Drs. Young and Kapoor contributed equally to this work.
The Impact of Inflammation on Metabolomic Profiles in Patients With Arthritis
Article first published online: 26 JUL 2013
© 2013 The Authors. Arthritis & Rheumatism is published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Arthritis & Rheumatism
Volume 65, Issue 8, pages 2015–2023, August 2013
How to Cite
Young, S. P., Kapoor, S. R., Viant, M. R., Byrne, J. J., Filer, A., Buckley, C. D., Kitas, G. D. and Raza, K. (2013), The Impact of Inflammation on Metabolomic Profiles in Patients With Arthritis. Arthritis & Rheumatism, 65: 2015–2023. doi: 10.1002/art.38021
- Issue published online: 26 JUL 2013
- Article first published online: 26 JUL 2013
- Accepted manuscript online: 5 JUN 2013 09:28AM EST
- Manuscript Accepted: 9 MAY 2013
- Manuscript Received: 9 NOV 2012
- Arthritis Research UK Clinical PhD Studentship. Grant Number: 18552
- Henry Wellcome Building for Biomolecular Nuclear Magnetic Resonance Spectroscopy at the University of Birmingham
- Wellcome Trust. Grant Number: 066490/Z/01/A
Inflammatory arthritis is associated with systemic manifestations including alterations in metabolism. We used nuclear magnetic resonance (NMR) spectroscopy–based metabolomics to assess metabolic fingerprints in serum from patients with established rheumatoid arthritis (RA) and those with early arthritis.
Serum samples were collected from newly presenting patients with established RA who were naive for disease-modifying antirheumatic drugs, matched healthy controls, and 2 groups of patients with synovitis of ≤3 months' duration whose outcomes were determined at clinical followup. Serum metabolomic profiles were assessed using 1-dimensional 1H-NMR spectroscopy. Discriminating metabolites were identified, and the relationships between metabolomic profiles and clinical variables including outcomes were examined.
The serum metabolic fingerprint in established RA was clearly distinct from that of healthy controls. In early arthritis, we were able to stratify the patients according to the level of current inflammation, with C-reactive protein correlating with metabolic differences in 2 separate groups (P < 0.001). Lactate and lipids were important discriminators of inflammatory burden in both early arthritis patient groups. The sensitivities and specificities of models to predict the development of either RA or persistent arthritis in patients with early arthritis were low.
The metabolic fingerprint reflects inflammatory disease activity in patients with synovitis, demonstrating that underlying inflammatory processes drive significant changes in metabolism that can be measured in the peripheral blood. The identification of metabolic alterations may provide insights into disease mechanisms operating in patients with inflammatory arthritis.