Metabolic basis of post-infectious sequelae after Ebola virus disease.

INTRODUCTION

Ebola virus disease (EVD) survivors often present with clinical sequelae after acute disease resolution, called post-Ebola syndrome (PES). Why some survivors develop these sequelae and others do not is poorly defined. Altered metabolism has been noted in acute EVD but has not been studied in PES. Here, we identified distinct metabolic pathways in EVD survivors with PES compared to asymptomatic survivors and potential biomarkers of PES.

OBJECTIVES

The purpose of this study was to determine if EVD survivors with PES demonstrated differential metabolism compared to asymptomatic EVD survivors.

METHODS

Plasma was collected from EVD survivors in Sierra Leone as part of an ongoing cohort study. Untargeted metabolomics (LC-MS/MS) was performed on survivors with and without sequelae as well as household contacts. Univariate, multivariate, biomarker and pathway analyses were performed in MetaboAnalyst. Spearman's R correlation was performed using JMP.

RESULTS

We identified differential expression of metabolites involved in multiple metabolic pathways in EVD survivors with PES compared to asymptomatic survivors. These pathways include the tricarboxylic acid cycle as well as amino acid, nucleotide, and short chain fatty acid metabolism. Several of these pathways are associated with immune dysfunction. The identified metabolites have potential use as biomarkers of PES.

CONCLUSION

EVD survivors with PES exhibit differing metabolism compared to asymptomatic EVD survivors in several pathways. Other studies have linked these pathways to immune dysfunction and chronic viral infection, however further immunometabolic studies of EVD survivors with PES are needed.