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Alsaleh M, Barbera TA, Reeves HL, Cramp ME, Ryder S, Gabra H, Nash K, Shen YL, Holmes E, Williams R, Taylor-Robinson SD. Characterization of the urinary metabolic profile of cholangiocarcinoma in a United Kingdom population. Hepat Med 2019; 11:47-67. [PMID: 31118840 PMCID: PMC6507078 DOI: 10.2147/hmer.s193996] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/06/2019] [Indexed: 01/09/2023] Open
Abstract
Background: Outside South-East Asia, most cases of cholangiocarcinoma (CCA) have an obscure etiology. There is often diagnostic uncertainty. Metabolomics using ultraperformance liquid chromatography mass spectrometry (UPLC-MS) offers the portent to distinguish disease-specific metabolic signatures. We aimed to define such a urinary metabolic signature in a patient cohort with sporadic CCA and investigate whether there were characteristic differences from those in patients with hepatocellular carcinoma (HCC), metastatic secondary liver cancer, pancreatic cancer and ovarian cancer (OCA). Methods: Spot urine specimens were obtained from 211 subjects in seven participating centers across the UK. Samples were collected from healthy controls and from patients with benign hepatic disease (gallstone, biliary strictures, sphincter of Oddi dysfunction and viral hepatitis) and patients with malignant conditions (HCC, pancreatic cancer, OCA and metastatic cancer in the liver). The spectral metabolite profiles were generated using a UPLC-MS detector and data were analyzed using multivariate and univariate statistical analyses. Results: The greatest class differences were seen between the metabolic profiles of disease-free controls compared to individuals with CCA with altered acylcarnitine, bile acid and purine levels. Individuals with benign strictures showed comparable urine profiles to patients with malignant bile duct lesions. The metabolic signatures of patients with bile duct tumors were distinguishable from patients with hepatocellular and ovarian tumors, but no difference was observed between CCA cases and patients with pancreatic cancer or hepatic secondary metastases. Conclusion: CCA causes subtle but detectable changes in the urine metabolic profiles. The findings point toward potential applications of metabonomics in early tumor detection. However, it is key to utilize both global and targeted metabonomics in a larger cohort for in-depth characterization of the urine metabolome in hepato-pancreato-biliary disease.
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Affiliation(s)
- Munirah Alsaleh
- Division of Surgery and Cancer, Imperial College London, London
| | | | - Helen L Reeves
- Northern Institute for Cancer Research, Medical School, University of Newcastle, Newcastle upon Tyne, UK
| | | | - Stephen Ryder
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK.,NIHR Biomedical Research Unit, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - Hani Gabra
- Division of Surgery and Cancer, Imperial College London, London.,Early Clinical Development, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - Kathryn Nash
- Liver Unit, Southampton General Hospital, Southampton, Hampshire, UK
| | - Yi-Liang Shen
- Division of Surgery and Cancer, Imperial College London, London.,Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Elaine Holmes
- Division of Surgery and Cancer, Imperial College London, London
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Alsaleh M, Barbera TA, Andrews RH, Sithithaworn P, Khuntikeo N, Loilome W, Yongvanit P, Cox IJ, Syms RR, Holmes E, Taylor–Robinson SD. Mass Spectrometry: A Guide for the Clinician. J Clin Exp Hepatol 2019; 9:597-606. [PMID: 31695250 PMCID: PMC6823691 DOI: 10.1016/j.jceh.2019.04.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 04/30/2019] [Indexed: 12/12/2022] Open
Abstract
Metabolic profiling, metabonomics and metabolomics are terms coined in the late 1990s as they emerged as the newest 'omics' technology at the time. This line of research enquiry uses spectroscopic analytical platforms, which are mainly nuclear magnetic resonance spectroscopy and mass spectrometry (MS), to acquire a snapshot of metabolites, the end products of a complex biological system. Metabolic profiling enables the detection, quantification and characterisation of metabolites in biofluids, cells and tissues. The source of these compounds can be of endogenous, microbial or exogenous origin, such as dietary or xenobiotic. This results in generating extensive, multivariate spectroscopic data that require specific statistical manipulation, typically performed using chemometric and pattern recognition techniques to reduce its dimensions, facilitate its biological interpretation and allow sample classification and biomarker discovery. Consequently, it is possible to study the dynamic metabolic changes in response to disease, intervention or environmental conditions. In this review, we describe the fundamentals of MS so that clinicians can be literate in the field and are able to interrogate the right scientific questions.
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Key Words
- CID, collision-induced dissociation
- DC, direct current
- ESI, electrospray ionisation
- FC, fold change
- GC, gas chromatography
- HILIC, hydrophilic interaction liquid chromatography
- LC, liquid chromatography
- MS, mass spectrometry
- MWA, metabolome-wide association
- NMR, nuclear magnetic resonance
- OPLS-DA, orthogonal partial least squared-discriminant analysis
- PC, principal component
- PCA, principal components analysis
- Q-TOF, quadrupole coupled with time-of-flight
- RF, radio frequency
- RP, reversed-phase
- UPLC, ultra-performance liquid chromatography
- VIP, variable importance of projection
- mass spectroscopy
- mass-charge ratio
- metabolic profiling
- metabolomics
- targeted profiling
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Affiliation(s)
- Munirah Alsaleh
- Division of Surgery and Cancer, Imperial College London, London, W2 INY, United Kingdom
| | - Thomas A. Barbera
- Division of Surgery and Cancer, Imperial College London, London, W2 INY, United Kingdom
| | - Ross H. Andrews
- Division of Surgery and Cancer, Imperial College London, London, W2 INY, United Kingdom,Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Narong Khuntikeo
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Watcharin Loilome
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Puangrat Yongvanit
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Isobel J. Cox
- Institute of Hepatology London, Foundation for Liver Research, 111 Coldharbour Lane, London SE5 9NT, United Kingdom,Faculty Pf Life Sciences & Medicine, King's College London, United Kingdom
| | - Richard R.A. Syms
- Department of Electrical and Electronic Engineering, Imperial College London, London SW7 2AZ, United Kingdom
| | - Elaine Holmes
- Division of Surgery and Cancer, Imperial College London, London, W2 INY, United Kingdom
| | - Simon D. Taylor–Robinson
- Division of Surgery and Cancer, Imperial College London, London, W2 INY, United Kingdom,Address for correspondence. Professor Simon Taylor-Robinson Liver Unit, St. Mary's Hospital, London, W2 1NY, United Kingdom. Tel.: +44 203 312 6199; fax: +44 207 924 9369.
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Alsaleh M, Leftley Z, Barbera TA, Sithithaworn P, Khuntikeo N, Loilome W, Yongvanit P, Cox IJ, Chamodol N, Syms RR, Andrews RH, Taylor-Robinson SD. Cholangiocarcinoma: a guide for the nonspecialist. Int J Gen Med 2018; 12:13-23. [PMID: 30588065 PMCID: PMC6304240 DOI: 10.2147/ijgm.s186854] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cholangiocarcinoma (CCA) is a tumor with increasing prevalence around the world. The prevalence of CCA is highest in East Asia and most significantly in the countries through which the Mekong River flows, owing to the presence of liver flukes, which are consumed in raw fish dishes. Outside Asia, the causes of bile duct cancers for the most part are unknown. In this review, we assess the current state of knowledge in both fluke-associated and sporadic CCA, from etiological, diagnostic, and treatment perspectives.
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Affiliation(s)
- Munirah Alsaleh
- Division of Surgery and Cancer, Imperial College London, London W2 INY, UK,
| | - Zoe Leftley
- Division of Surgery and Cancer, Imperial College London, London W2 INY, UK,
| | - Thomas A Barbera
- Division of Surgery and Cancer, Imperial College London, London W2 INY, UK,
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Narong Khuntikeo
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Watcharin Loilome
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Puangrat Yongvanit
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - I Jane Cox
- Faculty of Life Sciences & Medicine, King's College London, London SE5 9NT, UK
| | - Nittaya Chamodol
- Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Richard Ra Syms
- Department of Electrical and Electronic Engineering, Imperial College London, London SW7 2AZ, UK
| | - Ross H Andrews
- Division of Surgery and Cancer, Imperial College London, London W2 INY, UK, .,Cholangiocarcinoma Research Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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Shaw TN, Houston SA, Wemyss K, Bridgeman HM, Barbera TA, Zangerle-Murray T, Strangward P, Ridley AJL, Wang P, Tamoutounour S, Allen JE, Konkel JE, Grainger JR. Tissue-resident macrophages in the intestine are long lived and defined by Tim-4 and CD4 expression. J Exp Med 2018; 215:1507-1518. [PMID: 29789388 PMCID: PMC5987925 DOI: 10.1084/jem.20180019] [Citation(s) in RCA: 229] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/29/2018] [Accepted: 05/02/2018] [Indexed: 12/23/2022] Open
Abstract
Intestinal macrophages represent the last tissue macrophages thought to entirely adhere to van Furth's decades-old continuous monocyte replenishment model. In this study, Shaw et al. identify a population of intestinal macrophages that are long lived and maintained independently of monocyte replenishment over long periods of time. A defining feature of resident gut macrophages is their high replenishment rate from blood monocytes attributed to tonic commensal stimulation of this site. In contrast, almost all other tissues contain locally maintained macrophage populations, which coexist with monocyte-replenished cells at homeostasis. In this study, we identified three transcriptionally distinct mouse gut macrophage subsets that segregate based on expression of Tim-4 and CD4. Challenging current understanding, Tim-4+CD4+ gut macrophages were found to be locally maintained, while Tim-4–CD4+ macrophages had a slow turnover from blood monocytes; indeed, Tim-4–CD4– macrophages were the only subset with the high monocyte-replenishment rate currently attributed to gut macrophages. Moreover, all macrophage subpopulations required live microbiota to sustain their numbers, not only those derived from blood monocytes. These findings oppose the prevailing paradigm that all macrophages in the adult mouse gut rapidly turn over from monocytes in a microbiome-dependent manner; instead, these findings supplant it with a model of ontogenetic diversity where locally maintained subsets coexist with rapidly replaced monocyte-derived populations.
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Affiliation(s)
- Tovah N Shaw
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK.,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Stephanie A Houston
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK.,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Kelly Wemyss
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK.,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Hayley M Bridgeman
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK.,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Thomas A Barbera
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK.,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Tamsin Zangerle-Murray
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK.,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Patrick Strangward
- School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Amanda J L Ridley
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK.,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Ping Wang
- School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - Samira Tamoutounour
- Mucosal Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Judith E Allen
- School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK.,Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, Manchester, England, UK
| | - Joanne E Konkel
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK.,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
| | - John R Grainger
- Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, England, UK .,School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, England, UK
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