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Sci Rep. 2018 Mar 6;8(1):4083. doi: 10.1038/s41598-018-22338-1.

The Use of Metabolomics and Inflammatory Mediator Profiling Provides a Novel Approach to Identifying Pediatric Appendicitis in the Emergency Department.

Author information

1
Bio-NMR Center, Department of Biological Sciences, University of Calgary, Calgary, AB, Canada.
2
Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada.
3
Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
4
Division of Pediatric Critical Care, University of Alberta, Edmonton, AB, Canada.
5
Department of Surgery, University of Calgary, Calgary, AB, Canada.
6
Department of Pediatrics, University of Calgary, Calgary, AB, Canada. graham.thompson@ahs.ca.
7
Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada. graham.thompson@ahs.ca.

Abstract

Multiplexed profiling approaches including various 'omics' platforms are becoming a new standard of biomarker development for disease diagnosis and prognosis. The present study applied an integrated metabolomics and cytokine profiling approach as a potential aid to the identification of pediatric appendicitis. Metabolic analysis using serum (n = 121) and urine (n = 102) samples, and cytokine analysis using plasma (n = 121) samples from children presenting to the Emergency Department with abdominal pain were performed. Comparisons between children with appendicitis vs. non-appendicitis abdominal pain, and with perforated vs. non-perforated appendicitis were made using multivariate statistics. Serum and urine biomarker patterns were statistically significantly different between groups. The combined serum metabolomics and inflammatory mediator model revealed clear separation between appendicitis and non-appendicitis abdominal pain (AUROC: 0.92 ± 0.03) as well as for perforated and non-perforated appendicitis (AUROC: 0.88 ± 0.05). Urine metabolic analysis also demonstrated distinction between the groups appendicitis and non-appendicitis abdominal pain (AUROC: 0.85 ± 0.04), and perforated and non-perforated appendicitis (AUROC: 0.98 ± 0.02). In children presenting to the Emergency Department with abdominal pain, metabolomics and inflammatory mediator profiling are capable of distinguishing children with appendicitis from those without. The approach also differentiates between severities of disease. These results provide an important first step towards a potential aid for improving appendicitis identification.

PMID:
29511263
PMCID:
PMC5840182
DOI:
10.1038/s41598-018-22338-1
[Indexed for MEDLINE]
Free PMC Article

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