NMR metabolomics of cerebrospinal fluid differentiates inflammatory diseases of the central nervous system.

BACKGROUND:Myriad infectious and noninfectious causes of encephalomyelitis (EM) have similar clinical manifestations, presenting serious challenges to diagnosis and treatment. Metabolomics of cerebrospinal fluid (CSF) was explored as a method of differentiating among neurological diseases causing EM...

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Bibliographic Details
Published in:PLOS Neglected Tropical Diseases
Main Authors: Caitlin D French, Rodney E Willoughby, Amy Pan, Susan J Wong, John F Foley, L Joseph Wheat, Josefina Fernandez, Rafael Encarnacion, Joanne M Ondrush, Naaz Fatteh, Andres Paez, Dan David, Waleed Javaid, Ioana G Amzuta, Anne M Neilan, Gregory K Robbins, Andrew M Brunner, William T Hu, Darya O Mishchuk, Carolyn M Slupsky
Format: Article in Journal/Newspaper
Language:English
Published: Public Library of Science (PLoS) 2018
Subjects:
Arctic medicine. Tropical medicine
RC955-962
Public aspects of medicine
RA1-1270
Arctic
Online Access:https://doi.org/10.1371/journal.pntd.0007045
https://doaj.org/article/3aa1082067824612992ccdc101c68946
Description
Summary:BACKGROUND:Myriad infectious and noninfectious causes of encephalomyelitis (EM) have similar clinical manifestations, presenting serious challenges to diagnosis and treatment. Metabolomics of cerebrospinal fluid (CSF) was explored as a method of differentiating among neurological diseases causing EM using a single CSF sample. METHODOLOGY/PRINCIPAL FINDINGS:1H NMR metabolomics was applied to CSF samples from 27 patients with a laboratory-confirmed disease, including Lyme disease or West Nile Virus meningoencephalitis, multiple sclerosis, rabies, or Histoplasma meningitis, and 25 controls. Cluster analyses distinguished samples by infection status and moderately by pathogen, with shared and differentiating metabolite patterns observed among diseases. CART analysis predicted infection status with 100% sensitivity and 93% specificity. CONCLUSIONS/SIGNIFICANCE:These preliminary results suggest the potential utility of CSF metabolomics as a rapid screening test to enhance diagnostic accuracies and improve patient outcomes.

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