Distinct Urinary Metabolic Profile in Rheumatoid Arthritis Patients: A Possible Link between Diet and Arthritis Phenotype

被引:2
作者
Koh, Jung Hee [1 ]
Park, Yune-Jung [2 ]
Lee, Saseong [3 ]
Hong, Young-Shick [4 ]
Hong, Kwan Soo [5 ]
Yoo, Seung-Ah [3 ]
Cho, Chul-Soo [2 ,3 ]
Kim, Wan-Uk [2 ,3 ]
机构
[1] Pusan Natl Univ Hosp, Div Rheumatol, Dept Internal Med, Busan, South Korea
[2] Catholic Univ Korea, Div Rheumatol, Dept Internal Med, Coll Med, Seoul, South Korea
[3] Catholic Univ Korea, Ctr Integrat Rheumatoid Transcript & Dynam, Seoul, South Korea
[4] Chonnam Natl Univ, Div Food & Nutr, Gwangju, South Korea
[5] Korea Basic Sci Inst, Bioimaging Res Team, Cheongju, South Korea
来源
JOURNAL OF RHEUMATIC DISEASES | 2019年 / 26卷 / 01期
基金
新加坡国家研究基金会;
关键词
Rheumatoid arthritis; Urine; Metabolomics; Trimethylamine-N-oxide; Diet; DISEASE-ACTIVITY; P-CRESOL; SHARP/VAN; COLLAGEN; HEIJDE;
D O I
10.4078/jrd.2019.26.1.46
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. We undertook this study to investigate the discriminant metabolites in urine from patients with established rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and from healthy individuals. Methods. Urine samples were collected from 148 RA patients, 41 SLE patients and 104 healthy participants. The urinary metabolomic profiles were assessed using H-1 nuclear magnetic resonance spectroscopy. The relationships between discriminant metabolites and clinical variables were assessed. Collagen-induced arthritis was induced in mice to determine if a choline-rich diet reduces arthritis progression. Results. The urinary metabolic fingerprint of patients with established RA differs from that of healthy controls and SLE patients. Markers of altered gut microbiota (trimethylamine-N-oxide, TMAO), and oxidative stress (dimethylamine) were upregulated in patients with RA. In contrast, markers of mitochondrial dysfunction (citrate and succinate) and metabolic waste products (p-cresol sulfate, p-CS) were downregulated in patients with RA. TMAO and dimethylamine were negatively associated with serum inflammatory markers in RA patients. In particular, patients with lower p-CS levels exhibited a more rapid radiographic progression over two years than did those with higher p-CS levels. The in vivo functional study demonstrated that mice fed with 1% choline, a source of TMAO experienced a less severe form of collagen-induced arthritis than did those fed a control diet. Conclusion. Patients with RA showed a distinct urinary metabolomics pattern. Urinary metabolites can reflect a pattern indicative of inflammation and accelerated radiographic progression of RA. A choline-rich diet reduces experimentally-induced arthritis. This finding suggests that the interaction between diet and the intestinal microbiota contributes to the RA phenotype.
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页码:46 / +
页数:13
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