AUTHOR=Huang Ying , Zhao Xu , Zhang Zi-teng , Chen Shuai-shuai , Li Shan-shan , Shi Zhuo , Jing Jing , Huang Ang , Guo Yu-ming , Bai Zhao-fang , Zou Zheng-sheng , Xiao Xiao-he , Wang Jia-bo , Niu Ming 

TITLE=Metabolomics Profiling and Diagnosis Biomarkers Searching for Drug-Induced Liver Injury Implicated to Polygonum multiflorum: A Cross-Sectional Cohort Study

JOURNAL=Frontiers in Medicine

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.592434

DOI=10.3389/fmed.2020.592434

ISSN=2296-858X

ABSTRACT=<p><bold>Aim:</bold> The diagnosis of drug-induced liver injury (DILI) remains a challenge and the cases of <italic>Polygonum multiflorum</italic> Thunb. (PM) induced DILI (PM-DILI) have received much attention This study aimed to identify a simple and high-efficiency approach to PM-DILI diagnosis via metabolomics analysis.</p><p><bold>Methods:</bold> Plasma metabolites in 13 PM-DILI patients were profiled by liquid chromatography along with high-resolution mass spectrometry. Meanwhile, the metabolic characteristics of the PM-DILI were compared with that of autoimmune hepatitis (AIH), hepatitis B (HBV), and healthy volunteers.</p><p><bold>Results:</bold> Twenty-four metabolites were identified to present significantly different levels in PM-DILI patients compared with HBV and AIH groups. These metabolites were enriched into glucose, amino acids, and sphingolipids metabolisms. Among these essential metabolites, the ratios of P-cresol sulfate vs. phenylalanine and inosine vs. bilirubin were further selected using a stepwise decision tree to construct a classification model in order to differentiate PM-DILI from HBV and AIH. The model was highly effective with sensitivity of 92.3% and specificity of 88.9%.</p><p><bold>Conclusions:</bold> This study presents an integrated view of the metabolic features of PM-DILI induced by herbal medicine, and the four-metabolite decision tree technique imparts a potent tool in clinical diagnosis.</p>