Cerebrospinal fluid lipid profiles as exploratory biomarkers for pediatric meningitis: a proof-of-concept case series
Abstract
Objectives: To investigate the cerebrospinal fluid (CSF) lipid metabolite profiles of pediatric patients with purulent meningitis (PM) or viral meningitis (VM) and to explore their differential diagnostic potential.
Methods: In this proof-of-concept case series, 13 CSF samples from 10 pediatric patients were analyzed by lipidomics, distributed across four sample-level analytical groups: acute-phase PM (PM_A, n = 3) and recovery-phase PM (PM_R, n = 3) from 3 PM patients with paired sampling, acute-phase VM (VM_A, n = 3) from 3 VM patients, and non-meningitic controls (N, n = 4). Lipid separation and detection were performed by UPLC-MS/MS on a Q Exactive high-resolution mass spectrometer, and data were processed using LipidSearch v.4.1.
Results: Compared with the N group, the PM_A group displayed exploratory lipid alterations with 30 increased and 45 decreased metabolites, predominantly involving sphingolipid (SPH), dihexosylceramide (Hex2Cer), monohexosylceramide (Hex1Cer), lysophosphatidylcholine (LPC), and acylcarnitine (AcCa) species. Elevated Hex2Cer combined with reduced SPH represented a distinctive exploratory PM_A pattern. Receiver operating characteristic (ROC) analysis identified LPC(20:3) and Hex2Cer(d42:3) as exploratory candidate features for distinguishing PM_A from N (apparent AUC = 0.833 for each marker; leave-one-out jackknife AUC range 0.750-1.000, mean 0.833). Multi-feature composite AUCs were not reported because, at n = 7, any composite would be highly…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 10 participants or records.
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