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Metabolites
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Inflammatory Biomarkers in Critical Patients
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Inflammatory Biomarkers in Critical Patients

A special issue of Metabolites (ISSN 2218-1989).

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 9163

Special Issue Editor

Prof. Dr. Elena Planells

E-Mail Website
Guest Editor
Department of Physiology, University of Granada, 18071 Granada, Spain
Interests: critically ill patients; micronutrients; vitamins; minerals; nutritional assessment; requirements; biomarkers; antioxidants; oxidative stress; inflammation; infection; supplementation; metabolism
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Critically ill patients present with systemic inflammation caused by their hypercatabolic situation, mediated by acute oxidative stress and associated biomarker mobilisation. This results in compartmental redistribution and accelerated depletion of micronutrients and molecules that are indispensable for the balance of antioxidant systems and homeostasis, and thus, are necessary in a critical state. This leads to a worse outcome and prognosis throughout the intensive care unit (ICU) stay. Monitoring of associated biomarkers may be key in dealing with the inflammatory process suffered by the critically ill patient during their ICU stay, helping to optimise the therapeutic strategy and improve outcomes. This Special Issue will include research articles and reviews related to critical patients of any aetiology and the implications in the behaviour of biomarkers involved in inflammatory processes, which may be related to oxidative stress and antioxidant status, alterations in nutritional status, infectious processes, cell-mediated immune dysfunctions, etc.

Prof. Dr. Elena Planells
Guest Editor

Manuscript Submission Information

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Keywords

  • critical
  • inflammation
  • oxidative stress
  • biomarkers
  • SIRS

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Published Papers (5 papers)

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Research

9 pages, 936 KiB  
Article
Relationship of Thyroid Function with Renal Hemodynamics and Cholesterol Metabolism in Proteinuric Kidney Disease: A Pilot Study
by Yoshitaka Iwazu, Kazuhiko Kotani, Taro Sugase, Daisuke Nagata and Toshiyuki Yamada
Metabolites 2024, 14(2), 111; https://doi.org/10.3390/metabo14020111 - 7 Feb 2024
Cited by 1 | Viewed by 1612
Abstract
Nephrotic syndrome and hypothyroidism are respectively reported to influence renal hemodynamics and hypercholesterolemia. However, the relationship of proteinuria-associated thyroid function with renal hemodynamics and cholesterol metabolism has yet to be determined in a simultaneous analysis of thyroid, renal, and cholesterol variables. We investigated [...] Read more.
Nephrotic syndrome and hypothyroidism are respectively reported to influence renal hemodynamics and hypercholesterolemia. However, the relationship of proteinuria-associated thyroid function with renal hemodynamics and cholesterol metabolism has yet to be determined in a simultaneous analysis of thyroid, renal, and cholesterol variables. We investigated the hypothesis that the changes in thyroid hormones by proteinuria may contribute to changes in cholesterol metabolism and renal hemodynamics by proteinuria. Twenty-nine patients (17 men and 12 women) with proteinuric kidney disease (mean age 46 years) were enrolled in a pilot study. Data for serum free triiodothyronine (FT3), free thyroxine (FT4), total cholesterol, and filtration fraction (FF; assessed by para-aminohippuric acid clearance) were used in variable-adjusted correlation analyses. The patients had the following data (mean ± standard deviation): urinary protein 5.18 ± 3.28 g/day, FT3 2.18 ± 0.44 pg/mL, FT4 1.03 ± 0.26 ng/dL, FF 0.27 ± 0.07, and total cholesterol 327 ± 127 mg/dL. There was a significant positive correlation of FT3 with FF (β = 0.58, p = 0.01) and a significant inverse correlation of FT4 with total cholesterol (β = −0.40, p = 0.01). A positive correlation of FT3 with FF and an inverse correlation of FT4 with total cholesterol were demonstrated in patients with proteinuric kidney disease. The proteinuria-associated reduction in serum thyroid hormone levels was correlated with hypercholesterolemia and the reduced glomerular FF. Further studies of these relationships are required. Full article
(This article belongs to the Special Issue Inflammatory Biomarkers in Critical Patients)
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22 pages, 5556 KiB  
Article
Impact of Reperfusion on Plasma Oxylipins in ST-Segment Elevation Myocardial Infarction
by Zahra Solati, Arun Surendran, Harold M. Aukema and Amir Ravandi
Metabolites 2024, 14(1), 19; https://doi.org/10.3390/metabo14010019 - 27 Dec 2023
Viewed by 1700
Abstract
ST-segment elevation myocardial infarction (STEMI) occurs as a result of acute occlusion of the coronary artery. Despite successful reperfusion using primary percutaneous coronary intervention (PPCI), a large percentage of myocardial cells die after reperfusion, which is recognized as ischemia/reperfusion injury (I/R). There are [...] Read more.
ST-segment elevation myocardial infarction (STEMI) occurs as a result of acute occlusion of the coronary artery. Despite successful reperfusion using primary percutaneous coronary intervention (PPCI), a large percentage of myocardial cells die after reperfusion, which is recognized as ischemia/reperfusion injury (I/R). There are rapid changes in plasma lipidome during myocardial reperfusion injury. However, the impact of coronary artery reperfusion on plasma oxylipins is unknown. This study aimed to investigate alterations in the oxylipin profiles of STEMI patients during ischemia and at various reperfusion time points following PPCI. Blood samples were collected from patients presenting with STEMI prior to PPCI (Isch, n = 45) and subsequently 2 h following successful reperfusion by PPCI (R-2 h, n = 42), after 24 h (R-24 h, n = 44), after 48 h (R-48 h, n = 43), and then 30 days post PPCI (R-30 d, n = 29). As controls, blood samples were collected from age- and sex-matched patients with non-obstructive coronary artery disease after diagnostic coronary angiography. High-performance liquid chromatography–mass spectrometry (HPLC-MS/MS) using deuterated standards was used to identify and quantify oxylipins. In patients presenting with STEMI prior to reperfusion (Isch group), the levels of docosahexaenoic acid (DHA)-derived oxylipins were significantly higher when compared with controls. Their levels were also significantly correlated with the peak levels of creatine kinase (CK) and troponin T(TnT) before reperfusion (CK: r = 0.33, p = 0.046, TnT: r = 0.50, p = 1.00 × 10−3). The total concentrations of oxylipins directly produced by 5-lipoxygenase (5-LOX) were also significantly elevated in the Isch group compared with controls. The ratio of epoxides (generated through epoxygenase) to diols (generated by soluble epoxide hydrolysis (sEH)) was significantly lower in the Isch group compared with the controls. Following reperfusion, there was an overall reduction in plasma oxylipins in STEMI patients starting at 24 h post PPCI until 30 days. Univariate receiver operating characteristic (ROC) curve analysis also showed that an elevated ratio of epoxides to diols during ischemia is a predictor of smaller infarct size in patients with STEMI. This study revealed a large alteration in plasma oxylipins in patients presenting with STEMI when compared with controls. Total oxylipin levels rapidly reduced post reperfusion with stable levels reached 24 h post reperfusion and maintained for up to 30 days post infarct. Given the shifts in plasma oxylipins following coronary artery reperfusion, further research is needed to delineate their clinical impact in STEMI patients. Full article
(This article belongs to the Special Issue Inflammatory Biomarkers in Critical Patients)
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15 pages, 1461 KiB  
Article
Developing A Baseline Metabolomic Signature Associated with COVID-19 Severity: Insights from Prospective Trials Encompassing 13 U.S. Centers
by Kaifeng Yang, Zhiyu Kang, Weihua Guan, Sahar Lotfi-Emran, Zachary J. Mayer, Candace R. Guerrero, Brian T. Steffen, Michael A. Puskarich, Christopher J. Tignanelli, Elizabeth Lusczek and Sandra E. Safo
Metabolites 2023, 13(11), 1107; https://doi.org/10.3390/metabo13111107 - 24 Oct 2023
Viewed by 1845
Abstract
Metabolic disease is a significant risk factor for severe COVID-19 infection, but the contributing pathways are not yet fully elucidated. Using data from two randomized controlled trials across 13 U.S. academic centers, our goal was to characterize metabolic features that predict severe COVID-19 [...] Read more.
Metabolic disease is a significant risk factor for severe COVID-19 infection, but the contributing pathways are not yet fully elucidated. Using data from two randomized controlled trials across 13 U.S. academic centers, our goal was to characterize metabolic features that predict severe COVID-19 and define a novel baseline metabolomic signature. Individuals (n = 133) were dichotomized as having mild or moderate/severe COVID-19 disease based on the WHO ordinal scale. Blood samples were analyzed using the Biocrates platform, providing 630 targeted metabolites for analysis. Resampling techniques and machine learning models were used to determine metabolomic features associated with severe disease. Ingenuity Pathway Analysis (IPA) was used for functional enrichment analysis. To aid in clinical decision making, we created baseline metabolomics signatures of low-correlated molecules. Multivariable logistic regression models were fit to associate these signatures with severe disease on training data. A three-metabolite signature, lysophosphatidylcholine a C17:0, dihydroceramide (d18:0/24:1), and triacylglyceride (20:4_36:4), resulted in the best discrimination performance with an average test AUROC of 0.978 and F1 score of 0.942. Pathways related to amino acids were significantly enriched from the IPA analyses, and the mitogen-activated protein kinase kinase 5 (MAP2K5) was differentially activated between groups. In conclusion, metabolites related to lipid metabolism efficiently discriminated between mild vs. moderate/severe disease. SDMA and GABA demonstrated the potential to discriminate between these two groups as well. The mitogen-activated protein kinase kinase 5 (MAP2K5) regulator is differentially activated between groups, suggesting further investigation as a potential therapeutic pathway. Full article
(This article belongs to the Special Issue Inflammatory Biomarkers in Critical Patients)
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14 pages, 347 KiB  
Article
Effect of Pre-Hospital Intravenous Fluids on Initial Metabolic Acid-Base Status in Trauma Patients: A Retrospective Cohort Study
by Damien Bossel, Mylène Bourgeat, Olivier Pantet and Tobias Zingg
Metabolites 2023, 13(8), 937; https://doi.org/10.3390/metabo13080937 - 10 Aug 2023
Viewed by 1660
Abstract
Despite its known harmful effects, normal saline is still commonly used in the treatment of hypovolemia in polytrauma patients. Given the lack of pre-hospital research on this topic, the current study aims to assess the current practice of fluid administration during the pre-hospital [...] Read more.
Despite its known harmful effects, normal saline is still commonly used in the treatment of hypovolemia in polytrauma patients. Given the lack of pre-hospital research on this topic, the current study aims to assess the current practice of fluid administration during the pre-hospital phase of care and its effects on initial metabolic acid-base status in trauma patients. We extracted and completed data from patients recorded in the Lausanne University Hospital (CHUV) trauma registry between 2008 and 2019. Patients were selected according to their age, the availability of a blood gas analysis after arrival at the emergency room, data availability in the trauma registry, and the modality of arrival in the ED. The dominantly administered pre-hospital fluid was normal saline. No association between the type of fluid administered during the pre-hospital phase and the presence of hyperchloremic acidosis in the ED was observed. Full article
(This article belongs to the Special Issue Inflammatory Biomarkers in Critical Patients)
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13 pages, 988 KiB  
Article
Evolution of Status of Trace Elements and Metallothioneins in Patients with COVID-19: Relationship with Clinical, Biochemical, and Inflammatory Parameters
by Lourdes Herrera-Quintana, Héctor Vázquez-Lorente, Yenifer Gamarra-Morales, Jorge Molina-López and Elena Planells
Metabolites 2023, 13(8), 931; https://doi.org/10.3390/metabo13080931 - 9 Aug 2023
Cited by 1 | Viewed by 1325
Abstract
The inflammatory reaction and pathogenesis of COVID-19 may be modulated by circulating trace elements (Iron (Fe), Zinc (Zn), Copper (Cu), Manganese (Mn)) and Metallothioneins (MTs). Thus, the present study aimed to investigate their relationship with clinical, biochemical, and inflammatory parameters in patients with [...] Read more.
The inflammatory reaction and pathogenesis of COVID-19 may be modulated by circulating trace elements (Iron (Fe), Zinc (Zn), Copper (Cu), Manganese (Mn)) and Metallothioneins (MTs). Thus, the present study aimed to investigate their relationship with clinical, biochemical, and inflammatory parameters in patients with COVID-19 at the early Intensive Care Unit (ICU) phase. Critically ill patients (n = 86) were monitored from the first day of ICU admission until the third day of stay. Serum samples were used to assess mineral levels via Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and MT levels via differential pulse voltammetry. Levels of Cu and MTs were significantly decreased after 3 days (p < 0.05), increasing the prevalence of Cu-deficient values from 50% to 65.3% (p = 0.015). Fe and Zn were shown to have a predictive value for mortality and severity. The present study suggests trace element deficiency may be a risk factor during early ICU treatment of COVID-19, as it is related to different biochemical and clinical parameters, indicating a possible beneficial effect of restoring proper levels of these micronutrients. Full article
(This article belongs to the Special Issue Inflammatory Biomarkers in Critical Patients)
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