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Open AccessArticle

Multi-Platform Characterization of Cerebrospinal Fluid and Serum Metabolome of Patients Affected by Relapsing–Remitting and Primary Progressive Multiple Sclerosis

1
Department of Biomedical Sciences, Clinical Metabolomics Unit, University of Cagliari, 09121 Cagliari, Italy
2
Multiple Sclerosis Centre, Department of Medical Sciences and Public Health, Binaghi Hospital, University of Cagliari, via Is Guadazzonis 2, 09126 Cagliari, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2020, 9(3), 863; https://doi.org/10.3390/jcm9030863
Received: 24 February 2020 / Accepted: 17 March 2020 / Published: 21 March 2020
(This article belongs to the Section Clinical Neurology)
Background: Multiple sclerosis (MS) is a chronic immunemediated disease of the central nervous system with a highly variable clinical presentation and disease progression. In this study, we investigate the metabolomics profile of patients affected by relapsing–remitting MS (RRMS)and primary progressive MS (PPMS), in order to find potential biomarkers to distinguish between the two forms. Methods: Cerebrospinal Fluid CSF and blood samples of 34 patients (RRMS n = 22, PPMS n = 12) were collected. Nuclear magnetic resonance (1H-NMR) and mass spectrometry (coupled with a gas chromatography and liquid chromatography) were used as analytical techniques. Subsequently, a multivariate statistical analysis was performed; the resulting significant variables underwent U-Mann–Whitney test and correction for multiple comparisons. Receiver Operating Characteristic ROC curves were built and the pathways analysis was conducted. Results: The analysis of the serum and the CSF of the two classes, allowed the identification of several altered metabolites (lipids, biogenic amines, and amino acids). The pathways analysis indicated the following pathways were affected: Glutathione metabolism, nitrogen metabolism, glutamine–glutamate metabolism, arginine–ornithine metabolism, phenylalanine, tyrosine and tryptophan biosynthesis etc. Conclusion: The analysis allowed the identification of a set of metabolites able to classify RRMS and PPMS patients, each of whom express different patterns of metabolites in the two biofluids. View Full-Text
Keywords: multiple sclerosis; metabolomics; nuclear magnetic resonance; mass spectrometry; biomarkers; pathways analysis multiple sclerosis; metabolomics; nuclear magnetic resonance; mass spectrometry; biomarkers; pathways analysis
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Murgia, F.; Lorefice, L.; Poddighe, S.; Fenu, G.; Secci, M.A.; Marrosu, M.G.; Cocco, E.; Atzori, L. Multi-Platform Characterization of Cerebrospinal Fluid and Serum Metabolome of Patients Affected by Relapsing–Remitting and Primary Progressive Multiple Sclerosis. J. Clin. Med. 2020, 9, 863.

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