Basic Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2022; 14(4): 719-728
Published online Apr 27, 2022. doi: 10.4254/wjh.v14.i4.719
Assessment of periportal fibrosis in Schistosomiasis mansoni patients by proton nuclear magnetic resonance-based metabonomics models
Milena Lima Rodrigues, Tatiane Priscila Santos Rodrigues da Luz, Caroline Louise Diniz Pereira, Andrea Dória Batista, Ana Lúcia Coutinho Domingues, Ricardo Oliveira Silva, Edmundo Pessoa Lopes
Milena Lima Rodrigues, Caroline Louise Diniz Pereira, Ana Lúcia Coutinho Domingues, Edmundo Pessoa Lopes, Programa de Pós-Graduação em Medicina Tropical, Centro de Ciências Médicas, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
Tatiane Priscila Santos Rodrigues da Luz, Ricardo Oliveira Silva, Programa de Pós-Graduação em Química, Centro de Ciências Exatas e da Natureza, Universidade Federal de Pernambuco, Recife 50670-740, Pernambuco, Brazil
Andrea Dória Batista, Ana Lúcia Coutinho Domingues, Edmundo Pessoa Lopes, Hospital das Clínicas, Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife 50670-901, Pernambuco, Brazil
Author contributions: Rodrigues ML, Domingues ALC, Lopes EP, and Silva RO conceived and implemented the study; Rodrigues ML, Pereira CLD, and da Luz TPSR collected and performed analysis; Rodrigues ML, da Luz TPSR, Lopes EP, and Silva RO interpreted the data and drafted the manuscript; Domingues ALC, Batista AD, Lopes EP, and Silva RO critically revised the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the UFPE Research Ethical Committee involving human subjects, Certificate of Presentation of Ethical Appreciation (CAAE) 07291019.2.0000.8807.
Informed consent statement: Written informed consent for publication was obtained from all participants.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Edmundo Pessoa Lopes, MD, PhD, Professor, Staff Physician, Programa de Pós-Graduação em Medicina Tropical, Centro de Ciências Médicas, Universidade Federal de Pernambuco, Estrada das Ubaias, 311, apto. 901-A, Recife 50670-901, Pernambuco, Brazil. epalopes@uol.com.br
Received: May 18, 2021
Peer-review started: May 18, 2021
First decision: July 8, 2021
Revised: July 20, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: April 27, 2022
Abstract
BACKGROUND

The evaluation of periportal fibrosis (PPF) is essential for a prognostic assessment of patients with Schistosomiasis mansoni. The WHO Niamey Protocol defines patterns of fibrosis from abdominal ultrasonography, 1H-nuclear magnetic resonance (NMR)-based metabonomics has been employed to assess liver fibrosis in some diseases.

AIM

To build 1H-NMR-based metabonomics models (MM) to discriminate mild from significant periportal PPF and identify differences in the metabolite profiles.

METHODS

A prospective cross-sectional study was performed on schistosomiasis patients at a University Hospital in Northeastern Brazil. We evaluated 41 serum samples from 10 patients with mild PPF (C Niamey pattern) and 31 patients with significant PPF (D/E/F Niamey patterns). MM were built using partial least squares-discriminant analysis (PLS-DA) and orthogonal projections to latent structures discriminant analysis (OPLS-DA) formalisms.

RESULTS

PLS-DA and OPLS-DA resulted in discrimination between mild and significant PPF groups with R2 and Q2 values of 0.80 and 0.38 and 0.72 and 0.42 for each model, respectively. The OPLS-DA model presented accuracy, sensitivity, and specificity values of 92.7%, 90.3%, and 100% to discriminate significant PPF. The metabolites identified as responsible by discrimination were: N-acetylglucosamines, alanine, glycolaldehyde, carbohydrates, and valine.

CONCLUSION

MMs discriminated mild from significant PPF patterns in patients with Schistosomiasis mansoni through identification of differences in serum metabolites profiles.

Keywords: Metabolomics, Portal hypertension, Schistosoma mansoni, Biomarkers, Neglected disease, Nuclear magnetic resonance

Core Tip: In this study, we demonstrated a metabolic signatures and metabolic pathway disturbances that allowed to discriminate mild from significant periportal fibrosis in 41 patients with Schistosomiasis mansoni. Partial least squares-discriminant analysis (PLS-DA) and OPLS metabonomics models provided a clear separation between the groups. PLS-DA model presented accuracy, R2 and Q2 values equal to 0.85, 0.80 and 0.38, respectively, while OPLS model had R2 and Q2 values equal to 0.717 and 0.417, respectively. We also identified some metabolites responsible by discrimination which are associated with changes related to liver function and amino acids metabolism.