Abstract
BackgroundPlasmodium vivax is responsible for the majority of malarial infection in the Indian subcontinent. This species of the parasite is generally believed to cause a relatively benign form of the disease. However, recent reports from different parts of the world indicate that vivax malaria can also have severe manifestation. Host response to the parasite invasion is thought to be an important factor in determining the severity of manifestation. In this paper, attempt was made to determine the host metabolic response associated with P. vivax infection by means of NMR spectroscopy-based metabonomic techniques in an attempt to better understand the disease pathology.MethodsNMR spectroscopy of urine samples from P. vivax-infected patients, healthy individuals and non-malarial fever patients were carried out followed by multivariate statistical analysis. Two data analysis techniques were employed, namely, Principal Component Analysis [PCA] and Orthogonal Projection to Latent Structure Discriminant Analysis [OPLS-DA]. Several NMR signals from the urinary metabolites were further selected for univariate comparison among the classes.ResultsThe urine metabolic profiles of P. vivax-infected patients were distinct from those of healthy individuals as well as of non-malarial fever patients. A highly predictive model was constructed from urine profile of malarial and non-malarial fever patients. Several metabolites were found to be varying significantly across these cohorts. Urinary ornithine seems to have the potential to be used as biomarkers of vivax malaria. An increasing trend in pipecolic acid was also observed. The results suggest impairment in the functioning of liver as well as impairment in urea cycle.ConclusionsThe results open up a possibility of non-invasive analysis and diagnosis of P. vivax using urine metabolic profile. Distinct variations in certain metabolites were recorded, and amongst these, ornithine may have the potential of being used as biomarker of malaria. Pipecolic acid also showed increasing trend in the malaria patient compared to the other groups.
Highlights
Plasmodium vivax is responsible for the majority of malarial infection in the Indian subcontinent
This study reports on the understanding of the host metabolic changes in terms of the urinary metabolite profile of the P. vivax-infected patients
Urinary metabolite profile of malaria patients were found to be distinct from both healthy individuals and those of non-malarial fever patients
Summary
Plasmodium vivax is responsible for the majority of malarial infection in the Indian subcontinent. This species of the parasite is generally believed to cause a relatively benign form of the disease. Recent reports from different parts of the world indicate that vivax malaria can have severe manifestation. Attempt was made to determine the host metabolic response associated with P. vivax infection by means of NMR spectroscopy-based metabonomic techniques in an attempt to better understand the disease pathology. Followed by multivariate analyses using Principal Component Analysis [PCA] or Orthogonal Partial Least Square - Discriminant Analysis [OPLSDA] This provides the clustering of the samples into classes. Metabonomic analysis is being utilized in identification of novel biomarkers and/ or metabolic characterization during different diseases, such as diabetes [8] and congenital heart disease [9]
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