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Advancing translational metabolomics: From nutrition and drug metabolism to cancer biomarker discovery
Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - BMC, Analytical Chemistry.ORCID iD: 0000-0002-3577-9822
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

The human body clears both endogenous and exogenous compounds through phase I and phase II biotransformation reactions. These processes rely on enzymes that modify metabolites into more hydrophilic forms, facilitating their excretion. Phase II modifications such as sulfation, glucuronidation and acetylation play a critical role in diverse research fields including toxicology, nutrition and microbiome metabolism. Among these, the two major phase II conjugate classes, glucuronides and sulfates, have been closely linked to the microbiota-host co-metabolism. The microbiome metabolism also converts dietary components and drugs, and has been revealed to impact human health, including the production of potentially toxic compounds.

In this thesis, advanced metabolomics approaches were combined with new analytical and chemical biology tools to selectively investigate the phase II metabolome in multiple biological contexts. In a nutritional study, untargeted LC–MS metabolomics combined with enzymatic hydrolysis enabled the identification of over 150 sulfated and 140 glucuronidated metabolites in urine from a controlled dietary intervention. Several of these metabolites were proposed as dietary biomarkers of (poly)phenol intake, providing tools for objective dietary assessment and highlighting the contribution of gut microbial metabolism. In the next step, the glucuronide profiling was expanded to plasma, feces and cerebrospinal fluid. The results revealed that this conjugation class is also present in these less commonly studied biospecimens, including the novel detection of a drug-derived glucuronide in human CSF, highlighting the translational potential of this approach.

To improve analytical coverage, a novel chemical biology methodology was developed by immobilizing enzymes on magnetic beads. This tool enabled for the first time parallel analysis of glucuronides and sulfates in the same sample, allowing for semi-quantification within global metabolomics workflows. The focus then shifted to acetylation catalyzed by NAT2, where NAT2-dependent cytotoxicity was explored for several clinically relevant anticancer drugs. These findings showcased the importance of genetic variability in NAT2 activity for drug metabolism and potential treatment outcomes. Finally, a pan-cancer plasma metabolomics investigation identified both cancer-specific and shared metabolic alterations, as well as stage-dependent changes across lung, colorectal and ovarian cancers. These results highlight candidate biomarkers with potential applications in diagnosis and disease monitoring.

This thesis demonstrates how advanced analytical strategies can improve the characterization of phase II metabolites and support biomarker discovery across nutrition, pharmacology, and oncology. The results within this thesis provide useful insights for translational metabolomics, with applications in nutrimetabolomics, pharmacometabolomics, and cancer metabolomics.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2025. , p. 74
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 2578
Keywords [en]
Nutrimetabolomics, Cancer metabolomics, Pharmacometabolomics, Chemical biology, Phase II modifications, Gut microbiota
National Category
Analytical Chemistry
Research subject
Chemistry with specialization in Analytical Chemistry
Identifiers
URN: urn:nbn:se:uu:diva-565708ISBN: 978-91-513-2571-2 (print)OAI: oai:DiVA.org:uu-565708DiVA, id: diva2:1992202
Public defence
2025-10-15, A1:107a, BMC, Husargatan 3, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2025-09-24 Created: 2025-08-26 Last updated: 2025-09-24
List of papers
1. Characterizing the Sulfated and Glucuronidated (Poly)phenol Metabolome for Dietary Biomarker Discovery
Open this publication in new window or tab >>Characterizing the Sulfated and Glucuronidated (Poly)phenol Metabolome for Dietary Biomarker Discovery
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2025 (English)In: Journal of Agricultural and Food Chemistry, ISSN 0021-8561, E-ISSN 1520-5118, Vol. 73, no 11, p. 6702-6710Article in journal (Refereed) Published
Abstract [en]

(Poly)phenols, bioactive compounds abundant in plant-based diets, have attracted interest for their potential role in preventing chronic diseases including cardiometabolic and neurodegenerative diseases. This study investigates the global sulfatome and glucuronidated metabolome in urine samples from 100 healthy adults collected pre- and postintervention following a 3-day (poly)phenol-rich intervention consisting of flaxseeds, raspberry powder, and soy milk. Using untargeted mass spectrometric metabolomics combined with selective phase II enzymatic treatment, we detected 156 sulfated and 143 glucuronidated metabolites in urine samples. Significant changes postintervention were observed for 91 sulfates and 94 glucuronides. Receiver operating characteristic curve analysis identified a combination of six polyphenol-derived key metabolites: glucuronidated daidzein and the sulfated compounds of pyrogallol, ferulic acid, 4-methoxyphenol, enterolactone, and resorcinol, which resulted in the best combination with the highest predictive AUC of 0.97. These findings underscore the utility of these metabolites as sensitive and selective biomarkers of (poly)phenol dietary intake.

Place, publisher, year, edition, pages
American Chemical Society (ACS), 2025
Keywords
phase II modifications, metabolomics, gut microbiota, nutritional biomarkers, (poly)phenols
National Category
Nutrition and Dietetics Analytical Chemistry
Identifiers
urn:nbn:se:uu:diva-556846 (URN)10.1021/acs.jafc.4c12596 (DOI)001436059200001 ()40025695 (PubMedID)2-s2.0-105001062870 (Scopus ID)
Funder
Swedish Research Council, VR 2020-04707Swedish Cancer Society, 22 2449 Pj
Available from: 2025-05-19 Created: 2025-05-19 Last updated: 2025-08-26Bibliographically approved
2. Global metabolomics profiling of glucuronides in human plasma, fecal, and cerebrospinal fluid samples
Open this publication in new window or tab >>Global metabolomics profiling of glucuronides in human plasma, fecal, and cerebrospinal fluid samples
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2025 (English)In: Analytical and Bioanalytical Chemistry, ISSN 1618-2642, E-ISSN 1618-2650Article in journal (Refereed) Epub ahead of print
Abstract [en]

Glucuronidation is the major phase II biotransformation reaction that facilitates the clearance of exogenous compounds from the human body. Glucuronidated metabolites have been investigated in urine samples at a broad scale; however, their characterization in other human biospecimens is underexplored. Our study has now performed a comprehensive profiling of glucuronides in plasma, fecal, and cerebrospinal fluid (CSF) of humans. We performed a mass spectrometry-based analysis that combines enzymatic hydrolysis with a β-glucuronidase to selectively cleave the glucuronic acid moiety, a developed in-house glucuronide identification pipeline, and enzymatic synthesis of standard metabolites. In total, we identified 32 glucuronidated metabolites across the three sample types in both negative and positive mass spectrometry ionization modes using advanced MS/MS fragmentation analysis. We have utilized a straightforward enzymatic synthesis of glucuronidated metabolites for annotation at the highest confidence level. Among the identified conjugates, we detected glucuronides of different compound classes including drugs, bile acid derivatives, steroid conjugates, and phenolic compounds. Unexpectedly, we validated the glucuronides of acetaminophen and propofol in CSF samples, the latter representing a novel observation that highlights the importance of investigating phase II metabolites in uncommon sample types.

Place, publisher, year, edition, pages
Springer, 2025
Keywords
Glucuronides, Phase II modifications, Enzymatic synthesis, Metabolomics, Gut microbiota
National Category
Analytical Chemistry
Identifiers
urn:nbn:se:uu:diva-565687 (URN)10.1007/s00216-025-06082-w (DOI)
Available from: 2025-08-25 Created: 2025-08-25 Last updated: 2025-09-02Bibliographically approved
3. Immobilized Enzymes on Magnetic Beads for Separate Mass Spectrometric Investigation of Human Phase II Metabolite Classes
Open this publication in new window or tab >>Immobilized Enzymes on Magnetic Beads for Separate Mass Spectrometric Investigation of Human Phase II Metabolite Classes
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2023 (English)In: Analytical Chemistry, ISSN 0003-2700, E-ISSN 1520-6882, Vol. 95, no 33, p. 12565-12571Article in journal (Refereed) Published
Abstract [en]

The human body hasevolved to remove xenobiotics through a multistepclearance process. Non-endogenous metabolites are converted througha series of phase I and different phase II enzymes into compoundswith higher hydrophilicity. These compounds are important for diverseresearch fields such as toxicology, nutrition, biomarker discovery,doping control, and microbiome metabolism. One of the challenges inthese research fields has been the investigation of the two majorphase II modifications, sulfation and glucuronidation, and the correspondingunconjugated aglycon independently. We have now developed a new methodologyutilizing an immobilized arylsulfatase and an immobilized & beta;-glucuronidaseto magnetic beads for treatment of human urine samples. The enzymeactivities remained the same compared to the enzyme in solution. Theseparate mass spectrometric investigation of each metabolite classin a single sample was successfully applied to obtain the dietaryglucuronidation and sulfation profile of 116 compounds. Our new chemicalbiology strategy provides a new tool for the investigation of metabolitesin biological samples with the potential for broad-scale applicationin metabolomics, nutrition, and microbiome studies.

Place, publisher, year, edition, pages
American Chemical Society (ACS), 2023
National Category
Biochemistry Molecular Biology Analytical Chemistry
Identifiers
urn:nbn:se:uu:diva-511077 (URN)10.1021/acs.analchem.3c02988 (DOI)001044540300001 ()37552796 (PubMedID)
Funder
Swedish Research Council, VR 2016-04423/VR 2020-04707Swedish Cancer Society, 19 0347 PjScience for Life Laboratory, SciLifeLab, SLL 2016/5
Available from: 2023-09-07 Created: 2023-09-07 Last updated: 2025-08-26Bibliographically approved
4. NAT2 activity increases cytotoxicity of anthracycline antibiotics and HDAC inhibitors
Open this publication in new window or tab >>NAT2 activity increases cytotoxicity of anthracycline antibiotics and HDAC inhibitors
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2025 (English)In: Biochimica et Biophysica Acta - Molecular Basis of Disease, ISSN 0925-4439, E-ISSN 1879-260X, Vol. 1871, no 5, article id 167755Article in journal (Refereed) Published
Abstract [en]

The Arylamine-N-acetyltransferase-2 (NAT2) enzyme is involved in metabolism of commonly used drugs driving differences in efficacy and tolerability of treatments. To bridge the current knowledge gap on metabolism of cytotoxic drugs by NAT2, and identify anticancer agents whose effects depend on NAT2 activity, we assessed 147 clinically used drugs. Hit compounds were evaluated for metabolic conversion by acetylation in presence of recombinant NAT2. Among those 147 drugs we found doxorubicin, daunorubicin, epirubicin, valrubicin, teniposide, afatinib, carmustine, vincristine, panobinostat, and vorinostat to have increased toxicity to cancer cells expressing the rapid NAT2 allele. Additionally, we report NAT2-mediated acetylation of idarubicin, daunorubicin, doxorubicin, vorinostat, and CUDC-101. These findings have implications for pharmacogenomics and cancer precision medicine using conventional chemotherapeutic drugs, as improving their efficacy and safety may affect >4 million cancer patients worldwide that receive these drugs as standard of care.

Place, publisher, year, edition, pages
Elsevier, 2025
Keywords
Cancer, NAT2, Chemotherapy, Drug metabolism, Acetylation, Anthracyclines, HDAC inhibitors
National Category
Cancer and Oncology Pharmacology and Toxicology
Identifiers
urn:nbn:se:uu:diva-552519 (URN)10.1016/j.bbadis.2025.167755 (DOI)001448184200001 ()2-s2.0-86000656425 (Scopus ID)
Funder
Swedish Cancer Society, CAN 2018/772Swedish Cancer Society, 21 1719 PjSwedish Cancer Society, 24 3831 PjSwedish Research Council, 2020-02371Swedish Research Council, 2024-03357Swedish Childhood Cancer Foundation, PR2020-0171Swedish Childhood Cancer Foundation, PR2022-0099Familjen Erling-Perssons Stiftelse, 2023-0113Familjen Erling-Perssons Stiftelse, 2020-0037
Available from: 2025-03-16 Created: 2025-03-16 Last updated: 2025-08-26Bibliographically approved
5. Biomarker Discovery through Comparative Plasma Metabolomics for Lung, Colorectal and Ovarian Cancer
Open this publication in new window or tab >>Biomarker Discovery through Comparative Plasma Metabolomics for Lung, Colorectal and Ovarian Cancer
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(English)Manuscript (preprint) (Other academic)
Keywords
cancer metabolomics, biomarker discovery, lung cancer, colorectal cancer, ovarian cancer
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-565686 (URN)
Available from: 2025-08-25 Created: 2025-08-25 Last updated: 2025-08-26

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