1H NMR urine metabolomics is an effective prognostic indicator in acute spinal cord injury (ASCI): A prospective case-control study

Alka Singh; Rajeshwar Nath Srivastava; Tanushri Chatterji; Suruchi Singh; Lavini Raj; Abbas Ali Mahdi; Ravindra Kumar Garg; Raja Roy

doi:10.5897/JMSB2020.0023

Journal of
Metabolomics and Systems Biology

Abbreviation: J. Metabolomics Syst. Biol.
Language: English
ISSN: 2805-4210
DOI: 10.5897/JMSB
Start Year: 2010
Published Articles: 10

Full Length Research Paper

1H NMR urine metabolomics is an effective prognostic indicator in acute spinal cord injury (ASCI): A prospective case-control study

Alka Singh

Alka Singh
Department of Orthopaedic Surgery, King Georgeâ€™s Medical University (KGMU), Shahmina Road, Chowk, Lucknow, Uttar Pradesh, India.
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Rajeshwar Nath Srivastava

Rajeshwar Nath Srivastava
Department of Orthopaedic Surgery, King Georgeâ€™s Medical University (KGMU), Shahmina Road, Chowk, Lucknow, Uttar Pradesh, India.
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Tanushri Chatterji

Tanushri Chatterji
Department of Microbiology, Dr. Ram Manohar Lohia Institute of Medical Sciences (RMLIMS), Vibhuti Khand, Gomti Nagar, Lucknow, Uttar Pradesh, India.
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Suruchi Singh

Suruchi Singh
Centre of Biomedical Research, formerly Centre of Biomedical Magnetic Resonance (CBMR), Sanjay Gandhi Postgraduate Institute of Medical Sciences Campus, Rae Bareli Road, Lucknow, Uttar Pradesh, India.
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Lavini Raj

Lavini Raj
Department of Orthopaedic Surgery, King Georgeâ€™s Medical University (KGMU), Shahmina Road, Chowk, Lucknow, Uttar Pradesh, India.
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Abbas Ali Mahdi

Abbas Ali Mahdi
Department of Biochemistry, King Georgeâ€™s Medical University (KGMU), Shahmina Road, Chowk, Lucknow, Uttar Pradesh, India.
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Ravindra Kumar Garg

Ravindra Kumar Garg
Department of Neurology, King Georgeâ€™s Medical University (KGMU), Shahmina Road, Chowk, Lucknow, Uttar Pradesh, India.
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Raja Roy

Raja Roy
Centre of Biomedical Research, formerly Centre of Biomedical Magnetic Resonance (CBMR), Sanjay Gandhi Postgraduate Institute of Medical Sciences Campus, Rae Bareli Road, Lucknow, Uttar Pradesh, India.
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Article Number - BC1C04564954
Vol.4(1), pp. 1-21 , October 2020
https://doi.org/10.5897/JMSB2020.0023

Received: 15 January 2020
Accepted: 26 August 2020
Published: 31 October 2020

Abstract

Acute spinal cord injury (ASCI) is an extremely overwhelming disease with high morbidity and mortality. Despite significant successes in understanding the pathophysiology of ASCI, little is known about limiting neurological damage and predicting recovery. Biofluid metabolomics by 1H NMR spectroscopy for metabolites quantification specific to nervous tissue injury may determine the injury and progression. This study evaluates the urinary metabolic profile in ASCI cases on two different treatment modalities. One forty participants were enrolled. Group-1, “healthy control, n=70”, ASCI cases in Group-2 “fixation with stem cells therapy, n=35” and ASCI cases in Group-3, “fixation alone n=35”. Urine samples were collected at baseline and regular follow-ups up to the 6th month for 1H NMR spectroscopy. The sample spectra were subjected to multivariate Orthogonal Partial Least Square Discriminant Analysis (OPLS-DA) and Variable Importance to the Projection (VIP) analysis. The significant metabolites were correlated with neurological recovery. Acetate, creatinine, creatine, creatine phosphate, urea, and phenylalanine were found to be significant. The 3D scattered score plots in OPLS-DA represented the shifting of cases towards control in the final follow-up. It was further substantiated on VIP score plots. The metabolic aberrations in urine with disease severity in ASCI could be a potential biomarker of neurological recovery.

Key words: NMR spectroscopy, metabolomics, acute spinal cord injury (ASCI), Asia impairment scale (AIS), neurological recovery.

Abbreviation

AIS, Asia impairment scale; ASCI, Acute Spinal Cord Injury; ASIA, American Spinal Injury Association; BM, bone marrow; CSF, cerebrospinal fluid; MNC, mono nuclear cells; MSCs or BMSCs, mesenchymal stem cells/ bone marrow mesenchymal stromal cells; NMR, nuclear magnetic resonance; NOESY, nuclear overhauser effect spectroscopy; OPLS-DA, orthogonal partial least square discriminant analysis; OSC-PCA, orthogonal signal correction-principal component analysis; SD, standard deviation; VIP, variables importance in projection.