The content of a patient may be key to assessing whether or not he is approaching death.
No, it’s not a form of life Haruspicy. A team of doctors led by Alexander de Porto at the University of Chicago and the University of Amsterdam have created marker indicators with patient feces that help measure the risk of death within 30 days.
They name it the Metabolic Isolation Score (MDS), which could help save lives in critically ill patients in intensive care.
Their results provide an exciting promise as a future tool in diagnostic medicine, although they require attention and further investigation and verification.
“The findings suggest that fecal metabolic segregation, quantified via MDS, retains its potential as a biomarker for identifying critically ill patients in increased mortality,” De Porto and his colleagues Eric Pamer and Bhakti Patel told Sciencealert.
“This highlights the importance of intestinal metabolites as independent contributors to host resilience and provides a pathway for precision medicine.”
Serious patients hospitalized in intensive care units often develop severe syndromes Sepsis And acute respiratory dyspnea – but these syndromes do not always develop and evolve in the same way. This heterogeneity poses a major challenge to seeking to treat these patients. Two patients with the same syndrome may respond very differently to the same treatment.
One way to avoid this challenge is to identify the specific characteristics to treat, rather than attacking the entire syndrome at once, researchers said. Scientists know that critically ill patients often reduce their diversity Intestinal microbiotaand changes in the concentration of metabolites produced by their microbiota.
De Porto and his colleagues embarked on an investigation into Abnormalitiesintestinal microbiota imbalance, severely ill patients, as a treatment characteristic. They studied fecal samples collected from 196 patients showing respiratory failure or shock, divided into a training cohort of 147 patients and a validation cohort of 49 patients.
They used these samples to develop MDS based on the concentrations of 13 different fecal metabolites. The results show an auspicious pathway for further investigation.
“MDS works well in predicting mortality in training cohorts of medical ICU patients, with 84% accuracy, 89% sensitivity and 71% specificity,” the researchers said.
“However, despite showing similar trends, the validation cohort was unable to reach statistical significance, possibly due to the small sample size. These findings highlight the promise of MDS, but also the need to validate the predictive capacity and generalizability of independent cohorts prior to widespread application.”
What researchers found particularly interesting was that they were unable to find such links, even if the lack of microbiota diversity had previously been associated with adverse outcomes in critically ill patients. Instead, their results show a strong association between dysfunction and increased risk of death, suggesting that microbiota imbalances play an important role in patient health.
More work needs to be done before the team’s approach is suitable for clinical applications. Null results in a validation cohort of only 47 patients indicate that considerable refinement is required. However, there are some encouraging points.
For example, the lab shows that fecal metabolites can identify liver transplant patients at a higher risk of developing postoperative infection. Furthermore, although specific treatments have not yet been investigated or identified, MDS indicates several routes for further investigation.
“Metabolites, including scores such as short-chain fatty acids, bile acids, and tryptophan metabolites, refer to biological pathways that may be therapeutically targeted,” the researchers said. “Potential interventions may include dietary changes, administration of probiotics, or direct supplementation of these metabolites.”
The next step is to work on the validation of the MDS of a new set of new patients and to determine whether the link between observed abnormalities and increased risk of death is causal or symptomatic for another cause.
“Interventional trials targeting specific metabolites or pathways are then necessary to assess therapeutic benefits,” he said.
This study is published in Advances in science.
