= Discovery stage.
= Translation stage.
= Clinically available.

MSACL 2019 EU Abstract(s) for Metabolites & Metabolomics


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Podium Presentations for Metabolites & Metabolomics


Topic(s): Metabolites & Metabolomics

From Spectrometric Data to Metabolic Networks: An Integrated Quantitative View of Cell Metabolism

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Wednesday at 9:00

INTRODUCTION: Metabolite profiling – or metabolomics – presents a powerful global approach to measure shifts in metabolites as functional readouts of cellular state. Metabolites can complement upstream biochemical information obtained from genes, transcripts, and proteins and advance our understanding of how cells are altered in health and disease. Unfortunately, the great success in the characterization of genes, transcripts and proteins has currently no parallel in metabolites. Metabolomic studies are revealing large numbers of naturally occurring metabolites that cannot be characterized because their chemical structures and spectrometric data are not available. This is preventing metabolomics from evolving as fast as other omic sciences, and thus it is restricting the integration of multiple layers of omic data to gain more insights into the emergence of observed phenotypes.
OBJECTIVES: To fill this gap, new experimental approaches based on mass spectrometry (MS), and innovations in bioinformatics to enable a comprehensive analysis of cellular metabolites are needed.
RESULTS: Here I will present novel computational tools for: 1) identifying and quantifying metabolites from reconstructed GC-MS, LC-MS and MALDI-MS spectral profiles; 2) the structural characterisation of unknown metabolites; and 3) the use of isotopically labeled metabolites to study the flow of chemical moieties through the complex set of metabolic reactions that happen in the cell. Finally, I will show that the integrated analysis of proteomics and metabolomics data through metabolic networks provides a new conceptual structure for an alternative quantitative and predictive description of cell metabolism.


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Topic(s): Metabolites & Metabolomics

Metabolomics Applied to Coronary Clinical Burden: Use of Mass Spectrometry to Re-Stratify Asymptomatic Subjects of Intermediate Cardiovascular Risk

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Wednesday at 11:20

Introduction
Early detection of subclinical atherosclerosis has a major impact on the prevention actions of manifest coronary disease. The management of asymptomatic patients with intermediate Framingham risk is considered uncertain and additional tests are recommended to personalize the risk estimates. Prospection of metabolic markers and the evaluation of the detailed characteristics of the plaque with atherosclerotic burden score can be used as a complementary technique for re-stratification of the risk. Purpose: Compare the overall metabolic profile among patients with coronary plaques classified by modified Leaman score (CT-LeSc) versus control subjects (without plaques), using mass spectrometry (MS), correlating patient’s clinical data with possible molecular discriminants, for re-stratification of cardiovascular risk.

Methods
20 asymptomatic subjects classified as intermediate coronary artery disease risk according to the Framingham risk score, and with myocardial perfusion scintigraphy negative for ischemia and normal left ventricular fraction on transthoracic echocardiography, were recruited into four groups according to coronary computed tomography angiography (CCTA) and CT – LeSc: T1 (0,3 - 3,7); T2 (3,8 - 8,2); T3 (8,3 – 24,1) terciles. Plasma non-targeted metabolomics approach with UPLC-QTOF/MS was applied. Raw data was pre-processed in XCMS to extract chemical entities. Non-parametric univariate analysis and non-supervised (PCA), as well as supervised (PLS-DA) multivariate analysis were used to obtain the significant molecular features (p<0.05, VIP>1). CEU Mass Mediator was used to putatively identify the significant metabolites. The metabolic profile was compared with calcium score, carotid intima-media thickness, high sensitivity C-reactive protein and a family history of atherosclerotic disease regarding the capacity to reclassify cardiovascular risk.

Results
More than 2000 molecular features were extracted from the raw data. PLS-DA of the lipid profiles based on CT-LeSc showed good classification power (Q2=0.8960). No lipid profile showed discriminatory power when patients were classified based under calcified plaques (CP) and non-calcified and mixed plaques (NCMP), which is the current method on clinics to plaque characterization. 53 molecular features (MF) had significance both in uni- and multivariate analysis. 17 MF could be annotated. Phosphatidylethanolamine, phosphatidylcoline and cardiolipins were more abundant in the highest Leaman score groups (T2/T3).

Conclusions & Discussion
The global lipid profile of asymptomatic subjects at Framingham intermediate risk of coronary artery disease may be useful as a complementary molecular marker presenting valuable discriminant power between the different tomographic Leaman phenotypes. Unlike the classification based only on the presence of plaque calcification, the Leaman score discriminated with greater accuracy. The implementation of this high-performance analysis by MS forecasts an important future impact in the prevention of clinical events focusing on patients whose traditional risk markers fail to correctly stratify subjects. Application of new biomarkers with clinical utility may transform cardiovascular care, improving new diagnostic approach to subclinical atherosclerosis and enabling a more personalized medicine.

We acknowledge Dr. Francisco Laurindo for valuable discussion on cardiolipins role in atherosclerosis. To Carolina Gonzáles-Riaño and Dra. Joanna Godzien from CEMBIO for valuable tips on metabolites identification. To LBBQ/UnB, especially to Dr. Wagner Fontes.


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Topic(s): Metabolites & Metabolomics

Metabotyping Burn Injury Using UPLC-MS Coupled with Microdialysis

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Wednesday at 11:40

INTRODUCTION: Burn injury can be a devastating trauma, affecting millions of people worldwide, with long-term personal and social implications for patients. Burns can result in life-limiting chronic pain, often refractory to treatment. Mechanisms behind burn injury are poorly understood and there has been little research into the molecular basis of burns and subsequent pain. It is important to explore the local signalling environment, but studies are often destructive in nature and preclude the collection of longitudinal temporal data. Microdialysis is a sampling method allowing the in vivo collection of solutes primarily from the extracellular interstitium and is ideal for the study of burn injury. Metabolomics offers an unbiased approach to the elucidation of metabolites involved in pathological events. Coupled with mass spectrometry, it provides a sensitive platform for the detection of metabolic changes due to burn injury.
OBJECTIVES: Elucidation of altered metabolites due to burn injury - to enhance understanding of the pathological processes occurring and guide future therapeutic strategies.
METHODS: Subcutaneous microdialysis in a burn model was coupled with ultra performance liquid chromatography – mass spectrometry (UPLC-MS) analysis. Microdialysis was conducted for 0.5 hrs pre-burn and 3 hours post-burn, collected in half hour fractions for time series analysis. An Acquity UPLC system with a HSS T3 column was connected to a Synapt G2-S Q-ToF. Data were processed using XCMS software. Principal components analysis (PCA) was applied for unsupervised multivariate comparison of burn and control sites. Partial least squares discriminant-analysis (PLS-DA) was applied to rank metabolite features contributing to these differences. Model robustness was affirmed using CV-ANOVA. MS/MS studies for structural elucidation were performed using the same UPLC-MS system.
RESULTS: Hundreds of polar analytes and lipids were profiled from microdialysate samples over a reversed phase run of 12 minutes, yielding a high number of burn-altered metabolites. PCA scores plots showed tight quality control sample grouping, indicating acquisition stability. Clear metabolic differences were observed between microdialysates collected from burned tissue and the control sites. Two important molecules elevated in burn injury were structurally elucidated; niacinamide and uric acid. These two compounds are potentially involved in the pathology of burn injury.
CONCLUSION: This study demonstrates the application of high throughput metabolomic profiling to samples collected both continuously and specifically from the burn site. Further understanding the metabolic changes induced by burn injury will help to guide therapeutic intervention in the future. This approach is equally applicable to the analysis of other tissues and pathological conditions, so may further improve our understanding of the metabolic changes underlying a wide variety of pathological processes.


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Topic(s): Metabolites & Metabolomics

Assessing the Metabolome of Preterm Newborns: Findings from a Danish Population-based Study

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Wednesday at 14:30

INTRODUCTION:

Approximately 15 million babies worldwide are born preterm every year, and 1 million thereof die due to complications. The number of preterm birth, that is a baby born alive before 37 weeks of gestational age is constantly rising, and although some causes such as infections, diabetes or high blood pressure are known, the cause of a spontaneous preterm birth remains often unknown. A better understanding of the underlying metabolomic changes in preterm neonates could aid the development of solutions to prevent it as well as foster more feasible care and treatment options.

OBJECTIVES:

The objective of this study was to assess how the neonatal metabolome varies with gestational age and to investigate whether and how the metabolomic profile of preterm newborns differs from that of healthy term infants.

METHODS:

We used liquid chromatography tandem mass spectrometry (LC-MS/MS) in combination with metabolome mining tools, such as mass spectral molecular networking (GNPS), unsupervised substructure discovery (MS2LDA) as well as in silico annotation tools to assess the metabolomic profile from dried blood spots from over 300 neonates with varying gestational ages and health statuses sampled from the Danish National Biobank resource.

RESULTS:

We assessed the blood metabolomic profile and identified metabolites significantly varying across gestational age and with known effects also in disease etiology, such as for example bile or amino acids. Furthermore, metabolome mining tools, such as mass spectral molecular networking were revealed as powerful resources to differentiate molecules and drug metabolites from molecules likely originating from contaminating sources.

CONCLUSION:

In this study we could show that there are distinct metabolic features that vary with gestational age and that mass spectral metabolomics analysis of dried blood spots is a powerful tool to assess the metabolome of preterm neonates. With over 2 million dried blood spots, the Danish National Biobank is an exceptional resource for future large-scale integrated omics studies not only in the context of preterm birth but also for the investigation of other inborn diseases.


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Topic(s): Metabolites & Metabolomics

Podocyturia Evaluation in Women with Preeclampsia and Fabry Disease Patients Using a Tandem Mass Spectrometry Approach

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Wednesday at 14:50

Introduction. Podocyturia is a possible early sign of kidney abnormalities in patients. Currently, kidney damages are assessed using proteinuria measurements and the estimated glomerular filtration rate. Unfortunately, these parameters might not always be efficient in early detection of all patients. Most analytical techniques for the analysis of podocyturia are tedious, time-consuming, and may lead to results variability. We opted to develop a reliable methodology for podocyturia evaluation in patients with kidney involvement.
Objectives. The main objective of this project was to devise an efficient analytical tool for the analysis of peptides characteristic of podocyte proteins (podocin and podocalyxin) using a tandem mass spectrometry (MS/MS) method for early diagnosis of various kidney abnormalities. Random urine samples from women with preeclampsia, Fabry disease patients and controls were analyzed and correlations with other kidney disease biochemical parameters evaluated.
Method. A reversed-phase ultra-performance liquid chromatography coupled to a tandem mass spectrometry (UPLC-MS/MS) method was developed/validated to quantify peptides of podocalyxin and podocin in urine supernatant by using specific cleavable peptides and standards. One mL was pipetted from the supernatant of centrifuged random urine samples. A heavy cleavable peptide standard was added for each protein. Samples were treated with sodium deoxycholate, dithiothreitol and iodoacetamide prepared in an ammonium bicarbonate buffer to ensure an optimal trypsin digestion (2 h at 37oC). Tryptic peptides were purified by solid-phase extraction and evaporated. Samples were resuspended, filtered and analyzed using an Acquity-I Class Xevo UPLC TQ-S MS/MS (Waters Corp.).
Results. Peptides [ATFNPAQDK+2H]2+ (m/z 496.25->558.29 (y5)) and [APAATVVDVDEVR+2H]2+ (m/z 671.35->831.42 (y7)) were selected to quantify podocalyxin and podocin, respectively. The validation of the method for intraday- and interday assays showed biases below 15%. The molecules were stable at -20oC and -80oC. Our results show that a severe albuminuria content in urine samples did not unfavorably impact on the results. Podocalyxin levels were higher than podocin levels in patients, especially in pregnant women. Women with preeclampsia had abnormal levels of both proteins with a higher sensitivity for podocalyxin. Slightly increased levels of podocin were observed in Fabry males, while both protein levels were increased in untreated Fabry females compared to controls. Positive correlations were found in the preeclampsia groups: podocalyxin and podocin levels correlated with blood pressure, albuminuria and proteinuria levels. In the Fabry groups, podocalyxin levels correlated with urine glycosphingolipids, such as globotriaosylceramide and globotriaosylsphingosine levels.
Conclusion. This multiplex quantitative podocyturia methodology is reliable. It is a valuable investigative tool for patients with kidney involvement.


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Topic(s): Metabolites & Metabolomics

Exploratory Metabolomics of Urine and Plasma to Identify Novel Pharmacodynamic Biomarkers in a Phase I Clinical Trial of AZD3965

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Wednesday at 15:10

INTRODUCTION: A key metabolic alteration in tumour cells is increased dependency on glycolysis, resulting in the production of lactate which is transported out of cells by monocarboxylate transporters (MCT1 & MCT4) which are therefore a therapeutic target in cancer. Current literature suggests that inhibition of MCT1 in preclinical models can constrain cancer cell growth in tumours with low MCT4 expression. To date the systemic pharmacodynamic effects of the small-molecule non-competitive inhibitor of MCT1, AZD3965, the agent of study in this first-in-class (FIC) trial CRUKD12/004, have not been fully characterised. Preclinical metabolomics studies conducted at Imperial College London indicated that AZD3965 exposure caused increases in lactate, ketone bodies (also MCT1 substrates) and citrate in blood plasma and urine independently of tumour burden and tumour expression of MCT1, and also caused decreases in fatty acids in blood plasma.

OBJECTIVES: To investigate whether blood and urine levels of key metabolic markers are modified by AZD3965 treatment with the aim to provide pharmacodynamic biomarkers of efficiency, understand mechanisms of toxicity and define toxicity biomarkers.

METHODS: For the exploratory metabolomics study, we used NMR spectroscopy of urine and plasma samples from 34 patients from the trial to specifically monitor lactate and other ketone bodies and in addition a metabolomics screen using a well-validated LC-MS/MS protocol (Biocrates AbsoluteIDQ p180 kit) on plasma.

RESULTS: Metabolomics screen of plasma and urine appears to correlate with AZD3965 exposure and especially total urinary excretion of lactate and ketone bodies offers proof of target engagement. This effect is not mirrored in plasma suggesting that this may be primarily a renal effect. Observed systemic metabolic effects of AZD3965 exposure appear to lessen with repeated dosing, suggesting a rapid adaptive response. Metabolomics profile offers insides in understanding the mechanisms of drug toxicity and the potential to define metabolic biomarkers to identify individuals which are more likely susceptible to adverse drug toxicity.

CONCLUSIONS: The present metabolic profiling study provided biomarkers of drug exposure, proof of target engagement and understanding of the mechanism of drug toxicity. These results contributed to the successful completion of the Part 1 of the trial and the subsequent Part 2 is currently underway.


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Topic(s): Metabolites & Metabolomics

The Use of Rapid Evaporative Ionisation Mass Spectrometry (REIMS) as a Real-Time Bedside Test in Cervical Cancer Screening

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 08:30

Background / Objectives: Cervical cancer is the 4th most common cancer among women while its incidence is expected to rise by 43% in the UK by 2035 (Cancer Research UK, 2019). The microscopic examination of cervical cells currently carried out to screen asymptomatic women is prone to human error and can lead to high numbers of false-positives and false-negatives. Primary HPV DNA testing has been shown to be more accurate in screening and therefore is projected to replace cytology in the UK by the end of 2019 (Rebolj et al., 2019). Rapid evaporative ionization mass spectrometry (REIMS) is an innovative technique that allows interrogation of biological samples without any need for laborious sample preparation. Our main objective is to establish whether REIMS can be employed for the detection and grading of pre-invasive cervical changes. We also seek to assess the ability of REIMS to distinguish women with high-risk HPV (hrHPV) infection from women without infection.

Materials and Methods: Cell pellet from liquid-based cytology (LBC) samples has been analysed with REIMS. During REIMS, laser energy is directed to the sample of interest and rapid heating results in a vapour containing gas phase ions. The generated ions are introduced into a spectrometer and a mass spectrum with molecular information is produced. Samples from more than 400 women, with recorded hrHPV genotype and cytological / histological results, have been used. The derived mass spectra are used to differentiate between women with precancerous changes as well as those being hrHPV positive and negative.

Results: Our preliminary results show that REIMS can predict the presence and grade of disease with higher accuracy than current cytology. The diagnostic accuracy of REIMS was also comparable to the gold-standard HPV genotyping.

Conclusions: Using a near-real-time, bedside technique such as REIMS would reduce cost, repeated visits and prolonged waiting times, benefitting both clinicians and patients.

References
Cancer Research UK.
Rebolj M, Rimmer J, Denton K, Tidy J, Mathews C, Ellis K, et al. Primary cervical screening with high risk human papillomavirus testing: observational study. BMJ 2019; 364: l240.



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Topic(s): Metabolites & Metabolomics

Clinically Relevant Metabolites of the Human Gut Microbiota

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 8:50

INTRODUCTION: The human gut microbiota represents a pivotal environmental influence on the metabolism and overall health of the host. The immunomodulatory function of microbiota is mediated via the interaction of microbial metabolites with xenobiotic receptors expressed in immune cells and tissues. For instance, microbial catabolites of aromatic amino acids (i.e. tryptophan and tyrosine) were reported to activate pregnane X receptor (PXR) or aryl hydrocarbon receptor (AHR) in a ligand-specific fashion. The immune-metabolic homeostasis may be explored using quantitative metabolic profiling and targeted protein assays.

OBJECTIVES: The primary objective of this study was to determine the potential of specific microbial metabolites and inflammatory proteins as clinically relevant markers of pathology.
METHODS: Tandem mass spectrometry (MS/MS) assays were applied to biofluids and stool swabs using a triple quadrupole mass analyzer (selected reaction monitoring – SRM) for metabolic profiling of tryptophan, kynurenine and tyrosine pathways. SRM-proteomics assays were used for absolute quantification of inflammatory and immunological markers. The untargeted metabolic screening was performed using a high resolution/accurate mass (HR/AM) platform (Orbitrap Fusion, Thermo Scientific).

RESULTS: We have mapped the distribution of microbiota-associated metabolites within biofluids in adults, pregnant women, and neonates and linked them to levels of acute phase proteins. For instance, metabolites of human gut microbiota were quantitatively profiled in preterm premature rupture of the membranes pregnancies. Microbial indolepropionate was determined a reliable marker of adverse intra-amniotic conditions such as microbial-invasion of the amniotic cavity (MIAC). Next, we profiled microbial catabolites and inflammatory proteins in dried blood spots (DBS) and meconium/first stool swabs from neonates to establish signatures for microbial colonization acquired via vaginal delivery in comparison to Cesarean section.

CONCLUSION: The study has identified several metabolites produced by human gut microbiota as clinically relevant markers of dysbiosis or pathology. The functional characterization of microbiota is essential to understanding its role in immune homeostasis and human health.

ACKNOWLEDGMENT
This work was funded by the Grant Agency of the Czech Republic (project No. 17-24592Y), The Grant Agency of the Masaryk University (project No. MUNI/G/1131/2017), CETOCOEN PLUS (Ministry of Education, Youth and Sports e MEYS), (CZ.02.1.01/0.0/0.0/15_003/ 0000469) and by the RECETOX research infrastructure (MEYS), (LM2015051 and CZ.02.1.01/0.0/0.0/16_013/0001761).


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Topic(s): Metabolites & Metabolomics

Exploring the Interactions between Dietary Polyphenols, the Gut Microbiome and Human Health

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 9:10

Introduction:
Epidemiological and dietary intervention studies suggest that consumption of polyphenol-rich foods may have a number of health benefits, including reduced risk of cardiovascular disease. Increased intake of polyphenols, found at high levels in tea, fruit and vegetables, has been associated with health-promoting benefits including vascular and platelet function, blood pressure and improved plasma lipid profile. However, the mechanisms behind these benefits remain unclear, and the bioavailability of dietary polyphenols is highly variable between individuals. A significant fraction of dietary polyphenols can persist in the colon, where they are exposed to the gut microbiota. Since the study of the human gut microbiota is hindered by the complexity of this ecosystem and accessibility, in vitro gut models provide a powerful tool to build mechanistic knowledge around microbial polyphenol bioconversion.

Objectives:
The primary objective of this study was to understand the involvement of human microbiota in the metabolism of different plant polyphenol substrates using an in vitro. This approach enables investigation of broad metabolite perturbations and variations in microbial diversity to enhance mechanistic understanding of polyphenol bioactivity and nutritional influences to improve health through diet.

Methods:
Fermentation studies were performed using a three stage in vitro gut model with human stool from three donors, incubated in the presence of four different flavanol-containing substrates (Byrsonima intermedia, Rhizophora mangle, Serjania marginata and Theobroma cacao extracts). Samples were taken at ten time points over a 48-hour period (0, 1, 2, 3, 4, 5, 6, 8, 24 and 48 hrs).

Untargeted and targeted LC-MS metabolite profiling was applied to explore polyphenol metabolism and the influence on gut microbial activity.

Results:
Distinct metabolic differences were observed in the in vitro culture profiles in the presence of polyphenol substrates. Multivariate statistical analysis using principal components analysis (PCA) demonstrated variations in the metabolites produced by the different polyphenol extracts in a time dependent manner. Univariate analysis showed the magnitude of change between microbial metabolites and highlighted interindividual differences in metabolism, as well as changes in endogenous compounds in response to the polyphenol substrates. Targeted LC-MS/MS methods were also applied to profile phenolic, bile acid and short chain fatty acids to gain a deeper understanding into the potential mechanism of bioactivity of dietary polyphenols.

Conclusion:
The combination of untargeted and targeted LC-MS methods allowed for detailed exploration of gut microbial metabolism of plant polyphenols, providing an in-depth workflow to determine the bioconversion of dietary polyphenolic compounds.


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Topic(s): Metabolites & Metabolomics

Plasma Metabolomics Profiles Associated with Endothelial Health and Dysfunction and their Influence on Endothelial Metabolism

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 10:30

Background: Endothelial dysfunction (ED) contributes to diseases of the vasculature by influencing blood pressure, clotting and transport of fluids, nutrients and immune cells. Metabolic phenotypes associated with ED are not well characterized due to difficulties in assessing endothelial metabolism in situ.
Methods: We built a cell scale metabolic network model of endothelial metabolism (iEC2812) and applied it to infer endothelial metabotypes from i) plasma metabolomics data from 20 trauma patients vs. 20 controls and ii) ASGR1del12 carriers vs. controls to identify reactions associated with both dysfunctional and above normally healthy endothelium, respectively. Proposed changes in endothelial metabolism in situ were validated in endothelial cell models in vitro by metabolomics analysis of spent media and intracellular 13C glucose and 15N glutamine isotopologue analysis.
Results: Network analysis of plasma metabolomics data suggested that endothelial glycocalyx maintenance may contribute to endothelial dysfunction via altered flux into the hexosamine biosynthetic pathway. HUVEC monolayers titrated with physiological concentrations of catecholamines to induce endothelial dysfunction resulted in increased permeability and glycocalyx loss as verified by TEM, immunostaining and by permeability assays. A drop in the intracellular concentrations of the glycan precursors UDP-glucose and N-acetyl-glucosamine was observed. Isotopologue analysis supported lower turnover of glycocalyx intermediates and lower glycolytic and TCA cycle flux in dysfunctional endothelial cells.
Conclusion: Metabolic network analysis of three independent plasma metabolomics datasets highlighted the importance of glycan synthesis to endothelial health. Induction of endothelial dysfunction in vitro is accompanied by compromised glycan synthesis.


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Topic(s): Metabolites & Metabolomics

Computational Analysis of Mass Spectrometry Data for Standardised Diagnosis of Inborn Disorders of Steroidogenesis

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 11:10

Introduction: The adrenal cortex and gonads produce steroid hormones involved in salt and glucose homeostasis, blood pressure regulation, stress response and sex differentiation. These hormones are produced via a series of enzymatic steps and metabolites of steroids from each step are excreted and measurable in urine. Inborn disorders of steroidogenesis result from genetic mutations in distinct enzymes, causing a block in hormone production and lead to several forms of Congenital Adrenal Hyperplasia (CAH) and differences in sex development (DSD). Each enzyme deficiency is characterised by a distinct pattern of altered excretion of individual steroid metabolites relating to the specific enzymatic block. Ratios of urine steroid metabolites measured by gas chromatography-mass spectrometry (GC-MS) can be employed as surrogates of distinct steroidogenic enzyme activities. Widespread use of GC-MS multi-steroid profiling for rapid diagnosis of these disorders in the acute setting is often hampered by lack of specialist expertise. Here, we developed a novel steroid metabolomics approach for the detection and differentiation of inborn steroidogenic disorders, comparing its performance to that of conventional biochemical analysis by established steroid metabolite ratios.
Methods: We performed multi-steroid profiling by GC-MS in urine samples from 829 healthy controls and 178 patients with inborn steroidogenic disorders. This included the following enzyme deficiencies: CYP21A2(n=26), CYP11B1(n=12), CYP17A1(n=30), POR(n=37), HSD3B2(n=22), SRD5A2(n=51). We assessed the diagnostic performance of conventional biochemical diagnosis based on 14 previously published steroid metabolite ratios, indicative of distinct enzyme reactions. We compared this to the performance of a novel, machine learning-based steroid metabolomics algorithm applied to the GC-MS steroid profiling data, Angle Learning Vector Quantization (ALVQ). ALVQ uses 496 steroid metabolite ratios (all pairwise combinations of 32 measured metabolites) to classify samples by comparing similarity (quantified as cosine of the angle) of their steroid metabolome to learned representative steroid metabolome prototypes for each inborn disorder.
Results: ALVQ showed excellent sensitivity and specificity in the training set (100% and 99.7%, respectively), and good generalisability with sensitivity and specificity on testing random subsets of 89.6% and 99.0%, respectively. In comparison, conventional biochemical diagnosis, using 97.5% age and gender matched normative limits, demonstrated comparable sensitivity of 90.9%, but inferior specificity of 73.9%.
Discussion: We present a steroid metabolomics approach with acceptable performance for non-invasive, rapid and automated differentiation of inborn steroidogenic disorders. This approach is suited to facilitate much more widespread availability of steroid metabolome analysis for routine diagnosis but also to provide novel insights into steroid pathway systems.


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Topic(s): Metabolites & Metabolomics

LC- and CE-MS-based Workflow for Metabolic Read-Across of New Toxicants in Neuroinflammation

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 13:15

Introduction: Risk assessment of new or existing chemicals finds a bottleneck in the evaluation of their potential as toxicants. Current approaches are too resource intensive in terms of time, money and animal use, thus limiting the number of substances which can be assayed. Chemical risk assessment using in vitro biological models such as human cell cultures allows to increase throughput while reducing cost and animal use. In such models, untargeted metabolomics can unveil triggered adverse outcome pathways (AOP) without the need for previous hypotheses.
Objectives: Our goal was to use a metabolomics strategy to highlight metabolic changes taking place in human astrocytes as a cost-effective model to study toxicant-induced neuroinflammation before the actual clinical effects become manifest. Since different substances will trigger this process through different AOPs, each one will provide a characteristic metabolic fingerprint. By comparison to the signature obtained for model toxicants, the neuroinflammatory potential of new chemical entities can be predicted without the need for animal testing.
Methods: Monolayer human astrocyte cultures derived from induced pluripotent stem cells (iPS) were exposed to different model neuroinflammatory substances at different doses. With the aim to enlarge the biochemical information recovered from the samples, a combination of three different liquid-chromatography methods and two capillary electrophoresis modes were coupled to high-resolution mass spectrometry detection. By using in-house developed software and reference databases, data pretreatment and metabolite identification were streamlined. Finally, multivariate analysis (MVA) allowed to cluster toxicants and doses according to the induced biological responses.
Results: MVA analysis successfully clustered the samples according to the indentity and concentration of the applied substances. The control group is noticeably separated from the treated ones. Interleukin 1β at low dose shows a characteristic profile, while low doses of other cytokines tend to have a comparable effect on metabolic patterns. Interestingly, all the cell samples show a similar behavior when exposed to high doses of the tested substances. Such a convergence phenomenon suggests that subtle metabolic differences in early-stage or mild neuroinflammation can progress towards a stronger and less specific metabolic shift. Pathway enrichment tools were used to evidence the nature of the metabolic alterations observed.
Conclusion: We developed a new workflow comprising a panel of analytical platforms, data treatment steps, and data interpretation allowing to characterize the metabolic changes induced by neuroinflammatory triggers on human astrocyte cultures. This approach paves the way to a mid-throughput chemical risk assessment strategy not relying on animal models and allowing to foresee the expected toxicological mechanism of a new substances depending on the metabolic pattern..


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Topic(s): Metabolites & Metabolomics

Metabolomic Analysis of Human Atherosclerotic Plaques Reveals a Pathway of Foam Cell Apoptosis in Advanced Atherosclerosis

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 13:35

Introduction
Atherosclerosis remains a leading worldwide cause of mortality and morbidity. Advanced stenosing plaque can result to flow limitation or plaque rupture, leading to ischemic stroke or heart attack.

Objectives
The primary objective of this study is to provide a comprehensive in-depth elucidation of the metabolic dysregulations associated with atherosclerotic plaque deposition and identify potential novel targets and biomarkers for diagnosis and treatment tailoring.

Methods
Ultra-high performance liquid chromatography coupled to mass spectrometry (UHPLC-MS)-based metabolomics were utilized for the analysis of human advanced atherosclerotic tissue. From 78 patients, a total of 52 carotid and 26 femoral plaques were compared to 16 adjacent arterial non-plaque tissue (intimal thickening). Tissue samples were homogenised and extracted consecutively for aqueous and organic extracts. Aqueous extracts were analysed using hydrophilic interaction chromatography (HILIC-)UHPLC-MS, whilst organic extracts by reversed-phase (RP-)UHPLC-MS.
In vitro studies were performed using peripheral blood monocyte-derived macrophages (MDM) (from healthy volunteers). After one-week treatment with macrophage colony stimulating factor, MDM were treated with vehicle, acetylated-LDL (acLDL) and a combination of acLDL, soluble free unesterified cholesterol (FUEC) and Sandoz 58-035 (an acyl-CoA:cholesterol acyltransferase inhibitor). Using the vehicle and acLDL treatments as controls, the SAMD8 (the enzyme responsible for PE-Cer synthesis) gene mRNA was relatively quantified using real-time RT-PCR. Additionally, a flow cytometry cell death assay was employed to measure the levels of apoptosis and necrosis. Finally, cells from different treatments were extracted using organic solvents and analysed using a lipid profiling method (as described in the preceding paragraph).

Results
A panel of established as well as novel molecules, from several biological pathways, were identified as being dysregulated. These included FUEC, oxidized cholesteryl esters, purines, pyrimidines, sphingolipids and acylcarnitines. A previously unassociated sphingolipid, namely phosphatidylethanolamine-ceramide (PE-Cer), was detected with high statistical significance (p=9.8x10-12) and 2-fold reduction in plaque tissue. PE-Cer also demonstrated the highest (inverse) correlation to FUEC (ρ=-0.76).
In pilot validation studies, the acLDL/FUEC-treated MDM demonstrated elevated apoptosis, and a 2-fold reduction in PE-Cer, in concordance with the findings in human tissue. This was accompanied by a reduction of SAMD8 RNA. Finally, a comprehensive examination of the sphingolipid pathway demonstrated an increase in de novo ceramide synthesis, further to the recognised in apoptosis hydrolysis of sphingomyelin (to ceramide).

Conclusion
The PE-Cer pathway demonstrates a potentially pivotal role in advanced atherosclerosis, while previously unrecognised sphingolipid pathway alterations are revealed.


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Topic(s): Metabolites & Metabolomics

Nontargeted Metabolite Profiling of Human Lung Epithelial Cells (A549) with HILIC Mode UPLC HRMS: Silica Nanoparticle Mediated Cytotoxicity Effects

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 13:55

Non-Functionalized silica nanoparticles (SiNPs) are some of the widely used nanomaterial in diverse industrial sectors and nanoparticle based drug delivery applications. In industrial manufacturing environment SiNPs can possibly comes in contact with employees. Studies of cellular level toxicity effects of SiNPs in human cell lines are pivotal in the metabolite based biomarker discovery. Human lung epithelial cells (A549) are used to decipher the overall cellular level metabolic changes, non-targeted metabolite profiling with HILIC (hydrophilic interaction liquid chromatography) UPLC-HRMS method in a data dependent (DDA) mode was developed for this study. From the identified metabolome data and corresponding dysregulation in the metabolome of A549 biochemical pathways, our preliminary finding indicated 8 nm SiNPs elicit observable effects on the A549 cellular metabolism over larger SiNPs.The study identified some insights in early stage selective metabolite markers for nanomaterial related cytotoxicity in human cell line.Identified metabolites were annotated to pathways related to glutathione mediated detoxification, amino acid degradation, central carbohydrate metabolism and nucleotide metabolism with statistical significance (p < 0.01).

Introduction
Non-Functionalized amorphous silica nanoparticles(SiNPs) are used in nano material manufacturing and nanoparticle based drug formulation studies,they can possibly come in contact with humans via skin and inhalation routes. We have developed an untargeted UPLC HRMS method to assess cellular level metabolic dysregulation of SiNPs on human lung epithelial cells (A549).

Methods
A549 cell line control group and SiNPs (spherical 8, 80 and 120 nm dia.) as exposure groups were used in the metabolite profiling experiment. HILIC mode UPLC-HRMS positive and negative polarity methods were developed to acquire tandem MS data in a data dependent MS (DDA) mode.Pooled QC was used to monitor MS method and overall LC-MS hardware performance and method robustness. XCMS online (Scripps Research Institute) and Compound Discoverer 2.1 were used for metabolome MS data processing and statistical analysis.Retention time alignment based MS1 precursor peak areas were used in relative quantitation between experimental groups.The metabolite pathway annotation was carried out with KEGG and BioCyc pathway representation.

Results and conclusions
The 8 nm SiNPs tend to affect the cellular level physiology to a wider extend over larger SiNP exposure groups.Data analysis revealed significant changes in relative metabolome profiles, p-value < 0.01.Differential changes in metabolites were annotated to pathways of glutathione detoxification, glutathione redox reactions II, central carbon metabolism, amino acid degradation pathways and t-RNA re-charging.

Acknowledgements

Shyam Arvamudhan, PhD
North Carolina A and T University, Greensboro, NC.

Daniel Todd, PhD
Mass Spectrometry Facility
UNC Greensboro.


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Topic(s): Metabolites & Metabolomics

Deep Urinary Volatile Organic Compound Profiling with Headspace Sorptive Extraction and GCxGC-MS for Oesophago-Gastric Cancer Detection

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(Presenter)

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To be presented in Track 6 (Doppler Hall) on Thursday at 13:55

Introduction: There is a pressing need to develop new non-invasive screening tests for Oesophago-gastric (OG) cancer due to its high prevalence and poor survival. Previous studies have reported that urinary volatile organic compounds (VOCs) reflect human pathophysiological status. GC-MS based methods are the main approaches for urinary VOC profiling. However, biomarker discovery is limited by often inefficient and labour-intensive solvent extractions, by chromatographic resolution and by the unavailability of a complete, detailed, and high-throughput data-preprocessing methodology for large-scale untargeted VOC analysis of urine samples. Novel HiSorb sorptive extraction and conventional solid phase microextraction (SPME) are both tested and evaluated. GCxGC combined with TOF-MS is employed and offers outstanding identification capabilities. By coupling HiSorb/SPME with GCxGC-TOF-MS, this project aims to discover new predictive biomarkers for OG cancer.

Methods: Optimum extraction conditions are explored for HiSorb and SPME. Osmolality is measured for urine dilution correction; urinary VOCs are extracted using both techniques in parallel and are analysed in a GCxGC-TOF-TI-MS-FID system (Markes BenchTOF Select). A complete data pre-processing pipeline is developed, from sample aliquoting/quality control to batch correction/biological interpretation.

Results and Discussion: HiSorb shows potential advantages compared to SPME, including lower fragility, better reproducibility and VOC extraction. Osmolarity normalisation corrects the influence of urine concentration variation. Peak deconvolution/picking/identification is compared among various softwares. Reproducibility, blank contamination, instrument drift, run order and batch effects are estimated and corrected accordingly. Finally, the applicability of the method is tested in a pilot cohort of 70 patients.


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Topic(s): Metabolites & Metabolomics

Untargeted Steroidomics for the Identification of Novel Steroid Profiles in Dysregulated Steroidogenesis

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 14:30

Introduction: There is a need to develop new diagnostic tools to diagnose and subtype patients with dysregulated steroidogenesis. Methods used today may require medication to be altered, multistep testing, imaging and even surgery to be able to make a final diagnosis. We hypothesize that it is possible to avoid many of these steps if the correct biomarkers or plasma steroid profiles are identified for patients suffering from these steroid dysregulation diseases, allowing diagnosis using only a single plasma sample.
Objective: Identify novel steroid profiles to diagnose and subtype diseases with a dysregulated steroidogenesis by the use of untargeted steroidomics on a UPLC-IMS-MS/MS platform.
Method: Steroid extraction is performed using positive pressure on a 96-well SPE column. The extracted compounds are analyzed in an untargeted approach on a Vion IMS-QTof (Waters) coupled to an Acquity I-Class UPLC (Waters). The samples are separated on a Cortex UPLC C18 column (2.1mmx100mm, 1.6µm) with a 15 min gradient. Samples are analyzed in both positive and negative mode within a mass range from 50-1000 m/z using MS-MS with a high collision energy ramping from 26eV to 56eV.
The resulting ions are searched against an internal library of 40 steroids (that is continuously being expanded), and against public databases so as to give identifications to the ions.
To be able to determine the correct identifications the method has several features allow for further refinement of the identifications. Ion mobility allows for the measurement of the cross collisional section (CCS) values of the compounds, giving us another physical parameter by which we can separate isobaric compounds from one another. The common fragmentation pattern of steroids in CID adds another feature that can be used to identify a compound as a steroid.
Conclusion: Most steroid dysregulation diseases can’t be identified or subtyped by measurement of a single compound. A plasma steroid profile is more likely to be the way forward. By measuring a large number of steroids, as this approach allows, machine learning techniques can be applied to the datasets and determine steroid profiles for the different diseases resulting in a simple diagnostic approach.
We are applying this methodology to a variety of patients with dysregulated steroidogenesis in an attempt to differentiate ACC from ACA, subtype Cushing’s and subclinical Cushing’s patients and subtype primary aldosteronism without the need for an adrenal venous sampling.


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Topic(s): Metabolites & Metabolomics

Untargeted Metabolomic Profiles of Newborns that Will or Will Not Develop Autism: A Pilot Study on Dried Blood Spots

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 14:50

INTRODUCTION:
Today autism spectrum disorder (ASD) is diagnosed based on behavioral signs and assessment of communication skills. In this setting, early intervention is a challenge as behavioral signs can be reliably observed only during the first years of life. Whether behavioral impairments are reflected in the blood as biochemical abnormalities is unsure, but the quest for biomarkers is legitimate, as they would represent a useful tool to help in the diagnosis and treatment of ASD and in understanding its underlying molecular mechanisms.
The etiopathology of ASD is indeed still unclear. Main risk factors include genetic and non-genetic factors, especially exposure during fetal life. If the fate of the child is already largely determined at birth, biochemical abnormalities could potentially be detectable very early in life, before behavioral signs can be detected reliably.

OBJECTIVES:
To assess whether there is a marked difference in the metabolome of newborns developing ASD versus healthy controls, we compared metabolomic profiles of newborns who have or have not been diagnosed with ASD at age 7.

METHODS:
Under the iPsych consortium agreement, we randomly selected 37 pairs of matched cases and controls all born in 2005. Cases were subjects for which a diagnosis of ASD was registered in 2012. We performed an LC-MS/MS-based untargeted metabolomics analysis of biobanked dried blood spots, i.e. whole blood collected within the first few days of life for newborn screening purposes. Raw data were preprocessed using Compound Discoverer 2.1 and putatively annotated in mzCloud. followed by multivariate statistical analyses and data visualization, including heatmaps, principal component analysis, partial least-squares discriminant analysis, and paired t-tests combined to fold-change (volcano plots).

RESULTS:
More than 1000 mass spectral features were detected, of which approx. 300 could be putatively annotated based on MS2 fragmentation patterns and library search. Various chemical classes were covered and 15 compounds were identified by comparison with pure standards (amino acids and acylcarnitines). Although the untargeted analysis revealed no clear distinction between cases and controls, we were able to pinpoint mass spectral features differentially abundant in healthy children versus children diagnosed with ASD. Data processing targeting specific subclasses of metabolites will give another perspective on the potential differences between cases and controls.

CONCLUSION:
In this unique study, untargeted metabolomic analysis of the dried blood spots did not reveal significant differences between newborns that have or have not been diagnosed with ASD at age 7. Increasing statistical power, refining selection criteria (subtypes of ASD) and targeting subclasses of metabolites could offer new opportunities to help understand the course of the disease and to contribute to an improved diagnostic process.


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Topic(s): Metabolites & Metabolomics

Exploring the Volatomic Fingerprinting of Breast Cancer Tissue as an Untargeted Approach to Identify Potential Biomarkers

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 15:10

Introduction: Cancer is the second leading cause of death globally and is estimated to account for 9.6 million death in 2018 (WHO). Breast cancer (BC) remain the most common cancer in women and is ranked as the fifth amongst all cancers followed by colorectal, lung, cervix, and stomach cancers. The late diagnosis, using invasive and expensive procedures and the critical lack of medical and laboratorial infrastructures in the developing countries, are certainly two key contributing factors for this scenario. Therefore, more sensitive and specific diagnostic methods are urgently required.
Objective: The aim of this study was to explore the potential of the volatomic fingerprint of BC and breast cancer-free (BCF) tissues (n=30) from the same patients, to identify a set of endogenous volatile organic metabolites (EVOMs) potential BC biomarkers which might be used together or complementary with the most common BC diagnostics strategies.
Method: Tissue samples were thawed and 100 mg were weighted into 20 mL vials to which was added 17 % NaCl (w/v), 1000 µL of ultrapure water, 100 µL of the internal standard. The pH was adjusted to 2. The SPME fiber was introduced and exposed into the headspace for 75 min at 50 °C under agitation (800 rpm). The SPME fiber was removed from the vial and inserted into the GC injection during 10 min at 250 °C, separation on GC and identification by MS.
Results: Twenty-nine metabolites, belonging to several chemical families, were identified. Multivariate statistical analysis revealed some metabolites significantly altered in BC patients. Limonene, decanoic acid, acetic acid and furfural showed the highest sensitivity and specificity to discriminate of BC and BCF tissues (VIP >1, p < 0.05). The discrimination efficiency and accuracy of BC tissue metabolites was ascertained by ROC curve analysis that allowed the identification of some metabolites with high sensitivity and specificity. The metabolic pathway analysis indicated that the discriminatory metabolites could be originated from several dysregulated pathways in BC such as those involved in pyruvate and sulphur metabolism, and limonene degradation.
Conclusion: The obtained results suggest the possibility to identify endogenous metabolites as a platform to discover potential BC biomarkers and paves a way to investigate the related metabolomic pathways to improve the diagnostic tools of BC.
Acknowledgements: This work was supported by FCT-Fundação para a Ciência e a Tecnologia (project PEstOE/QUI/UI0674/2019 and INNOINDIGO/0001/2015), Madeira 14-20 Program (project PROEQUIPRAM - Reforço do Investimento em Equipamentos e Infraestruturas Científicas na RAM - M1420-01-0145-FEDER-000008) and by ARDITI-Agência Regional para o Desenvolvimento da Investigação Tecnologia e Inovação through the project M1420-01-0145-FEDER-000005 - Centro de Química da Madeira - CQM+ (Madeira 14-20). Catarina Silva acknowledge the FCT for the PhD grant (SFRH/BD/97039/2013).


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Topic(s): Metabolites & Metabolomics

Determination of D- and L-Lactic Acid in Urine by UPLC-MS with Electrospray Ionization Quantification

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 15:45

Introduction: Lactic acid is an organic acid found in two enantiomeric forms: the L- and D-lactate stereoisomers. D-lactic acid is produced from bacteria inhabiting the gut and also from mammalian methylglyoxal metabolism. In humans, the majority of systemic D-lactate is derived from the bacterial metabolism of carbohydrate in the upper GI tract. In pathological states, intestinal permeability is increased elevating the uptake of bacterial D-lactate from the gut. Circulating D-lactate concentrations may therefore provide a useful diagnostic tool for bacterial infections, gut permeability and GI health and disease.
Many studies show significant concentrations of D-lactate in the urine with potential to reflect an overload or fluctuations due to pathologies. However, a huge variation in the concentrations are reported depending on the analytical method used. Existing methods also lack sensitivity and due to demands for prior sample clean-up steps or sample derivatization are not sufficiently high-throughput to assess large sample sets. Determining the physiological significance and diagnostic value of urinary D-lactate requires a sensitive high-throughput analytical method to generate large-scale data to correlate with pathophysiological conditions. Here, we have optimized a sensitive and specific method to fulfil both requirements to investigate D-lactate concentrations following different types of enteric infections in infants.
Methods: The assay was developed from the method of Henry et al. (2012) using 170 urine samples that were processed without derivatisation or dilution. Samples were vortex-mixed, centrifuged at 4°C to remove debris and 500 μL aliquoted into vials. Isotopically labeled internal standards sodium d4-D/L lactic acid and 13C-L-lactic acid were spiked before injecting onto a Waters Acquity UHPLC solvent management system. Chromatographic separation was achieved by the use of an Astec Chirobiotic™ R chiral column under isocratic conditions using 15% (v/v) 33.3 mMol/L ammonium acetate in H2O and 85% (w/w) acetonitrile. MS detection was performed with a Waters Xevo TQ-S tandem quadrupole instrument using negative electrospray mode.
Results: The lower limit of quantification of D-lactic acid was 0.0005 mMol/L for D-lactate and 0.001 mMol/L for L-lactate. Calibration curves were linear over the ranges of 0.001–0.4 for L-lactic and 0.0005–0.1 mMol/L for D-lactic acid. The mean nominal concentrations were 0.006526 and 0.060077 mMol/L respectively for D- and L-lactic in samples.
Discussion and Conclusions: Following optimization this UPLC/MS approach for D-lactate determination is suitable for large-scale epidemiological research, reporting very low quantification limits. The protocol was successfully applied to a human infant cohort and on-going analysis is being performed to validate the method and investigate the biological significance of urinary D-lactate with intestinal infections and gut permeability status.


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Topic(s): Metabolites & Metabolomics

Optimising Laser Assisted - Rapid Evaporative Ionization - Mass Spectrometry Imaging (LA-REI-MSI) for the Spatially Resolved Analysis of Faecal Metabolites

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(Presenter)

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To be presented in Track 1 (Mozart 1-3) on Thursday at 16:05

Faecal metabolomics allows for the non-invasive study of biomarkers in gastrointestinal (GI) disease. Current analytical techniques are limited in their applicability as they can lack in sensitivity (Nuclear Magnetic Resonance Spectroscopy) or require time-intensive sample preparation (Gas Chromatography - Mass Spectrometry). Here, we present the optimisation of LA-REIMS for faecal sample analysis and its implementation into a novel high-throughput application of LA-REI-MSI for the near-real time analysis and mapping of metabolites in whole fresh or frozen human faecal samples.

In this method development study, participants with no known GI disease were recruited. Faecal samples were obtained, homogenised and prepared for faecal sample and faecal water (1:2 faeces: water) analysis using LA-REIMS in negative and positive ionisation modes. Faecal LA-REIMS was optimised in terms of laser and REIMS parameters to identify settings yielding the highest signal-to-noise ratio with least % carry-over between samples and smallest time interval between burns. The LA-REIMS optimisation was implemented in the LA-REI-MSI pipeline as a tool for direct-from-sample analysis with minimal sample preparation: Whole faecal samples (<1 hour of bowel evacuation) were segmented into cross-sectional plates (5mm) and analysed at 1 mm resolution. Pre-processing of data and statistical analysis in R Studio (V1.0.44) allowed for targeted or untargeted analysis. The highest relative intensity metabolites were carefully examined, and tentative fatty acid (FA) identification was carried out according to accurate mass and previous literature.

Based on the homogenised faecal sample of nine volunteers, optimized faecal LA-REIMS parameters were identified. The optimised settings demonstrate improved signal-to-noise ratios with decreased % carry-over between samples and were implemented in the LA-REI-MSI pipeline. Faecal samples from two healthy volunteers were investigated using LA-REI-MSI by visualizing the relative abundance and spatial distribution of metabolites. In the FA region, the most abundant peaks at m/z 255.24, 281.25, 279.25 demonstrate unique spatial distribution patterns and were putatively identified as palmitic acid, (18:1) FA, and (18:2) FA, respectively. In the m/z 600-1000, complex lipid species, which may hold utility in GI disease diagnostics, demonstrate heterogeneous distribution patterns. The heterogenous nature of key metabolites in faecal samples is an important consideration for faecal sample collection and processing before analysis. We are now performing observational studies in patients with colorectal cancer to determine potential biomarkers and their spatial distribution in faeces and targeted microbiome analysis of faecal microbial communities present.

The mapping of metabolites through faecal LA-REI-MSI is the first MSI technique to be used for the investigation of faeces and demonstrates clear application for biomarker discovery.


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Topic(s): Metabolites & Metabolomics

Steroidomics Profile Analysis by LCHR-MS in Human Seminal Fluid

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To be presented in Track 1 (Mozart 1-3) on Thursday at 16:25

INTRODUCTION: Steroids play a crucial role in homeostasis of many biological processes including spermatogenesis, thus being responsible for some male infertility issues. Although steroids have been largely studied in many biological matrices (such as urine and plasma), there is very limited information of the steroid content in seminal liquid and its potential study as potential indicators of male infertility and other conditions.
OBJECTIVES: In this study, a LC-HRMS strategy has been developed in order to obtain the steroidomic profile of human seminal fluid.
METHODS: A comparison between supported liquid extraction (SLE) and solid liquid extraction (SPE) was carried out, and the chosen SPE method further optimized to map the largest possible number of compounds. Steroids were identified by using DynaStI, a publicly available retention time prediction webtool developed in our lab, to match the experimental data (i.e. accurate mass and tR).
RESULTS: Altogether these resources allowed us to develop a post-targeted approach able to consistently detect 40 steroids in seminal plasma (with half of them being androgens). Such steroidal profile was stable across different extraction times and injection days. In addition to accurate mass and retention time, the identity of 70% of the steroids detected in such steroidomic profile was confirmed by comparing their fragmentation patterns in real samples to those of standards. Finally, the workflow was applied to compare and distinguish the steroidomics profile in seminal liquid from healthy volunteers (n = 6).
CONCLUSION: In all, the developed steroidomics strategy allows to reliably monitor an extended panel of 40 steroids in human seminal fluid.


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Poster Presentations for Metabolites & Metabolomics


Topic(s): Metabolites & Metabolomics

Targeted Metabolomics Reveals an Influence of the FTO Gene on the Kynurenine Pathway

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Poster #1d View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 12:00 for 1 hour in the Exhibit Hall.

INTRODUCTION: Genome wide association studies have identified the FTO gene as the first susceptibility gene of obesity. Previous studies have suggested a role of FTO in nucleic acid repair or modification, but how this leads to an alteration in energy homeostasis is unclear. In the present study, we utilized targeted metabolomics in an attempt to further elucidate mechanisms underlying the action of the FTO gene.

METHODS: This study was part of a health survey of employees of the Electricity Generating Authority of Thailand (n = 79 , 9 female and 70 male). Targeted metabolomics analysis was performed using the AbsoluteIDQ™ p180 kit combined with flow injection analysis and liquid chromatography tandem mass spectrometry. Genotyping of the FTO rs9939609 was performed using real-time PCR (TaqMan® MGB probes).
RESULTS: Using OPLS-DA, there was no apparent clustering of the metabolites in relation to the FTO genotype. Nevertheless, using variable importance on projection to identify metabolites with higher influence on potential clustering, it was found that tryptophan was among the metabolites within the 10 highest VIP scores. We therefore further examined the influence of the FTO gene on the major pathway of tryptophan catabolism, the kynurenine pathway. Pearson’s correlation analysis showed that kynurenine and tryptophan was positively correlated only in subjects with the rs9939609 G allele (n = 32, r = 0.56, p < 0.001) and the correlation coefficients were significantly higher in subjects having the G allele compared to those subjects without the G allele (P < 0.05). Moreover, kynurenine/trytophan ratio, a biomarker of the degree of tryptophan to kynurenine conversion, was significantly associated with the presence of the G allele independent of body mass index and gender.

CONCLUSION: FTO gene influences the conversion of tryptophan to kynurenine. Alternation in the kynurenine pathway may be one of the mechanism underlying the action of FTO in the pathogenesis of obesity and its related effects.


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Topic(s): Metabolites & Metabolomics

Enhanced Mass Spectrometric Profiling of the Human Blood Exposome Using an Optimised Dispersive Solid Phase Extraction Protocol

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Poster #2a View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 10:00 for 1 hour in the Exhibit Hall.

INTRODUCTION: The untargeted nature of metabolomics allows measurement of biofluid chemistry related to both endogenous metabolism and host-environment exposures (i.e. the exposome). Comprehensive coverage of chemically diverse metabolites present in human blood products benefits from the use of multiple methods, each oriented toward a small molecule subset generally segregated by polarity and hydrophobicity. Whilst recent developments in LC-MS profiling methodologies have delivered numerous solutions for the analysis of polar molecules (e.g. via HILIC-MS) and complex lipids, the analysis of moderately hydrophobic and amphipathic molecules in blood products (including much of the exposome) by RPC methodology, is complicated by the suppressive effects of lipids on the ionisation of low molecular weight (LMW) metabolites. Efficient and inexpensive solutions are required for the separation of small molecules from the remaining sample matrix fit for large scale and high throughput applications.
OBJECTIVES: To develop and optimise a blood preparation protocol enabling the use of a coordinated suite of analytical assays, specifically removing lipids and protein efficiently and inexpensively, with minimal effect on other LMW metabolites to enable RPC-UPLC-TOFMS profiling.
METHODS: A lipid removal sample preparation technique was developed using a novel dispersive solid phase extraction (DSPE) technique. Factors optimised to facilitate lipid removal with minimal loss of other analytes included design of experiment(DOE) protocols for aspects of the DSPE sorbent specification, and the solvent composition used for extraction. The feasibility and robustness of the extraction methodology explored on an exemplar epidemiological plasma dataset (n=285) using well-characterised RP-UPLC-TOFMS phenotyping for high resolution detection of chemical species and data processing pipelines.
RESULTS: A rapid sample preparation method using DSPE for the removal of lipids was optimised for human blood products. DSPE provided a straightforward reproducible approach which enabled the use of uncompromised RPC-UPLC-TOFMS to complement the coverage provided by HILIC and lipid analyses. UPLC-TOFMS data on the exemplar study was processed using XCMS software resulting in 3093 detected metabolite features. Repeated observation of specific reference features from pooled QC samples throughout an analytical batch demonstrated mean retention time RSD <0.3% and mean peak area RSD <5% with no post normalisation. Finally, to demonstrate the methods suitability to explore the exposome, both endogenous metabolites and known xenobiotics were annotated, and their population prevalence reported.
CONCLUSION: The optimised lipid removal method described enables improved characterisation of the human exposome using high-throughput metabolic phenotyping platform. Additional advantages include reduced cost and increased robustness when compared to conventional solid-phase sample clean-up protocols.


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Topic(s): Metabolites & Metabolomics

Detection of F-2 Mycotoxin Zearalenone in Human Urine. Consumption of Contaminated Cereal Crops or Doping Offence?

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Poster #2c View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

Introduction: Zearalenone or F-2 mycotoxin is a heat-stable, potent estrogenic metabolic product of some Fusarium and Gibberella species, found in cereal crops like maize, oats, wheat, rice and barley. Due to its similarity to naturally-occurring estrogens (17β-estradiol), zearalenone and its main metabolites (α-zearalenol, β-zearalenol, zeranol and taleranol) are considered by World Health Organization and European Commission as endocrine-disrupting chemicals and a possible cause of carcinogenesis.
Objectives: Due to its anabolic effects, zeranol and taleranol are banned in sport. The presence of this metabolites in athlete’s urine must be clearly attributed to illegal use or unintended contamination. The primary objective of this study is to develop and optimize a gas chromatography - mass spectrometry application for the detection of zeranol and/or taleranol in the presence of zearalenone mycotoxin.
Methods: The method was developed for gas chromatography –tandem mass spectrometry (GC-MS/MS) GC Trace 1310 connected to a TSQ Quantum XLS Ultra from Thermo Scientific. The GC was equipped with an HP-Ultra 1 (17m x 200µm and 0.11µm film tickness) from Agilent Technologies (USA). The temperature program was as follows: the initial temperature was 160°C hold time 2 min, increased by 5°C/min to 255°C and then by 30°C/min to 285°C (hold time 5 min) and finally by 60°C/min to a final temperature of 300°C (held 3.75 min). The transfer line temperature was set at 310°C. Helium was used as carrier gas (constant flow rate aprox.1 mL/min).
Results:The method for the detection of zearalenone and its main metabolites α-zearalenol, β-zearalenol, zeranol and taleranol was developed and validated. Both urine samples spiked with the compounds and real excretion urines were analyzed in order to test the validated method for limit of detection and matrix interference. Using this GC-MS/MS method, the analysts can discriminate between a urine sample resulting from illegal use of anabolic agent zeranol or unintended contamination.
Conclusion: Contamination of food with mycotoxins and veterinary products used as growth promoters is a global and dangerous phenomenon that could lead to unfair sanctions in sport for athletes. The detection of metabolic profile using mass spectrometry applications developed towards the differentiation between mycotoxin contamination and anabolic agent illegal administration is the solution in this case for a correct and accurate interpretation of analytical findings of zeranol in urine samples.


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Topic(s): Metabolites & Metabolomics

Prostate Cancer Metabolic Alterations Induced by Zika Virus

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Poster #5b View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 15:30 for 1 hour in the Exhibit Hall.

Introduction: Zika virus (ZIKV) is a flavivirus transmitted by Aedes aegypti mosquito, with high incidence of cases on Americas between 2015 and 2016. Although 80% of the cases are asymptomatic, ZIKV infection was associated to neurological complications such as Guillain-Barré syndrome and microcephaly. Based on these reports several initiatives started to understand viral infection process in human and mosquito cells. During experimental investigations it was demonstrated that ZIKV can impair neuronal growth, reduce neural stem cell and even mediate cell death. A hypothesis about the oncolytic potential of ZIKV due its ability of cell growth impairment was raised and later confirmed by in vitro and in vivo studies with glioblastoma cells. The antiproliferative effect of a ZIKV prototype (ZVp) was tested for several types of tumor cell resulting in ZVp activity against prostate cancer cells (PC-3). However, little is known about the cellular mechanisms associated prostate cancer cell death induced by Zika moieties.
Objective: Determine prostate cancer cell line (PC-3) metabolic alterations induced by Zika virus particle using high resolution mass spectrometry (HRMS).
Methods: A PC-3 cell in vitro model was exposed to ZVp for 24 hours and a group of non-exposed cells was used as control. Cells and supernatant were collected and the metabolites were extracted, ionized and directly injected in a HRMS instrument, ESI-LTQ-XL Orbitrap Discovery (Thermo Scientific, Bremen, Germany). The analysis was performed at the mass range of 400-1200 m/z in the negative and positive ion mode. The spectral data was analyzed using a Partial Least Squares Discriminant Analysis (PLS-DA). A VIP score list (Variable Importance in Projection) from MetaboAnalyst 4.0 software was used to determine the characteristic ions for ZVp exposed group. Using online databases potential biomarkers were identified (error <2ppm) and confirmed by tandem MS experiments.
Results: PLS-DA showed a marked separation between PC-3 exposed and non-exposed groups, suggesting discriminant molecules involved ZIKV induced cell alterations. The 20 proposed chemical markers translate lipid metabolism remodeling associated with ZIKV interaction with cell, inflammatory mediators and inductors of cell death. In addition, based on markers we proposed the involvement of one carbon metabolism, porphyrin pathway and protein glycosylation on ZIKV antiproliferative effect. The versatility of the metabolomic screening helped to indicate pathways that may be involved with ZIKV antiproliferative effect and are not so obvious for a first target study.
Conclusion: To our knowledge this is the first metabolomic investigation of ZIKV interaction with prostate cancer cells. Metabolomic strategies associated with HRMS have been supporting advances in ZIKV research, bringing innovation to viral infection biomarkers elucidation, developing diagnostic methods and understanding of ZIKV mechanisms and oncolytic potential.


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Topic(s): Metabolites & Metabolomics

Biomarker Analysis by Mass Spectrometry and Artificial Intelligence Techniques of Obese Human Plasma

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Poster #6b View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 15:30 for 1 hour in the Exhibit Hall.

<b>Introduction</b>
Obesity is characterized as a worldwide epidemic, accounting for more than 600 million diagnosed with obesity. It occurs due to an energy imbalance resulting in the accumulation of fat in the cells of adipose tissue. Clinical recognition of obesity already has pre-established parameters, but the involvement of metabolic variations makes functional diagnosis and prognosis difficult. Although it's possible to classify individuals from new diagnostic methods, these methods do not contemplate all stages of the metabolic process related to adipogenesis. The metabolomics complement the studies in the area of genomics and proteomics, analyzing the final products of the cellular metabolic pathways. Therefore, the aim of this study is the determination of biomarkers present in the plasma of obese patients by mass spectrometry.

<b>Methods</b>
To carry out the project, 90 volunteers of both sexes with diagnosis of overweight and obesity were selected. The participants were selected according to the Body Mass Index (BMI) with BMI individuals above 26 kg / m². For the control group, 90 volunteers of both sexes, eutrophic and free of obesity-associated comorbidities, were selected. From each individual of the groups, a 10mL blood tube with heparin was collected. From this material, 100μL of plasma was used for metabolomic analysis. Plasma samples were immersed in organic solvent (CH3OH) and subjected to chemical protonation or deprotonation. They were then analyzed in Mass Spectrometers MALDI-LTQ-MS (Thermo Scientific) and LTQ-Orbitrap Discovery (Thermo Scientific). Chemical markers will be determined from a machine learning algorithm (Random Forest). Random Forest is a robust and reliable classification method with high predictive performance and low generalization error that fits multiple decision trees and chooses a class that best aggregates the results of those trees.

<b>Results</b>
The mean BMIs for the non-obese and obese groups were 22.3 kg/m2 (SD: ± 2.8; range: 17.4-32.0 kg/m2) and 33.3 kg/m2 (SD: ± 6.5; range: 25.1-66.1 kg/m2), respectively (p<0.0001). The body fat percentage (BF%) average in non-obese and obese groups was 21.7% (SD: ± 3.5; range: 13.7-29.9 %) and 40.3% (SD: ± 9.2; range: 24.9-62.0 %), respectively. The waist circumference average in obese group was 107.1cm (SD: ± 14.6; range: 75-149 cm). The non-obese group had no comorbidities (high blood pressure or diabetes), whereas 15 (37.5%) had hypertension and 7 (17.5%) had diabetes in the obese group. The samples were analyzed and the data collected for the accomplishment of the statistical analysis. The chemical markers of the obese group were determined by random forest.

<b>Conclusions & Discussion</b>
From the algorithm, 8 specific markers were identified for the obese group. We are now in the stage of elucidation of the molecules and their metabolic pathways.


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Topic(s): Metabolites & Metabolomics

Simple and Rapid Tandem Mass Spectrometry Method for the Analysis of Methylmalonic Acid in Urine

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Poster #9a View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 10:00 for 1 hour in the Exhibit Hall.

Introduction: Vitamin B12 deficiency can lead to potentially irreversible neurological symptoms such as memory deficits and gait ataxia. Up to 40% of older adults show metabolic abnormalities due to vitamin B12 deficiency. However, most adults have normal levels of serum B12 so that this condition often remains under-recognized. Metabolic B12 deficiency causes an elevation of serum methylmalonic acid (MMA), an expensive test rarely available in clinical settings. Urine MMA also increases in cases of B12 deficiency, but it is unclear whether it correlates with serum MMA and thus be reliable for diagnostic purposes. Also, various inborn errors of metabolism lead to increased MMA levels in urine and plasma.

Objectives: The objectives of this research project were: 1) To develop and validate a multiplex UPLC-MS/MS method for the analysis of MMA and creatinine in urine without derivatization; 2) To determine MMA/creatinine levels in urine from a group of 35 older adults (>70 yrs) at different stages of B12 deficiency; 3) To compare the urine results obtained with this method with a validated GC/MS method necessitating derivatization; 4) To perform correlation studies between urine and serum MMA levels from samples collected at the same time from the same patients; 5) To analyze the levels of MMA/creatinine in urine samples collected on filter paper from newborns having B12 deficiency.

Methods: Briefly, 30 µL of urine were mixed with 60 µL of water containing MMA-D3 and creatinine-D3 internal standards. A 2-minute reverse phase chromatographic method was developed/validated, allowing the separation of MMA from succinic acid, a major isomeric interference. The Acquity I-Class UPLC system (Waters Corp.) was used. The absolute quantitation of MMA and creatinine was achieved by tandem mass spectrometry (Xevo TQ-S Micro, Waters) using the multiple reaction monitoring mode. Calibration curves with ranges up to 500 µM for MMA and 30 µM for creatinine were prepared. For newborn urine filter paper specimens, a 5 cm disk was extracted with 3 mL of NH4OH 0.01 M and analyzed in a similar manner.

Results: The validation of the method showed intra- and interday variations < 15%. Our results show that UPLC-MS/MS urine MMA/creatinine levels from 35 older adults were similar to those obtained by the GC-MS MMA method. Moreover, the correlations between MMA urine results obtained by UPLC-MS/MS with the plasma GC-MS results from the same patients were significant (Spearman r = 0.59).

Conclusion: A rapid and efficient UPLC-MS/MS method for the analysis of urine MMA and creatinine was developed and validated, requiring only a dilution of the specimen with the internal standards in a 2-min chromatographic run. This preliminary study suggests that MMA/creatinine urinary levels are equivalent to MMA plasma levels to evaluate B12 deficiency in older adults. Another method advantage is that urine specimen collection is less invasive than blood collection.


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Topic(s): Metabolites & Metabolomics

Serum Biomarkers of Chemoradiosensitivity in Esophageal Cancer is Identified by the Targeted Metabolomics Approach

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Poster #9d View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 12:00 for 1 hour in the Exhibit Hall.

Aim: To identify the serum metabolomics signature that is correlated with the chemoradiosensitivity of esophageal squamous cell carcinoma (ESCC).
Materials & Methods: Untargeted and targeted metabolomics analysis of serum samples from 26 ESCC patients, which were collected before the neoadjuvant chemoradiotherapy, were performed.
Results: On receiving the results of untargeted metabolomics analysis, we performed the targeted metabolomics analysis of the 6 metabolites (arabitol, betaine, glycine, L-serine, L-arginine, and L-aspartate). The serum levels of the 4 metabolites (arabitol, glycine, L-serine, and L-arginine) were significantly lower in the patients who achieved pathological complete response with neoadjuvant chemoradiotherapy compared with the patients who did not achieve pathological complete response (p=0.0086, 0.0345, 0.0106, and 0.0373, respectively).
Conclusion: The serum levels of metabolites might be useful for predicting the chemoradiosensitivity of ESCC patients.


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Topic(s): Metabolites & Metabolomics

Method Development of Amino Acid Analysis in a Dried Blood Spot for the Second-Tier Test in the Newborn Screening Program

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Poster #10c View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

Introduction: Metabolic disorders are caused by the accumulation of metabolites in the body which lead to irreversible physiological effects. The first-tier screening procedure for these disorders is typically performed on dried blood spot (DBS) samples by the MS/MS system. When a newborn screen is found to be positive, second-tier tests using plasma samples are provided to reduce false-positive and false-negative results. To prevent resampling and provide comfort for newborns, it is more convenient to use the same DBS sample taken in the first stage of screening. Objective: The objective of this study was development of a method based on the DBS instead of plasma analyses for each aminoacidemia disorder that could potentially use as second-tier tests. Methods: To optimize the extraction conditions of 19 naturally occurring amino acids from DBS, the central composite design and response surface methodology were used to demonstrate the influence of effective factors on the responses. Also, four different types of validation were compared, and the best validation method was selected.
Results: The best conditions for extraction of each amino acid related to the PKU and MSUD biomarkers were selected based on the response surface equations. Then the effect of the actual sample matrix and extraction efficiency on the responses have been measured based on the slop ratio of four different calibration curves. By comparison of their slop ratios, matrix free calibration method has been selected to continue the study. The intra- and inter-day precisions of all amino acids were below 11%. Mean recoveries from spiked DBS samples were among 78% and 111%. The lower limit of detection and lower limit of quantification for all amino acids were obtained between 0.02-0.10 and 0.06-0.33 µmol/L respectively. The biomarkers of PKU and MSUD were quantified among 148 participants. Finally, the results of HPLC-PDA with MS/MS as NBS standard protocol has compared and a good correlation between the results has been observed.
Conclusion: The study results provide evidence that the optimized methods are reliable not only as second-tier tests but also as affected children’s follow-up methods.


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Topic(s): Metabolites & Metabolomics

Metabolomic Barometer of Gestational and Postpartum Weight in Overweight Pregnant Women

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Poster #11b View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 15:30 for 1 hour in the Exhibit Hall.

Background: Obesity amongst women of reproductive age is increasingly common in developed nations and has been shown to adversely affect childhood cardio-metabolic, respiratory and cognitive-related health outcomes in offspring. Metabolomic signatures of obesity are readily captured in biofluids samples and could potentially provide a molecular barometer for monitoring excessive gestational weight gain (GWG) and postpartum weight loss (WL) in overweight/obese pregnant women.
Methods: Urine and blood plasma samples were collected from 114 overweight or obese ethnically diverse pregnant women from Chicago (USA), as part of a randomised diet and lifestyle intervention trial (Maternal Offspring Metabolics Family Intervention Trial; www.clinicaltrials.gov NCT01631747). Blood plasma lipids and urine samples at 15 weeks, 35 weeks of gestation, and at 1 year postpartum were respectively analysed by LC-MS and NMR.
Results: Urinary 4-deoxyerythronic acid was found positively correlated to body mass index (BMI) and a broad spectrum of alterations in levels of blood plasma phosphatidylcholines, lysophospholipids, and sphingomyelins were associated with BMI, GWG, and WL. Specifically, several plasmanyl-/plasmenyl-phospholipids were negatively associated with GWG, and lysophosphatidylcholines (including LPC 20:4) were positively associated with WL. Multiple lipids with apparent 18:2 fatty-acid chains were significantly associated with GWG/ WL, suggesting linoleic acid, an essential nutrient, may play an important role in prenatal and postpartum weight management.
Conclusions: Maternal obesity-related parameters are associated with urine and plasma metabolomic profiles, which could be further exploited to evaluate the beneficial effect of diet and lifestyle intervention in pregnancy.


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Topic(s): Metabolites & Metabolomics

Establishment of a Liquid-Chromatography Tandem Mass-Spectrometry Method for Vitamin D Metabolites to Detect 24-Hydroxylase Deficiency

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Poster #13d View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 12:00 for 1 hour in the Exhibit Hall.

INTRODUCTION: Most clinical laboratories measure total 25-hydroxy vitamin D by immunoassays with variable analytical performance. Other relevant metabolites, such as 25-hydroxy vitamin D2 (25(OH)D2), 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) and 25,26-dihydroxyvitamin D3 (25,26(OH)2D3) may provide additional information beyond the simple measurement of 25(OH)D. Liquid-chromatography tandem mass-spectrometry (LC-MS/MS) allows the simultaneous measurement of multiple vitamin D metabolites with high sensitivity and specificity.
OBJECTIVES: Hence, we established an in-house LC-MS/MS method, for the determination of 25(OH)D3, 25(OH)D2, 24,25(OH)2D3 and 25,26(OH)2D3 in order to detect individuals with 24-hydroxylase deficiency.
METHODS: Our method is based on the derivatization with 4-Phenyl-1,2,4-triazole-3,5-dione (PTAD) after protein precipitation and liquid-liquid-extraction. Chromatographic separation was performed on an Agilent HPLC 1260 system using a Zorbax C18Eclipse column and a gradient method with 2 mobile phases. The eluate was introduced into a Sciex 4500 MS/MS instrument for the detection of all four metabolites with a run time of 18 min.
This method was assessed by linearity, limit of detection (LOD), limit of quantification (LOQ), imprecision and recovery. Accuracy was analyzed by method comparison and the reliability of this method was evaluated in four patients, which were referred to our laboratory.
RESULTS: The analytical performance of our new method showed the following results: the within- and between-run precisions ranged between 1.8 and 10.4% and were within the acceptance criteria of <15 %. The LOD was 1.5 nmol/L for 25(OH)D3, and 0.3 nmol/L for 25(OH)2, 24,25(OH)2D3 and 25,26(OH)2D3. The LOQ was 3.1 nmol/L for 25(OH)D3, and 1.0 nmol/L for 25(OH)2, 24,25(OH)2D3 and 25,26(OH)2D3, respectively. In all four subjects a total 25(OH)D (=25(OH)D3 + 25(OH)D2) serum concentration of >100 nmol/L was measured. One subject had distinct lower 24,25(OH)2D3 and 25,26(OH)D3 concentrations of 0.16 nmol/L and 2.35 nmol/L, respectively. Subsequent sequencing of the 24-hydroxylase gene (CYP 24A1) confirmed an inactivating mutation.
CONCLUSION: Our in-house method showed a good and reliable analytical performance for all four tested vitamin D metabolites. Additionally, the establishment of this vitamin D assay enabled to detect a defect of the CYP24A1 gene coding for 24-hydroxylase, which was confirmed with CYP24A1 sequencing.


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Topic(s): Metabolites & Metabolomics

‘Functional Microbiomics’ – Standardized Assessment of Nutrition-Microbiome-Host Interplay by Targeted Metabolomics

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Poster #15b View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 15:30 for 1 hour in the Exhibit Hall.

Introduction
In recent years, microbiome research has dramatically reshaped our understanding of how symbiotic microbes impact on a multitude of (patho-)physiological processes in the host. However, causal links are still lacking to a large extent. Metabolomics allows the investigation of microbial metabolic activities, and is thus the ideal technology to assess functional nutrition-microbiota-host crosstalk. Here, we discuss the application of a newly developed standardized targeted assay for the quantification of endogenous and microbiota-derived metabolites covering central metabolic pathways.

Methods
Human EDTA plasma and fecal homogenate were analyzed by using a standardized, quantitative assay in kit format allowing for the multiplexed analysis of 630 metabolites by mass spectrometry. Liquid chromatography tandem mass spectrometry (LC-MS/MS) was employed for the analysis of 106 small molecules from 13 compound classes, whereas flow-injection analysis tandem mass spectrometry (FIA-MS/MS) was employed for the analysis of hexoses and 523 lipids from 12 lipid classes. A sample volume of 10 µL were used per well on a 96-well plate, preloaded with internal standards. After derivatization and extraction, LC-MS/MS and FIA-MS/MS analyses were performed (Agilent 1290 Infinity UHPLC – SCIEX QTRAP® 5500). MetIDQ™ software was used for the entire automated workflow, from sample registration to quality-controlled, quantitative results.

Results
In plasma, more than 455 metabolites were quantified above LOD with high precision, and more than 120 metabolites in fecal samples. To a large extent, the small molecules and lipids quantified in feces overlap with those in plasma. A higher number of lipids, especially phosphatidylcholines and triglycerides, were quantified in plasma compared to fecal samples. In addition to endogenous metabolites, a multitude of microbiota-derived metabolites were quantified.

Conclusion
The capability to quantify microbiota-derived metabolites in blood and fecal samples allows for correlation studies also with data from other omics technologies to investigate functional nutrition-microbiome-host interplay for uncovering causal links to pathophysiological processes, disease development, and response to drug treatment.


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Topic(s): Metabolites & Metabolomics

GC-MS Determination of Candidate Target Biomarkers for Early Detection of Oesophageal Squamous Cell Cancer

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Poster #17a View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 10:00 for 1 hour in the Exhibit Hall.

Introduction:

Branched chain amino acid metabolism is deregulated in numerous diseases including multiple subtypes of cancer. For both clinical and molecular studies, there is a need for a unified quantitative method for the key metabolite groups in this pathway. This study aimed to test whether gas-chromatography mass spectrometry (GC-MS) could be used for this purpose.

Method:
The twelve targets are branched chain amino acids (BCAA); valine, leucine and isoleucine, branched chain ketoacids (BCKA); ketomethylvalerate, ketoisocaproate and ketoisovalerate, branched chain fatty acids (BCFA); isovaleric acid, isobutyric acid and 2-methyl butanoic acid, glutamine , glutamic acid and α-ketoglurate. Several sample clean-up, derivatization reagents, column set-ups and oven temperature gradients are compared and optimised.

Results and discussion:

Stock solutions of target compounds where polar compounds are dissolved in deionised water and non-polar compounds in MTBE are made. Saliva samples are collected with an absorptive matrix. Cell media, supernatant and saliva samples are stored at -80oC till analysis. Polar and non-polar compounds are extracted from samples by drying under nitrogen stream and liquid-liquid extraction (LLE) with MTBE respectively. The dried samples are reconstituted with LLE extract. A previous method that utilised chiral derivatisation for BCAA, and methyl esterification for BCKA and BCFA yielded poor reproducibility and high limits of detection (LOD). Hence a silylation method for derivatisation is chosen. Derivatisation is optimised by deciding on the most suitable derivatiser; MTBSTFA and MTSTFA. MTBSTFA derivatisation yield better identification of isomeric peaks on comparison with MSTFA. Further optimisation of temperature, length of incubation time and amount of derivatiser is complete. To obtain the best chromatographic separation of target compounds, three columns, 20mx0.18mm ID x0.18μm d Agilent DB-5ms column, 30mx0.25mm ID x0.25μm d Agilent HP-5ms column and 30mx0.25mm ID x0.25μm d Agilent DB-17ms column are used to run the samples. The best results are achieved with DB-5ms column. The optimum temperature programme is an initial starting temperature of 60oC, ramp to 100OC at 23.5oC/minute with a 9.65 minute hold and a final ramp to 300oC at 40oC/minute and 5 minute hold. Selected ion mode is then generated. The 12 target compounds can be reproducibility determined with low limits of detection.

Conclusion:
This proposed method demonstrates the ability for high throughput, streamlined sample preparation and analysis for candidate biomarkers with GC-MS for use in liquid phase matrices; saliva and cell media. Our results demonstrate high reproducibility, accuracy and sensitivity in a range of matrices, therefore demonstrating that this GC-MS technique can be applied to identifying candidate biomarkers in OSCC.


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Topic(s): Metabolites & Metabolomics

Different Approaches for Vitamin D Determination in Newborns by LC-MS/MS

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Poster #17c View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

INTRODUCTION: Vitamin D plays a key role in metabolic processes in human body. Despite the growing social awareness, its large deficit is still being observed, which is particularly important in the case of pregnant women. Vitamin D concentration in the fetal period strictly depends on the maternal concentration. Deficiency of this vitamin in the newborn affects a number of diseases, including abnormal development of the bone or immune system. For this reason, preventing deficiency from the first days of life is extremely important.
METHODS: The tested materials were dried blood spots collected from the newborn for routine screening and umbilical cord blood serum. Biological samples were analyzed using liquid chromatography coupled with tandem mass spectrometry. Quantitative analysis was carried out for four vitamin D metabolites, i.e. 25(OH)D3, 3-epi-25(OH)D3, 25(OH)D2 and 24,25(OH)2D3. Application of the above technique was particularly important in the case of umbilical cord serum, because commonly available immunochemical methods give overstated results. Serum was prepared by liquid-liquid extraction, while DBS was extracted with an organic solvent in 96-well plate. For both materials, derivatization using Cookson-type reagent (DAPTAD) was applied.
PRELIMINARY DATA: The purpose of the study was to investigate whether there is a relationship between the concentration of vitamin D metabolites in umbilical cord serum and DBS. Newborns were diversified in terms of the amount of supplementation (different dose for premature babies, different for full-term pregnancy). Despite the correlation between these two materials, deviating values are observed. This may be due to the different effects of postpartum supplementation on the newborn, considering that the material in the form of DBS is collected within 3 days after delivery. The decisive advantage of both test materials is that they give the opportunity to assess the supply for vitamin D without additional harm to the infant.


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Topic(s): Metabolites & Metabolomics

Maternal Glutaric Aciduria Type 1 (GA 1) Detected Through Newborn Screening in Croatia

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Poster #18c View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

INTRODUCTION: Glutaric aciduria type 1 (GA-1; OMIM#231670) is an autosomal recessive inborn error of metabolism caused by deficiency of glutaryl-CoA dehydrogenase (GCDH) located in the catabolic pathways of L-lysine, L-hydroxylysine, and L-tryptophan. The enzymatic defect gives rise to neurotoxic metabolite glutaric acid (GA) and 3- hydroxyglutaric acid
(3-OH-GA) in the urine, and to glutaryl carnitine (C5DC), the marker metabolite used for newborn screening (NBS) . As in most inborn errors of metabolism, the phenotypic spectrum of GA 1 is broad. Most untreated individuals with GA-1 experience acute encephalopathic crises during the first six years of life that are triggered by infectious diseases, febrile reaction to vaccinations, and surgery. However, a small group of untreated GA 1 patients remains asymptomatic, even in adult life. Treatment for GA-1 consists of a low lysine diet, carnitine, and high-energy intake during illness.
OBJECTIVES: We describe a woman with GA 1 in whom the diagnosis was unsuspected until a low free carnitine level was found in her twin infants during routine newborn screening.
METHODS: Samples for NBS were prepared using Recipe reagent kit ClinSpot ® Complete Kits, amino acids and acylcarnitines in dried blood spots (DBS) on a tandem mass spectrometer coupled with high performance liquid chromatography, LC-MS/MS (MS8050 coupled with UPLC Nexera, both Shimadzu). Samples were ionized using electrospray ionization (ESI) in positive ion mode. Concentrations of individual acylcarnitine and amino acid species were calculated using isotope-labelled internal standards of known concentration for each analyte.
Urine organic acids were analyzed on capillary gas chromatography coupled with mass spectrometry (GC-MS-QP2010Plus, Shimadzu).
RESULTS: Isolated carnitine deficiency was found in one of the twin infants. The free carnitine (C0) concentration at day 3 in the newborn screening was 6.2 µmol/L (cut-off >8.8). Confirmation tests included plasma and DBS acylcarnitine profile for infants and their mother. The maternal DBS acylcarnitine profile showed markedly elevated glutarylcarnitine (C5DC= 1.9 µmol/L, cut-off <0.35) and decreased C0 (C0=4.0, cut-off >10). All of the metabolic findings of the baby were normal except for very low free carnitine level. Additional metabolic testing for mother showed clear elevations of glutaric and 3-hydroxyglutaric acid in urine organic acid analysis. Neonatal parameters normalized during the following weeks and confirmatory work-up of the non-affected neonates is negative.
CONCLUSION: An asymptomatic woman with GA 1 was detected through her infant´s newborn screening. This case has confirmed that expanded NBS may, besides expected reduction in the number of deceased or affected children, also yield other useful results: It can detect certain diseases in a mother, some acquired diseases in newborns and diseases in siblings of ill children detected by screening.


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Topic(s): Metabolites & Metabolomics

B Vitamin Reference Ranges Determination Using HPLC-MS/MS and Retrospective Statistical Analysis

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Poster #19e View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 10:00 for 1 hour in the Exhibit Hall.

Introduction

Determination of the correct reference intervals (RIs) is the basis for precise interpretation of the results in routine laboratory testing. The use of RIs established in other laboratories is often incorrect due to different populations and methods. Ideally, each laboratory should have its own RIs, however their determination is very costly for many laboratories. One of the compromise solutions is a retrospective mathematical analysis of routine tests for determining RIs. At present, there is no rigorous mathematical algorithm that would allow the RI to be set retrospectively from the results of routine research: in most methods, the researcher often has to use visual assessment or he faces not always the obvious choice.

Objectives

The objectives were to establish reference ranges for group B vitamins in the Caucasian population in whole blood and plasma using various methods proposed in statistics, evaluation of their advantages and disadvantages and develop clear criteria for choosing a particular method.

Methods

In this study, we have used HPLC/MS/MS method for determining the concentration of vitamins in whole blood and plasma. For retrospective data analysis and establishing reference ranges we have used and compared Bhattacharya, Hoffmann and Mixed Gaussian Models methods.

Results

664 patients were included. We established RIs for Caucasian population. For plasma: vitamin B2 (FAD) 56-97 nmol/l, vitamin B2 (riboflavin) 4-43 nmol/l, vitamin B3 (niacin) 13-161 nmol/l, vitamin B5 (pantothenic acid) 54,5 – 604,4 nmol/l, vitamin B6 (PLP) 11,3- 302 nmol/l, vitamin B7 (biotin) 0,025-5,647 nmol/l. For whole blood: vitamin B1 (TPP) 82 – 239 nmol/l, vitamin B2 (FAD) 116 – 393 nmol/l, vitamin B6 (PLP) 3,5 – 80 nmol/l.

Conclusion

At the moment there is no universal method for determining reference intervals. Depending on the data structure, each method has its own advantages and disadvantages. The most optimal in most cases was the Hoffman method presumably due to the best excluding from a sample people who take B vitamins as dietary supplements.


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Topic(s): Metabolites & Metabolomics

Comprehensive Clinical Acylcarnitines by LC-MS/MS

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Poster #20a View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 10:00 for 1 hour in the Exhibit Hall.

INTRODUCTION: Acylcarnitine profiling is routinely performed in order to quantitatively screen for disorders related to β-oxidation and / or organic acid metabolism. Today many laboratories still perform acylcarnitine profiling using LC-MS/MS based methodology that has remained almost unchanged for around 2 decades. This “classical” approach normally involves a direct infusion (no chromatographic separation) into the MS system following a butylation based sample derivatisation. Although this approach is still widely used today, improvement in LC-MS technology observed over the last 15 years such as UHPLC and higher sensitivity MS systems means that a non-derivatisation approach that can be more informative with a relatively rapid LC separation is feasible.

OBJECTIVES: The primary objective of the work was to replace existing methodologies within our hospital in order to enhance efficiency whilst keeping or improving upon analytical quality.
METHODS: The new method described consists of a simple protein precipitation (isotopic dilution) and relatively large sample dilution followed by a HILIC separation (UHPLC) and subsequently MS detection in the MRM mode. This approach allows the separation and quantification of 42 individual acylcarnitines. Comparisons were made with established, routine methods within our laboratory: the “classical” acylcarnitine profiling approach and a method for the quantification of free and total carnitine also by LC-MS/MS.

RESULTS: Free carnitine (C0) and total carnitine (the sum of all free and acylcarnitines in plasma / serum) compared well with the established routine LC-MS/MS targeted method for C0 (Passing-Bablok: Slope (95% CI): 1.04 (0.99-1.07), n = 57) and total carnitine (Passing-Bablok: Slope (95% CI): 0.96 (0.91-1.06), n = 57). For the evaluation / comparison between methodologies for the acylcarnitine quantitative profiling, 84 patient samples were compared, 23 of which were confirmed cases of either β-oxidation or organic acid metabolic disorders. The new method compared well, successfully identifying all the 23 confirmed cases.

CONCLUSION: The new method described will replace two existing routine methods within our hospital, therefore greatly improving upon laboratory efficiency and significantly increasing the number of samples that can be prepared, run and processed for routine analyses. We estimate that this development saves around 1-1 ½ days per week of both instrumental and technical labour time.


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Topic(s): Metabolites & Metabolomics

Solid Phase Microextraction (SPME) in Kidney Examination – LC-MS/MS-based Identification of Potentially Significant Metabolites in Graft Quality Assessment

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Poster #20c View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

Introduction:Transplantation is the treatment associated with increased survival rate and greater quality of patient’s life when compared to conventional dialysis. Even nowadays transplantology suffers from the lack of reliable methods of organ quality assessment. The standard protocols are limited to macroscopic appearance inspection or invasive tissue biopsy which do not provide a comprehensive information about the graft. Kidney is the organ largely associated with metabolic processes, thus measurements of metabolites concentrations may permit determining potential organ quality biomarkers and predicting the graft outcome. Hence, there is a need for new diagnostic solution allowing on site graft monitoring and quick decision-making processes during the surgery.
The goal of the project is to identify metabolites associated with changes occurring in transplanted kidneys during preservation with the use of in vivo and in situ low-invasive solid phase microextraction followed by LC-MS/MS instrumental analysis.
Methods:The study was performed on kidneys harvested from two types of porcine model donors: heart beating donor (HBD) and donor after cardiac death (DCD). Sample collection was performed according to the SPME method with the use of probes coated with 7 mm mixed-mode extraction phase. Sampling was conducted directly from the graft tissue: in vivo before transplantation, in situ after 1h, 3h, 5h, 7h of perfusion, in vivo 3 and 7 days after revascularization in the recipient, and additionally for DCD after 45 min and 2h of warm ischemia time. The untargeted metabolomic analysis was done with the use of liquid chromatography (RPC, HILIC) coupled with high resolution mass spectrometry (Q-Exactive Focus) in both positive and negative ionization modes. The putative identification of detected metabolites was done by comparison of accurate masses with metabolomic databases. In order to confirm identities of metabolites selected as significant ones in organ quality assessment, their retention times and fragmentation pattern were compared with chromatograms and MS/MS spectra of authentic standards.
Results:Monitoring the metabolomic profiles of kidneys allowed to observe biochemical changes occurring in the organ during preservation as well as biochemical differences between HBD and DCD types of donor. Alterations are mostly related to concentrations of metabolites which might be the part of ischemia/reperfusion injury mechanism due to their involvment in i.e. oxidative stress, ischemia and energy metabolism pathways.
Conclusions:SPME is a low-invasive method for direct in vivo kidney extraction without removing any tissue from the graft which makes the method an alternative for biopsy. The small size probe and minimal invasiveness of the approach permits for repeatable samplings from the same organ. Identified metabolites could be considered for further analyses towards decreased organ quality or progressing graft dysfunction biomarker validation.


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Topic(s): Metabolites & Metabolomics

Analysis of Changes in Bile Acids Concentration in Bile in Response to the Degree of Liver Ischemia and the Method of Organ Preservation

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Poster #22c View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

Introduction: Liver transplant surgery is currently the standard of treatment in patients with end-stage organ failure. Nowadays, the dominant method of organ preservation used by most transplantation centers is the static cold storage (SCS). However, a better method of organ preservation is sought, which would allow extending the storage time of the graft while maintaining its proper quality The proposed method is normothermic ex-vivo liver perfusion (NEVLP), based on maintaining normal metabolic activity, which gives the opportunity to better assessment of liver viability before implantation. One of the possibilities is to assess the production of bile by the liver perfused in these conditions. It is considered that the production of bile alone is not sufficient evidence for the proper functioning of the liver and directs the research to assess the composition of bile. Therefore, it is assumed that changes in the concentration of bile acids, which are the main component of bile, may correlate with changes occurring in the transplanted organ.

Methods: The study was performed on bile samples obtained from two types of porcine model donors: heart beating donor (HBD) and donor after cardiac death (DCD). Samples were collected during SCS and NEVLP at specific time points: before organ harvest, during perfusion (for NEVLP), reperfusion and the first few days after transplantation. The DCD group was divided due to the time of organ ischemia: 30’ for SCS and 30’, 60’, 90’ for NEVLP (n=3 in each group). Sample preparation was performed according to the thin-film solid phase microextraction (TF-SPME), using C18 sorbent as the extraction phase. Extracts were analyzed using the LC-MS platform with Nexera UHPLC system and a triple quadrupole mass spectrometer LC–MS 8060 (Shimadzu) equipped with an ESI source in the negative-ion mode working in the multiple reaction monitoring (MRM) mode.

Results: The conjugated forms of bile acids (with taurine or glycine) were significantly predominant in the bile samples compared to unconjugated forms. Changes in concentrations of individual bile acids depending on the method of preservation and the period of organ ischemia were observed. The high concentration of taurocholic acid is characteristic for the perfusion period (eg. 3793,64±255,5 vs. 1,81±0,45 ug/mL compared to SHAM for 30'DCD) and is still present in the reperfusion of the 90’DCD group. Furthermore, prolonged ischemia caused an increase in taurodeoxycholic (15.87±8.22 vs. 2.83±0.57 ug/mL) and glycodeoxycholic acid (135.82±78.5 vs. 18.56±4.57 ug/mL) levels in the first days after transplantation compared to HBD group.

Conclusions: TF-SPME is a high-throughput sample preparation method that can be effectively used for profiling bile samples. Changes in bile acid concentrations in bile samples may correlate with the metabolic processes occurring in the transplanted organ. Further research into the composition of bile may allow to find biomarkers of liver function.


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Topic(s): Metabolites & Metabolomics

Pharmacometabolomic Study of Novel Multitarget Drugs Based on Natural Prostaglandins in Terms of Therapeutic Effectiveness

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Poster #26a View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 10:00 for 1 hour in the Exhibit Hall.

Introduction. In last few years multi-target drugs have gained high popularity at the drug development market. Its main pharmacological effect is provided by the combined action of hybrid compounds that interact with several targets in the area of one disease. Novel biogenic molecules, prostanit® and nitroproston®, represent an interesting example of multi-target compounds. They are based on natural prostaglandins PGE1 (in prostanit®) and PGE2 (in nitroproston®) linked by a glycerol moiety to two nitric oxide (NO) ‒ donating fragments. Due to biogenic nature of the these pharmaceuticals, as well as rapid integration of their active components into biochemical cycles, metabolism study becomes difficult. To overcome these complexities, metabolomic approaches were used, giving an opportunity to investigate their metabolic pathways, mechanisms of action and therapeutic effectiveness.

Methods. There were conducted in vivo studies randomly assigning the target drugs (treatment groups) or a saline solution without the drug (vehicle control groups) to 12 rabbits (n=6 in each group). Using untargeted (LC-MS-IT-TOF) and targeted (LC-MS/MS) approaches rabbits plasma samples were measured at 10 time-points within 0-60 minutes. Further univariate and multivariate statistical methods were utilized for identification of the metabolites, which concentration levels were induced after drug administration.

Results. The heatmap showed clear discrimination between the vehicle control and treated groups for all found metabolites. Prostanit® and Nitroproston® undergo rapid hydrolysis that results in formation of their two main components: 1,3-dinitro glycerol and Prostglandin E (PGE1 and PGE2, respectively) that are subsequently oxidized to 15-keto-PGE and 13,14-dehydro-15-keto-PGE. We identified that the most significantly changed metabolic pathways, induced after Prostanit® administration were: purine, alanine, glutamate and glutathione metabolism. Moreover, Prostanit® administration activates oxidation processes (e.g. transformation of proline to hydroxyproline). At the same time, Nitroproston® impacted steroidogenesis, purine metabolism and ammonia recycling. Notably, multiple metabolites identified in our study connected to Nitroproston® have been previously considered as having anti-asthma properties (i.e. cortisol, cortisone, aspartate).

Conclusion. To the best of our knowledge this study is the first that describes the metabolic profiles of drugs based on natural prostaglandins. In this study there were presented suggested mechanisms of action and metabolic pathway interactions of drugs based on natural prostaglandins, as well as useful information for further understanding of their metabolic effects and therapeutic effectiveness.


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Topic(s): Metabolites & Metabolomics

Evaluation of an Artificial Serum as a Surrogate Matrix for Calibration Samples for a Preeclampsia Risk Prediction Test

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Poster #26c View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

Introduction
A specific challenge of developing LC-MS assays for the quantification of endogenous compounds such as biomarkers, is the choice of a suitable matrix for the preparation of calibrators and QC samples. Ideally, these samples should consist of the authentic biological matrix containing an accurately known concentration of the analyte. For endogenous substances, care should be taken using the authentic biological matrix since it typically contains a baseline concentration of the analyte complicating the preparation of calibrators. Furthermore, the use of the authentic matrix may lead to lot-to-lot variation affecting the manufacturability of calibrators and QC samples. In isotope-dilution mass spectrometry, the use of a surrogate matrix which mimics the authentic biological matrix as much as possible but is analyte-free has been proposed as a means to overcome this challenge (1, 2).

Here we evaluate the suitability of a protein-free substitute for plasma or serum, SeraSub™ (CST Technologies, New York, USA), as a surrogate matrix for the preparation of calibrators for PrePsia™ (Metabolomic Diagnostics, Cork, Ireland). PrePsia™ is a screening test to predict the risk for preterm preeclampsia in early pregnancy involving the analysis of specific metabolite biomarkers employing LC-MS/MS.

Methods
Plasma samples and calibrators were prepared using Stable Isotope Labeled Internal Standards (SIL-ISTD) and protein precipitation. Target endogenous small molecules were analysed by multiplexing ESI-LC-MS/MS assay. The validity of SeraSub™ as a surrogate matrix was evaluated by assessing: (i) levels of endogenous analyte, (ii) linearity in intended calibration interval, (iii) repeatability (% CV), and (iv) matrix effect. Results were compared with BSA 5% in PBS, an established surrogate matrix.

Results
SeraSub™ showed no traces of analytes of interest, whereas for BSA this was highly dependent on the procurement source. Both SeraSub™ and BSA showed comparable linearity in the intended calibration interval (SeraSub™ r2>0.96; BSA r2>0.98; using 7 calibrator levels), and acceptable repeatability for all target metabolites (CV<15% for 6 replicates per calibrator per matrix). Spiking both surrogate matrices and plasma with the SIL-ISTDs chosen for the respective metabolites revealed differential matrix effects.

Conclusion
Our results show that SeraSub™ is a promising alternative surrogate matrix to BSA 5% in PBS for LC-MS assays. However, for commercial assay development, the choice between SeraSub™ and other possible surrogate matrices will also consider further aspects such as price, availability, lot-to-lot variability and long-term stability.

1. van de Merbel NC. TrAC 2008;27(10):924-33.
2. Hess C, Sydow K, Kueting T, et al. Forensic Sci. Int. 2018;283:150-55.

Acknowledgements
This project has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement No 789083.



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Topic(s): Metabolites & Metabolomics

Advancement of the Quantitative Measurement of Enzyme Activities in Six Lysosomal Storage Disorders via LC-MSMS

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Poster #26f View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 15:30 for 1 hour in the Exhibit Hall.

Introduction: Since treatment advances for lysosomal storage disorders (LSDs), the application of mass spectrometry (MS) techniques have expanded to screening for some of the treatable LSDs. To date, flow injection MS (FI-MS) is generally the preferred screening technique to be of diagnostic value for 6 LSDs, namely Pompe, MPS-I, Fabry, Gaucher, Niemann-Pick A/B and Krabbe disorders, from a single dried blood spot (DBS) sample. We evaluated the analytical performance and diagnostic precision of a 6-plex LSD enzyme assay utilizing the technique of liquid chromatography with tandem MS (LC-MS/MS) within the clinical laboratory setting.
Methods: The LC-MS/MS method is intended for quantitative measurement of 6 individual LSD associated enzymatic products. Quality control (QC) DBS samples were obtained from the Centers for Disease Control and Prevention (CDC) and the Perkin Elmer NeoLSD MSMS kit. The selected QC samples are associated with a range of enzyme product concentrations that span the medical decision limit (MDL) and normal range as best possible. Enzyme activities are obtained by measuring the products formed when enzymes react with synthesized substrates to create specific products. Detection of the enzyme products was performed with an Agilent 6470 Triple Quadrupole LC-MS/MS equipped with an Agilent JetStream technology ESI source (operated in positive ion mode). Chromatographic separation was achieved using a reverse-phase C18 column and a gradient flow rate of 0.40 mL/min. Dynamic multiple reaction monitoring over an 8 minute run time was performed. In addition, an FI-MS method was implemented for comparison to the LC-MS/MS method. The analytical MS methods have been evaluating by linearity, linear range and precision.
Results: Compared to the FI-MS method, the LC-MS/MS method was generally found to be more linear (e.g. LC-MS/MS R2 0.99 – 0.97 vs FI-MS R2 0.97 – 0.85) with a wider linear range for all analytes of interest. Taking CVs into account, near the MDL, the LC-MS/MS method was overall more precise (e.g. LC-MS/MS CV 2% – 16% vs FI-MS CV 2% – 44%) than the FI-MS method. The LC-MS/MS method repeatedly showed comparable results to other laboratories in the CDC proficiency scheme. In addition, two metabolites were observed with the same transitions, but different retention times, than two of the target LSD enzymatic products. This may result in an over-estimation of enzyme products, specifically when reporting enzyme activity for Gaucher and Krabbe disease without applying LC.
Conclusion: We report an LC-MS/MS method for the analysis of 6 LSD enzymatic products, in a single DBS. Emphasized are the advantages of LC-MS/MS, including high selectivity leading to precise quantification of enzyme products and subsequent enzyme activity. This improved method displays good analytical performance and meets clinical laboratory requirements. In summary, the LC-MS/MS method is proposed as an alternative to the standard FI-MS procedure.


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Topic(s): Metabolites & Metabolomics

Comparison of Phenylketonuria Screening with a Fluorimetric Method and with Tandem Mass Spectrometry

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Poster #27b View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 15:30 for 1 hour in the Exhibit Hall.

Introduction: Early detection of diseases by newborn screening (NBS) is necessary for correct and timely clinical decisions. One of the early methods for NBS of phenylketonuria (PKU) was a fluorimetric method for quantification of phenylalanine (Phe). This method is still used in many countries in south-eastern Europe. The introduction of expanded NBS with tandem mass spectrometry (MS/MS) enabled screening for many diseases, including PKU. Slovenia is now in a unique position to compare the methods because it screens for PKU with a fluorimetric method detecting Phe and also using MS/MS for expanded NBS, also measuring Phe and tyrosine.
Objectives: Evaluation of MS/MS for screening of PKU and comparison with the fluorimetric method.
Methods: Fluorimetric method was performed using the Neonatal Phenylalanine kit from Perkin Elmer. The expanded NBS method is performed on a MS/MS in MRM mode, samples prepared using a nonderivatised kit NeoBase™ 2 Non-derivatized MS/MS kit from Perkin Elmer. Cut-off of Phe for both methods was 120 µmol/L, on the MS/MS we have an additional ratio Phe/Tyr for PKU screening with the cut-off 2.15.
We compared measurements of nearly 7000 newborn blood spots. The descriptive statistics, Bland-Altman analyses and Spearman correlation coefficient were calculated. The numbers of true positives and false positives for both methods were compared.
Results: Phe concentrations were 21 – 296 µmol/L, with the mean of 46 µmol/L (MS/MS method) and 10 – 280 µmol/L, with the mean of 67 µmol/L (fluorimetric method). Spearman correlation coefficient had a value of 0.49. Bland-Altman analysis comparing MS/MS method with the fluorimetric method in absolute values had a bias 21 µmol/L (SD 15.9 µmol/L), in percent difference the bias was 36 % (SD 21 %). The fluorimetric method yielded 16 positive results, one of the patients being a true positive. The MS/MS method flagged only the one PKU patient as positive.
Conclusion: The MS/MS and the fluorimetric method have a moderate correlation and the Bland-Altman analyses show that the fluorimetric method gives higher results. Nevertheless, the cut-off for MS/MS was the same as on the fluorimetric method, because the literature data and laboratory experiences do not warrant lower cut-offs. There were no false positives by MS/MS, which will occur after screening more newborns, yet it still showed that MS/MS was better suited for PKU screening. Both methods did not have any false negatives. Our results show that MS/MS is more suited for NBS of PKU and as Phe and Phe/Tyr are screened as part of the expanded NBS, MS/MS screening for PKU is also more cost and time effective.


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Topic(s): Metabolites & Metabolomics

Untargeted Metabolomic Profiling of Plasma Samples of Patients with MBOAT7 Gene Defect

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Poster #27d View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 12:00 for 1 hour in the Exhibit Hall.

INTRODUCTION: Inborn errors of metabolism related to biosynthesis and remodelling of phospholipids, sphingolipids is a newly emerging area in inherited metabolic disorders. Phospholipids are synthesized by a de-novo process, known as ‘‘Kennedy pathway’’ and are then dispersed asymmetrically by a remodeling process called ''Lands Cycle''.The MBOAT7, subject of the current study, is located in the Lands lipid remodeling pathway and inserts arachidonic acid to the sn-2 position of lysophosphotidylinositol. While there animal models of the MBOAT7 exist to elucidate its functional role, no study has yet been conducted on the effects of the MBOAT7 gene defect in humans.

OBJECTIVES: The goal this study was to explore the plasma metabolome profile of 12 patients with MBOAT7 gene mutation by mass spectrometry to explore the pathophysiological effects of the MBOAT7 gene defect and identify putative biomarkers.

METHODS: Plasma samples from 12 patients whose MBOAT7 gene defect was confirmed by exome sequencing and of 10 healthy individuals were obtained by following the Hacettepe University Rare Disease Biobank regulations by approval from the Hacettepe University Ethical Review Board. Plasma samples are then extracted and profiled by an Agilent Q-TOF-MS system equipped with 1260 HPLC by using InfinityLab Poroshell 120 RP column in both polarities. The resulting data are then uploaded to XCMS Online and MetaboAnalyst for filtering and data processing. Pooled plasma samples (n=5) were analyzed to calculate the coefficient of variation (CV). Masses whose abundance was not reproducible for all biological replicates, as indicated by a relative standard deviation (RSD) larger than 30 % in QC samples, were discarded.

RESULTS: We have found very significant changes in leukotriene metabolites, bile acids, stereate biosynthesis, and mevalonate pathways. Of note, leukotriene A4 and (5S)-HPETE increase by 4 fold (with p<8.5e-8, 8.4e-11 respectively). Arachidonate decrease by 2.4 and 18R-hydroxy-eicosapentaenoate increase by 4.7 fold. (p< 6.3e-12, 7.5e-7 respectively). The most important common feature of these pathways is their involvement as donors in the lipid remodeling pathway. The identified metabolites mighy give new insights into the pathophysiological changes and molecular mechanisms of the disease.

CONCLUSION: This is the first plasma metabolomics study of the MBOAT7 gene defect in humans. We have shown that patients with MBOAT7 gene defect cannot use arachidonic acid as a donor in lipid modeling and it is metabolized through the conversion of leukotrienes and the lipoxin pathway. We are further investigating the metabolites involved in the identified pathways to explore if they can be considered as valuable biomarkers.







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Topic(s): Metabolites & Metabolomics

Tandem Mass Spectrometry-based Analysis Reveal Relationship between Active DNA Demethylation and Krebs Cycle in AML and MDS

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Poster #27g View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

INTRODUCTION: The most dynamic process which regulates DNA methylation is recently discovered active demethylation. It involves ten-eleven translocation (TET) enzymes to catalyze stepwise oxidation of 5-methylcytosine (5-mCyt) to 5-hydroxymethylcytosine (5-hmCyt) and further demethylation products 5-formylcytosine (5-fCyt) and 5-carboxylcytosine (5-caCyt). Mutations targeting TET genes are frequently observed in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). Mutations in genes: succinate dehydrogenase (SDH), fumarate hydratase (FH) and isocitrate dehydrogenase (IDH) are also found in acute leukemias. These mutations result in accumulation of the succinate (SA), fumarate (FA), 2-oxoglutarate (2-OG) and R-2-hydroxyglutarate (R-2HG). It may deregulate the activity of TET enzymes and, in turn, DNA demethylation. Although the oncogenic mechanism of these mutations remains still under investigation, determine of these metabolites could be relevant for diagnosis, prognosis and treatment of a subset of patients with AML and MDS.

OBJECTIVES: The main objective of this study is to find out the relationship between the level of 5-mCyt and the derivatives of active DNA demethylation process and the level of metabolites: SA, FA and 2-OG/2-HG in plasma/urine of patients developing AML and MDS.

METHODS: In this study we have examined 3 groups: healthy controls, patients with AML and MDS at diagnosis de novo. In all groups we have measured the level of epigenetic DNA modifications in leukocytes using isotope-dilution automated online two-dimensional ultra-performance liquid chromatography with tandem mass spectrometry (2D-UPLC-MS/MS) and plasma/ urine concentrations of SA, FA and 2-OG using UPLC- MS/MS method. The level of R-2HG in urine and plasma has been measured using 2D-UPLC-MS/MS after derivatization with DATAN (Di-O-acetyl-L-tartaric anhydride).

RESULTS: Our preliminary research has shown two 5-hmCyt subpopulations in AML patient cohorts with higher and lower level of 5-hmCyt compare to healthy controls. Besides, we have observed reverse correlation between global level of 5-hmCyt and 2-hydroxyglutarates. We have noticed a few extreme values of 2-HGs in the urine of patients with AML and MDS. The level of D-2-HG and D/L 2HG ratio are notably increased 10-100-fold in AML (22%) and MDS (10%) patients in urine.
CONCLUSION: These research have shown relationship between the level of the derivates of active DNA demethylation process and metabolites. Larger studies need to be performed to revealed how the concentrations of SA, FA, 2-OG and R-2HG influence key enzymes of active DNA demethylation pathway.


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Topic(s): Metabolites & Metabolomics

Simultaneous Quantitation of Diabetes Markers and Comprehensive Metabolome Annotation Achieved via Semi-targeted Analysis of Serum Samples

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Poster #28f View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Wednesday at 15:30 for 1 hour in the Exhibit Hall.

Introduction: Type 2 Diabetes (T2D), the most prevalent form of diabetes, is a metabolic disorder characterized by decreased insulin sensitivity and abnormal hepatic glucose production. Monitoring metabolic alterations during T2D progression may provide better understanding of its pathogenesis and identify potential biomarkers for early diagnosis. Several metabolomics approaches have been applied in diabetic research for identification of metabolites associated with the risk of T2D and related pathways. Here, a semi-targeted workflow was designed to confidently measure known metabolic differentiators, such as branched-chain amino acids, while allowing for the discovery of previously unidentified metabolites that are altered during T2D progression. This approach combines high resolution accurate mass Orbitrap™ technology for maximum detection of known and unknown metabolites in serum samples, with intelligence-driven fragmentation for the identification of knowns and structural elucidation of unknown biomarkers.

Methods: Serum samples were obtained from 3 healthy donors and 3 T2D donors. A pooled sample was created from all samples and was used for quality control and identification of unknowns. Metabolites were extracted with an excess of cold methanol (3x) containing internal standards. Samples were analyzed with a Thermo Scientific™ Vanquish™ UHPLC system and a Thermo Scientific™ Orbitrap ID-X™ Tribrid™ mass spectrometer. A custom library containing fragmentation spectra and retention times for 300 authentic standards was created in-house. Data were processed using Thermo Scientific™ Compound Discoverer™ software for unknown identification, differential analysis and pathway mapping.

Results: A semi-targeted workflow was developed for the robust quantitation of known markers, such as branched chain amino acids, while at the same time, enabling comprehensive metabolic phenotyping of serum samples. Over 3,000 metabolites were detected, 200 of which could be confidently identified (MSI Level 1) against an in-house spectral library. The Orbitrap ID-X Tribrid MS with AcquireX intelligent acquisition software maximized the number of metabolites interrogated by MS/MS, by annotating non-biological and redundant features on-the-fly, resulting in confident metabolite annotations. Putative annotations (MSI Level 2 and 3) were obtained for more than 90% of the metabolites detected through searches against the mzCloud™ library and ChemSpider database. Differential analysis detected metabolite perturbations in amino acids and carnitines in serum from T2D donors, in agreement with previous studies.

Conclusion: The semi-targeted strategy described here presents a promising and facile workflow for the monitoring of known biomarkers, while enabling the discovery of novel disease biomarkers that could lead to further biochemical insights in disease progression and treatment outcome.
For Research Use Only. Not for use in diagnostic procedures.


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Topic(s): Metabolites & Metabolomics

Serum Metabolomics Using LC-MS Reveals Potential Biomarker of Myocardial Ischemia

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Poster #20k View Map
* Posters are up for the entire congress (Tue PM - Thu). *
This poster will be attended on Thursday at 09:30 for 1 hour in the Exhibit Hall.

Introduction
Cardiovascular disease (CVD), one of the leading cause of death worldwide, are influenced by a wide range of genetic, dietary, and environmental factors. As CVD is a complex pathophysiological disease, more intensive research is needed to elucidate the diagnostic approach. Metabolomics, a field of omics science that comprehensively analyze low-molecular-weight compounds in biological systems, can be used in patient omics profiling, diagnosis, and monitoring. In the present study, we aimed to identify biomarker candidates for myocardial infarction (MI) using mass spectrometry-based metabolomics.
Methods and Results
We performed metabolomic profiling of serum samples from MI patients (70 MI patients and 70 controls) in a discovery phase using UPLC/Q-TOF MS. And then, we analyzed serum sample (274 MI patients and 273 controls) in independent validation phase using UPLC/TQ MS. In discovery set, serum 11 metabolites, including purines, carnitine, acyl-carnitines, amino acids, taurine, and organic acids, showed significantly dysregulated levels in MI using Mann-Whitney test and ranked ANCOVA adjusted age and sex. Further, inosine and hypoxanthine were discriminated between MI and normal sample (area under the curve (AUC) value > 0.8) in the discovery set. Therefore, we conducted a targeted analysis of metabolites related to purine metabolism in the validation set. Serum concentrations of hypoxanthine, inosine, xanthine, and xanthosine were significantly higher in MI patients compared to the normal sample adjusted age and sex (p<0.001). Also, the diagnostic model of hypoxanthine, which was constructed based on the ROC curve of the MI patients and normal sample, showed the AUCs ranged from 0.8 to 0.864.
Conclusion
The current study demonstrated that hypoxanthine could be used as a biomarker candidate to distinguish MI patients from normal and metabolomics technologies are well suited for identifying biomarkers for CVD and provide value for clinical diagnosis of CVD.