Alanine, a potential amino acid biomarker of pediatric sepsis: a pilot study in PICU

• Published in: Amino acids Vol. 56; no. 1; p. 48
• Main Authors: Liu, Tiantian, Xu, Yaya, Hu, Shaohua, Feng, Shuyun, Zhang, Hong, Zhu, Xiaodong, Wang, Chunxia
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 27-07-2024; Springer Nature B.V
• Subjects: Alanine; Amino acids; Analytical Chemistry; Biochemical Engineering; Biochemistry; Biomarkers; Biomedical and Life Sciences; Brain injury; C-reactive protein; Correlation analysis; Demographic variables; Diagnosis; Diagnostic systems; Head injuries; Injury analysis; Kidney diseases; Kidneys; Life Sciences; Liver diseases; Lysine; Medical records; Metabolic disorders; Neurobiology; Original; Original Article; Patients; Pediatrics; Proteomics; Sepsis; Valine; Diagnostic biomarker; Sepsis; Alanine; Children; Amino acid profile
• ISSN: 1438-2199; 0939-4451; 1438-2199
• DOI: 10.1007/s00726-024-03408-3

Sepsis is characterized by a metabolic disorder of amino acid occurs in the early stage; however, the profile of serum amino acids and their alterations associated with the onset of sepsis remain unclear. Thus, our objective is to identify the specific kinds of amino acids as diagnostic biomarkers in pediatric patients with sepsis. Serum samples were collected from patients with sepsis admitted to the pediatric intensive care unit (PICU) between January 2019 and December 2019 on the 1
st
, 3
rd
and 7
th
day following admission. Demographic and laboratory variables were also retrieved from the medical records specified times. Serum amino acid concentrations were detected by UPLC-MS/MS system. PLS-DA (VIP > 1.0) and
Kruskal-Wallis
test (
p
 < 0.05) were employed to identify potential biomarkers.
Spearman’s
rank correlation analysis was conducted to find the potential association between amino acid levels and clinical features. The diagnostic utility for pediatric sepsis was assessed using receiver operating characteristic (
ROC
) curve analysis. Most of amino acid contents in serum were significantly decreased in patients with sepsis, but approached normal levels by the seventh day post-diagnosis. Threonine (THR), lysine (LYS), valine (VAL) and alanine (ALA) emerged as potential biomarkers related for sepsis occurrence, though they were not associated with PELOD/PELOD-2 scores. Moreover, alterations in serum THR, LYS and ALA were linked to complications of brain injury, and serum ALA levels were also related to sepsis-associated acute kidney injury. Further analysis revealed that ALA was significantly correlated with the
Glasgow
score, serum lactate and glucose levels, C-reactive protein (CRP), and other indicators for liver or kidney dysfunction. Notably, the area under the
ROC
curve (AUC) for ALA in distinguishing sepsis from healthy controls was 0.977 (95%
CI
: 0.925-1.000). The serum amino acid profile of children with sepsis is significantly altered compared to that of healthy controls. Notably, ALA shows promise as a potential biomarker for the early diagnosis in septic children.