Metabolite profiling differentiates children with acute wheezing from non-wheezing controls

Abstract Background The most common cause of wheezing exacerbations in children is respiratory viral infections, but the mechanisms that underlie acute wheezing and asthma remain unclear. Methods We measured metabolite abundance in serum samples collected from children with an acute lower respiratory illness (particularly acute wheezing and asthma) (N = 178) and healthy controls (N = 50) using liquid chromatography mass spectrometry. We hypothesised that acute lower respiratory illness cases would display increased abundance of compounds related to inflammation such as leukotrienes and mediators of lipid signalling compared with healthy controls. Results We found differences in levels of a number of metabolites between cases and controls, including cell membrane lipids, with increased levels of phosphatidylcholines and lysophosphatidylcholines and decreased levels of phosphatidylglycerols and phosphatidic acids in cases compared with controls. We constructed a predictive model that distinguished cases from controls with a high degree of accuracy (Area Under The Curve > 0.9). Conclusions We have shown that metabolomics may be a powerful tool to identify compounds that distinguish children with severe acute lower respiratory illness from controls.