Plasma dynamic metabolomics during anti-tuberculosis treatment identifies an amino acid panel with diagnostic potential

Tuberculosis (TB) belongs to infectious diseases leading to the high mortality and morbidity worldwide. Since long-term bacilli burden leads to metabolic disorders in TB patients, metabolic biomarkers with diagnosis and prognosis potential are worthy of elucidation. In this study, ¹H nuclear magnetic resonance spectroscopy (¹H NMR)-based plasma metabolomics were investigated dynamically in onset TB patients undergoing conventional anti-TB chemotherapy before and along with the treatment. We found that metabolomic profiles altered before and after the treatment of 2 and 4 months, among which four amino acids, including 4-aminobenzoate, phenylalanine, serine, and threonine, were screened out with significant decrease at 6 months after anti-TB therapy in the training longitudinal samples and validated in another longitudinal samples. Moreover, we have also confirmed the increase of 4 amino acid contents in the periphery of active TB patients when compared to those in healthy controls (HCs). Receiver operating characteristic (ROC) analysis revealed that the combination of 4 amino acids was able to distinguish TB patients from HC with an area under the curve (AUC) value of 0.912 ±0.031 (P < 0.0001). Therefore, our study has identified an amino acid panel with increased levels in active TB patients and declined along with conventional anti-TB treatment, which might be potential in distinguishing TB patients from HCs as well as prognosis candidates in clinics.