Urine metabolomics in dengue infection: elucidating hexadecane as a potential biomarker

Introduction: Dengue infection remains a major global health concern, necessitating rapid, non-invasive, and universally accessible diagnostic methods. Existing diagnostic modalities fail to simultaneously address the critical aspects of sensitivity, specificity, efficiency, and cost-effectiveness. The NS1 antigen detection test exhibits low sensitivity, while serology tests carry a high risk of false negativity due to low IgM titres in the early phase of infection. Urine-based metabolic profiling has emerged as a promising approach for the identification of specific disease biomarkers. This study aims to identify urinary metabolites associated with dengue infection, leveraging these biomarkers to develop a urine-based dengue test kit. Alkane group metabolites may rise as they act as energy substrate to assist viral replication. Materials and method: We analysed urine samples from 30 dengue-infected patients and 30 control subjects using Gas Chromatography-Mass Spectrometry (GC-MS). The analysis focused on identifying distinct metabolites based on retention time (RT) and similarity index (SI), with the quantification of their concentrations using peak area. Results: Our findings revealed a significant presence of hexadecane in the urine samples of dengue-infected subjects (p<0.01) compared to control subjects. This metabolite was characterized by a RT of 20.95 + 2.23 minutes, a SI of 85.50 + 5.00%, and a peak area of 1360566.25 + 1066618.37 a.u. Conclusion: The marked detection of hexadecane specifically in dengue patients, highlights its potential as a key biomarker for dengue detection. This discovery establishes the foundation for the development of rapid, non-invasive urine-based dengue diagnostic tests.