Deciphering the metabolic perturbation in hepatic alveolar echinococcosis: a 1H NMR-based metabolomics study

Caigui Lin,Guiping Shen,Zhiliang Wei,Lingqiang Zhang,Yueyue Liu,Kian-Kai Cheng,Haining Fan,Zhong Chen,Jiyang Dong

doi:10.1186/s13071-019-3554-0

Abstract

BackgroundHepatic alveolar echinococcosis (HAE) is caused by the growth of Echinococcus multilocularis larvae in the liver. It is a chronic and potentially lethal parasitic disease. Early stage diagnosis for this disease is currently not available due to its long asymptomatic incubation period. In this study, a proton nuclear magnetic resonance (1H NMR)-based metabolomics approach was applied in conjunction with multivariate statistical analysis to investigate the altered metabolic profiles in blood serum and urine samples obtained from HAE patients. The aim of the study was to identify the metabolic signatures associated with HAE.ResultsA total of 21 distinct metabolic differences between HAE patients and healthy individuals were identified, and they are associated with perturbations in amino acid metabolism, energy metabolism, glyoxylate and dicarboxylate metabolism. Furthermore, the present results showed that the Fischer ratio, which is the molar ratio of branched-chain amino acids to aromatic amino acids, was significantly lower (P < 0.001) in the blood serum obtained from the HAE patients than it was in the healthy patient group.ConclusionsThe altered Fischer ratio, together with perturbations in metabolic pathways identified in the present study, may provide new insights into the mechanistic understanding of HAE pathogenesis and potential therapeutic interventions.

Highlights

Hepatic alveolar echinococcosis (HAE) is caused by the growth of Echinococcus multilocularis larvae in the liver
After a long period of latent and asymptomatic stage, HAE can progress into a cirrhotic stage [6], or it can metastasize to other organs [7,8,9] and cause local organfunction impairment and metastatic infiltration [10]
All HAE patients were classified into six categories according to the parasite location within the liver (PNM) classification by World Health Organization (WHO)/ informal working group on echinococcosis (IWGE), as stated in methods

Summary

Introduction

Hepatic alveolar echinococcosis (HAE) is caused by the growth of Echinococcus multilocularis larvae in the liver. It is a chronic and potentially lethal parasitic disease. AE affects the liver in approximately 95% of diagnosed cases and is known as hepatic alveolar echinococcosis (HAE) [5]. HAE leads to liver-tissue injury or hepatic failure primarily through an infiltrative behaviour. It resembles the infiltrative proliferation of tumour growth and is clinically known as “worm cancer” or “parasite liver cancer”. After a long period of latent and asymptomatic stage, HAE can progress into a cirrhotic stage [6], or it can metastasize to other organs (e.g. the lungs and brain) [7,8,9] and cause local organfunction impairment and metastatic infiltration [10]

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