Biomarker Discovery in Childhood Asthma: A Pilot Study of Serum Metabolite Analysis for IgE-Dependent Allergy.

BACKGROUND Childhood asthma, especially in the youngest children, is difficult to diagnose and is often based on the patient's symptoms. This study compared metabolite concentrations in serum samples between 13 children with asthma and IgE-dependent allergy and 10 without asthma and IgE-dependent allergy, aged between 6 months and 5 years. MATERIAL AND METHODS The study included a total of 23 children. The targeted metabolomic analysis was performed using an AbsoluteIDQ p180 kit and analyzed using a triple quadrupole tandem mass spectrometer coupled with a high-performance liquid chromatograph. Statistical analyses included univariate tests and univariate and multivariate receiver operating characteristic (ROC) curves. RESULTS Of the 188 metabolites, 131 were determined in the samples. Additionally, 48 sums and ratios of metabolites were calculated. Significant differences (P<0.05) were found for the 6 metabolites of sphingolipids and glycerophospholipids and ratio serotonin synthesis. Multivariate ROC curve analysis was performed for phosphatidylcholine 40: 4 and serotonin synthesis ratio, which were selected based on the univariate ROC curve analysis results. This combined indicator's area under the curve (AUC) demonstrated greater sensitivity and specificity than the individual variables. CONCLUSIONS Our study sheds new light on differences in serum metabolite concentrations between patients under 5 years of age with asthma and IgE-dependent allergy and patients without asthma or IgE-dependent allergy. A multiclassifier integrating PC 40: 4 and serotonin synthesis ratio is a promising biomarker for diagnosing childhood asthma with IgE-dependent allergy, facilitating faster, more precise, and personalized diagnosis and treatment of pediatric patients.