{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:22:13Z","timestamp":1790083333377,"version":"4.0.1"},"reference-count":32,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Office of the Permanent Secretary, Ministry of Higher Education, Science, Research and Innovation","award":["RGNS63-051"],"award-info":[{"award-number":["RGNS63-051"]}]},{"name":"Basic Research Fund of Khon Kaen University under Cholangiocarcinoma Research Institute","award":["1500148"],"award-info":[{"award-number":["1500148"]}]},{"name":"Faculty of Medicine, Khon Kaen University","award":["RA108(2019)"],"award-info":[{"award-number":["RA108(2019)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The liver fluke\n                      <jats:italic>Opisthorchis viverrini<\/jats:italic>\n                      (OV), which subsequently inhabits the biliary system and results in periductal fibrosis (PDF), is one of the primarily causes of cholangiocarcinoma (CCA), a bile duct cancer with an exceptionally high incidence in the northeast of Thailand and other Greater Mekong Subregion (GMS) countries. Insights in fecal metabolic changes associated with PDF and CCA are required for further molecular research related to gut health and potential diagnostic biological marker development.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, nuclear magnetic resonance (NMR) metabolomics was applied for fecal metabolic phenotyping from 55 fecal water samples across different study groups including normal bile duct, PDF and CCA groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      By using NMR spectroscopy-based metabolomics, fecal metabolic profiles of patients with CCA or PDF and of individuals with normal bile duct have been established with a total of 40 identified metabolites. Further multivariate statistical analysis and hierarchical clustering heat map have demonstrated the PDF- and CCA-specific metabotypes through various altered metabolite groups including amino acids, alcohols, amines, anaerobic glycolytic metabolites, fatty acids, microbial metabolites, sugar, TCA cycle intermediates, tryptophan catabolism substrates, and pyrimidine metabolites. Compared to the normal bile duct group, PDF individuals showed the significantly elevated relative concentrations of fecal ethanol, glycine, tyrosine, and\n                      <jats:italic>N<\/jats:italic>\n                      -acetylglucosamine whereas CCA patients exhibited the remarkable fecal metabolic changes that can be evident through the increased relative concentrations of fecal uracil, succinate, and 5-aminopentanoate. The prominent fecal metabolic alterations between CCA and PDF were displayed by the reduction of relative concentration of methanol observed in CCA. The metabolic alterations associated with PDF and CCA progression have been proposed with the involvement of various metabolic pathways including TCA cycle, ethanol biogenesis, hexamine pathway, methanol biogenesis, pyrimidine metabolism, and lysine metabolism. Among them, ethanol, methanol, and lysine metabolism strongly reflect the association of gut-microbial host metabolic crosstalk in PDF and\/or CCA patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PDF- and CCA-associated metabotypes have been investigated displaying their distinct fecal metabolic patterns compared to that of normal bile duct group. Our study also demonstrated that the perturbation in co-metabolism of host and gut bacteria has been involved from the early step since OV infection to CCA tumorigenesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.15386","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T03:59:12Z","timestamp":1683604752000},"page":"e15386","source":"Crossref","is-referenced-by-count":8,"title":["<sup>1<\/sup>\n                    H NMR fecal metabolic phenotyping of periductal fibrosis- and cholangiocarcinoma-specific metabotypes defining perturbation in gut microbial-host co-metabolism"],"prefix":"10.7717","volume":"11","author":[{"given":"Rujikorn","family":"Treeriya","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8027-3361","authenticated-orcid":true,"given":"Phuc N.","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attapol","family":"Titapun","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poramate","family":"Klanrit","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Department of Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manida","family":"Suksawat","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanaporn","family":"Kulthawatsiri","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suphasarang","family":"Sirirattanakul","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Watcharin","family":"Loilome","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Department of Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6743-5047","authenticated-orcid":true,"given":"Nisana","family":"Namwat","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Department of Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arporn","family":"Wangwiwatsin","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Department of Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nittaya","family":"Chamadol","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narong","family":"Khuntikeo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jutarop","family":"Phetcharaburanin","sequence":"additional","affiliation":[{"name":"Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Khon Kaen University Phenome Centre, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Department of Systems Biosciences and Computational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"},{"name":"Center of Excellence for Innovation in Chemistry (PERCH-CIC), Faculty of Science, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2023,5,9]]},"reference":[{"issue":"1","key":"10.7717\/peerj.15386\/ref-1","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.jceh.2019.06.001","article-title":"Characterisation of the serum metabolic signature of cholangiocarcinoma in a United Kingdom cohort","volume":"10","author":"Alsaleh","year":"2020","journal-title":"Journal of Clinical and Experimental Hepatology"},{"key":"10.7717\/peerj.15386\/ref-2","doi-asserted-by":"publisher","first-page":"13","DOI":"10.2147\/IJGM.S186854","article-title":"Cholangiocarcinoma: a guide for the nonspecialist","volume":"12","author":"Alsaleh","year":"2019a","journal-title":"International Journal of General Medicine"},{"issue":"1","key":"10.7717\/peerj.15386\/ref-3","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1038\/s41598-021-00530-0","article-title":"Mapping of population disparities in the cholangiocarcinoma urinary metabolome","volume":"11","author":"Alsaleh","year":"2021","journal-title":"Scientific Reports"},{"issue":"6","key":"10.7717\/peerj.15386\/ref-4","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/j.jceh.2019.06.005","article-title":"Characterisation of the urinary metabolic profile of liver fluke-associated cholangiocarcinoma","volume":"9","author":"Alsaleh","year":"2019b","journal-title":"Journal of Clinical and Experimental Hepatology"},{"issue":"3","key":"10.7717\/peerj.15386\/ref-5","doi-asserted-by":"publisher","first-page":"e023217","DOI":"10.1136\/bmjopen-2018-023217","article-title":"Association between periductal fibrosis and bile duct dilatation among a population at high risk of cholangiocarcinoma: a cross-sectional study of cholangiocarcinoma screening in Northeast Thailand","volume":"9","author":"Chamadol","year":"2019","journal-title":"BMJ Open"},{"issue":"5","key":"10.7717\/peerj.15386\/ref-6","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1002\/jhbp.64","article-title":"Histological confirmation of periductal fibrosis from ultrasound diagnosis in cholangiocarcinoma patients","volume":"21","author":"Chamadol","year":"2014","journal-title":"Journal of Hepato-Biliary-Pancreatic Sciences"},{"issue":"5","key":"10.7717\/peerj.15386\/ref-7","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.1021\/ac048630x","article-title":"Statistical total correlation spectroscopy: an exploratory approach for latent biomarker identification from metabolic 1H NMR data sets","volume":"77","author":"Cloarec","year":"2005","journal-title":"Analytical Chemistry"},{"issue":"1","key":"10.7717\/peerj.15386\/ref-8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/nu11010025","article-title":"The role of succinate in the regulation of intestinal inflammation","volume":"11","author":"Connors","year":"2019","journal-title":"Nutrients"},{"issue":"2","key":"10.7717\/peerj.15386\/ref-9","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1152\/physrev.00034.2014","article-title":"Metabolic meth-anol: molecular pathways and physiological roles","volume":"95","author":"Dorokhov","year":"2015","journal-title":"Physiological Reviews"},{"issue":"6230","key":"10.7717\/peerj.15386\/ref-10","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1126\/science.aaa4972","article-title":"Cancer and the microbiota","volume":"348","author":"Garrett","year":"2015","journal-title":"Science"},{"issue":"9","key":"10.7717\/peerj.15386\/ref-11","doi-asserted-by":"publisher","first-page":"4661","DOI":"10.1021\/acs.analchem.5b04159","article-title":"Optimized sample handling strategy for metabolic profiling of human feces","volume":"88","author":"Gratton","year":"2016","journal-title":"Analytical Chemistry"},{"issue":"6335","key":"10.7717\/peerj.15386\/ref-12","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1126\/science.aag2029","article-title":"Neonatal acquisition of Clostridia species protects against colonization by bacterial pathogens","volume":"356","author":"Kim","year":"2017","journal-title":"Science"},{"issue":"10","key":"10.7717\/peerj.15386\/ref-13","doi-asserted-by":"publisher","first-page":"e0006044","DOI":"10.1371\/journal.pntd.0006044","article-title":"Exploratory metabolomics study of the experimental opisthorchiasis in a laboratory animal model (golden hamster, Mesocricetus auratus)","volume":"11","author":"Kokova","year":"2017","journal-title":"PLOS Neglected Tropical Diseases"},{"key":"10.7717\/peerj.15386\/ref-14","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.3389\/fmicb.2019.01286","article-title":"Investigating host microbiota relationships through functional metagenomics","volume":"10","author":"Laville","year":"2019","journal-title":"Frontiers in Microbiology"},{"issue":"14","key":"10.7717\/peerj.15386\/ref-15","doi-asserted-by":"publisher","first-page":"6149","DOI":"10.1007\/s00253-013-4995-6","article-title":"Microbial production of glucosamine and N-acetylglucosamine: advances and perspectives","volume":"97","author":"Liu","year":"2013","journal-title":"Applied Microbiology and Biotechnology"},{"issue":"4","key":"10.7717\/peerj.15386\/ref-16","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1093\/bib\/bbaa224","article-title":"Transcriptional landscape of cholangiocarcinoma revealed by weighted gene coexpression network analysis","volume":"22","author":"Long","year":"2021","journal-title":"Briefings in Bioinformatics"},{"issue":"1","key":"10.7717\/peerj.15386\/ref-17","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1038\/s41385-018-0087-3","article-title":"Succinate receptor mediates intestinal inflammation and fibrosis","volume":"12","author":"Macias-Ceja","year":"2019","journal-title":"Mucosal Immunology"},{"key":"10.7717\/peerj.15386\/ref-18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.psyneuen.2019.104469","article-title":"Fecal microbiota and metabolites are distinct in a pilot study of pediatric Crohn\u2019s disease patients with higher levels of perceived stress","volume":"111","author":"Mackner","year":"2021","journal-title":"Psychoneuroendocrinology"},{"key":"10.7717\/peerj.15386\/ref-19","first-page":"1181","article-title":"\u201cMetabonomics\u201d: understanding the metabolic responses of living systems to pathophysiological stimuli via multivariate statistical analysis of biological NMR spectroscopic data","volume-title":"Xenobiotica","volume":"29","author":"Nicholson","year":"1999"},{"issue":"1","key":"10.7717\/peerj.15386\/ref-20","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1186\/s40170-021-00266-5","article-title":"Integration of global metabolomics and lipidomics approaches reveals the molecular mechanisms and the potential biomarkers for postoperative recurrence in early-stage cholangiocarcinoma","volume":"9","author":"Padthaisong","year":"2021","journal-title":"Cancer & Metabolism"},{"issue":"W1","key":"10.7717\/peerj.15386\/ref-21","doi-asserted-by":"publisher","first-page":"W388","DOI":"10.1093\/nar\/gkab382","article-title":"MetaboAnalyst 5.0: narrowing the gap between raw spectra and functional insights","volume":"49","author":"Pang","year":"2021","journal-title":"Nucleic Acids Research"},{"issue":"2","key":"10.7717\/peerj.15386\/ref-22","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/S1286-4579(02)00080-1","article-title":"Prevention of gut inflammation by Bifidobacterium in dextran sulfate-treated gnotobiotic mice associated with Bacteroides strains isolated from ulcerative colitis patients","volume":"5","author":"Setoyama","year":"2003","journal-title":"Microbes and Infection"},{"key":"10.7717\/peerj.15386\/ref-23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fmicb.2017.00268","article-title":"Combined signature of the fecal microbiome and metabolome in patients with gout","volume":"8","author":"Shao","year":"2017","journal-title":"Frontiers in Microbiology"},{"key":"10.7717\/peerj.15386\/ref-24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13099-018-0252-y","article-title":"N-Acetyl-glucosamine influences the biofilm formation of Escherichia coli","volume":"10","author":"Sicard","year":"2018","journal-title":"Gut Pathogens"},{"issue":"4","key":"10.7717\/peerj.15386\/ref-25","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1002\/hep.23134","article-title":"Advanced periductal fibrosis from infection with the carcinogenic human liver fluke Opisthorchis viverrini correlates with elevated levels of interleukin-6","volume":"50","author":"Sripa","year":"2009","journal-title":"Hepatology"},{"key":"10.7717\/peerj.15386\/ref-26","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3389\/fpubh.2022.766023","article-title":"Metabolic phenotyping predicts gemcitabine and cisplatin chemosensitivity in patients with cholangiocarcinoma","volume":"10","author":"Suksawat","year":"2022","journal-title":"Frontiers in Public Health"},{"issue":"5","key":"10.7717\/peerj.15386\/ref-27","doi-asserted-by":"publisher","first-page":"2361","DOI":"10.1021\/pr8009885","article-title":"Top-down systems biology modeling of host metabotype-microbiome associations in obese rodents","volume":"8","author":"Waldram","year":"2009","journal-title":"Journal of Proteome Research"},{"issue":"D1","key":"10.7717\/peerj.15386\/ref-28","doi-asserted-by":"publisher","first-page":"D608","DOI":"10.1093\/nar\/gkx1089","article-title":"HMDB 4.0: the human metabolome database for 2018","volume":"46","author":"Wishart","year":"2018","journal-title":"Nucleic Acids Research"},{"issue":"D1","key":"10.7717\/peerj.15386\/ref-29","doi-asserted-by":"publisher","first-page":"D801","DOI":"10.1093\/nar\/gks1065","article-title":"HMDB 3.0-the human metabolome database in 2013","volume":"41","author":"Wishart","year":"2013","journal-title":"Nucleic Acids Research"},{"issue":"SUPPL. 1","key":"10.7717\/peerj.15386\/ref-30","doi-asserted-by":"publisher","first-page":"D603","DOI":"10.1093\/nar\/gkn810","article-title":"HMDB: a knowledgebase for the human metabolome","volume":"37","author":"Wishart","year":"2009","journal-title":"Nucleic Acids Research"},{"issue":"SUPPL. 1","key":"10.7717\/peerj.15386\/ref-31","doi-asserted-by":"publisher","first-page":"D521","DOI":"10.1093\/nar\/gkl923","article-title":"HMDB: the human metabolome database","volume":"35","author":"Wishart","year":"2007","journal-title":"Nucleic Acids Research"},{"issue":"5","key":"10.7717\/peerj.15386\/ref-32","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1002\/jhbp.63","article-title":"Risk biomarkers for assessment and chemoprevention of liver fluke-associated cholangiocarcinoma","volume":"21","author":"Yongvanit","year":"2014","journal-title":"Journal of Hepato-Biliary-Pancreatic Sciences"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/15386.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/15386.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/15386.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/15386.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T03:59:29Z","timestamp":1683604769000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/15386"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,9]]},"references-count":32,"alternative-id":["10.7717\/peerj.15386"],"URL":"https:\/\/doi.org\/10.7717\/peerj.15386","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,9]]},"article-number":"e15386"}}