MONITORING OF CHILD AND TEENS’ ADHESION TO ALLERGIC RHINITIS PROPHYLAXIS BY NMR-BASED METABONOMICS ASSAYS
metabolomics, allergic rhinitis, asthma, childhood
Allergic rhinitis is an immunoglobulin E mediated chronic inflammatory disease that affects about 40% of world population, being very frequent among children and teenagers. The effectiveness of allergic rhinitis treatment is dependent on patients’ adherence to therapy. In clinical practice, this patients’ adherence assessment is subjective, once uses patient self-report. In this paper, we report a pilot study using NMR-based Metabonomics to monitor childrenand teenagers’ adherence to allergic rhinitis treatment. This study was developed at Clinics Hospital of UFPE, Brazil.Twenty-five volunteers were included in the study. 1H NMR spectra of serum these volunteers were obtained and processed using multivariate statistical tools. Initially, Hierarchical Clusters Analysis (HCA) was employed for spontaneous grouping of the samples. Two groups were defined containing eleven and fourteen samples each. It was not observed relationship among patients’ self-report of adherence and the groups identified by HCA. Main difference observed between the groups was the response to treatment – nine of eleven volunteers did not response to treatment, while six of fourteen volunteers did not responseto treatment in another group. Orthogonal Partial Least Square Discriminant Analysis (OPLS-DA) was used to identify the main variables responsible for discrimination. Alanine, serine, arginine, choline, N-acetyl D-glucosamine, glutamate, lactate, glucose, VLDL/LDL were the metabolites identified. The metabolites that had high serum level among those volunteers who did not response to treatment are associate with the chronicity and severity more intense of disease than those volunteers who presented some response to treatment. This is an indication that NMR based metabonomics can be useful to monitor allergic rhinitis treatment.