Title: METABOLOMIC ANALYSIS TO PREDICT THE ONSET AND SEVERITY OF
NECROTIZING ENTEROCOLITIS
Version: 1 Date: 26 Aug 2024
Reviewer's report:
Thanks for inviting me to review this manuscript. A prospective study was conducted and urine
from preterm infants was longitudinally collected at birth (<48 hours), 14 and 28 days. Neonates
were followed for their development of NEC, SIP, or other GI conditions and compared to those
of matched healthy controls. Urine samples were then investigated by untargeted metabolomic
analysis based on mass-spectrometry afterwards. The conclusions demonstrated the urinary
metabolome is closely associated with underlying gastrointestinal disease beginning very early
in life. Furthermore, urinary metabolic features characterize NEC patients vs healthy controls
from birth until 28 days of life. Finally, untargeted metabolomics can identify patients who
will develop surgical NEC as early as birth, with a potential role for impaired fatty acid and
acylcarnitine metabolism.
This manuscript is interesting. However it remains some major concerns#
1. The inclusion criteria of the study were “All infants who were admitted to the NICU and who
were born at <34+0 gestational weeks (GW) or who had congenital heart disease (CHD)”. So
just wondering why infants with CDH should be involved? Because CDH may be an isolated
factor associated with abnormal metabolism and result in bias of data analysis. In terms of
NEC diagnosis, infants with Bell stage I should be excluded, which is suspected NEC but not
confirmed NEC.
2. Is any previous studies or literatures support the current timing of urine collection? In addition,
it is not clear the relationship between the timing of urine collection and NEC onset since the
characteristic of metabolism is time dependent.
3. Did authors compare the metabolic analysis results among plasma, urine and fecal samples
from each patient to find out which is the best resource to predict NEC onset and severity?
4. Multiple factors contribute to NEC onset and progression. Did authors try to combine the
metabolic analysis results with other NEC related clinical parameters for improving the accuracy
of NEC predictions?
Title: METABOLOMIC ANALYSIS TO PREDICT THE ONSET AND SEVERITY OF
NECROTIZING ENTEROCOLITIS
Version: 1 Date: 26 Aug 2024
Reviewer's report:
Thanks for inviting me to review this manuscript. A prospective study was conducted and urine
from preterm infants was longitudinally collected at birth (<48 hours), 14 and 28 days. Neonates
were followed for their development of NEC, SIP, or other GI conditions and compared to those
of matched healthy controls. Urine samples were then investigated by untargeted metabolomic
analysis based on mass-spectrometry afterwards. The conclusions demonstrated the urinary
metabolome is closely associated with underlying gastrointestinal disease beginning very early
in life. Furthermore, urinary metabolic features characterize NEC patients vs healthy controls
from birth until 28 days of life. Finally, untargeted metabolomics can identify patients who
will develop surgical NEC as early as birth, with a potential role for impaired fatty acid and
acylcarnitine metabolism.
This manuscript is interesting. However it remains some major concerns#
1. The inclusion criteria of the study were “All infants who were admitted to the NICU and who
were born at <34+0 gestational weeks (GW) or who had congenital heart disease (CHD)”. So
just wondering why infants with CDH should be involved? Because CDH may be an isolated
factor associated with abnormal metabolism and result in bias of data analysis. In terms of
NEC diagnosis, infants with Bell stage I should be excluded, which is suspected NEC but not
confirmed NEC.
2. Is any previous studies or literatures support the current timing of urine collection? In addition,
it is not clear the relationship between the timing of urine collection and NEC onset since the
characteristic of metabolism is time dependent.
3. Did authors compare the metabolic analysis results among plasma, urine and fecal samples
from each patient to find out which is the best resource to predict NEC onset and severity?
4. Multiple factors contribute to NEC onset and progression. Did authors try to combine the
metabolic analysis results with other NEC related clinical parameters for improving the accuracy
of NEC predictions?
Please review this paper.
user
Title: METABOLOMIC ANALYSIS TO PREDICT THE ONSET AND SEVERITY OF
NECROTIZING ENTEROCOLITIS
Version: 1 Date: 26 Aug 2024
Reviewer's report:
Thanks for inviting me to review this manuscript. A prospective study was conducted and urine
from preterm infants was longitudinally collected at birth (<48 hours), 14 and 28 days. Neonates
were followed for their development of NEC, SIP, or other GI conditions and compared to those
of matched healthy controls. Urine samples were then investigated by untargeted metabolomic
analysis based on mass-spectrometry afterwards. The conclusions demonstrated the urinary
metabolome is closely associated with underlying gastrointestinal disease beginning very early
in life. Furthermore, urinary metabolic features characterize NEC patients vs healthy controls
from birth until 28 days of life. Finally, untargeted metabolomics can identify patients who
will develop surgical NEC as early as birth, with a potential role for impaired fatty acid and
acylcarnitine metabolism.
This manuscript is interesting. However it remains some major concerns#
1. The inclusion criteria of the study were “All infants who were admitted to the NICU and who
were born at <34+0 gestational weeks (GW) or who had congenital heart disease (CHD)”. So
just wondering why infants with CDH should be involved? Because CDH may be an isolated
factor associated with abnormal metabolism and result in bias of data analysis. In terms of
NEC diagnosis, infants with Bell stage I should be excluded, which is suspected NEC but not
confirmed NEC.
2. Is any previous studies or literatures support the current timing of urine collection? In addition,
it is not clear the relationship between the timing of urine collection and NEC onset since the
characteristic of metabolism is time dependent.
3. Did authors compare the metabolic analysis results among plasma, urine and fecal samples
from each patient to find out which is the best resource to predict NEC onset and severity?
4. Multiple factors contribute to NEC onset and progression. Did authors try to combine the
metabolic analysis results with other NEC related clinical parameters for improving the accuracy
of NEC predictions?
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