A Comparative Metabolomic Evaluation of Behcet's Disease with Arthritis and Seronegative Arthritis Using Synovial Fluid

Joong Kyong Ahn¹, Sooah Kim², Jungyeon Kim², Jiwon Hwang³, Hyungjin Kim⁴, Hyemin Jeong⁵, Yeong Hee Eun⁶, Chan Hong Jeon⁷, Jaejoon Lee⁵, Eun-Mi Koh⁵, Kyoung Heon Kim² and Hoon-Suk Cha⁸, ¹Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, ²Department of Biotechnology, Korea University Graduate School, Seoul, South Korea, ³Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, ⁴Department of medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, ⁵Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, ⁶Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, ⁷Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, South Korea, ⁸Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Behcet's syndrome, Biomarkers, metabolomics and synovial fluid

Session Information

Date: Tuesday, November 10, 2015

Title: Vasculitis Poster III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Behcet’s disease (BD) is a chronic, complex systemic vasculitis of unknown etiology characterized by orogenital ulcers, uveitis, and arthritis. Arthritis and arthralgias in BD are known to be the most common rheumatologic findings with a prevalence ranging from 40 to 70%. However, arthritis in BD is often confused with seronegative arthritis (SNA) including seronegative spondyloarthropathy (SNSpA) and seronegative rheumatoid arthritis (SNRA) because of shared clinical symptoms and the lack of definitive biomarkers for BD. The purpose of this study was to evaluate the metabolomic profiling of synovial fluid (SF) from patients with arthritis in BD and SNA to investigate possible metabolic patterns and potential biomarkers for arthritis in BD.

Methods: SF samples were collected from BD patients with arthritis (n = 6, mean age 34.8 ± 16.4 years), SNSpA (n = 13, mean age 30.9 ± 11.0 years), and SNRA (n = 5, mean age 65.8 ± 10.7 years). Metabolomic profiling was performed by gas chromatography/time-of-flight mass spectrometry in conjunction with univariate and multivariate statistical analyses.

Results: A total of 123 metabolites were identified from samples. Orthogonal partial least square-discriminant analysis showed clear discrimination between arthritis in BD and SNA. A set of 11 metabolites were identified as potential biomarkers for arthritis in BD using variable importance for projection values and the Wilcoxon-Mann-Whitney test. Compared with SNA, arthritis in BD exhibited relatively high levels of glutamate, valine, citramalate, leucine, methionine sulfoxide, glycerate, phosphate, lysine, isoleucine, urea, and citrulline. There were two markers identified, elevated methionine sulfoxide and citrulline, that were associated with increased oxidative stress, providing a potential link to BD-associated neutrophil hyperactivity. Glutamate, citramalate, and valine were selected and validated as putative biomarkers for arthritis in BD (sensitivity, 100%; specificity, 61.1%).

Conclusion: This is the first report to present potential biomarkers from SF for discriminating arthritis in BD from SNA. The metabolomics of SF may be helpful in searching for potential biomarkers and elucidating the clinicopathogenesis of arthritis in BD.

Disclosure: J. K. Ahn, None; S. Kim, None; J. Kim, None; J. Hwang, None; H. Kim, None; H. Jeong, None; Y. H. Eun, None; C. H. Jeon, None; J. Lee, None; E. M. Koh, None; K. H. Kim, None; H. S. Cha, Advanced Biomass R&D Center of Korea (2011-0031353), 2,National Research Foundation of Korea funded by the Ministry of Education (NRF-2013R1A1A2059103), 2,the Korea Health Technology R&D Project (HI14C2285), 2.

To cite this abstract in AMA style:

Ahn JK, Kim S, Kim J, Hwang J, Kim H, Jeong H, Eun YH, Jeon CH, Lee J, Koh EM, Kim KH, Cha HS. A Comparative Metabolomic Evaluation of Behcet’s Disease with Arthritis and Seronegative Arthritis Using Synovial Fluid [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/a-comparative-metabolomic-evaluation-of-behcets-disease-with-arthritis-and-seronegative-arthritis-using-synovial-fluid/. Accessed .

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