Evidence map›Paper›PMID 37138028›Full record

ArticlePediatric research2023

The hydrocortisone-responsive urinary metabolome of premature infants.

Dara Torgerson, Miguel Guardado, Martina Steurer, Cheryl Chapin, Ryan D Hernandez, Philip L Ballard

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Dara TorgersonEpidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Miguel GuardadoEpidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Martina SteurerPediatrics, University of California San Francisco, San Francisco, CA, USA.
Cheryl ChapinPediatrics, University of California San Francisco, San Francisco, CA, USA.
Ryan D HernandezBioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA.
Philip L BallardPediatrics, University of California San Francisco, San Francisco, CA, USA. Phil.ballard@ucsf.edu.
University of California, San Francisco · US

Funding

Rarely Common: Uncovering the dominant role of rare variants in the genetic architecture of complex human traits.R01GM142112 · NIGMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HERNANDEZ, RYAN D. · 2021 to 2024
$2.2M
Integrative metabolomics of bronchopulmonary dysplasia in extremely low gestational age infantsR01HL153429 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BALLARD, PHILIP L., TORGERSON, DARA · 2021 to 2024
$1.6M
The Urinary Metabolome and Bronchopulmonary Dysplasia in Premature InfantsR21HD097600 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BALLARD, PHILIP L., TORGERSON, DARA · 2019 to 2020
$444k
NHLBI NIH HHS R01 HL153429NICHD NIH HHS R21 HD097600NIGMS NIH HHS R01 GM142112
6 · The paper itself

Abstract

backgroundExtremely premature infants are at risk for circulatory collapse or respiratory failure that are often treated with hydrocortisone (HC); however, there is no information on the metabolic consequences of this therapy.

methodsLongitudinal urine samples from infants <28 weeks gestation in the Trial of Late Surfactant were analyzed by untargeted UHPLC:MS/MS. Fourteen infants who received a tapering course of HC beginning at 3 mg/kg/day for ≥9 days were compared to 14 matched control infants. A secondary cross-sectional analysis by logistic regression used urines from 314 infants.

resultsOf 1145 urinary metabolites detected, abundance of 219, representing all the major biochemical pathways, changed at p < 0.05 in the HC-treated group with 90% decreasing; 3 cortisol derivatives increased ~2-fold with HC therapy. Only 11% of regulated metabolites remained responsive at the lowest HC dose. Regulated metabolites included two steroids and thiamin that are associated with lung inflammation in infants. HC responsiveness was confirmed in 57% of metabolites by cross-sectional analysis.

conclusionsHC treatment of premature infants influenced in a dose-dependent manner abundance of 19% of identified urinary metabolites of diverse biochemical systems, primarily reducing concentrations. These findings indicate that exposure to HC reversibly impacts the nutritional status of premature infants. IMPACT: Hydrocortisone treatment of premature infants with respiratory failure or circulatory collapse alters levels of a subset of urinary metabolites representing all major biochemical pathways. This is the first description of the scope, magnitude, timing and reversibility of metabolomic changes in infants in response to hydrocortisone, and it confirms corticosteroid regulation of three biochemicals that are associated with lung inflammatory status. The findings indicate a dose-dependency of hydrocortisone for metabolomic and anti-inflammatory effects, that prolonged therapy may lower the supply of many nutrients, and that monitoring concentrations of cortisol and inflammation markers may be a useful clinical approach during corticosteroid therapy.

Indexed as

Respiratory InsufficiencyShockCross-Sectional StudiesHumansHydrocortisoneInfantInfant, NewbornInfant, PrematureMetabolomeTandem Mass SpectrometryHydrocortisone

Identifiers

PMID37138028
PMCPMC10589081
OpenAlexW4367856334

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.