Metabonomics uncovers a reversible proatherogenic lipid profile during infliximab therapy of inflammatory bowel disease

Research output: Contribution to journalArticlepeer-review


  • Jacob Tveiten Bjerrum
  • Casper Steenholdt
  • Mark Ainsworth
  • Ole Haagenb Nielsen
  • Fuhua Hao
  • Yulan Wang

Colleges, School and Institutes

External organisations

  • Copenhagen University Hospitals
  • Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Centre for Magnetic Resonance, Wuhan Institute of Physics and Mathematics, The Chinese Academy of Science


Background: One-third of inflammatory bowel disease (IBD) patients show no response to infliximab (IFX) induction therapy, and approximately half of patients responding become unresponsive over time. Thus, identification of potential treatment response biomarkers are of great clinical significance. This study employs spectroscopy-based metabolic profiling of serum from patients with IBD treated with IFX and healthy subjects (1) to substantiate the use of spectroscopy as a semi-invasive diagnostic tool, (2) to identify potential biomarkers of treatment response, and (3) to characterize the metabolic changes during management of patients with tumor necrosis factor-α inhibitors.

Methods: Successive serum samples collected during IFX induction treatment (weeks 0, 2, 6, and 14) from 87 IBD patients and 37 controls were analyzed by 1H nuclear magnetic resonance (NMR) spectroscopy. Data were analyzed with principal components analysis and orthogonal projection to latent structures discriminant analysis using SIMCA-P+ v12 and MATLAB.

Results: Metabolic profiles were significantly different between active ulcerative colitis (UC) and controls, active Crohn’s disease (CD) and controls, and quiescent CD and controls. Metabolites holding differential power belonged primarily to lipids and phospholipids with proatherogenic characteristics and metabolites in the pyruvate metabolism, suggestive of an intense inflammation-driven energy demand. IBD patients not responding to IFX were identified as a potential distinct group based on their metabolic profile, although no applicable response biomarkers could be singled out in the current setting.

Conclusion: 1H NMR spectroscopy of serum samples is a powerful semi-invasive diagnostic tool in flaring IBD. and Wwith its use we provide unique insights into the metabolic changes taking place during induction treatment with IFX is provided. Of distinct clinical relevance is the identification of a reversible proatherogenic lipid profile in IBD patients with active disease, which partially explains the increased risk of cardiovascular disease, associated with IBD.


Original languageEnglish
JournalBMC medicine
Issue number184
Early online date16 Oct 2017
Publication statusPublished - 16 Oct 2017


  • Chron's disease , diagnostics , metabolomics , serum , ulcerative colitis

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