Serum 5-Hydroxyindoleacetic Acid and Ratio of 5-Hydroxyindoleacetic Acid to Serotonin as Metabolomics Indicators for Acute Oxidative Stress and Inflammation in Vancomycin-Associated Acute Kidney Injury.
Hyun-Seung LeeSang-Mi KimJa Hyun JangHyung-Doo ParkSoo-Youn LeePublished in: Antioxidants (Basel, Switzerland) (2021)
The incidence of vancomycin-associated acute kidney injury (VAKI) varies from 5-43%, and early detection of VAKI is important in deciding whether to discontinue nephrotoxic agents. Oxidative stress is the main mechanism of VAKI, and serotonin (5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) have been examined with respect to their involvement in ischemia/reperfusion damage in experimental animal models. In the current study, we assessed 5-HT and 5-HIAA as novel biomarkers for detecting VAKI in patients who have infections or compromised renal function, using a mass spectrometry-based metabolomics approach. We conducted amino acid profiling analysis and measurements of 5-HT and 5-HIAA using serum from subjects with VAKI (n = 28) and non-VAKI control subjects (n = 69), consisting of the infection subgroup (n = 23), CKD subgroup (n = 23), and healthy controls (HCs, n = 23). 5-HT was significantly lower in the VAKI group than in the non-VAKI groups, and the concentration of 5-HIAA and the ratio of 5-HIAA to 5-HT (5-HIAA/5-HT) showed higher values in the VAKI group. The infection subgroup presented a significantly greater 5-HIAA/5-HT ratio compared with the HC subgroup. Our study revealed that increased 5-HIAA/5-HT ratio has the potential to act as a VAKI surrogate marker, reflecting acute oxidative stress and inflammation.
Keyphrases
- oxidative stress
- acute kidney injury
- mass spectrometry
- end stage renal disease
- chronic kidney disease
- dna damage
- amino acid
- ischemia reperfusion injury
- randomized controlled trial
- induced apoptosis
- newly diagnosed
- methicillin resistant staphylococcus aureus
- risk assessment
- ejection fraction
- respiratory failure
- staphylococcus aureus
- clinical trial
- phase iii
- patient reported outcomes
- liquid chromatography
- extracorporeal membrane oxygenation
- prognostic factors
- climate change
- endoplasmic reticulum stress
- ms ms
- open label
- gas chromatography
- capillary electrophoresis
- tandem mass spectrometry
- heat shock protein