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Lee CH, Banoei MM, Ansari M, Cheng MP, Lamontagne F, Griesdale D, Lasry DE, Demir K, Dhingra V, Tran KC, Lee T, Burns K, Sweet D, Marshall J, Slutsky A, Murthy S, Singer J, Patrick DM, Lee TC, Boyd JH, Walley KR, Fowler R, Haljan G, Vinh DC, Mcgeer A, Maslove D, Mann P, Donohoe K, Hernandez G, Rocheleau G, Trahtemberg U, Kumar A, Lou M, Dos Santos C, Baker A, Russell JA, Winston BW. Using a targeted metabolomics approach to explore differences in ARDS associated with COVID-19 compared to ARDS caused by H1N1 influenza and bacterial pneumonia. Crit Care 2024; 28:63. [PMID: 38414082 PMCID: PMC10900651 DOI: 10.1186/s13054-024-04843-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
RATIONALE Acute respiratory distress syndrome (ARDS) is a life-threatening critical care syndrome commonly associated with infections such as COVID-19, influenza, and bacterial pneumonia. Ongoing research aims to improve our understanding of ARDS, including its molecular mechanisms, individualized treatment options, and potential interventions to reduce inflammation and promote lung repair. OBJECTIVE To map and compare metabolic phenotypes of different infectious causes of ARDS to better understand the metabolic pathways involved in the underlying pathogenesis. METHODS We analyzed metabolic phenotypes of 3 ARDS cohorts caused by COVID-19, H1N1 influenza, and bacterial pneumonia compared to non-ARDS COVID-19-infected patients and ICU-ventilated controls. Targeted metabolomics was performed on plasma samples from a total of 150 patients using quantitative LC-MS/MS and DI-MS/MS analytical platforms. RESULTS Distinct metabolic phenotypes were detected between different infectious causes of ARDS. There were metabolomics differences between ARDSs associated with COVID-19 and H1N1, which include metabolic pathways involving taurine and hypotaurine, pyruvate, TCA cycle metabolites, lysine, and glycerophospholipids. ARDSs associated with bacterial pneumonia and COVID-19 differed in the metabolism of D-glutamine and D-glutamate, arginine, proline, histidine, and pyruvate. The metabolic profile of COVID-19 ARDS (C19/A) patients admitted to the ICU differed from COVID-19 pneumonia (C19/P) patients who were not admitted to the ICU in metabolisms of phenylalanine, tryptophan, lysine, and tyrosine. Metabolomics analysis revealed significant differences between C19/A, H1N1/A, and PNA/A vs ICU-ventilated controls, reflecting potentially different disease mechanisms. CONCLUSION Different metabolic phenotypes characterize ARDS associated with different viral and bacterial infections.
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Affiliation(s)
- Chel Hee Lee
- Department of Critical Care Medicine, University of Calgary, Alberta, Canada
| | - Mohammad M Banoei
- Department of Critical Care Medicine, University of Calgary, Alberta, Canada
| | - Mariam Ansari
- Department of Critical Care Medicine, University of Calgary, Alberta, Canada
| | - Matthew P Cheng
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | | | - Donald Griesdale
- Critical Care Medicine, Vancouver General Hospital and University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada
| | - David E Lasry
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | - Koray Demir
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | - Vinay Dhingra
- Critical Care Medicine, Vancouver General Hospital and University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada
| | - Karen C Tran
- Division of General Internal Medicine, Vancouver General Hospital and University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada
| | - Terry Lee
- Centre for Health Evaluation and Outcome Science (CHEOS), St. Paul's Hospital and University of British Columbia, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Kevin Burns
- Department of Medicine, Division of Nephrology, Ottawa Hospital Research Institute, and University of Ottawa, 1967 Riverside Dr., Rm. 535, Ottawa, ON, K1H 7W9, Canada
| | - David Sweet
- Critical Care Medicine and Emergency Medicine, Vancouver General Hospital and University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada
| | - John Marshall
- Department of Surgery, St. Michael's Hospital and University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
| | - Arthur Slutsky
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Srinivas Murthy
- British Columbia Children's Hospital, University of British Columbia, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Joel Singer
- Centre for Health Evaluation and Outcome Science (CHEOS), St. Paul's Hospital and University of British Columbia, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - David M Patrick
- British Columbia Centre for Disease Control (BCCDC) and School of Population and Public Health, University of British Columbia, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
| | - Todd C Lee
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | - John H Boyd
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Keith R Walley
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Robert Fowler
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Greg Haljan
- Department of Medicine and Critical Care Medicine, Surrey Memorial Hospital, 13750 96th Avenue, Surrey, BC, V3V 1Z2, Canada
| | - Donald C Vinh
- Divisions of Infectious Diseases & Medical Microbiology, McGill University Health Center, McGill's Interdisciplinary Initiative in Infection and Immunity, Montreal, PQ, Canada
| | - Alison Mcgeer
- Mt. Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada
| | - David Maslove
- Department of Critical Care, Kingston General Hospital and Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada
| | | | | | | | | | - Uriel Trahtemberg
- Department of Critical Care, Galilee Medical Center, Nahariya, Israel
- Bar Ilan University, Ramat Gan, Israel
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Anand Kumar
- Departments of Medicine and Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Ma Lou
- Departments of Medicine and Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Claudia Dos Santos
- Department of Medicine and Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada
| | - Andrew Baker
- Departments of Critical Care and Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - James A Russell
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
- Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Brent W Winston
- Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology, University of Calgary, Health Research Innovation Center (HRIC), Room 4C64, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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