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This study aims to identify plasma metabolomic biomarkers for spontaneous isolated superior mesenteric artery dissection (SISMAD) and its complications.

February 14, 2026

Metabolomic Signatures of Spontaneous Isolated Superior Mesenteric Artery Dissection: Indole Derivatives and Lysophospholipids as Novel Biomarkers

Key Points

This study aims to identify plasma metabolomic biomarkers for spontaneous isolated superior mesenteric artery dissection (SISMAD) and its complications.
Analyzed plasma samples from 30 SISMAD patients and 30 healthy controls
Used ultra-high-performance liquid chromatography and orbitrap mass spectrometry for metabolite profiling
Applied principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) to assess data
Identified 123 metabolites changed in positive ion mode and 128 in negative mode
Significant reductions in tryptophan-related metabolites, including methyl 2-(1H-indol-3-yl) acetate and indole-3-pyruvic acid (IPA)
Lysophosphatidylethanolamine (LysoPE) showed the highest diagnostic accuracy with AUC of 0.986

Abstract

ABSTRACT Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare but increasingly recognized vascular disorder that can lead to intestinal dysfunction with severe complications. Currently, no plasma biomarkers, particularly metabolomics‐based markers, have been identified for SISMAD. To identify novel plasma biomarkers and potential therapeutic targets for SISMAD and its associated intestinal dysfunction, we analyzed plasma samples from 30 patients with SISMAD and 30 healthy controls. Blood was collected within 72 h of diagnosis. Ultra‐high‐performance liquid chromatography coupled with orbitrap mass spectrometry was used to profile metabolites, followed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS‐DA) to analyze the data. A total of 123 and 128 metabolites were significantly changed in the positive and negative ion modes, respectively. Notably, tryptophan‐related metabolites, including methyl 2‐(1 H ‐indol‐3‐yl) acetate and indole‐3‐pyruvic acid (IPA), were significantly reduced in the SISMAD group ( p < 0.001), with a strong correlation between the two (Corr. = 0.989, p < 0.001). Pathway analysis revealed that glycerophospholipid metabolism was most enriched, primarily driven by lysophospholipids (LPLs), particularly lysophosphatidylethanolamine (LysoPE), which showed the highest fold change and diagnostic accuracy (area under the curve AUC = 0.986). This study identifies significant metabolic alterations in SISMAD, including reductions in indole derivatives (methyl 2‐(1 H ‐indol‐3‐yl) acetate and IPA and several LPLs, such as LysoPE, lysophosphatidylcholine (LysoPC), and lysophosphatidylglycerol (LysoPG). These findings highlight potential diagnostic biomarkers and therapeutic targets for SISMAD and its associated intestinal dysfunction, providing a promising avenue for clinical management and intervention.

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Metabolomic Signatures of Spontaneous Isolated Superior Mesenteric Artery Dissection: Indole Derivatives and Lysophospholipids as Novel Biomarkers

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