Nuclear Magnetic Resonance (NMR)-based Metabonomics Assays to Evaluate Allergic Rhinitis Treatment in Children and Teenagers

Objective: To identify metabolic profiles potentially associated with treatment adherence and allergic rhinitis severity in children and adolescents. Methods: This prospective study was conducted at a university hospital in Brazil, involving 25 volunteers. ¹H NMR spectra of the volunteers' serum samples were obtained and analyzed using multivariate statistics. Initially, Hierarchical Cluster Analysis (HCA) was employed, resulting in two groups containing 11 and 14 samples, respectively. Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA) was used to identify the variables responsible for group discrimination. Results: Patient-reported adherence to treatment proved unreliable when compared to the HCA results. The primary difference between the groups was their response to treatment: in Group II, 81.8% of volunteers did not respond to treatment, whereas in Group I, this figure was 42.8%. Alanine, serine, arginine, choline, N-acetyl-D-glucosamine, glutamate, lactate, glucose, and VLDL/LDL were the identified metabolites. The metabolic profile of volunteers in Group II suggests a more severe clinical condition compared to those in Group I. Conclusion: NMR demonstrated the ability to differentiate patients' responses to allergic rhinitis treatment, effectively identifying those with more severe and chronic forms of the disease.