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

Abstract Hepatic alveolar echinococcosis (HAE) is a chronic and potentially lethal parasitic disease. It is caused by growth of Echinococcus multilocularis larvae in liver. To date, early-stage diagnosis for the disease is not mature due to its long asymptomatic incubation period. In this study, a proton nuclear magnetic resonance ( 1 H NMR) -based metabolomics approach was applied in conjunction with multivariate statistical analysis to investigate the altered metabolic profiles in blood serum and urine samples from HAE patients and to identify characteristic metabolic markers associated with HAE. The current results identified 21 distinctive metabolic difference between the HAE patients and healthy individuals, which can be associated with perturbations in energy metabolism, amino acid metabolism, oxidative stress, and neurotransmitter imbalance. In addition, the Fischer ratio, which is the molar ratio of branched-chain amino acids to aromatic amino acids was found significantly lower ( p <0.001) in blood serum from HAE patients. The ratio, together with changes in other metabolic pathways may provide new insight into mechanistic understanding of HAE pathogenesis, and may be useful for early-stage HAE diagnosis. Author Summary Hepatic alveolar echinococcosis (HAE) is a life-threatening disease caused by Echinococcus multilocularis infection. The disease has a long asymptomatic early stage (5~15 years), which complicates effective diagnosis of early-stage HAE even with advanced imaging techniques. Metabolomics is an emerging analytical platform that comprises of analysis of all small molecule metabolites that are present within an organism. The applications of metabolomics method on HAE may help to reveal the molecular biology mechanisms of HAE. In the current study, we had used 1 H NMR-based metabolomics technique to investigate blood serum and urine samples from HAE patients. Altered metabolic responses and characteristic differential metabolites for HAE were identified. The metabolic profiling of human biofluids provided valuable information for early-stage HAE diagnosis and for therapeutic interventions, without having to extract HAE vesicles from patients. By featuring global and comprehensive metabolic status, the metabolomics approach holds considerable promise as a noninvasive, dynamic, and effective tool for probing the underlying mechanism of HAE.