Hexosylceramides and glycerophosphatidylcholine GPC(36:1) increase in Multi Organ Dysfunction Syndrome patients with Pediatric Intensive Care Unit Admission over 8 day hospitalization

Leimanis-Laurens, M. L.; Wolfrum, E.; Ferguson, K.; Grunwell, J. R.; Sanfilippo, D.; Prokop, J. W.; Lydic, T.; Rajasekaran, S.

Glycero- and sphingo- lipids are important in plasma membrane structure, caloric storage and signaling. An un-targeted lipidomics approach for a cohort of critically ill pediatric intensive care unit (PICU) patients, undergoing multi-organ dysfunction syndrome (MODS) was compared to sedation controls. After IRB approval, patients meeting criteria for MODS were screened, con-sented (n=24), and blood samples were collected from the PICU at HDVCH, Michigan; eight pa-tients needed veno-arterial extracorporeal membrane oxygenation (VA ECMO). Sedation con-trols were presenting for routine sedation (n=4). Plasma lipid profiles were determined by nano-electrospray (nESI) direct infusion high resolution/accurate mass spectrometry (MS) and tandem mass spectrometry (MS/MS). Biostatistics analysis was performed using R v 3.6.0. 61 patient samples over 3 time points revealed a ceramide metabolite, hexosylceramide (Hex-Cer) was high across all time points (mean 1.63% - 3.19%; vs. controls 0.22%). Fourteen species sta-tistically differentiated from sedation controls (P-value [≤]0.05); sphingomyelin (SM) [SM(d18:1/23:0), SM(d18:1/22:0), SM(d18:1/23:1), SM(d18:1/21:0), SM(d18:1/24:0)]; and glycer-ophosphotidylcholine (GPC) [GPC(36:01), GPC(18:00), GPC(O:34:02), GPC(18:02), GPC(38:05), GPC(O:34:03), GPC(16:00), GPC(40:05), GPC(O:36:03)]. Hex-Cer has been shown to be involved in viral infection and may be at play during acute illness. GPC(36:01) was elevated in all MODS patients at all time points and is associated with inflammation and brain injury.