title: Global host metabolic response to Plasmodium vivax infection: a 1H NMR based urinary metabonomic study.
abstract: BACKGROUND
  Plasmodium vivax is responsible for the majority of malarial infection in the Indian subcontinent. This species of the parasite is generally believed to cause a relatively benign form of the disease. However, recent reports from different parts of the world indicate that vivax malaria can also have severe manifestation. Host response to the parasite invasion is thought to be an important factor in determining the severity of manifestation. In this paper, attempt was made to determine the host metabolic response associated with P. vivax infection by means of NMR spectroscopy-based metabonomic techniques in an attempt to better understand the disease pathology.
  
  
  METHODS
  NMR spectroscopy of urine samples from P. vivax-infected patients, healthy individuals and non-malarial fever patients were carried out followed by multivariate statistical analysis. Two data analysis techniques were employed, namely, Principal Component Analysis [PCA] and Orthogonal Projection to Latent Structure Discriminant Analysis [OPLS-DA]. Several NMR signals from the urinary metabolites were further selected for univariate comparison among the classes.
  
  
  RESULTS
  The urine metabolic profiles of P. vivax-infected patients were distinct from those of healthy individuals as well as of non-malarial fever patients. A highly predictive model was constructed from urine profile of malarial and non-malarial fever patients. Several metabolites were found to be varying significantly across these cohorts. Urinary ornithine seems to have the potential to be used as biomarkers of vivax malaria. An increasing trend in pipecolic acid was also observed. The results suggest impairment in the functioning of liver as well as impairment in urea cycle.
  
  
  CONCLUSIONS
  The results open up a possibility of non-invasive analysis and diagnosis of P. vivax using urine metabolic profile. Distinct variations in certain metabolites were recorded, and amongst these, ornithine may have the potential of being used as biomarker of malaria. Pipecolic acid also showed increasing trend in the malaria patient compared to the other groups.
authors.affiliation: Department of Chemical Sciences, Tata Institute of Fundamental Research, Mumbai, India.
authors.forename: Arjun
authors.initials: A
authors.lastname: Sengupta
authors.forename: Soumita
authors.initials: S
authors.lastname: Ghosh
authors.forename: Angika
authors.initials: A
authors.lastname: Basant
authors.forename: Suhas
authors.initials: S
authors.lastname: Malusare
authors.forename: Parul
authors.initials: P
authors.lastname: Johri
authors.forename: Sulabha
authors.initials: S
authors.lastname: Pathak
authors.forename: Shobhona
authors.initials: S
authors.lastname: Sharma
authors.forename: Haripalsingh M
authors.initials: HM
authors.lastname: Sonawat
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism / Q000652:urine*; D016022:Case-Control Studies; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D016780:Malaria, Vivax / Q000378:metabolism* / Q000469:parasitology / Q000652:urine; D008297:Male; D055442:Metabolome; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009952:Ornithine / Q000378:metabolism / Q000652:urine*; D010875:Pipecolic Acids / Q000378:metabolism / Q000652:urine; D010966:Plasmodium vivax / Q000472:pathogenicity; D011237:Predictive Value of Tests; D013048:Specimen Handling / Q000379:methods
chemical_list: D015415:Biomarkers; D010875:Pipecolic Acids; D009952:Ornithine; C031345:pipecolic acid