Metabolic effects of albumin therapy in acute lung injury measured by 1H-NMR spectroscopy of plasma: a pilot study

• Type of Material: Article
• Authors: Youngja Park, Emory University; Dean P Jones, Emory University; Thomas R Ziegler, Emory University; Kichun Lee, Emory University; Kavitha Kotha, Emory University; Tianwei Yu, Emory University; Greg Martin, Emory University
• Language: English
• Date: 2011-10
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2011 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins
• Final Published Version (URL): http://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2011&issue=10000&article=00015&type=abstract
• Title of Journal or Parent Work: Critical Care Medicine
• ISSN: 0090-3493
• Volume: 39
• Issue: 10
• Start Page: 2308
• End Page: 2313
• Grant/Funding Information: This research was supported by NIH grants P50 AA013757 (YP, DPJ, GSM), K23 HL067739 (GSM), K24 RR023356 (TRZ), R03 DK066008 (DPJ) and U54 RR024380 (TRZ, DPJ, GSM), as well as the Woodruff Foundation and the Emory-Georgia Tech Center for Health Discovery and Well-Being.
• Keywords: 1H-NMR; acute lung injury; metabolomics; human plasma; albumin
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Objectives Improved means to monitor and guide interventions could be useful in the intensive care unit (ICU). Metabolomic analysis with bioinformatics is used to understand mechanisms and identify biomarkers of disease development and progression. This pilot study evaluated plasma 1H-NMR spectroscopy as a means to monitor metabolism following albumin administration in acute lung injury (ALI) patients. Design This study was conducted on plasma samples from 6 albumin-treated and 6 saline-treated patients from a larger double-blind trial. The albumin group was administered 25 g of 25% human albumin in 0.9% saline every 8 h for a total of 9 doses over 72 h. 0.9% saline was used as placebo. Blood samples were collected immediately prior to, 1 h after and 4 h after the albumin/saline administration for the 1st, 4th, and 7th doses (first dose of each day for 3 days). Samples were analyzed by 1H-NMR spectroscopy, and spectra were analyzed by principal component analysis and biostatistical methods. Measurements and Main Results After 1 day of albumin therapy, changes in small molecules, including amino acids and plasma lipids, were evident with Principal Component Analysis (PCA). Differences remained 3 days after the last albumin administration. Analysis of data along with spectra from healthy controls showed that patients receiving albumin had a trajectory toward the spectra observed in healthy individuals while placebo controls did not. Conclusions The data suggest that metabolic changes detected by 1H-NMR spectroscopy and bioinformatics tool may be useful approach to clinical research especially in acute lung injury.