Mapping the biochemical trajectory of nephrotoxicity by pattern recognition of NMR urinanalysis.
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Biomedical subjects
Publications and source records attributed to J K Nicholson.
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1H NMR spectra have been measured at 500 and 600 MHz on 23 human cerebrospinal fluid samples obtained at autopsy from Alzheimer's disease patients and controls. The spectra at 500 MHz were quantified using 42 descriptors based on NMR peak heights and it was shown that differences between the two classes were apparent in the delta 2.4-2.9 region. Remeasured at 600 MHz a detailed examination of this chemical shift range identified citrate, aspartate, N-acetyl aspartate, methionine and glutamate in this region of the spectra. Principal components analysis showed that a separation of the two classes was possible and detailed statistics indicated that citrate level was the principal marker. Patient age and the interval between death and autopsy (parameters not closely matched between the two groups) were examined statistically to establish whether these might account for the citrate differences. Although they could possibly account for them to some extent, the relationship between citrate levels and disease state remained significant at p < 0.05. The data invite a test of the importance of citrate levels in Alzheimer's disease using samples taken ex vivo.
The application of high-resolution 750 MHz 1H-NMR spectroscopy to a biological fluid is demonstrated for the first time and its advantages over 600 MHz 1H observation shown by reference to studies on human blood plasma. Improvements in signal dispersion were observed which facilitated improved signal assignments. Differences in lipid/lipoprotein signal line-widths between 600 and 750 MHz were noted indicating that ultrahigh field measurements may help to give insight into dynamic motional phenomena of lipids in whole plasma. The two-dimensional J-resolved (JRES) technique and spin-echo spectra measured at 750 MHz have enabled new signal assignments to be made in control plasma. The application of 750 MHz JRES to the clinical chemical problem of the detection of abnormal metabolites associated with chronic renal failure is also demonstrated.
Despite increasing attempts to control environmental pollution, changes in the distribution and bioavailability of toxic metals like mercury and cadmium are still occurring. Apart from natural processes, other contributory factors include the gradual spread of industrialization, the use of sewage sludge as a fertilizer and the acidification of Northern Hemisphere groundwater. Animals (including man and domestic varieties) can accumulate harmful concentrations of toxic metals. We therefore looked for damage to the kidneys in seabirds contaminated with mercury and cadmium and made comparisons with kidneys from three other groups of animals: seabirds from an uncontaminated colony, metal-dosed birds and metal-dosed mice. We report here that, comparing all these groups of animals, individuals with comparatively high levels of metals had nephrotoxic lesions of a similar type and severity. Moreover, the metal concentrations at which damage began and at which biochemical changes could be detected were below those presently considered as relatively safe for humans by the World Health Organization.
The identity of the human metabolites of ketoprofen (2-(3-benzoylphenyl)-propanoic acid) excreted via urine was investigated after a single oral dose of the racemic drug. Drug metabolites were concentrated and partially purified from urine using solid-phase extraction chromatography before separation and identification by directly coupled HPLC-MS and HPLC-NMR. The metabolites identified were the ester glucuronides of the parent drug and its phase I metabolites, 2-[3-(3-hydroxybenzoyl)phenyl]-propanoic acid, 2-[3-(4-hydroxybenzoyl)phenyl]-propanoic acid and 2-[3-(hydroxy(phenyl)methyl)phenyl]-propanoic acid, the latter formed by reduction of the ketone group of ketoprofen. In addition, two novel minor metabolites were identified as the ether glucuronides of 2-[3-(3-hydroxybenzoyl)phenyl]-propanoic acid and 2-[3-(4-hydroxybenzoyl)phenyl]-propanoic acid. These conjugates were all observed as diastereoisomeric pairs of unequal proportions. Purification of these metabolites by preparative chromatography allowed stereochemistry assignments. Metabolites were quantified by 1H-NMR spectroscopy after spectral simplification achieved by hydrolysis of the conjugates.
Metabolic fingerprints, in the form of patterns of high-concentration endogenous metabolites, of 1-nitronaphthalene (NN)-induced lung toxicity have been elucidated in bronchoalveolar lavage fluid (BALF), urine, blood plasma, and intact lung and liver tissue using NMR spectroscopy-based metabolic profiling. A single dose of NN (75 mg kg(-1)) was administered orally to Sprague-Dawley rats. BALF and lung tissue were obtained 24 h after dosing from these animals and matched control rats post-mortem. High-resolution (1)H-NMR spectroscopy of BALF samples indicated that NN caused increases in concentrations of choline, amino acids (leucine, isoleucine and alanine) and lactate together with decreased concentrations of succinate, citrate, creatine, creatinine and glucose. In addition, the intact lung weights were higher in the NN-treated group (p<0.01), consistent with pulmonary oedema. The NMR-detected perturbations indicated that NN induces a perturbation in energy metabolism in both lung and liver tissue, as well as surfactant production and osmolyte levels in the lungs. As well as reporting the first NMR spectroscopic combined examination of BALF and intact lung, this study indicates that such holistic approaches to investigating mechanisms of lung toxicity may be of value in evaluating disease progression or the effects of therapeutic intervention in pulmonary conditions such as surfactant disorders or asthma.
Major advances in nuclear magnetic resonance (NMR) spectroscopic methods and technology have led to the increased use of this technique to study kidney metabolism and function. These studies include: (1) the identification of organic osmolytes in the renal medulla and their role as potential markers of medullary development and damage; (2) changes in renal epithelial cell organic solute transport, such as autosomal dominant polycystic kidney disease, and (3) the biochemical heterogeneity of the nephron and identification of markers of site-specific renal damage in experimental animals and man. The present review summarises these data with the aim of demonstrating how NMR can be used as an indirect, and non-invasive probe of homeostatic mechanisms in vivo and in vitro.
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