iScience (Jul 2024)

Circulating biomarkers of kidney angiomyolipoma and cysts in tuberous sclerosis complex patients

  • Varvara I. Rubtsova,
  • Yujin Chun,
  • Joohwan Kim,
  • Cuauhtemoc B. Ramirez,
  • Sunhee Jung,
  • Wonsuk Choi,
  • Miranda E. Kelly,
  • Miranda L. Lopez,
  • Elizabeth Cassidy,
  • Gabrielle Rushing,
  • Dean J. Aguiar,
  • Wei Ling Lau,
  • Rebecca S. Ahdoot,
  • Moyra Smith,
  • Aimee L. Edinger,
  • Sang-Guk Lee,
  • Cholsoon Jang,
  • Gina Lee

Journal volume & issue
Vol. 27, no. 7
p. 110265

Abstract

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Summary: Patients with tuberous sclerosis complex (TSC) develop multi-organ disease manifestations, with kidney angiomyolipomas (AML) and cysts being one of the most common and deadly. Early and regular AML/cyst detection and monitoring are vital to lower TSC patient morbidity and mortality. However, the current standard of care involves imaging-based methods that are not designed for rapid screening, posing challenges for early detection. To identify potential diagnostic screening biomarkers of AML/cysts, we performed global untargeted metabolomics in blood samples from 283 kidney AML/cyst-positive or -negative TSC patients using mass spectrometry. We identified 7 highly sensitive chemical features, including octanoic acid, that predict kidney AML/cysts in TSC patients. Patients with elevated octanoic acid have lower levels of very long-chain fatty acids (VLCFAs), suggesting that dysregulated peroxisome activity leads to overproduction of octanoic acid via VLCFA oxidation. These data highlight AML/cysts blood biomarkers for TSC patients and offers valuable metabolic insights into the disease.

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