title: Metabolomic Profiling of Autoimmune Hepatitis: The Diagnostic Utility of Nuclear Magnetic Resonance Spectroscopy.
abstract: Autoimmune hepatitis (AIH) is often confused with other liver diseases because of their shared nonspecific symptoms and serological and histological overlap. This study compared the plasma metabolomic profiles of patients with AIH, primary biliary cirrhosis (PBC), PBC/AIH overlap syndrome (OS), and drug-induced liver injury (DILI) with those of healthy subjects to identify potential biomarkers of AIH. Metabolomic profiling and biomarker screening were performed using proton nuclear magnetic resonance spectroscopy (1H NMR) coupled with a partial least-squares discriminant analysis. Compared with the levels in healthy volunteers and other liver disease patients, AIH patients exhibited relatively high levels of plasma pyruvate, lactate, acetate, acetoacetate, and glucose. Such metabolites are typically related to energy metabolism alterations and may be a sign of metabolic conversion to the aerobic glycolysis phenotype of excessive immune activation. Increased aromatic amino acids and decreased branched-chain amino acids were found in the plasma of AIH patients. The whole NMR profiles were stepwise-reduced, and nine metabolomic biomarkers having the greatest significance in the discriminant analysis were obtained. The diagnostic utility of the selected metabolites was assessed, and these biomarkers achieved good sensitivity, specificity, and accuracy (all above 93%) in distinguishing AIH from PBC, DILI, and OS. This report is the first to present the metabolic phenotype of AIH and the potential utility of1H NMR metabolomics in the diagnosis of AIH.
authors.affiliation: China Military Institute of Chinese Medicine, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Jia-Bo
authors.initials: JB
authors.lastname: Wang
authors.affiliation: China Military Institute of Chinese Medicine, 302 Military Hospital , Beijing 100039, PR China.|Yunnan University of Traditional Chinese Medicine , Kunming 650500, PR China.
authors.forename: Shi-Biao
authors.initials: SB
authors.lastname: Pu
authors.affiliation: Diagnosis and Treatment Center for Non-infectious Diseases, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Capital Normal University , Beijing 100089, PR China.
authors.forename: Zhong-Feng
authors.initials: ZF
authors.lastname: Li
authors.affiliation: China Military Institute of Chinese Medicine, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Ming
authors.initials: M
authors.lastname: Niu
authors.affiliation: National Center of Biomedical Analysis, Academy of Military Medical Sciences , Beijing 100850, PR China.
authors.forename: Xian-Zhong
authors.initials: XZ
authors.lastname: Yan
authors.affiliation: China Military Institute of Chinese Medicine, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Yan-Ling
authors.initials: YL
authors.lastname: Zhao
authors.affiliation: The Institute of Translational Hepatology, The Research Center for Biological Therapy, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Li-Feng
authors.initials: LF
authors.lastname: Wang
authors.affiliation: Shanxi University , Taiyuan 030006, PR China.
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Qin
authors.affiliation: Beijing Friendship Hospital, Capital Medical University , Beijing 100050, PR China.
authors.forename: Zhi-Jie
authors.initials: ZJ
authors.lastname: Ma
authors.affiliation: China Military Institute of Chinese Medicine, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Ya-Ming
authors.initials: YM
authors.lastname: Zhang
authors.affiliation: Diagnosis and Treatment Center for Non-infectious Diseases, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Bao-Sen
authors.initials: BS
authors.lastname: Li
authors.affiliation: Integrative Medical Center, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Sheng-Qiang
authors.initials: SQ
authors.lastname: Luo
authors.affiliation: Integrative Medical Center, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Man
authors.initials: M
authors.lastname: Gong
authors.affiliation: Integrative Medical Center, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Yong-Qiang
authors.initials: YQ
authors.lastname: Sun
authors.affiliation: Diagnosis and Treatment Center for Non-infectious Diseases, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Zheng-Sheng
authors.initials: ZS
authors.lastname: Zou
authors.affiliation: Integrative Medical Center, 302 Military Hospital , Beijing 100039, PR China.
authors.forename: Xiao-He
authors.initials: XH
authors.lastname: Xiao
keywords: Autoimmune hepatitis; NMR; biomarker; diagnosis; metabolomics