Human genetic and metabolite variation reveals that methylthioadenosine is a prognostic biomarker and an inflammatory regulator in sepsis.
Author(s)
Type
Journal Article
Abstract
Sepsis is a deleterious inflammatory response to infection with high mortality. Reliable sepsis biomarkers could improve diagnosis, prognosis, and treatment. Integration of human genetics, patient metabolite and cytokine measurements, and testing in a mouse model demonstrate that the methionine salvage pathway is a regulator of sepsis that can accurately predict prognosis in patients. Pathway-based genome-wide association analysis of nontyphoidal Salmonella bacteremia showed a strong enrichment for single-nucleotide polymorphisms near the components of the methionine salvage pathway. Measurement of the pathway's substrate, methylthioadenosine (MTA), in two cohorts of sepsis patients demonstrated increased plasma MTA in nonsurvivors. Plasma MTA was correlated with levels of inflammatory cytokines, indicating that elevated MTA marks a subset of patients with excessive inflammation. A machine-learning model combining MTA and other variables yielded approximately 80% accuracy (area under the curve) in predicting death. Furthermore, mice infected with Salmonella had prolonged survival when MTA was administered before infection, suggesting that manipulating MTA levels could regulate the severity of the inflammatory response. Our results demonstrate how combining genetic data, biomolecule measurements, and animal models can shape our understanding of disease and lead to new biomarkers for patient stratification and potential therapeutic targeting.
Date Issued
2017-03-08
Date Acceptance
2017-02-03
Citation
Science Advances, 2017, 3 (3)
ISSN
2375-2548
Publisher
American Association for the Advancement of Science
Journal / Book Title
Science Advances
Volume
3
Issue
3
Copyright Statement
2017 © The Authors,
some rights reserved;
exclusive licensee
American Association
for the Advancement
of Science. Distributed
under a Creative
Commons Attribution
NonCommercial
License 4.0 (CC BY-NC).
some rights reserved;
exclusive licensee
American Association
for the Advancement
of Science. Distributed
under a Creative
Commons Attribution
NonCommercial
License 4.0 (CC BY-NC).
Identifier
PII: 1602096
Subjects
APIP
SIRS
Salmonella
biomarker
cytokine
inflammation
methionine salvage
methylthioadenosine
pyroptosis
sepsis
Publication Status
Published online
Article Number
e1602096