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Fingerprinting Acute Digestive Diseases by Untargeted NMR Based Metabolomics

Giotto Biotech, S.r.l, Via Madonna del Piano 6, 50019 Sesto Fiorentino, Italy
Department of Surgery and Translational Medicine, School of Medicine, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
Department of Emergency Medicine and Surgery, Careggi University Hospital, 50134 Florence, Italy
Magnetic Resonance Center (CERM), University of Florence, Via L. Sacconi 6, 50019 Sesto Fiorentino, Italy
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2018, 19(11), 3288;
Received: 24 September 2018 / Revised: 18 October 2018 / Accepted: 19 October 2018 / Published: 23 October 2018
(This article belongs to the Special Issue Metabonomics in Gastroenterology and Hepatology)
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Precision medicine may significantly contribute to rapid disease diagnosis and targeted therapy, but relies on the availability of detailed, subject specific, clinical information. Proton nuclear magnetic resonance (1H–NMR) spectroscopy of body fluids can extract individual metabolic fingerprints. Herein, we studied 64 patients admitted to the Florence main hospital emergency room with severe abdominal pain. A blood sample was drawn from each patient at admission, and the corresponding sera underwent 1H–NMR metabolomics fingerprinting. Unsupervised Principal Component Analysis (PCA) analysis showed a significant discrimination between a group of patients with symptoms of upper abdominal pain and a second group consisting of patients with diffuse abdominal/intestinal pain. Prompted by this observation, supervised statistical analysis (Orthogonal Partial Least Squares–Discriminant Analysis (OPLS-DA)) showed a very good discrimination (>90%) between the two groups of symptoms. This is a surprising finding, given that neither of the two symptoms points directly to a specific disease among those studied here. Actually herein, upper abdominal pain may result from either symptomatic gallstones, cholecystitis, or pancreatitis, while diffuse abdominal/intestinal pain may result from either intestinal ischemia, strangulated obstruction, or mechanical obstruction. Although limited by the small number of samples from each of these six conditions, discrimination of these diseases was attempted. In the first symptom group, >70% discrimination accuracy was obtained among symptomatic gallstones, pancreatitis, and cholecystitis, while for the second symptom group >85% classification accuracy was obtained for intestinal ischemia, strangulated obstruction, and mechanical obstruction. No single metabolite stands up as a possible biomarker for any of these diseases, while the contribution of the whole 1H–NMR serum fingerprint seems to be a promising candidate, to be confirmed on larger cohorts, as a first-line discriminator for these diseases. View Full-Text
Keywords: acute digestive disease; biliary colic; pancreatitis; metabolomics; intestinal ischemia; ileus; intestinal strangulated obstruction acute digestive disease; biliary colic; pancreatitis; metabolomics; intestinal ischemia; ileus; intestinal strangulated obstruction

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Takis, P.G.; Taddei, A.; Pini, R.; Grifoni, S.; Tarantini, F.; Bechi, P.; Luchinat, C. Fingerprinting Acute Digestive Diseases by Untargeted NMR Based Metabolomics. Int. J. Mol. Sci. 2018, 19, 3288.

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