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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rmt</journal-id><journal-title-group><journal-title xml:lang="ru">Общая реаниматология</journal-title><trans-title-group xml:lang="en"><trans-title>General Reanimatology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1813-9779</issn><issn pub-type="epub">2411-7110</issn><publisher><publisher-name>FSBI "SRIGR" RAMS</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15360/1813-9779-2022-2-22-36</article-id><article-id custom-type="elpub" pub-id-type="custom">rmt-2210</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Метаболомное профилирование крови пациентов с хроническим нарушением сознания</article-title><trans-title-group xml:lang="en"><trans-title>Metabolomic Profiling of the Blood of Patients with Chronic Consciousness Disorders</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Орлова</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Orlova</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>197376</p><p>ул. Профессора Попова, д. 14</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Anastasia A. Orlova</p><p>197376</p><p>14 Professor Popova Str.</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кондратьева</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kondrat'eva</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Екатерина Анатольевна Кондратьева</p><p>191014</p><p>ул. Маяковского, д. 12</p><p>Санкт-Петербург</p><p>107031</p><p>ул. Петровка, д. 25, стр. 2</p><p>Москва</p></bio><bio xml:lang="en"><p>Ekaterina A. Kondrat'eva</p><p>191014</p><p>12 Mayakovsky Str.</p><p>St. Petersburg</p><p>107031</p><p>25 Petrovka Str., Bldg. 2</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дубровский</surname><given-names>Я. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dubrovskii</surname><given-names>Ya. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>197341</p><p>ул. Аккуратова, д. 2</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Yaroslav A. Dubrovskii</p><p>197341</p><p>2 Akkuratova Str.</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дрягина</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Dryagina</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Российский научно-исследовательский нейрохирургический институт им. проф. А. Л. Поленова (филиал)</p><p>191014</p><p>ул. Маяковского, д. 12</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Natalia V. Dryagina</p><p>191014</p><p>12 Mayakovsky Str.</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Вербицкая</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Verbitskaya</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>197022</p><p>ул. Льва Толстого, д. 6–8</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Elena V. Verbitskaya</p><p>197022</p><p>6–8 Lev Tolstoy Str.</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кондратьев</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kondratev</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Российский научно-исследовательский нейрохирургический институт им. проф. А. Л. Поленова (филиал)</p><p>191014</p><p>ул. Маяковского, д. 12</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Sergey A. Kondratev</p><p>191014</p><p>12 Mayakovsky Str.</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Костарева</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kostareva</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>197341</p><p>ул. Аккуратова, д. 2</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Anna A. Kostareva</p><p>197341</p><p>2 Akkuratova Str.</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кондратьев</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Kondratev</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Российский научно-исследовательский нейрохирургический институт им. проф. А. Л. Поленова (филиал)</p><p>191014</p><p>ул. Маяковского, д. 12</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Anatoly N. Kondratev</p><p>191014</p><p>12 Mayakovsky Str.</p><p>St. Petersburg</p></bio><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Санкт-Петербургский государственный химико-фармацевтический университет Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>St. Petersburg State Chemical and Pharmaceutical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Российский научно-исследовательский нейрохирургический институт им. проф. А. Л. Поленова, филиал НМИЦ им. В. А. Алмазова; Федеральный научно-клинический центр реаниматологии и реабилитологии (ФНКЦ РР)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A. L. Polenov Russian Research Institute for Neurosurgery, V.A. Almazov National Research Center; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр им. В. А. Алмазова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V. A. Almazov National Medical Research Center, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Российский научно-исследовательский нейрохирургический институт им. проф. А. Л. Поленова, филиал НМИЦ им. В. А. Алмазова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A. L. Polenov Russian Research Institute for Neurosurgery, V.A. Almazov National Research Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Первый Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Academician I. P. Pavlov First Saint-Petersburg State Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>28</day><month>04</month><year>2022</year></pub-date><volume>18</volume><issue>2</issue><fpage>22</fpage><lpage>36</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Орлова А.А., Кондратьева Е.А., Дубровский Я.А., Дрягина Н.В., Вербицкая Е.В., Кондратьев С.А., Костарева А.А., Кондратьев А.Н., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Орлова А.А., Кондратьева Е.А., Дубровский Я.А., Дрягина Н.В., Вербицкая Е.В., Кондратьев С.А., Костарева А.А., Кондратьев А.Н.</copyright-holder><copyright-holder xml:lang="en">Orlova A.A., Kondrat'eva E.A., Dubrovskii Y.A., Dryagina N.V., Verbitskaya E.V., Kondratev S.A., Kostareva A.A., Kondratev A.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.reanimatology.com/rmt/article/view/2210">https://www.reanimatology.com/rmt/article/view/2210</self-uri><abstract><p>   Основными вариантами хронического нарушения сознания (ХНС), развивающегося при неблагоприятном исходе комы, являются вегетативное состояние / синдром ареактивного бодрствования (ВС / САБ) и состояние минимального сознания (СМС).</p><p>   Цель исследования — изучение основных различий метаболомных нарушений у пациентов в ВС / САБ и СМС, а также выявление изменений метаболома в зависимости от фазы сна или бодрствования.   Материалы и методы. Методами обращенно-фазовой и гидрофильной хроматографии провели нецелевой метаболомный анализ плазмы крови 10 пациентов в ВС / САБ (группа 1), 6 пациентов в СМС (группа 2). Этиология поражения головного мозга: группа 1 (ЧМТ — 2, гипоксия — 8), группа 2 (ЧМТ — 5, гипоксия — 1). У всех пациентов катетеризировали внутреннюю яремную вену, забор крови проводили в состоянии бодрствования в дневное время в течение 2 суток. Аликвоты пулированных образцов плазмы очищали от белковых компонентов, анализировали методом высокоэффективной жидкостной хроматографии в двух режимах — обращенно-фазовом и гидрофильном. Масс-спектрометрическое детектирование проводили в режиме сканирования по полному ионному току: регистрация положительно-заряженных ионов в диапазоне m/z от 50 до 1300 а. е. м. Выравнивание и нормализацию данных производили с использованием программного обеспечения MS-DIAL ver. 4.70, различия выявляли методами дисперсионного, дискриминантного и кластерного анализа. Статистическую обработку и визуализацию данных проводили с использованием программного обеспечения MetaboAnalyst 5.0 (https://www.metaboanalyst.ca/).   Результаты. Выявили четыре основных метаболита (при VIP &gt; 0,5), содержание которых в наибольшей степени модулировалось в зависимости от рассматриваемой группы: 4 (m/z 124,0867, Rt = 17,67, p &lt; 0,01), 33 (m/z 782,5722, Rt = 17,69, p &lt; 0,01), 6 (m/z 125,0904, Rt = 18,43, p &lt; 0,01) и 1 (m/z 463,2304, Rt = 15,78, p &lt; 0,01), при отсутствии значимых различий между дневными и ночными заборами образцов крови. Показали наличие значимых количественных различий трех метаболитов в группах: 14 (m/z 162,1126, Rt = 10,28, p &lt; 0,01), 35 (m/z 780,5483, Rt = 7,65, p &lt; 0,01) и 41 (m/z 806,5649, Rt = 7,58, p &lt; 0,01), и четырех метаболитов при сравнении дневных и ночных заборов: 14 (m/z 162,1126, Rt = 10,28, p = 0,0201), 35 (m/z 780,5483, Rt = 7,65, p &lt; 0,01), 41 (m/z 806,5649, Rt = 7,58, p &lt; 0,01) и 48 (m/z 848,5354, Rt = 7,65, p &lt; 0,01).   Заключение. Нецелевой метаболомный анализ подтвердил гипотезу о вероятных значимых количественных и качественных различиях состава метаболитов в зависимости от формы ХНС и циркадианного ритма. В ходе исследования установили набор метаболитов – потенциальных биомаркеров для дифференциальной диагностики ВС / САБ и СМС — 4, 33, 6, 1 (в эксперименте на обращенно-фазовой колонке) и 14, 35, 41, 48 (в эксперименте на гидрофильной колонке), исходя из их значительного вклада в проявление межгрупповых и внутригрупповых различий. Целью дальнейших исследований будет проведение идентификации и характеристики обозначенных метаболитов.</p></abstract><trans-abstract xml:lang="en"><p>   The main variants of chronic consciousness disorder (CCD) developing in adverse coma outcome are vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimal consciousness state (MCS).   The aim of the study was to investigate the main differences in metabolomic abnormalities in patients with VS / UWS and MCS, as well as to identify changes in metabolomics depending on sleep or wakefulness phase.   Materials and Methods. Untargeted metabolome analysis of blood plasma of 10 patients in VS / UWS (group 1) and 6 patients in MCS (group 2) was performed using reversed-phase and hydrophilic chromatography methods. The underlying conditions of brain injury were TBI (2 in group 1 and 5 in group 2) and hypoxia (8 in group 1 and 1 in group 2). The internal jugular vein was catheterized in all patients, and blood was collected while awake during the daytime for 2 days. Aliquots of pooled plasma samples were purified from protein components and analyzed by high-performance liquid chromatography in two modes: reversed-phase and hydrophilic ones. Mass-spectrometric detection was performed in full ion current scanning mode: registration of positively charged ions in the m/z range from 50 to 1300 a.u. Data were adjusted and normalized using MS-DIAL software ver. 4.70 software; differences were identified using analysis of variance, discriminant and cluster analysis. The data were analyzed and visualized using MetaboAnalyst 5.0 software (https://www.metaboanalyst.ca).   Results. Four major metabolites (at VIP &gt; 0.5), which content was most modulated depending on the study group, were identified including 4 (m/z 124.0867, Rt = 17.67, p &lt; 0.01), 33 (m/z 782.5722, Rt = 17.69, p &lt; 0.01), 6 (m/z 125.0904, Rt = 18.43, p &lt; 0.01) and 1 (m/z 463.2304, Rt = 15.78, p &lt; 0.01), with no significant differences between daytime and nighttime blood samples. Significant quantitative differences were shown for three metabolites in the groups, 14 (m/z 162.1126, Rt = 10.28, p &lt; 0.01), 35 (m/z 780.5483, Rt = 7.65, p &lt; 0.01), and 41 (m/z 806.5649, Rt = 7.58, p &lt; 0.01), and four metabolites when comparing the daytime and nighttime samples: 14 (m/z 162.1126, Rt = 10.28, p = 0.0201), 35 (m/z 780.5483, Rt = 7.65, p &lt; 0.01), 41 (m/z 806.5649, Rt = 7.58, p &lt; 0.01), and 48 (m/z 848.5354, Rt = 7.65, p &lt; 0.01).   Conclusion. Untargeted metabolomic analysis confirmed the hypothesis of likely significant quantitative and qualitative differences in metabolite composition depending on the type of CCD and circadian rhythm. The study established a set of metabolites that are potential biomarkers for differential diagnosis of VS/UWS and MCS including 4, 33, 6, 1 (in the experiment on the reversed-phase column) and 14, 35, 41, 48 (in the experiment on the hydrophilic column), based on their significant contribution to intergroup and intragroup differences. Further studies will be aimed to characterize the identified metabolites.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хроническое нарушение сознания</kwd><kwd>вегетативное состояние</kwd><kwd>синдром ареактивного бодрствования</kwd><kwd>состояние минимального сознания</kwd><kwd>метаболомика</kwd><kwd>метаболомный профиль</kwd><kwd>гематоэнцефалический барьер</kwd><kwd>циркадианный ритм</kwd><kwd>глимфатическая система</kwd><kwd>прогнозирование восстановления сознания</kwd><kwd>мультидисциплинарный подход</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic consciousness disorder</kwd><kwd>vegetative state</kwd><kwd>unresponsive wakefulness syndrome</kwd><kwd>minimal consciousness state</kwd><kwd>metabolomics</kwd><kwd>metabolomic profile</kwd><kwd>blood-brain barrier</kwd><kwd>circadian rhythm</kwd><kwd>glymphatic system</kwd><kwd>prediction of consciousness recovery</kwd><kwd>multidisciplinary approach</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование выполнено при финансовой поддержке РФФИ в рамках научного проекта № 19-29-01066</funding-statement><funding-statement xml:lang="en">The study was supported by the Russian Foundation for Basic Research under Scientific Project No. 19-29-01066</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Пирадов М. 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