Raman spectroscopy applied to identify metabolites in urine of physically active subjects

Disentangled global and local features of multi-source data variational autoencoder: An interpretable model for diagnosing IgAN via multi-source Raman spectral fusion techniques

A single Raman spectrum reflects limited molecular information. Effective fusion of the Raman spectra of serum and urine source domains helps to obtain richer feature information. However, most of the current studies on immunoglobulin A nephropathy (IgAN) based on Raman spectroscopy are based on small sample data and low signal-to-noise ratio. If a multi-source data fusion strategy is directly adopted, it may even reduce the accuracy of disease diagnosis. To this end, this paper proposes a data enhancement and spectral optimization method based on variational autoencoders to obtain reconstructed Raman spectra with doubled sample size and improved signal-to-noise ratio. In the diagnosis of IgAN in multi-source domain Raman spectra, this paper builds a global and local feature decoupled variational autoencoder (DMSGL-VAE) model based on multi-source data. First, the statistical features after spectral segmentation are extracted, and the latent variables obtained by the variational encoder are decoupled through the decoupling module. The global representation and local representation obtained represent the global shared information and local unique information of the serum and urine source domains, respectively. Then, the cross-source reconstruction loss and decoupling loss are used to constrain the decoupling, and the effectiveness of the decoupling is proved quantitatively and qualitatively. Finally, the features of different source domains were integrated to diagnose IgAN, and the results were analyzed for important features using the SHapley Additive exPlanations algorithm. The experimental results showed that the AUC value of the DMSGL-VAE model for diagnosing IgAN on the test set was as high as 0.9958. The SHAP algorithm was used to further prove that proteins, hydroxybutyrate, and guanine are likely to be common biological fingerprint substances for the diagnosis of IgAN by serum and urine Raman spectroscopy. In summary, the DMSGL-VAE model designed based on Raman spectroscopy in this paper can achieve rapid, non-invasive, and accurate screening of IgAN in terms of classification performance. And interpretable analysis may help doctors further understand IgAN and make more efficient diagnostic measures in the future.

Raman Spectroscopic Analysis of Urinary Creatine and Phosphate in Athletes: Pre- and Post-Training Assessment

The aim of this study was to detect biochemical components in the urine of bodybuilders who ingested creatine pretraining compared to individuals who did not ingest creatine after physical exercise using Raman spectroscopy. Twenty volunteers practicing bodybuilding were selected to collect pre- and post-training urine samples, where 10 volunteers ingested creatine 30 min before pretraining urine collection (creatine group), and 10 did not (control group). The samples were subjected to Raman spectroscopy, and the spectra of both creatine and control groups and the difference (post-pre) for both groups were analyzed. Principal component analysis (PCA) technique was applied to the samples. The results showed peaks of creatine and phosphate in urine after training (creatine post-training group), suggesting that part of the creatine was absorbed and metabolized, and part was excreted. Raman spectroscopy could be applied to detect biocompounds in urine, such as unmetabolized creatine and phosphate.

MXene-based SERS spectroscopic analysis of exosomes for lung cancer differential diagnosis with deep learning

Lung cancer with heterogeneity has a high mortality rate due to its late-stage detection and chemotherapy resistance. Liquid biopsy that discriminates tumor-related biomarkers in body fluids has emerged as an attractive technique for early-stage and accurate diagnosis. Exosomes, carrying membrane and cytosolic information from original tumor cells, impart themselves endogeneity and heterogeneity, which offer extensive and unique advantages in the field of liquid biopsy for cancer differential diagnosis. Herein, we demonstrate a Gramian angular summation field and MobileNet V2 (GASF-MobileNet)-assisted surface-enhanced Raman spectroscopy (SERS) technique for analyzing exosomes, aimed at precise diagnosis of lung cancer. Specifically, a composite substrate was synthesized for SERS detection of exosomes based on Ti3C2Tx Mxene and the array of gold-silver core-shell nanocubes (MGS), that combines sensitivity and signal stability. The employment of MXene facilitates the non-selective capture and enrichment of exosomes. To overcome the issue of potentially overlooking spatial features in spectral data analysis, 1-D spectra were first transformed into 2-D images through GASF. By using transformed images as the input data, a deep learning model based on the MobileNet V2 framework extracted spectral features from higher dimensions, which identified different non-small cell lung cancer (NSCLC) cell lines with an overall accuracy of 95.23%. Moreover, the area under the curve (AUC) for each category exceeded 0.95, demonstrating the great potential of integrating label-free SERS with deep learning for precise lung cancer differential diagnosis. This approach allows routine cancer management, and meanwhile, its non-specific analysis of SERS signatures is anticipated to be expanded to other cancers.

Utilizing Raman spectroscopy for urinalysis to diagnose acute kidney injury stages in cardiac surgery patients

BACKGROUND

The successful treatment and improvement of acute kidney injury (AKI) depend on early-stage diagnosis. However, no study has differentiated between the three stages of AKI and non-AKI patients following heart surgery. This study will fill this gap in the literature and help to improve kidney disease management in the future.

METHODS

In this study, we applied Raman spectroscopy (RS) to uncover unique urine biomarkers distinguishing heart surgery patients with and without AKI. Given the amplified risk of renal complications post-cardiac surgery, this approach is of paramount importance. Further, we employed the partial least squares-support vector machine (PLS-SVM) model to distinguish between all three stages of AKI and non-AKI patients.

RESULTS

We noted significant metabolic disparities among the groups. Each AKI stage presented a distinct metabolic profile: stage 1 had elevated uric acid and reduced creatinine levels; stage 2 demonstrated increased tryptophan and nitrogenous compounds with diminished uric acid; stage 3 displayed the highest neopterin and the lowest creatinine levels. We utilized the PLS-SVM model for discriminant analysis, achieving over 90% identification rate in distinguishing AKI patients, encompassing all stages, from non-AKI subjects.

CONCLUSIONS

This study characterizes the incidence and risk factors for AKI after cardiac surgery. The unique spectral information garnered from this study can also pave the way for developing an in vivo RS method to detect and monitor AKI effectively.

Nitrosamine formation driven by electrochemical chlorination of urine-containing source waters: Effects of operational conditions

We investigated the formation of nitrosamines from urine during electrochemical chlorination (EC) using dimensionally stable anodes. Short-term electrolysis (< 1 h) of urine at 25 mA cm-2 generated seven nitrosamines (0.1-7.4 µg L-1), where N-nitrosodimethylamine, N-nitrosomethylethylamine, and N-nitrosodiethylamine were predominant with concentrations ranging from 1.2 to 7.4 µg L-1. Mechanistic studies showed that the formation kinetics of nitrosamines was influenced by urine aging and composition, with fresh urine generating the highest levels (0.9-5.8 µg L-1) compared with aged, centrifuged, or filtered urine (0.2-4.1 µg L-1). Concurrently, studies on urine pretreatment through filtration and centrifugation underscored the significance of nitrogenous metabolites (such as protein-like products and urinary amino acids) and particle-associated humic fractions in nitrosamine formation during EC of urine. This finding was confirmed through chromatographic and spectroscopic studies utilizing LCOCD, Raman spectra, and 3DEEM fluorescence spectra. Parametric studies demonstrated that the ultimate [nitrosamines] increased at a pH range of 4.5-6.2, and with increasing [bromide], [ammonium], and current density. Conversely, sulfate and carbonate ions inhibited nitrosamine formation. Moreover, the implications of EC in urine-containing source waters were evaluated. The results indicate that regardless of the urine source (individual volunteers, septic tank, swimming pool, untreated municipal wastewater), high levels of nitrosamines (0.1-17.6 µg L-1) were generated, surpassing the potable reuse guideline of 10 ng L-1. Overall, this study provides insights to elucidate the mechanisms underlying nitrosamine formation and optimize the operating conditions. Such insights facilitate suppressing the generation of nitrosamine byproducts during electrochemical treatment of urine-containing wastewater.

Novel non-invasive method for urine mapping: Deep-learning-enabled SERS spectroscopy for the rapid differential detection of kidney allograft injury

The kidney allograft has been under continuous attack from diverse injuries since the very beginning of organ procurement, leading to a gradual decline in function, chronic fibrosis, and allograft loss. It is vital to routinely and precisely monitor the risk of injuries after renal transplantation, which is difficult to achieve because the traditional laboratory tests lack sensitivity and specificity, and graft biopsies are invasive with the risk of many complications and time-consuming. Herein, a novel method for the diagnosis of graft injury is demonstrated, using deep learning-assisted surface-enhanced Raman spectroscopy (SERS) of the urine analysis. Specifically, we developed a hybrid SERS substrate composed of gold and silver with high sensitivity to the urine composition under test, eliminating the need for labels, which makes measurements easy to perform and meanwhile results in extremely abundant and complex Raman vibrational bands. Deep learning algorithms were then developed to improve the interpretation of the SERS spectral fingerprints. The deep learning model was trained with SERS signals of urine samples of recipients with different injury types including delayed graft function (DGF), calcineurin-inhibitor toxicity (CNIT), T cell-mediated rejection (TCMR), antibody-mediated rejection (AMR), and BK virus nephropathy (BKVN), which explored the features of these types and achieved the injury differentiation with an overall accuracy of 93.03%. The results highlight the potential of combining label-free SERS spectroscopy with deep learning as a method for liquid biopsy of kidney allograft injuries, which can provide great potential to diagnose and evaluate allograft injuries, and thus extend the life of kidney allografts.

Label-Free SERS of Urine Components: A Powerful Tool for Discriminating Renal Cell Carcinoma through Multivariate Analysis and Machine Learning Techniques

The advent of Surface-Enhanced Raman Scattering (SERS) has enabled the exploration and detection of small molecules, particularly in biological fluids such as serum, blood plasma, urine, saliva, and tears. SERS has been proposed as a simple diagnostic technique for various diseases, including cancer. Renal cell carcinoma (RCC) ranks as the sixth most commonly diagnosed cancer in men and is often asymptomatic, with detection occurring incidentally. The onset of symptoms typically aligns with advanced disease, aggressive histology, and unfavorable prognosis, and therefore new methods for an early diagnosis are needed. In this study, we investigated the utility of label-free SERS in urine, coupled with two multivariate analysis approaches: Principal Component Analysis combined with Linear Discriminant Analysis (PCA-LDA) and Support Vector Machine (SVM), to discriminate between 50 RCC patients and 44 healthy donors. Employing LDA-PCA, we achieved a discrimination accuracy of 100% using 13 principal components, and an 88% accuracy in discriminating between different RCC stages. The SVM approach yielded a training accuracy of 100%, a validation accuracy of 99% for discriminating between RCC and controls, and an 80% accuracy for discriminating between stages. The comparative analysis of raw and normalized SERS spectral data shows that while raw data disclose relative concentration variations in urine metabolites between the two classes, the normalization of spectral data significantly improves the accuracy of discrimination. Moreover, the selection of principal components with markedly distinct scores between the two classes serves to alleviate overfitting risks and reduces the number of components employed for discrimination. We obtained the accuracy of the discrimination between the RCC patients cases and healthy donors of 90% for three PCs and a linear discrimination function, and a 88% accuracy of discrimination between stages using six PCs, mitigating practically the risk of overfitting and increasing the robustness of our analysis. Our findings underscore the potential of label-free SERS of urine in conjunction with chemometrics for non-invasive and early RCC detection.

Spectral insights: Navigating the frontiers of biomedical and microbiological exploration with Raman spectroscopy

Raman spectroscopy (RS), a powerful analytical technique, has gained increasing recognition and utility in the fields of biomedical and biological research. Raman spectroscopic analyses find extensive application in the field of medicine and are employed for intricate research endeavors and diagnostic purposes. Consequently, it enjoys broad utilization within the realm of biological research, facilitating the identification of cellular classifications, metabolite profiling within the cellular milieu, and the assessment of pigment constituents within microalgae. This article also explores the multifaceted role of RS in these domains, highlighting its distinct advantages, acknowledging its limitations, and proposing strategies for enhancement.

Surface-enhanced Raman Spectroscopy in urinalysis of hypertension patients with kidney disease

Arterial hypertension (AH) is a multifactorial and asymptomatic disease that affects vital organs such as the kidneys and heart. Considering its prevalence and the associated severe health repercussions, hypertension has become a disease of great relevance for public health across the globe. Conventionally, the classification of an individual as hypertensive or non-hypertensive is conducted through ambulatory blood pressure monitoring over a 24-h period. Although this method provides a reliable diagnosis, it has notable limitations, such as additional costs, intolerance experienced by some patients, and interferences derived from physical activities. Moreover, some patients with significant renal impairment may not present proteinuria. Accordingly, alternative methodologies are applied for the classification of individuals as hypertensive or non-hypertensive, such as the detection of metabolites in urine samples through liquid chromatography or mass spectrometry. However, the high cost of these techniques limits their applicability for clinical use. Consequently, an alternative methodology was developed for the detection of molecular patterns in urine collected from hypertension patients. This study generated a direct discrimination model for hypertensive and non-hypertensive individuals through the amplification of Raman signals in urine samples based on gold nanoparticles and supported by chemometric techniques such as partial least squares-discriminant analysis (PLS-DA). Specifically, 162 patient urine samples were used to create a PLS-DA model. These samples included 87 urine samples from patients diagnosed with hypertension and 75 samples from non-hypertensive volunteers. In the AH group, 35 patients were diagnosed with kidney damage and were further classified into a subgroup termed (RAH). The PLS-DA model with 4 latent variables (LV) was used to classify the hypertensive patients with external validation prediction (P) sensitivity of 86.4%, P specificity of 77.8%, and P accuracy of 82.5%. This study demonstrates the ability of surface-enhanced Raman spectroscopy to differentiate between hypertensive and non-hypertensive patients through urine samples, representing a significant advance in the detection and management of AH. Additionally, the same model was then used to discriminate only patients diagnosed with renal damage and controls with a P sensitivity of 100%, P specificity of 77.8%, and P accuracy of 82.5%.

Rapid identification of early renal damage in asymptomatic hyperuricemia patients based on urine Raman spectroscopy and bioinformatics analysis

Objective: The issue of when to start treatment in patients with hyperuricemia (HUA) without gout and chronic kidney disease (CKD) is both important and controversial. In this study, Raman spectroscopy (RS) was used to analyze urine samples, and key genes expressed differentially CKD were identified using bioinformatics. The biological functions and regulatory pathways of these key genes were preliminarily analyzed, and the relationship between them as well as the heterogeneity of the urine components of HUA was evaluated. This study provides new ideas for the rapid evaluation of renal function in patients with HUA and CKD, while providing an important reference for the new treatment strategy of HUA disease. Methods: A physically examined population in 2021 was recruited as the research subjects. There were 10 cases with normal blood uric acid level and 31 cases with asymptomatic HUA diagnosis. The general clinical data were collected and the urine samples were analyzed by Raman spectroscopy. An identification model was also established by using the multidimensional multivariate method of orthogonal partial least squares discriminant analysis (OPLS-DA) model for statistical analysis of the data, key genes associated with CKD were identified using the Gene Expression Omnibus (GEO) database, and key biological pathways associated with renal function damage in CKD patients with HUA were analyzed. Results: The Raman spectra showed significant differences in the levels of uric acid (640 cm^-1), urea, creatinine (1,608, 1,706 cm^-1), proteins/amino acids (642, 828, 1,556, 1,585, 1,587, 1,596, 1,603, 1,615 cm^-1), and ketone body (1,643 cm^-1) (p < 0.05). The top 10 differentially expressed genes (DEGs) associated with CKD (ALB, MYC, IL10, FOS, TOP2A, PLG, REN, FGA, CCNA2, and BUB1) were identified. Compared with the differential peak positions analyzed by the OPLS-DA model, it was found that the peak positions of glutathione, tryptophan and tyrosine may be important markers for the diagnosis and progression of CKD. Conclusion: The progression of CKD was related to the expression of the ALB, MYC, IL10, PLG, REN, and FGA genes. Patients with HUA may have abnormalities in glutathione, tryptophan, tyrosine, and energy metabolism. The application of Raman spectroscopy to analyze urine samples and interpret the heterogeneity of the internal environment of asymptomatic HUA patients can be combined with the OPLS-DA model to mine the massive clinical and biochemical examination information on HUA patients. The results can also provide a reference for identifying the right time for intervention for uric acid as well as assist the early detection of changes in the internal environment of the body. Finally, this approach provides a useful technical supplement for exploring a low-cost, rapid evaluation and improving the timeliness of screening. Precise intervention of abnormal signal levels of internal environment and energy metabolism may be a potential way to delay renal injury in patients with HUA.

Analysis of urine Raman spectra differences from patients with diabetes mellitus and renal pathologies

Background

Chronic kidney disease (CKD) poses a major public health burden. Diabetes mellitus (DM) is one of the major causes of CKD. In patients with DM, it can be difficult to differentiate diabetic kidney disease (DKD) from other causes of glomerular damage; it should not be assumed that all DM patients with decreased eGFR and/or proteinuria have DKD. Renal biopsy is the standard for definitive diagnosis, but other less invasive methods may provide clinical benefit. As previously reported, Raman spectroscopy of CKD patient urine with statistical and chemometric modeling may provide a novel, non-invasive methodology for discriminating between renal pathologies.

Methods

Urine samples were collected from renal biopsied and non-biopsied patients presenting with CKD secondary to DM and non-diabetic kidney disease. Samples were analyzed by Raman spectroscopy, baselined with the ISREA algorithm, and subjected to chemometric modeling. Leave-one-out cross-validation was used to assess the predictive capabilities of the model.

Results

This proof-of-concept study consisted of 263 samples, including renal biopsied, non-biopsied diabetic and non-diabetic CKD patients, healthy volunteers, and the Surine™ urinalysis control. Urine samples of DKD patients and those with immune-mediated nephropathy (IMN) were distinguished from one another with 82% sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV). Among urine samples from all biopsied CKD patients, renal neoplasia was identified in urine with 100% sensitivity, specificity, PPV, and NPV, and membranous nephropathy was identified with 66.7% sensitivity, 96.4% specificity, 80.0% PPV, and 93.1% NPV. Finally, DKD was identified among a population of 150 patient urine samples containing biopsy-confirmed DKD, other biopsy-confirmed glomerular pathologies, un-biopsied non-diabetic CKD patients (no DKD), healthy volunteers, and Surine™ with 36.4% sensitivity, 97.8% specificity, 57.1% PPV, and 95.1% NPV. The model was used to screen un-biopsied diabetic CKD patients and identified DKD in more than 8% of this population. IMN in diabetic patients was identified among a similarly sized and diverse population with 83.3% sensitivity, 97.7% specificity, 62.5% PPV, and 99.2% NPV. Finally, IMN in non-diabetic patients was identified with 50.0% sensitivity, 99.4% specificity, 75.0% PPV, and 98.3% NPV.

Conclusions

Raman spectroscopy of urine with chemometric analysis may be able to differentiate between DKD, IMN, and other glomerular diseases. Future work will further characterize CKD stages and glomerular pathology, while assessing and controlling for differences in factors such as comorbidities, disease severity, and other lab parameters.

The Potential Applications of Raman Spectroscopy in Kidney Diseases

Raman spectroscopy (RS) is a spectroscopic technique based on the inelastic interaction of incident electromagnetic radiation (from a laser beam) with a polarizable molecule, which, when scattered, carries information from molecular vibrational energy (the Raman effect). RS detects biochemical changes in biological samples at the molecular level, making it an effective analytical technique for disease diagnosis and prognosis. It outperforms conventional sample preservation techniques by requiring no chemical reagents, reducing analysis time even at low concentrations, and working in the presence of interfering agents or solvents. Because routinely utilized biomarkers for kidney disease have limitations, there is considerable interest in the potential use of RS. RS may identify and quantify urinary and blood biochemical components, with results comparable to reference methods in nephrology.

Analyzing the serum of hemodialysis patients with end-stage chronic kidney disease by means of the combination of SERS and machine learning

The aim of this paper is a multivariate analysis of SERS characteristics of serum in hemodialysis patients, which includes constructing classification models (PLS-DA, CNN) by the presence/absence of end-stage chronic kidney disease (CKD) with dialysis and determining the most informative spectral bands for identifying dialysis patients by variable importance distribution. We found the spectral bands that are informative for detecting the hemodialysis patients: the 641 cm^-1, 724 cm^-1, 1094 cm^-1 and 1393 cm^-1 bands are associated with the degree of kidney function inhibition; and the 1001 cm^-1 band is able to demonstrate the distinctive features of hemodialysis patients with end-stage CKD.

High Uniformity and Enhancement Au@AgNS 3D Substrates for the Diagnosis of Breast Cancer

Breast cancer appears to be one of the leading causes of cancer-related morbidity and mortality for women worldwide. The accurate and rapid diagnosis of breast cancer is hence critical for the treatment and prognosis of patients. With the vibrational fingerprint information and high detection sensitivity, surface-enhanced Raman spectroscopy (SERS) has been extensively applied in biomedicine. Here, an optimized bimetallic nanosphere (Au@Ag NS) 3D substrate was fabricated for the aim of the diagnosis of breast cancer based on the SERS analysis of the extracellular metabolites. The unique stacking mode of 3D Au@Ag NSs provided multiple plasmonic hot spots according to the theoretical calculations of the electromagnetic field distribution. The low relative standard deviation (RSD = 2.7%) and high enhancement factor (EF = 1.42 × 10⁵) proved the uniformity and high sensitivity. More importantly, the normal breast cells and breast cancer cells could be readily distinguished from the corresponding SERS spectra based on the extracellular metabolites. Furthermore, the clear clusters of SERS spectra from MCF-7 and MDA-MB-231 extracellular metabolites in the orthogonal partial least-squares discriminant analysis plot indicate the distinct metabolic fingerprint between breast cancer cells, which imply their potential clinical application in the diagnosis of breast cancer.

Raman Spectroscopic Detection and Quantification of Macro- and Microhematuria in Human Urine

Hematuria refers to the presence of blood in urine. Even in small amounts, it may be indicative of disease, ranging from urinary tract infection to cancer. Here, Raman spectroscopy was used to detect and quantify macro- and microhematuria in human urine samples. Anticoagulated whole blood was mixed with freshly collected urine to achieve concentrations of 0, 0.25, 0.5, 1, 2, 6, 10, and 20% blood/urine (v/v). Raman spectra were obtained at 785 nm and data analyzed using chemometric methods and statistical tests with the Rametrix toolboxes for Matlab. Goldindec and iterative smoothing splines with root error adjustment (ISREA) baselining algorithms were used in processing and normalization of Raman spectra. Rametrix was used to apply principal component analysis (PCA), develop discriminate analysis of principal component (DAPC) models, and to validate these models using external leave-one-out cross-validation (LOOCV). Discriminate analysis of principal component models were capable of detecting various levels of microhematuria in unknown urine samples, with prediction accuracies of 91% (using Goldindec spectral baselining) and 94% (using ISREA baselining). Partial least squares regression (PLSR) was then used to estimate/quantify the amount of blood (v/v) in a urine sample, based on its Raman spectrum. Comparing actual and predicted (from Raman spectral computations) hematuria levels, a coefficient of determination (R²) of 0.91 was obtained over all hematuria levels (0-20% v/v), and an R² of 0.92 was obtained for microhematuria (0-1% v/v) specifically. Overall, the results of this preliminary study suggest that Raman spectroscopy and chemometric analyses can be used to detect and quantify macro- and microhematuria in unprocessed, clinically relevant urine specimens.

Metabolomics in Exercise and Sports: A Systematic Review

BACKGROUND

Metabolomics is a field of omics science that involves the comprehensive measurement of small metabolites in biological samples. It is increasingly being used to study exercise physiology and exercise-associated metabolism. However, the field of exercise metabolomics has not been extensively reviewed or assessed.

OBJECTIVE

This review on exercise metabolomics has three aims: (1) to provide an introduction to the general workflow and the different metabolomics technologies used to conduct exercise metabolomics studies; (2) to provide a systematic overview of published exercise metabolomics studies and their findings; and (3) to discuss future perspectives in the field of exercise metabolomics.

METHODS

We searched electronic databases including Google Scholar, Science Direct, PubMed, Scopus, Web of Science, and the SpringerLink academic journal database between January 1st 2000 and September 30th 2020.

RESULTS

Based on our detailed analysis of the field, exercise metabolomics studies fall into five major categories: (1) exercise nutrition metabolism; (2) exercise metabolism; (3) sport metabolism; (4) clinical exercise metabolism; and (5) metabolome comparisons. Exercise metabolism is the most popular category. The most common biological samples used in exercise metabolomics studies are blood and urine. Only a small minority of exercise metabolomics studies employ targeted or quantitative techniques, while most studies used untargeted metabolomics techniques. In addition, mass spectrometry was the most commonly used platform in exercise metabolomics studies, identified in approximately 54% of all published studies. Our data indicate that biomarkers or biomarker panels were identified in 34% of published exercise metabolomics studies.

CONCLUSION

Overall, there is an increasing trend towards better designed, more clinical, mass spectrometry-based metabolomics studies involving larger numbers of participants/patients and larger numbers of metabolites being identified.

Trend in creatinine determining methods: Conventional methods to molecular-based methods

Renal failure (RF) disease is ranked as one of the most prevalent diseases with severe morbidity and mortality. Early diagnosis of RF leads to subsequent control of disease to reduce the poor prognosis. The level of sera creatinine is considered as a significant biomarker for kidney biofunction, which is routinely detected by the Jaffe reaction. The normal range for creatinine in the blood may be 0.84-1.21 mg/dL. Low accuracy, insufficient sensitivity, explosive and toxicity of picric acid, and pseudo-interaction with nonspecific elements such as ammonium ions in the Jaffe method lead to the development of various techniques for precise detection of creatinine such as spectroscopic, electrochemical, and chromatography approaches and sensors based on enzymes, molecular imprinted polymer and nanoparticles, etc. Based on previously established results, they are trying to construct sensors with high accuracy, optimum sensitivity, acceptable linear/calibration range, and limit of detection, which are small in size and applicable by the patient him/herself (point-of-care testing). By comparing the results of research, a molecularly imprinted electrochemiluminescence-based sensor with linear/calibration range of 5-1 mMconcentration of creatinine and the detection limit of 0.5 nM has the best detectable resolution with 2 million measurable points. In this paper, we will review the recently developed methods for measuring creatinine concentration and renal biofunction.

Comparison of Surface-Enhanced Raman Scattering Properties of Serum and Urine for the Detection of Chronic Kidney Disease in Patients

Chronic kidney disease (CKD) affects more than 10% of the global population and is associated with significant morbidity and mortality. In most cases, this disease is developed silently, and it can progress to the end-stage renal failure. Therefore, early detection becomes critical for initiating effective interventions. Routine diagnosis of CKD requires both blood test and urinalyses in a clinical laboratory, which are time-consuming and have low sensitivity and specificity. Surface-enhanced Raman scattering (SERS) is an emerging method for rapidly assessing kidney function or injury. This study was designed to compare the differences between the SERS properties of the serum and urine for easy and simple detection of CKD. Enrolled for this study were 126 CKD patients (Stages 2-5) and 97 healthy individuals. SERS spectra of both the serum and urine samples were acquired using a Raman spectrometer (785 nm excitation). The correlation of chemical parameters of kidney function with the spectra was examined using prinicpal component analysis (PCA) combined with linear discriminant analysis (LDA) and partial least squares (PLS) analysis. Here, we showed that CKD was discriminated from non-CKD controls using PCA-LDA with a sensitivity of 74.6% and a specificity of 93.8% for the serum spectra, and 78.0% and 86.0 % for the urine spectra. The integration area under the receiver operating characteristic curve was 0.937 ± 0.015 (p < 0.0001) for the serum and 0.886 ± 0.025 (p < 0.0001) for the urine. The different stages of CKD were separated with the accuracy of 78.0% and 75.4% by the serum and urine spectra, respectively. PLS prediction (R²) of the serum spectra was 0.8540 for the serum urea (p < 0.001), 0.8536 for the serum creatinine (p < 0.001), 0.7500 for the estimated glomerular filtration rate (eGFR) (p < 0.001), whereas the prediction (R²) of urine spectra was 0.7335 for the urine urea (p < 0.001), 0.7901 for the urine creatinine (p < 0.001), 0.4644 for the eGFR (p < 0.001) and 0.6579 for the urine microalbumin (p < 0.001). In conclusion, the accuracy of associations between SERS findings of the serum and urine samples with clinical conclusions of CKD diagnosis in this limited number of patients is similar, suggesting that SERS may be used as a rapid and easy-to-use method for early screening of CKD, which however needs further evaluation in a large cohort study.

Fluorescence photobleaching of urine for improved signal to noise ratio of the Raman signal - An exploratory study

Urine analysis is an important clinical test routinely performed in pathology labs for disease diagnosis and prognosis. In recent years, near-infrared Raman spectroscopy has drawn considerable attention for urine analysis as it can provide rapid, reliable, and reagent-free analysis of urine samples. However, one important practical problem encountered in such Raman measurements is the orders of magnitude stronger spectral background preventing one to utilize the full dynamic range of the detector which is required for the measurement of Raman signal with good signal-to-noise ratio (SNR). We report here the results of an exploratory study carried out on human urine samples to show that the photobleaching, which is a major disadvantage during the fluorescence measurement, could be utilized for suppressing the measured background to improve the SNR of the Raman peaks. It was found that once the photobleaching reached its plateau, there were improvements by ~67% and ~47% in the SNR and the signal to background ratio (SBR), respectively, of the Raman signals as compared to the spectra measured at the start of acquisition. Further, the reduced background also allowed us to utilize the full dynamic range of the detector at increased integration time without saturating the detector indicating the possibility of obtaining an improved detection limit.

Feasibility of Voltage-Applied SERS Measurement of Bile Juice as an Effective Analytical Scheme to Enhance Discrimination between Gall Bladder (GB) Polyp and GB Cancer

A unique surface-enhanced Raman scattering (SERS) measurement scheme to discriminate gall bladder (GB) polyp and GB cancer by analysis of bile juice is proposed. Along with the high sensitivity of SERS, external voltage application during SERS measurement was incorporated to improve sample discriminability. For this purpose, Au nanodendrites were constructed on a screen-printed electrode (referred to as AuND@SPE), and Raman spectra of extracted aqueous phases from raw bile juice samples were acquired using the AuND@SPE at voltages from -300 to 300 mV. The sample spectra resembled that of bilirubin, possessing an open chain tetrapyrrole, showing that bilirubin derivatives in bile juice were mainly responsible for the observed peaks. Discrimination of GB polyp and GB cancer using just the normal SERS spectra was not achieved but became apparent when the spectra were acquired at a voltage of -100 mV. When voltage-applied SERS spectra of bilirubin and urobilinogen (one of bilirubin's derivatives) were examined, a sudden intensity elevation occurring at -100 mV was observed for urobilinogen but not bilirubin. Based on examination of corresponding cyclic voltammograms, the potential-driven strong adsorption of urobilinogen (no faradaic charge transfer) on AuND occurring at -100 mV induced a substantial increase in SERS intensity. It was presumed that the content of urobilinogen in the bile juice of a GB cancer patient would be higher than that of a GB polyp patient, and the contained urobilinogen was sensitively highlighted by applying -100 mV during SERS measurement, allowing clear discrimination of GB cancer against GB polyp.

Towards Raman spectroscopy of urine as screening tool

For the screening purposes urine is an especially attractive biofluid, since it offers easy and noninvasive sample collection and provides a snapshot of the whole metabolic status of the organism, which may change under different pathological conditions. Raman spectroscopy (RS) has the potential to monitor these changes and utilize them for disease diagnostics. The current study utilizes mouse models aiming to compare the feasibility of the urine based RS combined with chemometrics for diagnosing kidney diseases directly influencing urine composition and respiratory tract diseases having no direct connection to urine formation. The diagnostic models for included diseases were built using principal component analysis with linear discriminant analysis and validated with a leave-one-mouse-out cross-validation approach. Considering kidney disorders, the accuracy of 100% was obtained in discrimination between sick and healthy mice, as well as between two different kidney diseases. For asthma and invasive pulmonary aspergillosis achieved accuracies were noticeably lower, being, respectively, 77.27% and 78.57%. In conclusion, our results suggest that RS of urine samples not only provides a solution for a rapid, sensitive and noninvasive diagnosis of kidney disorders, but also holds some promises for the screening of nonurinary tract diseases.

Tetrahydrocannabinol Sensing in Complex Biofluid with Portable Raman Spectrometer Using Diatomaceous SERS Substrates

Using thin-layer chromatography in tandem with surface-enhanced Raman spectroscopy (TLC-SERS) and tetrahydrocannabinol (THC) sensing in complex biological fluids is successfully conducted with a portable Raman spectrometer. Both THC and THC metabolites are detected from the biofluid of marijuana-users as biomarkers for identifying cannabis exposure. In this article, ultra-sensitive SERS substrates based on diatomaceous earth integrated with gold nanoparticles (Au NPs) were employed to detect trace levels of cannabis biomarkers in saliva. Strong characteristic THC and THC metabolite SERS peaks at 1601 and 1681 cm-1 were obtained despite the moderate interference of biological molecules native to saliva. Urine samples were also analyzed, but they required TLC separation of THC from the urine sample to eliminate the strong influence of urea and other organic molecules. TLC separation of THC from the urine was performed by porous microfluidic channel devices using diatomaceous earth as the stationary phase. The experimental results showed clear separation between urea and THC, and strong THC SERS characteristic peaks. Principal component analysis (PCA) was used to analyze the SERS spectra collected from various THC samples. The spectra in the principal component space were well clustered for each sample type and share very similar scores in the main principal component (PC1), which can serve as the benchmark for THC sensing from complex SERS spectra. Therefore, we proved that portable Raman spectrometers can enable an on-site sensing capability using diatomaceous SERS substrates to detect THC in real biological solutions. This portable THC sensing technology will play pivotal roles in forensic analysis, medical diagnosis, and public health.

Raman spectroscopic discrimination of normal and cancerous lung tissues

Raman spectroscopy is non-destructive method that allows monitoring of biological tissues with minimal intervention. FT-Raman (λ_ex 1064 nm) and NIR-Vis-Raman (λ_ex 785 nm) spectroscopic measurements were used in ex vivo analysis of normal, non-cancerous abnormal and cancerous lung tissues. Spectroscopic discrimination of the lung tissue samples was made by the use of the ratio of characteristic bands and multivariate statistical methods (PCA, LDA). The combination of Raman spectroscopy and multivariate statistics may have a diagnostic potential for recognizing of cancer lesions in lung.