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Proc Natl Acad Sci U S A DOI:10.1073/pnas.0906039107

A plasma signature of human mitochondrial disease revealed through metabolic profiling of spent media from cultured muscle cells.

Publication TypeJournal Article
Year of Publication2010
AuthorsShaham, O, Slate, NG, Goldberger, O, Xu, Q, Ramanathan, A, Souza, AL, Clish, CB, Sims, KB, Mootha, VK
JournalProc Natl Acad Sci U S A
Date Published2010 Jan 26
KeywordsAdult, Animals, Biomarkers, Cell Line, Creatine, Culture Media, Electron Transport, Female, Humans, Male, Metabolomics, Mice, Middle Aged, Mitochondrial Diseases, Muscle Cells, Young Adult

Mutations in either the mitochondrial or nuclear genomes can give rise to respiratory chain disease (RCD), a large class of devastating metabolic disorders. Their clinical management is challenging, in part because we lack facile and accurate biomarkers to aid in diagnosis and in the monitoring of disease progression. Here we introduce a sequential strategy that combines biochemical analysis of spent media from cell culture with analysis of patient plasma to identify disease biomarkers. First, we applied global metabolic profiling to spotlight 32 metabolites whose uptake or secretion kinetics were altered by chemical inhibition of the respiratory chain in cultured muscle . These metabolites span a wide range of pathways and include lactate and alanine, which are used clinically as biomarkers of RCD. We next measured the cell culture-defined metabolites in human plasma to discover that creatine is reproducibly elevated in two independent cohorts of RCD patients, exceeding lactate and alanine in magnitude of elevation and statistical significance. In cell culture extracellular creatine was inversely related to the intracellular phosphocreatine:creatine ratio suggesting that the elevation of plasma creatine in RCD patients signals a low energetic state of tissues using the phosphocreatine shuttle. Our study identifies plasma creatine as a potential biomarker of human mitochondrial dysfunction that could be clinically useful. More generally, we illustrate how spent media from cellular models of disease may provide a window into the biochemical derangements in human plasma, an approach that could, in principle, be extended to a range of complex diseases.


Alternate JournalProc. Natl. Acad. Sci. U.S.A.
PubMed ID20080599
PubMed Central IDPMC2824369
Grant ListR01 DK081457 / DK / NIDDK NIH HHS / United States
M01 RR001066 / RR / NCRR NIH HHS / United States
RR-01066 / RR / NCRR NIH HHS / United States
/ / Howard Hughes Medical Institute / United States
R01 DK081457-02 / DK / NIDDK NIH HHS / United States
R01DK081457 / DK / NIDDK NIH HHS / United States