DL-Phenylalanine 500mg capsules

ObjectiveTo systematically collate and evaluate metabolomics-based biomarkers of ischemic stroke (IS) to guide clinical diagnosis and treatment.MethodsComprehensive literature searches were conducted in PubMed, Embase, and Web of Science using "IS" and "metabolomics" as core keywords, covering publications up through February 2024. Any original metabolomic research related to IS was selected. Key information such as study demographics, study type, objectives, metabolomic analysis methods, and main findings were extracted and analyzed. Frequently mentioned metabolites were subjected to enrichment analysis using the MetaboAnalyst 6.0 platform.ResultsA total of 51 studies were included. Quality assessment revealed that 54.8% of the diagnostic studies and 69.2% of the prognostic studies were high-quality, with most controlling for confounding factors. Metabolite analysis revealed associations between decreased proline, isoleucine, valine, and alanine levels with IS. Increased tyrosine, glutamine, phenylalanine, sphingomyelin, glutamate, lactate and glucose, and decreased LysoPC (18:2), histidine, and methionine levels were linked to IS onset. Specific metabolite combinations, such as serine, isoleucine, betaine, PC (5:0/5:0), and LysoPE (18:2), showed high precision in predicting acute ischemic stroke (AIS) (training set AUC = 0.988, test set AUC = 0.971). Glycine-serine-threonine and valine-leucine-isoleucine pathways were significant in diagnosing IS and AIS, and in differentiating ischemic and hemorrhagic strokes, as well as identifying post-stroke depression and cognitive impairment.ConclusionThis study confirms the potential diagnostic and prognostic value of changes in amino acids and lipids, as well as other metabolites and metabolic pathways, in IS. These findings highlight the promise of metabolomics in IS diagnosis, differential diagnosis, risk assessment, and complication identification. However, further validation is needed due to the varying quality of the included studies.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD42022335505.

Abstract licence: CC BY

BackgroundPhenylketonuria (PKU) is one of the common Inborn Errors of Metabolism diseases, that is caused by a phenylalanine hydroxylase (PAH) deficiency or cofactor tetrahydrobiopterin. This systematic review and meta-analysis aimed to investigate the prevalence of PKU in Iran.MethodsThe protocol was registered in PROSPERO (CRD42024540811). The MOOSE protocol and the PRISMA guidelines were used. The Web of Sciences, PubMed/ Medline, Sciences Direct, Google Scholar, Scopus, Civilica, IranDoc, and SID databases were searched on 31/03/2024. The I2 index and Q test were used to check heterogeneity. Comprehensive meta-analysis software (CMA ver. 2) was used (P ResultsFinally, 20 studies with 1,992,090 Iranian neonates were included. The prevalence of screen-positive cases was 75.6 (95% CI: 48.1-118.72). The prevalence of confirmed PKU was 16.7 (95% CI: 13.6- 20.5); this prevalence in girls and boys was 15.2 (95% CI: 5.2-44.2) and 9.8 (95% CI: 3.2- 29.8), respectively. 53% of the cases had Hyperphenylalaninemia (HPA). The prevalence of HPA and classical PKU was estimated at 8.9 (95% CI: 5.9-13.41) and 8.0 (95% CI: 5.1-12.59), respectively. Subgroup analysis was performed based on region, province, and study quality to discover the source of heterogeneity. In addition, mixed effects meta-regression was used to find the relationship between continuous variables. Sensitivity analysis showed that the pooled estimate was robust.ConclusionsIt seems that the screening program in Iran was effective and detected almost all PKU cases in the first few days of their lives. This information showed that the PKU prevalence is relatively higher than in most parts of the world, thus their prevalence should be controlled.

Abstract licence: CC BY