Targeted metabolomic profiling of cerebrospinal fluid from patients with progressive multifocal leukoencephalopathy

PLoS One. 2020 Nov 24;15(11):e0242321. doi: 10.1371/journal.pone.0242321. eCollection 2020.

Abstract

Progressive multifocal leukoencephalopathy (PML), caused by JC polyomavirus, is a demyelinating disease of the central nervous system that primarily affects oligodendrocytes. It can cause significant morbidity and mortality. An early diagnosis is of high relevance as timely immune reconstitution is essential. However, diagnosis can be challenging if virus detection via cerebrospinal fluid (CSF) PCR remains negative. Hence, identifying CSF biomarkers for this disease is of crucial importance. We applied a targeted metabolomic screen to CSF from 23 PML patients and eight normal pressure hydrocephalus (NPH) patients as controls. Out of 188 potentially detectable metabolites, 48 (13 amino acids, 4 biogenic amines, 1 acylcarnitine, 21 phosphatidylcholines, 8 sphingolipids, and the sum of hexoses) passed the quality screen and were included in the analyses. Even though there was a tendency towards lower concentrations in PML (mostly of phosphatidylcholines and sphingomyelins), none of the differences between PML and controls in individual metabolite concentrations reached statistical significance (lowest p = 0.104) and there were no potential diagnostic biomarkers (highest area under the ROC curve 0.68). Thus, CSF metabolite changes in PML are likely subtle and possibly larger group sizes and broader metabolite screens are needed to identify potential CSF metabolite biomarkers for PML.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Case-Control Studies
  • Cerebrospinal Fluid / chemistry
  • Cerebrospinal Fluid / cytology
  • Cerebrospinal Fluid / metabolism*
  • Chromatography, High Pressure Liquid
  • Discriminant Analysis
  • Female
  • Humans
  • Least-Squares Analysis
  • Leukoencephalopathy, Progressive Multifocal / diagnosis*
  • Leukoencephalopathy, Progressive Multifocal / pathology
  • Male
  • Metabolome*
  • Metabolomics / methods
  • Middle Aged
  • Phosphatidylcholines / cerebrospinal fluid
  • ROC Curve
  • Sphingomyelins / cerebrospinal fluid
  • Tandem Mass Spectrometry

Substances

  • Phosphatidylcholines
  • Sphingomyelins

Grants and funding

This study was partly funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany’s Excellence Strategy – EXC 2155 – Projektnummer 390874280 (to MS). There was no additional external funding received for this study.