Pregnancy and newborns disorders followed by urine metabolomics

Chapter 1 introduces the scope of the work by identifying the clinically relevant prenatal disorders and presently available diagnostic methods. The methodology followed in this work is presented, along with a brief account of the principles of the analytical and statistical tools employed. A thorough description of the state of the art of metabolomics in prenatal research concludes the chapter, highlighting the merit of this novel strategy to identify robust disease biomarkers. The scarce use of maternal and newborn urine in previous reports enlightens the relevance of this work. Chapter 2 presents a description of all the experimental details involved in the work performed, comprising sampling, sample collection and preparation issues, data acquisition protocols and data analysis procedures. The proton Nuclear Magnetic Resonance (NMR) characterization of maternal urine composition in healthy pregnancies is presented in Chapter 3. The urinary metabolic profile characteristic of each pregnancy trimester was defined and a 21-metabolite signature found descriptive of the metabolic adaptations occurring throughout pregnancy. 8 metabolites were found, for the first time to our knowledge, to vary in connection to pregnancy, while known metabolic effects were confirmed. This chapter includes a study of the effects of non-fasting (used in this work) as a possible confounder. Chapter 4 describes the metabolomic study of 2nd trimester maternal urine for the diagnosis of fetal disorders and prediction of later-developing complications. This was achieved by applying a novel variable selection method developed in the context of this work. It was found that fetal malformations (FM) (and, specifically those of the central nervous system, CNS) and chromosomal disorders (CD) (and, specifically, trisomy 21, T21) are accompanied by changes in energy, amino acids, lipids and nucleotides metabolic pathways, with CD causing a further deregulation in sugars metabolism, urea cycle and/or creatinine biosynthesis. Multivariate analysis models´ validation revealed classification rates (CR) of 84% for FM (87%, CNS) and 85% for CD (94%, T21). For later-diagnosed preterm delivery (PTD), preeclampsia (PE) and intrauterine growth restriction (IUGR), it is found that urinary NMR profiles have early predictive value, with CRs ranging from 84% for PTD (11-20 gestational weeks, g.w., prior to diagnosis), 94% for PE (18-24 g.w. pre-diagnosis) and 94% for IUGR (2-22 g.w. pre-diagnosis). This chapter includes results obtained for an ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) study of pre-PTD samples and correlation with NMR data. One possible marker was detected, although its identification was not possible. Chapter 5 relates to the NMR metabolomic study of gestational diabetes mellitus (GDM), establishing a potentially predictive urinary metabolic profile for GDM, 2-21 g.w. prior to diagnosis (CR 83%). Furthermore, the NMR spectrum was shown to carry information on individual phenotypes, able to predict future insulin treatment requirement (CR 94%). Chapter 6 describes results that demonstrate the impact of delivery mode (CR 88%) and gender (CR 76%) on newborn urinary profile. It was also found that newborn prematurity, respiratory depression, large for gestational age growth and malformations induce relevant metabolic perturbations (CR 82-92%), as well as maternal conditions, namely GDM (CR 82%) and maternal psychiatric disorders (CR 91%). Finally, the main conclusions of this thesis are presented in Chapter 7, highlighting the value of maternal or newborn urine metabolomics for pregnancy monitoring and disease prediction, towards the development of new early and non-invasive diagnostic methods.

Metabolic signature of lung cancer: a metabolomic study of human tissues and biofluids

This thesis reports the application of metabolomics to human tissues and biofluids (blood plasma and urine) to unveil the metabolic signature of primary lung cancer. In Chapter 1, a brief introduction on lung cancer epidemiology and pathogenesis, together with a review of the main metabolic dysregulations known to be associated with cancer, is presented. The metabolomics approach is also described, addressing the analytical and statistical methods employed, as well as the current state of the art on its application to clinical lung cancer studies. Chapter 2 provides the experimental details of this work, in regard to the subjects enrolled, sample collection and analysis, and data processing. In Chapter 3, the metabolic characterization of intact lung tissues (from 56 patients) by proton High Resolution Magic Angle Spinning (HRMAS) Nuclear Magnetic Resonance (NMR) spectroscopy is described. After careful assessment of acquisition conditions and thorough spectral assignment (over 50 metabolites identified), the metabolic profiles of tumour and adjacent control tissues were compared through multivariate analysis. The two tissue classes could be discriminated with 97% accuracy, with 13 metabolites significantly accounting for this discrimination: glucose and acetate (depleted in tumours), together with lactate, alanine, glutamate, GSH, taurine, creatine, phosphocholine, glycerophosphocholine, phosphoethanolamine, uracil nucleotides and peptides (increased in tumours). Some of these variations corroborated typical features of cancer metabolism (e.g., upregulated glycolysis and glutaminolysis), while others suggested less known pathways (e.g., antioxidant protection, protein degradation) to play important roles. Another major and novel finding described in this chapter was the dependence of this metabolic signature on tumour histological subtype. While main alterations in adenocarcinomas (AdC) related to phospholipid and protein metabolisms, squamous cell carcinomas (SqCC) were found to have stronger glycolytic and glutaminolytic profiles, making it possible to build a valid classification model to discriminate these two subtypes. Chapter 4 reports the NMR metabolomic study of blood plasma from over 100 patients and near 100 healthy controls, the multivariate model built having afforded a classification rate of 87%. The two groups were found to differ significantly in the levels of lactate, pyruvate, acetoacetate, LDL+VLDL lipoproteins and glycoproteins (increased in patients), together with glutamine, histidine, valine, methanol, HDL lipoproteins and two unassigned compounds (decreased in patients). Interestingly, these variations were detected from initial disease stages and the magnitude of some of them depended on the histological type, although not allowing AdC vs. SqCC discrimination. Moreover, it is shown in this chapter that age mismatch between control and cancer groups could not be ruled out as a possible confounding factor, and exploratory external validation afforded a classification rate of 85%. The NMR profiling of urine from lung cancer patients and healthy controls is presented in Chapter 5. Compared to plasma, the classification model built with urinary profiles resulted in a superior classification rate (97%). After careful assessment of possible bias from gender, age and smoking habits, a set of 19 metabolites was proposed to be cancer-related (out of which 3 were unknowns and 6 were partially identified as N-acetylated metabolites). As for plasma, these variations were detected regardless of disease stage and showed some dependency on histological subtype, the AdC vs. SqCC model built showing modest predictive power. In addition, preliminary external validation of the urine-based classification model afforded 100% sensitivity and 90% specificity, which are exciting results in terms of potential for future clinical application. Chapter 6 describes the analysis of urine from a subset of patients by a different profiling technique, namely, Ultra-Performance Liquid Chromatography coupled to Mass Spectrometry (UPLC-MS). Although the identification of discriminant metabolites was very limited, multivariate models showed high classification rate and predictive power, thus reinforcing the value of urine in the context of lung cancer diagnosis. Finally, the main conclusions of this thesis are presented in Chapter 7, highlighting the potential of integrated metabolomics of tissues and biofluids to improve current understanding of lung cancer altered metabolism and to reveal new marker profiles with diagnostic value.

Estimação robusta em modelos lineares de equações simultâneas

Os Modelos de Equações Simultâneas (SEM) são modelos estatísticos com muita tradição em estudos de Econometria, uma vez que permitem representar e estudar uma vasta gama de processos económicos. Os estimadores mais usados em SEM resultam da aplicação do Método dos Mínimos Quadrados ou do Método da Máxima Verosimilhança, os quais não são robustos. Em Maronna e Yohai (1997), os autores propõem formas de “robustificar” esses estimadores. Um outro método de estimação com interesse nestes modelos é o Método dos Momentos Generalizado (GMM), o qual também conduz a estimadores não robustos. Estimadores que sofrem de falta de robustez são muito inconvenientes uma vez que podem conduzir a resultados enganadores quando são violadas as hipóteses subjacentes ao modelo assumido. Os estimadores robustos são de grande valor, em particular quando os modelos em estudo são complexos, como é o caso dos SEM. O principal objectivo desta investigação foi o de procurar tais estimadores tendo-se construído um estimador robusto a que se deu o nome de GMMOGK. Trata-se de uma versão robusta do estimador GMM. Para avaliar o desempenho do novo estimador foi feito um adequado estudo de simulação e foi também feita a aplicação do estimador a um conjunto de dados reais. O estimador robusto tem um bom desempenho nos modelos heterocedásticos considerados e, nessas condições, comporta-se melhor do que os estimadores não robustos usados no estudo. Contudo, quando a análise é feita em cada equação separadamente, a especificidade de cada equação individual e a estrutura de dependência do sistema são dois aspectos que influenciam o desempenho do estimador, tal como acontece com os estimadores usuais. Para enquadrar a investigação, o texto inclui uma revisão de aspectos essenciais dos SEM, o seu papel em Econometria, os principais métodos de estimação, com particular ênfase no GMM, e uma curta introdução à estimação robusta.

Modelos autoregressivos por limiares em séries de contagem

A modelação e análise de séries temporais de valores inteiros têm sido alvo de grande investigação e desenvolvimento nos últimos anos, com aplicações várias em diversas áreas da ciência. Nesta tese a atenção centrar-se-á no estudo na classe de modelos basedos no operador thinning binomial. Tendo como base o operador thinning binomial, esta tese focou-se na construção e estudo de modelos SETINAR(2; p(1); p(2)) e PSETINAR(2; 1; 1)T , modelos autorregressivos de valores inteiros com limiares autoinduzidos e dois regimes, admitindo que as inovações formam uma sucessão de variáveis independentes com distribuição de Poisson. Relativamente ao primeiro modelo analisado, o modelo SETINAR(2; p(1); p(2)), além do estudo das suas propriedades probabilísticas e de métodos, clássicos e bayesianos, para estimar os parâmetros, analisou-se a questão da seleção das ordens, no caso de elas serem desconhecidas. Com este objetivo consideraram-se algoritmos de Monte Carlo via cadeias de Markov, em particular o algoritmo Reversible Jump, abordando-se também o problema da seleção de modelos, usando metodologias clássica e bayesiana. Complementou-se a análise através de um estudo de simulação e uma aplicação a dois conjuntos de dados reais. O modelo PSETINAR(2; 1; 1)T proposto, é também um modelo autorregressivo com limiares autoinduzidos e dois regimes, de ordem unitária em cada um deles, mas apresentando uma estrutura periódica. Estudaram-se as suas propriedades probabilísticas, analisaram-se os problemas de inferência e predição de futuras observações e realizaram-se estudos de simulação.

Modelos de espacialização : integração no pensamento composicional

O presente trabalho propõe-se a conceptualizar os modelos e a criar novas ferramentas para a espacialização da música electroacústica, bem como a explorar formas de integração deste parâmetro na composição musical. É proposta uma taxonomia da espacialização na música electroacústica, com base no levantamento de fontes realizado. O conjunto de aplicações informáticas concebido utiliza o conhecimento actual sobre a audição espacial, implementa duas propostas de desenvolvimento sobre as técnicas de espacialização e incorpora os modelos de espacialização conceptualizados. Por fim, as obras musicais compostas propõem e exploram formas para a utilização da espacialização enquanto elemento gerador do material musical na composição de música electroacústica.

Organic contaminants in urban soils: major inputs and potential risks

Urban soil quality may be severely affected by hydrophobic organic contaminants (HOCs), impairing environmental quality and human health. A comprehensive study was conducted in two contrasting Portuguese urban areas (Lisbon and Viseu) in order to assess the levels and potential risks of these contaminants, to identify sources and study their behaviour in soils. The concentrations of HOCs were related to the size of the city, with much higher contamination levels observed in Lisbon urban area. Source apportionment was performed by studying the HOCs profiles, their relationship with potentially toxic elements and general characteristics of soil using multivariate statistical methods. Lisbon seems to be affected by nearby sources (traffic, industry and incineration processes) whereas in Viseu the atmospheric transport may be playing an important role. In a first tier of risk assessment (RA) it was possible to identify polycyclic aromatic hydrocarbons (PAHs) in Lisbon soils as a potential hazard. The levels of PAHs in street dusts were further studied and allowed to clarify that traffic, tire and pavement debris can be an important source of PAHs to urban soils. Street dusts were also identified as being a potential concern regarding human and environmental health, especially if reaching the nearby aquatic bodies. Geostatistical tools were also used and their usefulness in a RA analysis and urban planning was discussed. In order to obtain a more realistic assessment of risks of HOCs to environment and human health it is important to evaluate their available fraction, which is also the most accessible for organisms. Therefore, a review of the processes involved on the availability of PAHs was performed and the outputs produced by the different chemical methods were evaluated. The suitability of chemical methods to predict bioavailability of PAHs in dissimilar naturally contaminated soils has not been demonstrated, being especially difficult for high molecular weight compounds. No clear relationship between chemical and biological availability was found in this work. Yet, in spite of the very high total concentrations found in some Lisbon soils, both the water soluble fraction and the body residues resulting from bioaccumulation assays were generally very low, which may be due to aging phenomena. It was observed that the percentage of soluble fraction of PAHs in soils was found to be different among compounds and mostly regulated by soil properties. Regarding bioaccumulation assays, although no significant relationship was found between soil properties and bioavailability, it was verified that biota-to-soil bioaccumulation factors were sample dependent rather than compound dependent. In conclusion, once the compounds of potential concern are targeted, then performing a chemical screening as a first tier can be a simple and effective approach to start a RA. However, reliable data is still required to improve the existing models for risk characterization.