Serum-Urine Matched Metabolomics for Predicting Progression of Henoch-Schonlein Purpura Nephritis

• Main Authors: Qian Zhang, Ling-Yun Lai, Yuan-Yuan Cai, Ma-Jie Wang, Gaoxiang Ma, Lian-Wen Qi, Jun Xue, Feng-Qing Huang
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-05-01
• Series: Frontiers in Medicine
• Subjects: choline and cis-vaccenic acid; differential diagnosis; Henoch-Schonlein purpura nephritis; nephrotic proteinuria; serum-urine matched metabolomics
• Online Access: https://www.frontiersin.org/articles/10.3389/fmed.2021.657073/full

Henoch-Schonlein purpura nephritis (HSPN) is a common glomerulonephritis secondary to Henoch-Schonlein purpura (HSP) that affects systemic metabolism. Currently, there is a rarity of biomarkers to predict the progression of HSPN. This work sought to screen metabolic markers to predict the progression of HSPN via serum-urine matched metabolomics. A total of 90 HSPN patients were enrolled, including 46 HSPN (+) patients with severe kidney damage (persistent proteinuria >0.3 g/day) and 44 HSPN (–) patients without obvious symptoms (proteinuria < 0.3 g/day). Untargeted metabolomics was determined by liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-Q/TOF-MS). A total of 38 and 50 differential metabolites were, respectively, identified in serum and urine from the comparison between HSPN (+) and HSPN (–) patients. Altered metabolic pathways in HSPN (+) mainly included glycerophospholipid metabolism, pyruvate metabolism, and citrate cycle. A panel of choline and cis-vaccenic acid gave areas under the curve of 92.69% in serum and 72.43% in urine for differential diagnosis between HSPN (+) and HSPN (–). In addition, the two metabolites showed a significant association with clinical indices of HSPN. These results suggest that serum-urine matched metabolomics comprehensively characterized the metabolic differences between HSPN (+) and HSPN (–), and choline and cis-vaccenic acid could serve as biomarkers to predict HSPN progression.