Differences between infected and noninfected synovial fluid: an observational study using metabolic phenotyping (or “metabonomics

Bone & Joint Research

article

Pouya Akhbari¹  Matthew K. Jaggard¹  Claire L. Boulangé²  Uddhav Vaghela³  Gonçalo Graça²  Rajarshi Bhattacharya¹  John C. Lindon²  Horace R. T. Williams⁴  Chinmay M. Gupte¹ 

[1] Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust;Department of Metabolism, Digestion and Reproduction, Imperial College London;Department of Surgery and Cancer, Imperial College London;Department of Digestive Diseases, Imperial College London

关键词: Metabolic profiling;    Metabonomics;    Nuclear magnetic resonance spectroscopy;    Infection;    Synovial fluid;   

DOI  :  10.1302/2046-3758.101.BJR-2020-0285.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsThe diagnosis of joint infections is an inexact science using combinations of blood inflammatory markers and microscopy, culture, and sensitivity of synovial fluid (SF). There is potential for small molecule metabolites in infected SF to act as infection markers that could improve accuracy and speed of detection. The objective of this study was to use nuclear magnetic resonance (NMR) spectroscopy to identify small molecule differences between infected and noninfected human SF.MethodsIn all, 16 SF samples (eight infected native and prosthetic joints plus eight noninfected joints requiring arthroplasty for end-stage osteoarthritis) were collected from patients. NMR spectroscopy was used to analyze the metabolites present in each sample. Principal component analysis and univariate statistical analysis were undertaken to investigate metabolic differences between the two groups.ResultsA total of 16 metabolites were found in significantly different concentrations between the groups. Three were in higher relative concentrations (lipids, cholesterol, and N-acetylated molecules) and 13 in lower relative concentrations in the infected group (citrate, glycine, glycosaminoglycans, creatinine, histidine, lysine, formate, glucose, proline, valine, dimethylsulfone, mannose, and glutamine).ConclusionMetabolites found in significantly greater concentrations in the infected cohort are markers of inflammation and infection. They play a role in lipid metabolism and the inflammatory response. Those found in significantly reduced concentrations were involved in carbohydrate metabolism, nucleoside metabolism, the glutamate metabolic pathway, increased oxidative stress in the diseased state, and reduced articular cartilage breakdown. This is the first study to demonstrate differences in the metabolic profile of infected and noninfected human SF, using a noninfected matched cohort, and may represent putative biomarkers that form the basis of new diagnostic tests for infected SF.

【 授权许可】

CC BY-NC