title: A Urinary Metabolic Signature for Multiple Sclerosis and Neuromyelitis Optica.
abstract: Urine is a metabolite-rich biofluid that reflects the body's effort to maintain chemical and osmotic homeostasis. Clinical diagnosis routinely relies on urine samples because the collection process is easy and noninvasive. Despite these advantages, urine is an under-investigated source of biomarkers for multiple sclerosis (MS). Nuclear magnetic resonance spectroscopy (NMR) has become a common approach for analyzing urinary metabolites for disease diagnosis and biomarker discovery. For illustration of the potential of urinary metabolites for diagnosing and treating MS patients, and for differentiating between MS and other illnesses, 38 urine samples were collected from healthy controls, MS patients, and neuromyelitis optica-spectrum disorder (NMO-SD) patients and analyzed with NMR, multivariate statistics, one-way ANOVA, and univariate statistics. Urine from MS patients exhibited a statistically distinct metabolic signature from healthy and NMO-SD controls. A total of 27 metabolites were differentially altered in the urine from MS and NMO-SD patients and were associated with synthesis and degradation of ketone bodies, amino acids, propionate and pyruvate metabolism, tricarboxylic acid cycle, and glycolysis. Metabolites altered in urine from MS patients were shown to be related to known pathogenic processes relevant to MS, including alterations in energy and fatty acid metabolism, mitochondrial activity, and the gut microbiota.
authors.affiliation: Department of Chemistry, University of Nebraska-Lincoln , Lincoln, Nebraska 68588-0304, United States.
authors.forename: Teklab
authors.initials: T
authors.lastname: Gebregiworgis
authors.affiliation: Department of Neurology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark , Odense, Denmark.
authors.forename: Helle H
authors.initials: HH
authors.lastname: Nielsen
authors.affiliation: School of Veterinary Medicine and Biomedical Sciences, University of Nebraska-Lincoln , Lincoln, Nebraska 68583-0905, United States.
authors.forename: Chandirasegaran
authors.initials: C
authors.lastname: Massilamany
authors.affiliation: School of Veterinary Medicine and Biomedical Sciences, University of Nebraska-Lincoln , Lincoln, Nebraska 68583-0905, United States.
authors.forename: Arunakumar
authors.initials: A
authors.lastname: Gangaplara
authors.affiliation: School of Veterinary Medicine and Biomedical Sciences, University of Nebraska-Lincoln , Lincoln, Nebraska 68583-0905, United States.
authors.forename: Jay
authors.initials: J
authors.lastname: Reddy
authors.affiliation: Department of Neurology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark , Odense, Denmark.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Illes
authors.affiliation: Department of Chemistry, University of Nebraska-Lincoln , Lincoln, Nebraska 68588-0304, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Powers
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D055442:Metabolome; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000378:metabolism* / Q000652:urine; D015999:Multivariate Analysis; D009471:Neuromyelitis Optica / Q000175:diagnosis / Q000378:metabolism* / Q000652:urine; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: NMR; metabolomics; multiple sclerosis; multivariate statistics; neuromyelitis optica-spectrum disorder; urine biomarkers