Published online Apr 21, 2017. doi: 10.3748/wjg.v23.i15.2685
Peer-review started: November 23, 2016
First decision: December 19, 2016
Revised: January 11, 2017
Accepted: March 15, 2017
Article in press: March 15, 2017
Published online: April 21, 2017
To understand the underlying metabolic changes in human liver disease we have applied nuclear magnetic resonance (NMR) metabolomics analysis to human liver tissue.
We have carried out pilot study using 1H-NMR to derive metabolomic signatures from human liver from patients with steatosis, nonalcoholic steatohepatitis (NASH) or alcohol-related liver damage (ARLD) to identify species that can predict outcome and discriminate between alcohol and metabolic-induced liver injuries.
Changes in branched chain amino acid homeostasis, tricarboxylic acid cycle and purine biosynthesis intermediates along with betaine were associated with the development of cirrhosis in both ARLD and nonalcoholic fatty liver disease. Species such as propylene glycol and as yet unidentified moieties that allowed discrimination between NASH and ARLD samples were also detected using our approach.
Our high throughput, non-destructive technique for multiple analyte quantification in human liver specimens has potential for identification of biomarkers with prognostic and diagnostic significance.
Core tip: We have for the first time performed a comparative analysis of 1H-NMR spectra from human liver derived from patients with different, but histologically similar etiologies, and steatotic donor tissue. In agreement with the fibrotic and inflammatory picture in the diseased livers, analytes relating to energy and protein metabolism and ketone body production were altered compared to the donor samples. More importantly, novel combinations of markers that may have diagnostic or prognostic significance were also identified by this approach.