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However, there is still no consensus about their resulting metabolic derangements; thus, this study was conducted to determine the distinct metabolic profiles of these two drugs. A total of 69 children with asthma during acute exacerbation were included, and their serum and urine were investigated using high\u2010resolution nuclear magnetic resonance (<jats:styled-content style=\"fixed-case\">NMR<\/jats:styled-content>). A metabolomics analysis was performed using a principal component analysis and orthogonal signal correction\u2013partial least squares using <jats:styled-content style=\"fixed-case\">SIMCA<\/jats:styled-content>\u2010P. The different metabolites were identified, and the distinct metabolic profiles were analysed using Met<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>. A high\u2010resolution <jats:styled-content style=\"fixed-case\">NMR<\/jats:styled-content>\u2010based serum and urine metabolomics approach was established to study the overall metabolic changes after inhaled budesonide and salbutamol in asthmatic children during acute exacerbation. The perturbed metabolites included 22 different metabolites in the serum and 21 metabolites in the urine. Based on an integrated analysis, the changed metabolites included the following: increased 4\u2010hydroxybutyrate, lactate, cis\u2010aconitate, 5\u2010hydroxyindoleacetate, taurine, trans\u20104\u2010hydroxy\u2010l\u2010proline, tiglylglycine, 3\u2010hydroxybutyrate, 3\u2010methylhistidine, glucose, cis\u2010aconitate, 2\u2010deoxyinosine and 2\u2010aminoadipate; and decreased alanine, glycerol, arginine, glycylproline, 2\u2010hydroxy\u20103\u2010methylvalerate, creatine, citrulline, glutamate, asparagine, 2\u2010hydroxyvalerate, citrate, homoserine, histamine, sn\u2010glycero\u20103\u2010phosphocholine, sarcosine, ornithine, creatinine, glycine, isoleucine and trimethylamine N\u2010oxide. The Met<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> analysis revealed seven involved metabolic pathways: arginine and proline metabolism; taurine and hypotaurine metabolism; glycine, serine and threonine metabolism; glyoxylate and dicarboxylate metabolism; methane metabolism; citrate cycle; and pyruvate metabolism. The perturbed metabolic profiles suggest potential metabolic reprogramming associated with a combination treatment of inhaled budesonide and salbutamol in asthmatic children.<\/jats:p>","DOI":"10.1111\/bcpt.12686","type":"journal-article","created":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T18:26:22Z","timestamp":1476383182000},"page":"303-311","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Distinct Metabolic Profile of Inhaled Budesonide and Salbutamol in Asthmatic Children during Acute Exacerbation"],"prefix":"10.1111","volume":"120","author":[{"given":"Yang","family":"Quan\u2010Jun","sequence":"first","affiliation":[{"name":"Department of Pharmacy Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Jian\u2010Ping","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Jian\u2010Hua","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Yong\u2010Long","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Bo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Jing\u2010Xian","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dai","family":"Bona","sequence":"additional","affiliation":[{"name":"Instrumental Analysis Center of Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,5]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"226","article-title":"A clinical audit of the management of acute asthmatic attacks in adults and children presenting to an emergency department","volume":"63","author":"Dasgupta S","year":"2014","journal-title":"West Indian Med J"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aller.2014.05.010"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild\u20102015\u2010310145"},{"key":"e_1_2_7_5_1","first-page":"667","article-title":"Chinese guideline for the prevention and management of bronchial asthma (Primary Health Care Version)","volume":"5","author":"Asthma Workgroup; 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