Metabolomic analysis of cerebral spinal fluid from patients with severe brain injury.
Metabolomic analysis of cerebral spinal fluid from patients with severe brain injury.
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DOI：
10.1007/978-3-7091-1434-6_20
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发表时间：
2013-01-01
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影响因子：
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通讯作者：
Martin, Neil A
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文献类型：
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作者：
Glenn, Thomas C;Hirt, Daniel;Martin, Neil A
质子核磁共振（H-NMR）光谱分析的脑脊髓液提供了一个快速，非侵入性的方式来评估脑损伤患者的代谢活动。在一项前瞻性研究中，我们比较了44例TBI患者和13例未受伤对照组的CSF。筛选CSF的10个参数：β-葡萄糖（Glu）、乳酸盐（Lac）、丙二醇（PG）、谷氨酰胺（Gln）、丙氨酸（Ala）、α-葡萄糖（A-Glu）、丙酮酸盐（PYR）、肌酸（Cr）、肌酐（Crt）和乙酸盐（Ace）。使用混合效应测量，我们发现对照和创伤浓度（mM）之间存在统计学显著差异。TBI患者的PG浓度显著较高，而乳酸盐、谷氨酰胺和肌酸存在统计学趋势。TBI患者的总肌酐浓度显著降低。TBI患者和未受伤的对照组之间关于β-或α-葡萄糖、丙氨酸、丙酮酸或乙酸盐没有显著差异。代谢物之间的相关性分析显示，在未受伤的受试者中，β-葡萄糖和α-葡萄糖（r = 0.74）、肌酐和丙酮酸（r = 0.74）、丙氨酸和肌酸（r = 0.62）以及谷氨酰胺和α-葡萄糖（r = 0.60）之间的相关性最强。对于TBI患者，乳酸盐和α-葡萄糖（r = 0.54）、乳酸盐和丙氨酸（r = 0.53）以及α-葡萄糖和丙氨酸（r = 0.48）之间的相关性最强。GLM和多模型推断表明，PG、谷氨酰胺、α-葡萄糖和肌酐的组合代谢产物是CMRO 2、ICP和GOSe的最强预测因子。通过分析TBI患者的CSF，我们的目标是创建脑损伤的代谢组学指纹。
Proton nuclear magnetic resonance (H-NMR) spectroscopic analysis of cerebral spinal fluid provides a quick, non-invasive modality for evaluating the metabolic activity of brain-injured patients. In a prospective study, we compared the CSF of 44 TBI patients and 13 non-injured control subjects. CSF was screened for ten parameters: beta-glucose (Glu), lactate (Lac), propylene glycol (PG), glutamine (Gln), alanine (Ala), alpha-glucose (A-Glu), pyruvate (PYR), creatine (Cr), creatinine (Crt), and acetate (Ace). Using mixed effects measures, we discovered statistically significant differences between control and trauma concentrations (mM). TBI patients had significantly higher concentrations of PG, while statistical trends existed for lactate, glutamine, and creatine. TBI patients had a significantly decreased concentration of total creatinine. There were no significant differences between TBI patients and non-injured controls regarding beta- or alpha-glucose, alanine, pyruvate or acetate. Correlational analysis between metabolites revealed that the strongest significant correlations in non-injured subjects were between beta- and alpha-glucose (r = 0.74), creatinine and pyruvate (r = 0.74), alanine and creatine (r = 0.62), and glutamine and alpha-glucose (r = 0.60). For TBI patients, the strongest significant correlations were between lactate and alpha-glucose (r = 0.54), lactate and alanine (r = 0.53), and alpha-glucose and alanine (r = 0.48). The GLM and multimodel inference indicated that the combined metabolites of PG, glutamine, alpha-glucose, and creatinine were the strongest predictors for CMRO2, ICP, and GOSe. By analyzing the CSF of patients with TBI, our goal was to create a metabolomic fingerprint for brain injury.