Dynamic changes of serum metabolites associated with infection and severity of patients with acute hepatitis E infection

Dynamic changes in metabolites may affect liver disease progression, and provide new methods for predicting liver damage. We used ultra-performance liquid chromatography-mass spectroscopy to assess serum metabolites in healthy controls (HC), and patients with acute hepatitis E (AHE) or hepatitis E virus acute liver failure (HEV-ALF). The principal component analysis, partial least squares discriminant analysis, and discriminant analysis of orthogonal projections to latent structures models illustrated significant differences in the metabolite components between AHE patients and HCs, or between HEV-ALF and AHE patients. In pathway enrichment analysis, we further identified two altered pathways, including linoleic acid metabolism and phenylalanine, tyrosine, and tryptophan biosynthesis, when comparing AHE patients with HCs. Linoleic acid metabolism and porphyrin and chlorophyll metabolism pathways were significantly different in HEV-ALF when compared with AHE patients. The discriminative performances of differential metabolites showed that taurocholic acid, glycocholic acid, glycochenodeoxycholate-3-sulfate, and docosahexaenoic acid could be used to distinguish HEV-ALF from AHE patients. The serum levels of glycocholic acid, taurocholic acid, deoxycholic acid glycine conjugate, and docosahexaenoic acid were associated with the prognosis of HEV-ALF patients. Dynamic changes in serum metabolites were associated with AHE infection and severity. The identified metabolites can be used to diagnose and predict the prognosis of HEV-ALF.

Automated summary

This study investigates the dynamic changes in metabolites associated with liver disease progression, particularly in predicting the prognosis of hepatitis E virus acute liver failure (HEV-ALF). Ultra-performance liquid chromatography-mass spectroscopy was used to evaluate serum metabolites in healthy controls (HC), acute hepatitis E (AHE) patients, and HEV-ALF patients. Significant differences in metabolite components were observed between AHE patients and HC, as well as between HEV-ALF and AHE patients. Pathway enrichment analysis revealed altered linoleic acid metabolism and phenylalanine, tyrosine, and tryptophan biosynthesis pathways in AHE patients compared to HC. In HEV-ALF, the linoleic acid metabolism and porphyrin and chlorophyll metabolism pathways differed significantly from AHE patients. Differential metabolites such as taurocholic acid, glycocholic acid, glycochenodeoxycholate-3-sulfate, and docosahexaenoic acid showed discriminatory performance in distinguishing HEV-ALF from AHE patients. Serum levels of specific metabolites were associated with the prognosis of HEV-ALF patients. The dynamic changes in serum metabolites were found to be associated with AHE infection and severity, and the identified metabolites have the potential to be used for diagnosis and prognosis prediction of HEV-ALF.