1 influenza induced ARDS.
Metabolomic diferences between COVID-19 and H1N1 influenza induced ARDS.
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DOI：
10.1186/s13054-021-03810-3
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发表时间：
2021-11-15
期刊：
影响因子：
--
通讯作者：
Izquierdo-Garcia JL
中科院分区：
文献类型：
--
作者：
Lorente JA;Nin N;Villa P;Vasco D;Miguel-Coello AB;Rodriguez I;Herrero R;Peñuelas O;Ruiz-Cabello J;Izquierdo-Garcia JL
急性呼吸窘迫综合征(ARDS)是一种以肺部炎症和肺水肿为特征的呼吸衰竭。2019年冠状病毒病(新冠肺炎)在更严重的病例中与急性呼吸窘迫综合征有关。本研究旨在比较新冠肺炎和甲型流感肺炎诱导的代谢改变在急性呼吸窘迫综合征中的特异性。18例新冠肺炎引起的ARDS和20例IAP引起的ARDS患者住进重症监护室。ADDS被定义为美欧共识会议中的定义。与新冠肺炎患者相比，间歇性胰腺炎患者更年轻，经常接受更多去甲肾上腺素治疗以维持平均动脉压 >； 65 mm Hg。血清样品用核磁共振波谱分析。多变量统计分析用于确定不同组间的代谢差异。进行代谢途径分析，以确定与ARDS发生发展最相关的途径。新冠肺炎或间歇性胰腺炎所致的ARDS对氨基酸代谢、脂代谢、糖酵解和促性腺激素代谢有不同的调节。新冠肺炎会导致严重的能源供应短缺，从而导致补充能源生成途径。相比之下，IAP患者遭受更明显的炎症和氧化应激反应。分类模型对肺炎病因的判别准确率为100%。我们的发现支持这样一个概念，即ARDS与一种特殊的代谢特征有关，这种代谢特征可以区分不同病因的ARDS患者，是一种潜在的诊断、预后和治疗的生物标记物。网上版载有补充材料，可在10.1186/s13054-021-03810-3查阅。
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by lung inflammation and pulmonary edema. Coronavirus disease 2019 (COVID-19) is associated with ARDS in the more severe cases. This study aimed to compare the specificity of the metabolic alterations induced by COVID-19 or Influenza A pneumonia (IAP) in ARDS. Eighteen patients with ARDS due to COVID-19 and twenty patients with ARDS due to IAP, admitted to the intensive care unit. ARDS was defined as in the American-European Consensus Conference. As compared with patients with COVID-19, patients with IAP were younger and received more often noradrenaline to maintain a mean arterial pressure > 65 mm Hg. Serum samples were analyzed by Nuclear Magnetic Resonance Spectroscopy. Multivariate Statistical Analyses were used to identify metabolic differences between groups. Metabolic pathway analysis was performed to identify the most relevant pathways involved in ARDS development. ARDS due to COVID-19 or to IAP induces a different regulation of amino acids metabolism, lipid metabolism, glycolysis, and anaplerotic metabolism. COVID‐19 causes a significant energy supply deficit that induces supplementary energy-generating pathways. In contrast, IAP patients suffer more marked inflammatory and oxidative stress responses. The classificatory model discriminated against the cause of pneumonia with a success rate of 100%. Our findings support the concept that ARDS is associated with a characteristic metabolomic profile that may discriminate patients with ARDS of different etiologies, being a potential biomarker for the diagnosis, prognosis, and management of this condition. The online version contains supplementary material available at 10.1186/s13054-021-03810-3.
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