Journal Article Epublish 4 citations
PubMed: 36430566 DOI: 10.3390/ijms232214089
Alterations in the Kynurenine-Tryptophan Pathway and Lipid Dysregulation Are Preserved Features of COVID-19 in Hemodialysis.
Int J Mol Sci 23(22)
Authors: Max Schuller, Monika Oberhuber, Barbara Prietl, Elmar Zügner, Eva-Maria Prugger, Christoph Magnes, Alexander H Kirsch, Sabine Schmaldienst, Thomas Pieber, Marianne Brodmann, Alexander R Rosenkranz, Philipp Eller, Kathrin Eller
Affiliations
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
- Center for Biomarker Research in Medicine, CBmed GmbH, 8010 Graz, Austria.
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
- Institute for Biomedicine and Health Sciences (HEALTH), Joanneum Research Forschungsgesellschaft m.b.H. 8010 Graz, Austria.
- Klinikum Favoriten, Wiener Krankenanstaltenverbund, 1100 Vienna, Austria.
- Division of Angiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
- Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
Abstract
Coronavirus disease 2019 (COVID-19)-induced metabolic alterations have been proposed as a source for prognostic biomarkers and may harbor potential for therapeutic exploitation. However, the metabolic impact of COVID-19 in hemodialysis (HD), a setting of profound a priori alterations, remains unstudied. To evaluate potential COVID-19 biomarkers in end-stage kidney disease (CKD G5), we analyzed the plasma metabolites in different COVID-19 stages in patients with or without HD. We recruited 18 and 9 asymptomatic and mild, 11 and 11 moderate, 2 and 13 severely affected, and 10 and 6 uninfected HD and non-HD patients, respectively. Plasma samples were taken at the time of diagnosis and/or upon admission to the hospital and analyzed by targeted metabolomics and cytokine/chemokine profiling. Targeted metabolomics confirmed stage-dependent alterations of the metabolome in non-HD patients with COVID-19, which were less pronounced in HD patients. Elevated kynurenine levels and lipid dysregulation, shown by an increase in circulating free fatty acids and a decrease in lysophospholipids, could distinguish patients with moderate COVID-19 from non-infected individuals in both groups. Kynurenine and lipid alterations were also associated with ICAM-1 and IL-15 levels in HD and non-HD patients. Our findings support the kynurenine pathway and plasma lipids as universal biomarkers of moderate and severe COVID-19 independent of kidney function.
MeSH
Tryptophan, Kynurenine, Kidney, Biomarkers, Covid-19, Metabolomics, Plasma