title: Cerebrospinal fluid metabolomic profiling in tuberculous and viral meningitis: Screening potential markers for differential diagnosis.
abstract: BACKGROUND
  Tuberculous meningitis (TBM) is the most severe and frequent form of central nervous system tuberculosis. The current lack of efficient diagnostic tests makes it difficult to differentiate TBM from other common types of meningitis, especially viral meningitis (VM). Metabolomics is an important tool to identify disease-specific biomarkers. However, little metabolomic information is available on adult TBM.
  
  
  METHODS
  We used1H nuclear magnetic resonance-based metabolomics to investigate the metabolic features of the CSF from 18 TBM and 20 VM patients. Principal component analysis and orthogonal signal correction-partial least squares-discriminant analysis (OSC-PLS-DA) were applied to analyze profiling data. Metabolites were identified using the Human Metabolome Database and pathway analysis was performed with MetaboAnalyst 3.0.
  
  
  RESULTS
  The OSC-PLS-DA model could distinguish TBM from VM with high reliability. A total of 25 key metabolites that contributed to their discrimination were identified, including some, such as betaine and cyclohexane, rarely reported before in TBM. Pathway analysis indicated that amino acid and energy metabolism was significantly different in the CSF of TBM compared with VM.
  
  
  CONCLUSIONS
  Twenty-five key metabolites identified in our study may be potential biomarkers for TBM differential diagnosis and are worthy of further investigation.
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing 101149, China.
authors.forename: Zihui
authors.initials: Z
authors.lastname: Li
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing 101149, China.
authors.forename: Boping
authors.initials: B
authors.lastname: Du
authors.affiliation: People's Liberation Army No. 263 Hospital, Beijing 101149, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: People's Liberation Army No. 263 Hospital, Beijing 101149, China.
authors.forename: Jinli
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing 101149, China.
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing 101149, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Jia
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing 101149, China.
authors.forename: Aiying
authors.initials: A
authors.lastname: Xing
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing 101149, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing 101149, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Liu
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing 101149, China. Electronic address: zzd417@163.com.
authors.forename: Zongde
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002555:Cerebrospinal Fluid / Q000378:metabolism*; D003937:Diagnosis, Differential; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D053858:Metabolic Networks and Pathways; D055432:Metabolomics; D025341:Principal Component Analysis; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid* / Q000175:diagnosis
chemical_list: D015415:Biomarkers
keywords: Biomarker; Metabolomics; NMR; Tuberculous meningitis; Viral meningitis