Plasma lipidomic profile signature of rheumatoid arthritis versus Lyme arthritis patients

Objectives: Distinguishing of rheumatoid arthritis (RA) and Lyme arthritis (LA) is difficult, because of similar symptoms. This presents a significant clinical problem since treatments are quite different in both diseases. We investigated the plasma phospholipid profiles of RA and LA patients versus healthy subjects to find metabolic changes responsible for differentiation of both diseases. Methods: Plasma was collected from 9 RA, 9 LA, and 9 healthy subjects. Extracted lipids were analyzed using LC-MS/MS to characterize phospholipid profiles of RA, LA and healthy subjects. Principal components analysis (PCA), partial least squares-discriminate analysis (PLS-DA) and variable importance in projection (VIP) scores were used to estimate the importance of each phospholipid variable. Results: We identified 114 phospholipids in plasma. Phospholipid profiles were significantly different in RA and LA patients than in healthy subjects. Principal discriminant phospholipids between RA and LA groups were LPE (14:0), LPC(14:0) PI(18:0/20:4), PI(18:2/18:0), PI(16:1/18:2), PI(18:1/18:0), and PI(18:0/20:3). Conclusions: Our study provides insights into the alteration of the plasma phospholipid profile of LA patients, resulting from Borrelia burgdorferi infection, that may lead to improved LA diagnosis and differentiation of this disease from RA. Furthermore, LPE (14:0) was found to have a high potential to be a possible biomarker of LA.