Metabolomics. 2026 Jul 31;22(4):136. doi: 10.1007/s11306-026-02510-9.
ABSTRACT
OBJECTIVES: Patent ductus arteriosus (PDA) is one of the most common heart conditions in preterm infants, and indomethacin treatment is used for PDA closure. However, its efficacy varies among patients. This pilot study aimed to identify novel metabolic biomarkers to predict effective indomethacin response in infants with PDA.
METHODS: Preterm infants with PDA < 34 weeks gestational age were recruited and treated with indomethacin. Plasma and urine samples were collected before and 2-7 days after initial treatment. Longitudinal targeted oxylipin and untargeted metabolomics analysis were performed on plasma and urine samples.
RESULTS: Among 17 infants, 12 were responders and 5 non-responders to indomethacin treatment. Before the treatment, four plasma oxylipins: 12,13-DiHOME, 9,10-DiHOME, 15,16-DiHODE, and 9,10-DiHODE were significantly higher in responders compared to non-responders (P < 0.05). Following treatment, these oxylipins decreased in responders but remained stable in non-responders. Urinary 12,13-DiHOME showed an opposite trend, with lower baseline concentrations in the responders.
CONCLUSIONS: Pre-treatment plasma levels of four oxylipins were associated with effective PDA response to indomethacin. The balance of oxylipins and prostaglandins is important in duct patency and may predict which infants responding to indomethacin. These pilot findings contribute to the identification of potential neonatal pharmacometabolomic biomarkers and create new hypotheses that can guide future research towards personalized PDA management in preterm infants.
PMID:42538509 | DOI:10.1007/s11306-026-02510-9