title: Application of (1)H NMR-based serum metabolomic studies for monitoring female patients with rheumatoid arthritis.
abstract: Rheumatoid arthritis is a chronic autoimmune-based inflammatory disease that leads to progressive joint degeneration, disability, and an increased risk of cardiovascular complications, which is the main cause of mortality in this population of patients. Although several biomarkers are routinely used in the management of rheumatoid arthritis, there is a high demand for novel biomarkers to further improve the early diagnosis of rheumatoid arthritis, stratification of patients, and the prediction of a better response to a specific therapy. In this study, the metabolomics approach was used to provide relevant biomarkers to improve diagnostic accuracy, define prognosis and predict and monitor treatment efficacy. The results indicated that twelve metabolites were important for the discrimination of healthy control and rheumatoid arthritis. Notably, valine, isoleucine, lactate, alanine, creatinine, GPC  APC and histidine relative levels were lower in rheumatoid arthritis, whereas 3-hydroxyisobutyrate, acetate, NAC, acetoacetate and acetone relative levels were higher. Simultaneously, the analysis of the concentration of metabolites in rheumatoid arthritis and 3 months after induction treatment revealed that L1, 3-hydroxyisobutyrate, lysine, L5, acetoacetate, creatine, GPC+APC, histidine and phenylalanine were elevated in RA, whereas leucine, acetate, betaine and formate were lower. Additionally, metabolomics tools were employed to discriminate between patients with different IL-17A genotypes. Metabolomics may provide relevant biomarkers to improve diagnostic accuracy, define prognosis and predict and monitor treatment efficacy in rheumatoid arthritis.
authors.affiliation: Department of Chemistry, Wroclaw University of Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wrocław, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Zabek
authors.affiliation: Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Swierkot
authors.affiliation: Laboratory of Clinical Immunogenetics and Pharmacogenetics, Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Rudolfa Weigla 12, 53-114 Wrocław, Poland; Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), OT Gatersleben, Corrensstrasse 3, D-06466 Stadt Seeland, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Malak
authors.affiliation: Department of Chemistry, Wroclaw University of Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wrocław, Poland.
authors.forename: Iga
authors.initials: I
authors.lastname: Zawadzka
authors.affiliation: Faculty of Chemistry, Opole University, Pl. Kopernika 11a, 45-040 Opole, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Deja
authors.affiliation: Laboratory of Clinical Immunogenetics and Pharmacogenetics, Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Rudolfa Weigla 12, 53-114 Wrocław, Poland; Department and Clinic of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland. Electronic address: bogunia@iitd.pan.wroc.pl.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Bogunia-Kubik
authors.affiliation: Department of Chemistry, Wroclaw University of Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wrocław, Poland. Electronic address: piotr.mlynarz@pwr.edu.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Mlynarz
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D011522:Protons
chemical_list: D015415:Biomarkers; D011522:Protons
keywords: (1)H NMR spectroscopy; Metabolomics; Rheumatoid arthritis