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

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,^(1)H-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:Nacetylglucosamines,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.