A Metabolomic Approach for Screening of Acute Liver Failure Patients in Hepatitis E Virus Infection

Background: Hepatitis E is mainly an acute and self-limiting disease which is endemic to resource poor regions of the world. Some patients have an increased susceptibility to develop fulminant hepatitis which is a rare disorder with high mortality and resource cost. In this study, a metabonomic approach was used to investigate the biochemical perturbation of the serum samples from acute liver failure patients induced by hepatitis E virus. Materials and Methods: Serum samples from hepatitis E virus-related acute liver failure patients (n = 20) and healthy controls (n = 20) were studied. Gas chromatography–mass spectrometry technique integrated with a commercial mass spectral library for the peak identification was used to detect the serum metabonome. Results: Out of the 24 metabolites detected, the serum levels of benzenepropanoic acid, lactic acid, hexadecanoic acid, L-proline, serine, and butanoic acid were significantly higher in the acute liver failure patients than those in the healthy control, whereas octadecanoic acid, N-formylglycine, and isoleucine were significantly higher in healthy controls compared to cases. These metabolites are suggested to be involved in various metabolic activities. Conclusion: These results may indicate that metabonomic analysis of the serum samples can provide integrative information to assess the severity of the liver failure, which is beneficial for predicting the pathogenetic condition and the course of liver disease.