Correlation of Metabolic Profiles of Plasma and Cerebrospinal Fluid Of
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H OH metabolites OH Article Correlation of Metabolic Profiles of Plasma and Cerebrospinal Fluid of High-Grade Glioma Patients Artem D. Rogachev 1,2,* , Nikolay A. Alemasov 3 , Vladimir A. Ivanisenko 3 , Nikita V. Ivanisenko 3, Evgeniy V. Gaisler 1, Olga S. Oleshko 1 , Sergey V. Cheresiz 1 , Sergey V. Mishinov 4 , Vyacheslav V. Stupak 4 and Andrey G. Pokrovsky 1 1 V. Zelman Institute for Medicine and Psychology, Novosibirsk State University, Pirogov str., 2, 630090 Novosibirsk, Russia; [email protected] (E.V.G.); [email protected] (O.S.O.); [email protected] (S.V.C.); [email protected] (A.G.P.) 2 N. N. Vorozhtsov Novosibirsk Institute of Organic Chemistry, acad. Lavrentiev ave., 9, 630090 Novosibirsk, Russia 3 Institute of Cytology and Genetics of Siberian Branch of Russian Academy of Sciences, acad. Lavrentiev ave., 10, 630090 Novosibirsk, Russia; [email protected] (N.A.A.); [email protected] (V.A.I.); [email protected] (N.V.I.) 4 FSBI “Novosibirsk Research Institute of Traumatology and Orthopedics Named after Ya. L. Tsiviyan”, Frunze str., 17, 630091 Novosibirsk, Russia; [email protected] (S.V.M.); [email protected] (V.V.S.) * Correspondence: [email protected]; Tel.: +7-(383)-330-97-47 Abstract: This work compares the metabolic profiles of plasma and the cerebrospinal fluid (CSF) of the patients with high-grade (III and IV) gliomas and the conditionally healthy controls using the Citation: Rogachev, A.D.; Alemasov, wide-range targeted screening of low molecular metabolites by HPLC-MS/MS. The obtained data N.A.; Ivanisenko, V.A.; Ivanisenko, were analyzed using robust linear regression with Huber’s M-estimates, and a number of metabolites N.V.; Gaisler, E.V.; Oleshko, O.S.; with correlated content in plasma and CSF was identified. The statistical analysis shows a significant Cheresiz, S.V.; Mishinov, S.V.; Stupak, V.V.; Pokrovsky, A.G. Correlation of correlation of metabolite content in plasma and CSF samples for the majority of metabolites. Several Metabolic Profiles of Plasma and metabolites were shown to have high correlation in the control samples, but not in the glioma patients. Cerebrospinal Fluid of High-Grade This can be due to the specific metabolic processes in the glioma patients or to the damaged integrity Glioma Patients. Metabolites 2021, 11, of blood-brain barrier. The results of our study may be useful for the understanding of molecular 133. https://doi.org/10.3390/ mechanisms underlying the development of gliomas, as well as for the search of potential biomarkers metabo11030133 for the minimally invasive diagnostic procedures of gliomas. Academic Editors: Peter Meikle and Keywords: glioma; metabolomics; liquid chromatography; tandem mass spectrometry; plasma; Thusitha W. Rupasinghe cerebrospinal fluid Received: 21 December 2020 Accepted: 22 February 2021 Published: 25 February 2021 1. Introduction Publisher’s Note: MDPI stays neutral Gliomas, which represent the majority (81%) of malignant brain tumors, are classified with regard to jurisdictional claims in using WHO grade criteria into 4 grades based on increasing degree of anaplasia and aggres- published maps and institutional affil- siveness, with malignant gliomas comprising grades III and IV tumors. The most prevalent iations. glioma types include astrocytoma (WHO grade I–IV), oligodendroglioma (WHO grade II– III), and oligoastrocytomas (WHO grade II–III). High-grade gliomas include glioblastoma (WHO Grade IV astrocytoma), anaplastic (WHO Grade III) astrocytoma, anaplastic (WHO Grade III) oligodendroglioma and mixed (WHO Grade III) oligoastrocytomas [1,2]. The most common type of glioma is glioblastoma, which accounts for 82% of malignant Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. gliomas and has the worst survival prognosis, with only 5% of patients surviving 5 years This article is an open access article after diagnosis [1,2]. The 5-year survival rates for Grade III malignant gliomas are signif- distributed under the terms and icantly higher (~25% for anaplastic astrocytoma, 45% for anaplastic oligodendroglioma conditions of the Creative Commons and ~50% for mixed oligoastrocytic tumors [1]. A multimodal treatment including surgical Attribution (CC BY) license (https:// removal of tumor with a concomitant/adjuvant radio- and chemotherapy (temozolomide) creativecommons.org/licenses/by/ is the first-line standard-of-care for glioblastoma, the use of which increased the median 4.0/). survival to 15 months vs 12 months with radiotherapy alone [2]. Metabolites 2021, 11, 133. https://doi.org/10.3390/metabo11030133 https://www.mdpi.com/journal/metabolites Metabolites 2021, 11, 133 2 of 13 Although the clinical point of view exists that early diagnosis (and treatment) do not improve the outcomes in glioblastoma, an alternative opinion suggests that an early diagnosis and accurate tumor classification must become a cornerstone of an efficient personalized therapy [3]. In fact, the current diagnostic procedure for glioblastoma always results in a late diagnosis, since it relies on neurological tests and neuroimaging. Meanwhile, numerous studies underscore the importance of a maximum surgical removal of tumor mass up to the borders of the healthy surrounding tissue for a better survival and life expectancy of glioblastoma patients [3], which, in case of a brain tumor, is, apparently, less feasible with larger and more advanced late-diagnosed neoplasms. An early diagnosis of a brain tumor is, thus, an important task for the improvement of treatment efficiency and survival of the patients. The development of minimally invasive approaches for the early detection and classification of tumors is indispensable for choosing a more efficient therapeutic strategy. The malignant cells including those of brain tumors have been long known to pos- sess metabolic alterations [4–6]. These features are due to their enhanced survival and reproduction under the conditions when nutrients and oxygen are scarce, which may be caused by the gene mutations resulting in an altered functioning of different enzymatic pathways [7–9]. An apparent difference in the metabolic profiles of normal and malignant cells laid the groundwork for the development of diagnostic methods relying upon the identification of specific disease biomarkers. The study of brain tumor metabolome and the search for biomarkers indicative of brain tumor development and helpful in tumor grading or making the diagnosis of tumor recurrence pose an ongoing challenge, different instrumental approaches to which are being developed. The cerebrospinal fluid (CSF), which is secreted by the choroids plexus and the meninges, and circulates between brain ventricles and spinal subarachnoid space, is in- volved in a number of protection, metabolic and drainage functions. Consisting of ~80% of blood-derived and 20% of brain-derived components and being permanently renewed, it maintains the electrolytic and acid-base balance of the brain and supplies the nutrients and signal molecules to the neuronal and glial cells. Meanwhile, it serves as a lymphatic system for the CNS by draining off the wastes and neurotoxic products of brain metabolism. It also provides mechanical support and protection against brain traumas and is involved in intracranial pressure maintenance. Filtration of blood-derived immune molecules, such as the immunoglobulins and cytokines through the blood-brain barrier (BBB) into the CSF ensures the immunological function of the CSF. Finally, the CSF is directly involved in the circadian cycle control via its prostaglandin D2 (PGD2) and prostaglandin-D-synthase (PGDS) system [10]. The CSF is an important diagnostic tool for the search of biomarkers of brain diseases and dysfunctions. A number of published studies is dedicated to the identification of biomarkers of Parkinson’s and Alzheimer’s diseases, multiple sclerosis, etc. [11–14]. An apparent disadvantage of metabolomic approaches to the CSF analysis is the relative invasiveness of the CSF withdrawal procedure, which requires a lumbar puncture. A number of published studies presents the metabolomic screening for glioma biomark- ers in individual CSF [15,16] or plasma [17,18] samples. Meanwhile, a limited number of studies analyses the relative metabolite content in matched CSF and plasma samples in different pathologies, e.g., Alzheimer disease [19], and neither publication compares the matched CSF and plasma metabolite profiles in the patients with gliomas. Here, we present a wide-range metabolomic analysis of the CSF and blood plasma samples in the groups of glioma patients and conditionally healthy controls, as well as a correlation study of the metabolomic profiles of matched CSF/plasma samples in the individual study subjects. 2. Results and Discussion The plasma and CSF samples were obtained from each participant and analyzed in three replicates. As much as 289 metabolites (Table S1) were screened by HPLC-MS/MS using the approach described by Yuan et al. [20]. This approach consists of a targeted Metabolites 2021, 11, 133 3 of 14 Metabolites 2021, 11, 133 3 of 13 approach described by Yuan et al. [20]. This approach consists of a targeted analysis of metabolitesanalysis of metabolites in MRM mode in MRM using mode positive/negative using positive/negative polarity switching polarity switchingfollowed by followed a rela- tivebya quantitation relative quantitation of the compounds. of the compounds. After analysis After of analysis samples, of the samples, resulting the chromato- resulting gramschromatograms were integrated