Metabolomic analysis to predict the onset and severity of necrotizing enterocolitis.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968547 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-230X (Electronic) Linking ISSN: 1471230X NLM ISO Abbreviation: BMC Gastroenterol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Enterocolitis, Necrotizing*/urine ; Metabolomics* ; Biomarkers*/urine ; Infant, Premature*/urine ; Carnitine*/analogs & derivatives ; Carnitine*/urine; Humans ; Infant, Newborn ; Prospective Studies ; Female ; Male ; Case-Control Studies ; Intestinal Perforation/urine ; Severity of Illness Index ; Infant, Premature, Diseases/urine ; Infant, Premature, Diseases/diagnosis ; Gestational Age

Background: Necrotizing enterocolitis (NEC) is the most devastating gastrointestinal (GI) emergency in preterm neonates. Untargeted metabolomics may allow the identification of biomarkers involved in NEC pathophysiology.
Methods: We conducted a prospective study including preterm infants born at < 34 gestational weeks (GWs) whose urine was longitudinally collected at birth (< 48 h, T0) and at 14 (T1) and 28 days (T2). Neonates were followed for their development of NEC, spontaneous intestinal perforation (SIP), or other GI conditions and compared to those of matched healthy controls. Urine samples were investigated by untargeted metabolomic analysis based on mass-spectrometry.
Results: Thirty-five patients with NEC, 5 patients with SIP, 14 patients with other GI diseases and 113 controls were enrolled and selected for metabolomic analysis on the basis of their clinical characteristics and available samples. Considering urine samples at T0, the one-class classification approach was able to correctly classify 16/20 subjects (80%) who developed NEC, 3/3 (100%) who developed SIP and 5/7 subjects (71.4%) with other GI pathologies as not belonging to the control group. Neonates with surgical NEC had higher N-acetylaspartic acid, butyrylcarnitine and propionylcarnitine levels than did those with medical NEC. Considering the time evolution of the urinary metabolome, the NEC and control groups showed differences independently of the time point.
Conclusions: The urinary metabolome is closely associated with the underlying GI disease from birth. Urinary metabolic features characterize NEC patients from healthy controls until 28 days of life. The early urinary metabolome has the potential to predict surgical NEC. Future studies are needed to validate our results.
(© 2024. The Author(s).)

Foods. 2022 Jan 26;11(3):. (PMID: 35159496)
J Med Chem. 2016 Oct 13;59(19):8649-8666. (PMID: 27295417)
N Engl J Med. 2011 Jan 20;364(3):255-64. (PMID: 21247316)
Int J Mol Sci. 2015 Jul 15;16(7):16067-84. (PMID: 26184189)
Methods Mol Biol. 2020;2064:1-8. (PMID: 31565762)
Nutrients. 2020 Apr 30;12(5):. (PMID: 32365850)
Ital J Pediatr. 2018 Jul 25;44(1):84. (PMID: 30045775)
J Pediatr Gastroenterol Nutr. 2017 Dec;65(6):e120-e132. (PMID: 28379923)
Gut. 2014 Aug;63(8):1284-92. (PMID: 24048736)
Front Mol Biosci. 2021 Jun 15;8:680159. (PMID: 34212004)
Front Pediatr. 2020 Dec 08;8:602255. (PMID: 33425815)
Expert Rev Mol Diagn. 2016 Oct;16(10):1053-1058. (PMID: 27403597)
Clin Perinatol. 2020 Jun;47(2):383-397. (PMID: 32439118)
J Pediatr. 2014 Mar;164(3):607-12.e1-7. (PMID: 24433829)
Int J Dev Neurosci. 2007 Aug;25(5):317-24. (PMID: 17604935)
J Pediatr Surg. 2020 Jun;55(6):998-1001. (PMID: 32173122)
Pediatr Res. 2016 Mar;79(3):425-31. (PMID: 26571220)
Arch Dis Child Fetal Neonatal Ed. 2022 May;107(3):336-339. (PMID: 34257102)
Pediatr Clin North Am. 1986 Feb;33(1):179-201. (PMID: 3081865)
Int J Surg. 2022 Mar;99:106268. (PMID: 35183734)
J Pediatr. 2017 Feb;181:80-85.e1. (PMID: 27836286)
Microbiome. 2016 Dec 29;4(1):67. (PMID: 28034304)
Biometrics. 1982 Dec;38(4):963-74. (PMID: 7168798)
Nat Rev Drug Discov. 2003 Aug;2(8):668-76. (PMID: 12904817)
Front Mol Biosci. 2022 Oct 05;9:1006822. (PMID: 36275615)
Sci Rep. 2018 Jul 20;8(1):10984. (PMID: 30030452)
J Pediatr Surg. 2022 Jun;57(6):981-985. (PMID: 35287964)
Expert Rev Proteomics. 2021 Apr;18(4):247-259. (PMID: 33896313)
J Clin Med. 2022 Sep 07;11(18):. (PMID: 36142917)
BMC Pediatr. 2020 Jul 13;20(1):344. (PMID: 32660457)
mSphere. 2018 Jun 6;3(3):. (PMID: 29875143)
Pediatr Res. 2020 Aug;88(Suppl 1):10-15. (PMID: 32855506)
J Chromatogr B Analyt Technol Biomed Life Sci. 2019 Jun 1;1117:10-21. (PMID: 30991202)
Microbiome. 2013 Apr 16;1(1):13. (PMID: 24450576)
Acta Paediatr. 2022 Jan;111(1):45-53. (PMID: 34626496)
BMC Microbiol. 2019 Mar 4;19(1):52. (PMID: 30832576)
Nutrients. 2022 Sep 18;14(18):. (PMID: 36145235)
J Pediatr. 2009 May;154(5):638-44. (PMID: 19364557)
JIMD Rep. 2013;7:1-6. (PMID: 23430487)
Metabolites. 2023 Dec 24;14(1):. (PMID: 38248817)
J Pediatr Genet. 2021 Feb 17;12(2):179-183. (PMID: 37090833)
J Pediatr. 2020 May;220:86-92.e3. (PMID: 31982088)
Int J Neurosci. 2011 Jun;121(6):305-9. (PMID: 21348802)
Ann Surg. 1978 Jan;187(1):1-7. (PMID: 413500)
Curr Pediatr Rev. 2019;15(2):115-124. (PMID: 30864508)
Metab Brain Dis. 2009 Jun;24(2):283-98. (PMID: 19294497)
Nutrients. 2021 Jan 24;13(2):. (PMID: 33498880)
Front Pediatr. 2022 Nov 28;10:1048322. (PMID: 36518779)
J Pediatr. 2017 Feb;181:9-11. (PMID: 27931825)

Keywords: Biomarker; Mass-spectrometry; Metabolome; Necrotizing enterocolitis; Preterm neonate

0 (Biomarkers)
S7UI8SM58A (Carnitine)
25576-40-3 (butyrylcarnitine)

Date Created: 20241025 Date Completed: 20241026 Latest Revision: 20241030

20250114

PMC11515140

10.1186/s12876-024-03453-y

39455932