Assessment of periportal fibrosis in Schistosomiasis mansoni patients by proton nuclear magnetic resonance-based metabonomics models

World J Hepatol. 2022 Apr 27;14(4):719-728. doi: 10.4254/wjh.v14.i4.719.

Abstract

Background: The evaluation of periportal fibrosis (PPF) is essential for a prognostic assessment of patients with Schistosomiasis mansoni. The WHO Niamey Protocol defines patterns of fibrosis from abdominal ultrasonography, 1H-nuclear magnetic resonance (NMR)-based metabonomics has been employed to assess liver fibrosis in some diseases.

Aim: To build 1H-NMR-based metabonomics models (MM) to discriminate mild from significant periportal PPF and identify differences in the metabolite profiles.

Methods: A prospective cross-sectional study was performed on schistosomiasis patients at a University Hospital in Northeastern Brazil. We evaluated 41 serum samples from 10 patients with mild PPF (C Niamey pattern) and 31 patients with significant PPF (D/E/F Niamey patterns). MM were built using partial least squares-discriminant analysis (PLS-DA) and orthogonal projections to latent structures discriminant analysis (OPLS-DA) formalisms.

Results: PLS-DA and OPLS-DA resulted in discrimination between mild and significant PPF groups with R2 and Q2 values of 0.80 and 0.38 and 0.72 and 0.42 for each model, respectively. The OPLS-DA model presented accuracy, sensitivity, and specificity values of 92.7%, 90.3%, and 100% to discriminate significant PPF. The metabolites identified as responsible by discrimination were: N-acetylglucosamines, alanine, glycolaldehyde, carbohydrates, and valine.

Conclusion: MMs discriminated mild from significant PPF patterns in patients with Schistosomiasis mansoni through identification of differences in serum metabolites profiles.

Keywords: Biomarkers; Metabolomics; Neglected disease; Nuclear magnetic resonance; Portal hypertension; Schistosoma mansoni.