NMR plasma metabolome discriminates subjects with dengue infection from non‐specific febrile infection

Abstract

Brazil has a very high incidence of dengue. In 2013, approximately 1,500,000 cases of dengue infection, which presents no specific treatments,and over 200 deaths were reported. We aim to investigate plasma metabolome of subjects presenting symptoms of dengue fever (DF; mild), dengue hemorrhagic fever (DHF; severe), and subjects with non‐specific infection (NS). Samples were obtained in a cohort with dengue patients in Recife, Brazil. Plasma metabolomic analyzes were carried out by 1H Nuclear Magnetic Resonance. Using multivariate analysis, plasma metabolome from NS was discriminated from DF and DHF subjects. Additionally, DF plasma metabolome presenting secondary Dengue infection varies during the course infection. Candidate metabolites that contributed to the discriminatory pattern include β‐hydroxybutirate, citrate, succinate, tyrosine and valine. Discriminating NS from dengue infection through plasma NMR‐based metabolomics indicates that these analyzes could provide insights into the underlying molecular mechanisms of dengue pathogenesis. Moreover, following plasma metabolome during the course of dengue infection could help discriminating individuals at risk to develop severe infection and to predict the disease outcome.