title: Metabolomic study of biochemical changes in the plasma and urine of primary dysmenorrhea patients using UPLC-MS coupled with a pattern recognition approach.
abstract: Primary dysmenorrhea (PD) is characterized by painful menstrual cramps without any organic pathology and has a prevalence of up to 90% in adolescents. Recent advances in its etiology and pathogenesis are providing more speculative hypotheses focused on integral systems. Using a targeted tandem mass spectrometry (MS/MS)-based metabolomic platform, we explored the changes of metabolic profiling in plasma/urine simultaneously between PD patients and healthy controls before and after a 3-month herbal medicine (namely Shaofu Zhuyu formula concentrated-granule, SFZYFG) therapy. To detect and identify potential biomarkers associated with PD and SFZYFG treatment, we also performed a combined UPLC-QTOF-MS/MS-based metabolomic profiling of the plasma/urine samples, indicating a further deviation of the patients' global metabolic profile from that of controls. The total thirty-five metabolites (nineteen in plasma and sixteen in urine), up-regulated or down-regulated (p < 0.05 or 0.01), were identified and contributed to PD progress. These promising identified biomarkers underpinning the metabolic pathway including sphingolipid metabolism, steroid hormone biosynthesis, and glycerophospholipid metabolism are disturbed in PD patients, which were identified by using pathway analysis with MetPA. Twenty-four altered metabolites and fourteen biochemical indicators were restored back to the control-like level after the treatment of SFZYFG and could be potential biomarkers for monitoring therapeutic efficacy. These findings may be promising to yield a valuable insight into the pathophysiology of PD and to advance the approaches of treatment, diagnosis, and prevention of PD and related syndromes.
authors.affiliation: Jiangsu Key Laboratory for High Technology Research of TCM Formulae, Nanjing University of Chinese Medicine, Nanjing 210046, P.R. China.
authors.forename: Shulan
authors.initials: S
authors.lastname: Su
authors.forename: Jinao
authors.initials: J
authors.lastname: Duan
authors.forename: Peijuan
authors.initials: P
authors.lastname: Wang
authors.forename: Pei
authors.initials: P
authors.lastname: Liu
authors.forename: Jianming
authors.initials: J
authors.lastname: Guo
authors.forename: Erxin
authors.initials: E
authors.lastname: Shang
authors.forename: Dawei
authors.initials: D
authors.lastname: Qian
authors.forename: Yuping
authors.initials: Y
authors.lastname: Tang
authors.forename: Zongxiang
authors.initials: Z
authors.lastname: Tang
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D004365:Drugs, Chinese Herbal / Q000494:pharmacology; D004412:Dysmenorrhea / Q000097:blood* / Q000188:drug therapy / Q000652:urine*; D005260:Female; D020404:Glycerophospholipids / Q000097:blood / Q000652:urine; D012739:Gonadal Steroid Hormones / Q000097:blood / Q000652:urine; D006801:Humans; D053858:Metabolic Networks and Pathways / Q000187:drug effects*; D055442:Metabolome; D025341:Principal Component Analysis; D011446:Prospective Studies; D013107:Sphingolipids / Q000097:blood / Q000652:urine; D053719:Tandem Mass Spectrometry
chemical_list: D015415:Biomarkers; D004365:Drugs, Chinese Herbal; D020404:Glycerophospholipids; D012739:Gonadal Steroid Hormones; D013107:Sphingolipids