Rapid and Sensitive Differentiating Ischemic and Hemorrhagic Strokes by Dried Blood Spot Based Direct Injection Mass Spectrometry Metabolomics Analysis.
Cerebral infarction (CI) and intracerebral hemorrhage are lethal cerebrovascular diseases, sometimes sharing similar clinical manifestations but with distinct therapeutic strategies. Delayed treatment usually resulted in poor prognosis. A timely diagnosis report is highly warranted especially in emergency. One hundred twenty-nine CI patients, 73 intracerebral hemorrhage (ICH) patients, and 98 controls were enrolled in this study. A direct injection mass spectrometry metabolomics approach was adopted using dried blood spot samples. This targeted metabolomics analysis focused on absolute quantitation of 23 amino acids, 26 carnitine/carnitine esters, and 22 calculated ratios parameters. Compared to the normal control group, CI and ICH showed distinct metabolite changes, respectively. For stroke differentiation, Tyr, C5-OH/C0, Cit, Asn, Pro, Val, Arg/Orn, Leu, and Val/Phe were elevated in the CI group. On the contrary, C5:1, Phe/Tyr, (C0 + C2 + C3 + C16 + C18:1)/Cit, and Met/Leu were of lower levels in the CI group. Using regression model based on some of the above-mentioned parameters, 79.07% of stroke patients from a new set could be definitely confirmed. This study proved the targeted metabolomics analysis was a promising tool for rapid and timely stroke differentiation.
First Affiliated Hospital of Liaoning Medical University, Jinzhou, P.R. China.
Zhansheng
Z
Hu
First Affiliated Hospital of Liaoning Medical University, Jinzhou, P.R. China.
Zhitu
Z
Zhu
First Affiliated Hospital of Liaoning Medical University, Jinzhou, P.R. China.|Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China.|Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, P.R. China.
Yunfeng
Y
Cao
Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China.
Lixuan
L
Wang
Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China.
Xiaoyu
X
Sun
Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China.
Jun
J
Dong
Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China.|Tianjin Life Science Research Center and Department of Microbiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, P.R. China.
Zhongze
Z
Fang
Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China.
Yanhua
Y
Fang
Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China.
Xiaoxue
X
Xu
First Affiliated Hospital of Liaoning Medical University, Jinzhou, P.R. China.|Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China.|Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, P.R. China.|Clinical Laboratory, Dalian Sixth People's Hospital, Dalian, PR China.
Peng
P
Gao
First Affiliated Hospital of Liaoning Medical University, Jinzhou, P.R. China. cmushz@163.com.|Joint Center for Translational Medicine, Dalian Institute of Chemical Physics, Chinese Academy of Sciences and First Affiliated Hospital of Liaoning Medical University, Dalian, P.R. China. cmushz@163.com.
Sun
S
Hongzhi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000097:blood; D002331:Carnitine; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000150:complications; D002544:Cerebral Infarction / Q000097:blood* / Q000150:complications; D002851:Chromatography, High Pressure Liquid; D059788:Dried Blood Spot Testing / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D013058:Mass Spectrometry / Q000379:methods*; D055432:Metabolomics / Q000379:methods; D008875:Middle Aged; D010446:Peptide Fragments; D012372:ROC Curve; D020521:Stroke / Q000150:complications* / Q000209:etiology
D000596:Amino Acids; D010446:Peptide Fragments; D002331:Carnitine
mass spectrometry; metabolomics; stroke