Time-dependent metabolic phenotyping of inflammatory dysregulation

• Main Author: Wolfer, Arnaud
• Other Authors: Nicholson, Jeremy K. ; Ebbels, Timothy
• Published: Imperial College London 2016
• Subjects: 610
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.739602

A rich and functional description of a patient health status is the fundamental basis for the personalisation of treatment and the targeting of interventions. The function of inflammation in the healing process as well as its involvement in most major diseases is well established, yet the specific mechanism by which it contributes to the pathogenesis is still not fully understood. If conditions arising from a dysregulation of the inflammatory process are to be treated before they become irreversible, a novel understanding of these pathologies must be achieved and a stratification of patients based on their inflammatory status undertaken. The work presented in this thesis aims to deliver new analytical and statistical approaches to support the investigation of the time-dependent dysregulation of inflammation. Lipid mediators have been described as exerting a major role in the initiation and regulation of the inflammatory response, yet analytical platforms for their large-scale characterisation in human biofluids are lacking. This thesis reports the validation of an assay for the simultaneous quantification of pro- and anti-inflammatory signalling molecules in multiple human biofluids. The coverage of the assay in each biofluid is subsequently established, characterising inflammatory signalling across biological compartments. A second study explores the assay’s applicability in a clinical context; investigating the relationship between lipid mediators, current clinical markers of inflammation and post-operative complications. Characterising the interplay between signalling and regulatory networks is key to understanding a living system’s response to perturbations, yet few statistical approaches are suited for the detection of time-dependent patterns in short and irregularly sampled longitudinal datasets. This thesis reports the development of a statistical approach to support the identification of altered time-trajectories in such studies. The method’s wide applicability is subsequently demonstrated on two investigations covering the diversity of metabolic phenotyping data generation platforms. This thesis is a proof of concept for the characterisation of patient-specific inflammatory status in a clinical context and the identification of altered time-dependent patterns. Both analytical and statistical developments have been motivated by the needs of real world applications and provide a template for the characterisation and analysis of the molecular basis for treatment.