Application of 1H NMR spectroscopy-based metabonomics to feces of cervical cancer patients with radiation-induced acute intestinal symptoms.
OBJECTIVE
Radiation-induced acute intestinal symptoms (RIAISs) are a common complication of radiotherapy for cervical cancer. The aim of this study was to use (1)H nuclear magnetic resonance ((1)H NMR) combined with chemometric analysis to develop a metabolic profile of patients with RIAISs.


METHODS
Fecal samples were collected from 66 patients with cervical cancer before and after pelvic radiotherapy. After radiotherapy, RIAISs occurred in eleven patients. We selected another 11 patients from participants without RIAISs whose age, stage, histological type and treatment methods are matched with RIAIS patients as the control group. (1)H NMR spectroscopy combined with multivariate pattern recognition analysis was used to generate metabolic profile data, as well as to establish a RIAIS-specific metabolic phenotype.


RESULTS
Orthogonal partial least-squares discriminant analysis was used to distinguish samples between the pre- and post-radiotherapy RIAIS patients and between RIAIS patients and controls. Fecal samples from RIAIS patients after pelvic radiotherapy were characterized by increased concentrations of α-ketobutyrate, valine, uracil, tyrosine, trimethylamine N-oxide, phenylalanine, lysine, isoleucine, glutamine, creatinine, creatine, bile acids, aminohippurate, and alanine, accompanied by reduced concentrations of α-glucose, n-butyrate, methylamine, and ethanol relative to samples from RIAIS patients before pelvic radiotherapy, while in RIAIS patients relative to controls, trimethylamine, n-butyrate, fumarate and acetate were down-regulated and valine, TMAO, taurine, phenylalanine, lactate, isoleucine and creatinine were up-regulated.


CONCLUSIONS
We obtained the metabolic profile of RIAIS patients from fecal samples using NMR-based metabonomics. This profile has the potential to be developed into a novel clinical tool for RIAIS diagnosis or therapeutic monitoring, and could contribute to an improved understanding of the disease mechanism. However, because of the limitations of methods, technique, bacterial contamination of feces and small sample size, further research and verification are needed.
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Yanlan
Y
Chai
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Juan
J
Wang
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Tao
T
Wang
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Yunyi
Y
Yang
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Jin
J
Su
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Fan
F
Shi
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Jiquan
J
Wang
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China; Renmin Hospital, Hubei University of Medicine, PR China.
Xi
X
Zhou
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Bin
B
He
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China.
Hailin
H
Ma
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, PR China. Electronic address: liuzmail@163.com.
Zi
Z
Liu
D000208:Acute Disease; D000328:Adult; D000368:Aged; D016002:Discriminant Analysis; D005243:Feces; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000528:radiation effects; D016018:Least-Squares Analysis; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis* / Q000378:metabolism; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*
Cervical cancer; Metabonomics; NMR; Pelvic radiotherapy; Radiation-induced acute intestinal symptoms