Examination of plasma metabolomic profiles of immune thrombocytopenic purpura patients with Q-TOF LC/MS

Aim: ITP is an autoimmune disease characterized by a decrease in circulating platelet count due to autoantibodies directed against platelets. This study aimed to elucidate the pathophysiology of ITP by comparing the metabolomic and lipidomic profiles of patients diagnosed with ITP and healthy controls. Materials and Methods: Plasma samples obtained from 39 patients with ITP and 41 age-matched healthy controls (22–65 years) were analyzed using Q-TOF LC/MS–based untargeted metabolomics and lipidomics approaches. Multivariate statistical analyses, including PCA and PLS-DA, were performed to evaluate group separation. Differential metabolites were further assessed using volcano plot analysis and VIP scores. Metabolite identification was achieved through an in-house spectral library and putative database annotations. Subgroup analyses were conducted according to treatment status and the presence of comorbidities. Results: A total of 58 discriminative metabolites were identified between the ITP and control groups. Prostaglandin H2, testosterone, protoporphyrinogen IX, 11-dehydrocorticosterone, asymmetric dimethylarginine, 4-hydroxyretinoic acid, prostaglandin A2, progesterone, N1,N12-diacetylspermine, prostaglandin E3, cortisol, dolichyl β-D-glucosyl phosphate, N1-acetylspermine, phenylalanine, and leukotriene A4 were significantly increased in the ITP group. In contrast, dehydroepiandrosterone sulfate, 2-oxovaleric acid, oxalosuccinic acid, and 13-oxo-octadecadienoic acid were decreased. Pathway analysis revealed significant alterations in steroid hormone metabolism, steroidogenesis, and biotin metabolism. Conclusion: The metabolomic profiles of patients with ITP were found to differ significantly from those of healthy controls. Phenylalanine, glutamine, 2-oxovaleric acid, and docosahexaenoic acid may be involved in the pathophysiology of ITP, and these findings may provide a basis for future targeted metabolomic investigations.