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- Title
Blood Metabolomic Signatures to Identify Bacterial Infection in Patients with Decompensated Cirrhosis.
- Authors
Fischer, Petra; Pandrea, Stanca; Grigoras, Crina; Ștefanescu, Horia; Farcău, Oana; Tefas, Cristian; Socaciu, Carmen; Procopeț, Bogdan; Ionescu, Daniela
- Abstract
Background & Aims: Bacterial infections are associated with high mortality rates in patients with decompensated cirrhosis. Early diagnosis with the available diagnostic tools is challenging. Metabolomics is a novel technique with a widespread application in hepatology. The aims of our study were to find new biomarkers for decompensated cirrhosis and for those with overlapping bacterial infections. Methods: 43 patients with compensated and 54 patients with decompensated cirrhosis were enrolled in the study. In patients with decompensation, a complete infectious workup was performed at admission. Blood and ascitic fluid were collected and stored at -80° C until performing the metabolomic analysis. Statistical analysis was performed using the Metaboanalyst 4.0 software. Results: 36 patients (66%) in the decompensated group were infected. Among them, 15 had multiple infections; thus, finally, 52 infections were diagnosed. The main metabolic pathways affected in patients with decompensated cirrhosis were those related to lipid metabolism, involving acylcarnitines, stearic acid derivatives, and 12/15 HETE-GABA. N-oleoyl ethanolamine was the most promising biomarker for bacterial infection diagnosis. Moreover, prostaglandin E2/D2/H2 and N-oleoyl alanine levels were higher in Grampositive infections and ceramides (d16:2/18:0), in Gram-negative infections, respectively. L-phenylalanine (m/z=166.09) and lysophosphatidylethanolamine (18:3/0:0) were the two most relevant identified ascitic biomarkers for spontaneous bacterial peritonitis diagnosis. Conclusions: The lipid and energetic metabolic pathways were the most affected in patients with decompensated cirrhosis and those with overlapping infections.
- Subjects
BACTERIAL diseases; METABOLOMICS; CIRRHOSIS of the liver; STEARIC acid; ASCITIC fluids
- Publication
Journal of Gastrointestinal & Liver Diseases, 2022, Vol 31, Issue 1, p40
- ISSN
1841-8724
- Publication type
Article
- DOI
10.15403/jgld-4034