Metabolomic analysis of urine with Nuclear Magnetic Resonance spectroscopy in patients with idiopathic sudden sensorineural hearing loss: A preliminary study.
OBJECTIVE
Idiopathic sudden sensorineural hearing loss is a frequent emergency, with unknown aetiology and usually treated with empiric therapy. Steroids represent the only validated treatment but prognosis is unpredictable and the possibility to select the patients who will not respond to steroids could avoid unnecessary treatments. Metabolomic profiling of the biofluids target the analysis of the final product of genic expression and enzymatic activity, defining the biochemical phenotype of a whole biologic system.


METHODS
We studied the metabolomics of the urine of a cohort of patients with idiopathic sudden sensorineural hearing loss, correlating the metabolic profiles with the clinical outcomes. Metabolomic profiling of urine samples was performed by1H Nuclear Magnetic Resonance spectroscopy in combination with multivariate statistical approaches.


RESULTS
26 patients were included in the study: 5 healthy controls, 13 patients who did not recover after treatment at 6 months while the remaining 8 patients recovered from the hearing loss. The orthogonal partial least square-discriminant analysis score plot showed a significant separation between the two groups, responders and non-responders after steroid therapy, R2Y of 0.83, Q2of 0.38 and p value <0.05. The resulting metabolic profiles were characterized by higher levels of urinary B-Alanine, 3-hydroxybutyrate and Trimethylamine N-oxide, and lower levels of Citrate and Creatinine in patients with worst outcome.


CONCLUSIONS
Idiopathic sudden sensorineural hearing loss is a specific disease with unclear systemic changes, but our data suggest that there are different types of this disorder or patients predisposed to effective action of steroids allowing the recover after treatment.
Department of Otorhinolaryngology, AOU Cagliari, Cagliari University, Italy. Electronic address: filippocarta@unica.it.
Filippo
F
Carta
Department of Biomedical Sciences, University of Cagliari, Italy.
Milena
M
Lussu
Department of Otorhinolaryngology, AOU Cagliari, Cagliari University, Italy.
Fabrizio
F
Bandino
Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, AOU Cagliari, Cagliari University, Italy.
Antonio
A
Noto
Department of Hearing and Speech University of Kansas Medical Center, Kansas City, KS, USA.
Marcello
M
Peppi
I.M. Sechenov First Moscow State Medical University, 11991 Moscow, Russia.
Natalia
N
Chuchueva
Department of Biomedical Sciences, University of Cagliari, Italy.
Luigi
L
Atzori
Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, AOU Cagliari, Cagliari University, Italy.
Vassilios
V
Fanos
Department of Otorhinolaryngology, AOU Cagliari, Cagliari University, Italy.
Roberto
R
Puxeddu
D020155:3-Hydroxybutyric Acid / Q000652:urine*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000409:Alanine / Q000652:urine*; D000925:Anticoagulants / Q000627:therapeutic use; D001301:Audiometry, Pure-Tone; D016022:Case-Control Studies; D002648:Child; D019343:Citric Acid / Q000652:urine; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D017984:Enoxaparin / Q000627:therapeutic use; D005260:Female; D003639:Hearing Loss, Sudden / Q000628:therapy / Q000652:urine*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D055432:Metabolomics; D008744:Methylamines / Q000652:urine*; D008875:Middle Aged; D011282:Pregnenediones / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D066244:Proton Magnetic Resonance Spectroscopy; D014556:Urine / Q000737:chemistry; D055815:Young Adult
D000925:Anticoagulants; D017984:Enoxaparin; D007166:Immunosuppressive Agents; D008744:Methylamines; D011282:Pregnenediones; D019343:Citric Acid; D003404:Creatinine; C005855:trimethyloxamine; C021988:deflazacort; D000409:Alanine; D020155:3-Hydroxybutyric Acid
Idiopathic sudden sensorineural hearing loss; Metabolomics