#METABOLOMICS WORKBENCH stephensondj_20230908_115906 DATATRACK_ID:4299 STUDY_ID:ST002857 ANALYSIS_ID:AN004681 VERSION 1 CREATED_ON 09-13-2023 #PROJECT PR:PROJECT_TITLE Intracerebroventricular Transplantation of Foetal Allogeneic Neural Stem Cells PR:PROJECT_TITLE in Patients with Secondary Progressive Multiple Sclerosis (hNSC-SPMS): a phase I PR:PROJECT_TITLE dose-escalation clinical trial PR:PROJECT_TYPE MS untargeted analysis PR:PROJECT_SUMMARY SUMMARY This is an open-label, first-in-human, dose-escalation phase I study PR:PROJECT_SUMMARY (NCT03282760, EudraCT2015‐004855‐37) to determine the feasibility, safety, PR:PROJECT_SUMMARY and tolerability of the transplantation of allogeneic human neural PR:PROJECT_SUMMARY stem/progenitor cells (hNSCs) for the treatment of progressive multiple PR:PROJECT_SUMMARY sclerosis. We report the analysis of 1 year of data from the first cohort of 15 PR:PROJECT_SUMMARY patients from two trial sites that received increasing numbers of allogeneic PR:PROJECT_SUMMARY hNSCs delivered via intracerebroventricular injection in combination with an PR:PROJECT_SUMMARY immunosuppressive regimen. No treatment-related deaths nor serious adverse PR:PROJECT_SUMMARY events (AEs) were observed over the 12-month follow-up. Participants displayed PR:PROJECT_SUMMARY stability of clinical and laboratory parameters, as well as lesion load and PR:PROJECT_SUMMARY activity at the brain MRIs, compared to study entry. Longitudinal metabolomics PR:PROJECT_SUMMARY and lipidomics analyses of cerebrospinal fluid and serum from these patients PR:PROJECT_SUMMARY identified time and dose-dependent responses, with increased levels of free PR:PROJECT_SUMMARY fatty acids and acylcarnitines in the CSF, especially at the highest dose of PR:PROJECT_SUMMARY injected hNSCs at the one-year follow-up time point. Finally, a significant PR:PROJECT_SUMMARY inverse correlation was found between the highest dose of injected hNSCs and the PR:PROJECT_SUMMARY smaller parenchymal brain volume change (PBVC; Spearman’s rho= -0.7, p= 0.03), PR:PROJECT_SUMMARY clinical covariates that correlated with CSF levels of free fatty acids, PR:PROJECT_SUMMARY acyl-carnitines, oxylipins, conjugated bile acids and purine breakdown and PR:PROJECT_SUMMARY deamination products, such as hypoxanthine. The absence of AEs and the stability PR:PROJECT_SUMMARY of functional and structural outcomes is reassuring in terms of risks and PR:PROJECT_SUMMARY represent a main milestone to rigorously address the challenges for the safe PR:PROJECT_SUMMARY translation of key principles of stem cell biology into effective regenerative PR:PROJECT_SUMMARY medicines. PR:INSTITUTE University of Colorado PR:DEPARTMENT Department of Biochemistry and Molecular Genetics PR:LABORATORY Angelo D’Alessandro PR:LAST_NAME Stephenson PR:FIRST_NAME Daniel PR:ADDRESS Research 1 South L18-1303 12801 E. 17th Ave., Aurora, Colorado, 80045, USA PR:EMAIL daniel.stephenson@cuanschutz.edu PR:PHONE 303-724-3339 PR:DOI http://dx.doi.org/10.21228/M8G43R #STUDY ST:STUDY_TITLE Intracerebroventricular Transplantation of Foetal Allogeneic Neural Stem Cells ST:STUDY_TITLE in Patients with Secondary Progressive Multiple Sclerosis (hNSC-SPMS): a phase I ST:STUDY_TITLE dose-escalation clinical trial - Metabolomics Analysis of Human CSF ST:STUDY_SUMMARY This is an open-label, first-in-human, dose-escalation phase I study ST:STUDY_SUMMARY (NCT03282760, EudraCT2015‐004855‐37) to determine the feasibility, safety, ST:STUDY_SUMMARY and tolerability of the transplantation of allogeneic human neural ST:STUDY_SUMMARY stem/progenitor cells (hNSCs) for the treatment of progressive multiple ST:STUDY_SUMMARY sclerosis. We report the analysis of 1 year of data from the first cohort of 15 ST:STUDY_SUMMARY patients from two trial sites that received increasing numbers of allogeneic ST:STUDY_SUMMARY hNSCs delivered via intracerebroventricular injection in combination with an ST:STUDY_SUMMARY immunosuppressive regimen. No treatment-related deaths nor serious adverse ST:STUDY_SUMMARY events (AEs) were observed over the 12-month follow-up. Participants displayed ST:STUDY_SUMMARY stability of clinical and laboratory parameters, as well as lesion load and ST:STUDY_SUMMARY activity at the brain MRIs, compared to study entry. Longitudinal metabolomics ST:STUDY_SUMMARY and lipidomics analyses of cerebrospinal fluid and serum from these patients ST:STUDY_SUMMARY identified time and dose-dependent responses, with increased levels of free ST:STUDY_SUMMARY fatty acids and acylcarnitines in the CSF, especially at the highest dose of ST:STUDY_SUMMARY injected hNSCs at the one-year follow-up time point. Finally, a significant ST:STUDY_SUMMARY inverse correlation was found between the highest dose of injected hNSCs and the ST:STUDY_SUMMARY smaller parenchymal brain volume change (PBVC; Spearman’s rho= -0.7, p= 0.03), ST:STUDY_SUMMARY clinical covariates that correlated with CSF levels of free fatty acids, ST:STUDY_SUMMARY acyl-carnitines, oxylipins, conjugated bile acids and purine breakdown and ST:STUDY_SUMMARY deamination products, such as hypoxanthine. The absence of AEs and the stability ST:STUDY_SUMMARY of functional and structural outcomes is reassuring in terms of risks and ST:STUDY_SUMMARY represent a main milestone to rigorously address the challenges for the safe ST:STUDY_SUMMARY translation of key principles of stem cell biology into effective regenerative ST:STUDY_SUMMARY medicines. ST:INSTITUTE University of Colorado ST:DEPARTMENT Department of Biochemistry and Molecular Genetics ST:LABORATORY Angelo D’Alessandro ST:LAST_NAME Stephenson ST:FIRST_NAME Daniel ST:ADDRESS Research 1 South L18-1303 12801 E. 17th Ave., Aurora, Colorado, 80045, USA ST:EMAIL daniel.stephenson@cuanschutz.edu ST:PHONE 303-724-3339 ST:SUBMIT_DATE 2023-09-08 #SUBJECT SU:SUBJECT_TYPE Human SU:SUBJECT_SPECIES Homo sapiens SU:TAXONOMY_ID 9606 SU:GENDER Male and female #SUBJECT_SAMPLE_FACTORS: SUBJECT(optional)[tab]SAMPLE[tab]FACTORS(NAME:VALUE pairs separated by |)[tab]Additional sample data SUBJECT_SAMPLE_FACTORS 1151 DS1-123-005 TimeGroup:FU1 RAW_FILE_NAME=DS1-123-005+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-005-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-005+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-005-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-005-neg_oxylipinsCSF.mzXML; ID=1 SUBJECT_SAMPLE_FACTORS 1219 DS1-123-032 TimeGroup:FU1 RAW_FILE_NAME=DS1-123-032+pos_metabolomicsCSF.mzXML; 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RAW_FILE_NAME=DS1-123-050+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-050-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-050-neg_oxylipinsCSF.mzXML; ID=37 SUBJECT_SAMPLE_FACTORS 1151 DS1-123-071 TimeGroup:REND RAW_FILE_NAME=DS1-123-071+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-071-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-071+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-071-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-071-neg_oxylipinsCSF.mzXML; ID=38 SUBJECT_SAMPLE_FACTORS 1252 DS1-123-087 TimeGroup:REND RAW_FILE_NAME=DS1-123-087+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-087-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-087+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-087-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-087-neg_oxylipinsCSF.mzXML; ID=39 SUBJECT_SAMPLE_FACTORS 1210 DS1-123-102 TimeGroup:REND RAW_FILE_NAME=DS1-123-102+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-102-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-102+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-102-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-102-neg_oxylipinsCSF.mzXML; ID=40 SUBJECT_SAMPLE_FACTORS 1194 DS1-123-106 TimeGroup:REND RAW_FILE_NAME=DS1-123-106+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-106-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-106+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-106-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-106-neg_oxylipinsCSF.mzXML; ID=41 SUBJECT_SAMPLE_FACTORS 1181 DS1-123-116 TimeGroup:REND RAW_FILE_NAME=DS1-123-116+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-116-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-116+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-116-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-116-neg_oxylipinsCSF.mzXML; ID=42 SUBJECT_SAMPLE_FACTORS 1243 DS1-123-117 TimeGroup:REND RAW_FILE_NAME=DS1-123-117+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-117-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-117+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-117-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-117-neg_oxylipinsCSF.mzXML; ID=43 SUBJECT_SAMPLE_FACTORS 1296 DS1-123-123 TimeGroup:REND RAW_FILE_NAME=DS1-123-123+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-123-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-123+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-123-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-123-neg_oxylipinsCSF.mzXML; ID=44 SUBJECT_SAMPLE_FACTORS 1323 DS1-123-131 TimeGroup:REND RAW_FILE_NAME=DS1-123-131+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-131-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-131+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-131-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-131-neg_oxylipinsCSF.mzXML; ID=45 SUBJECT_SAMPLE_FACTORS 1326 DS1-123-133 TimeGroup:REND RAW_FILE_NAME=DS1-123-133+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-133-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-133+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-133-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-133-neg_oxylipinsCSF.mzXML; ID=46 SUBJECT_SAMPLE_FACTORS 1326 DS1-123-145 TimeGroup:REND RAW_FILE_NAME=DS1-123-145+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-145-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-145+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-145-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-145-neg_oxylipinsCSF.mzXML; ID=47 SUBJECT_SAMPLE_FACTORS 1151 DS1-123-001 TimeGroup:START RAW_FILE_NAME=DS1-123-001+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-001-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-001+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-001-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-001-neg_oxylipinsCSF.mzXML; ID=48 SUBJECT_SAMPLE_FACTORS 1178 DS1-123-003 TimeGroup:START RAW_FILE_NAME=DS1-123-003+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-003-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-003+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-003-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-003-neg_oxylipinsCSF.mzXML; ID=49 SUBJECT_SAMPLE_FACTORS 1219 DS1-123-014 TimeGroup:START RAW_FILE_NAME=DS1-123-014+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-014-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-014+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-014-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-014-neg_oxylipinsCSF.mzXML; ID=50 SUBJECT_SAMPLE_FACTORS 1228 DS1-123-015 TimeGroup:START RAW_FILE_NAME=DS1-123-015+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-015-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-015+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-015-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-015-neg_oxylipinsCSF.mzXML; ID=51 SUBJECT_SAMPLE_FACTORS 1249 DS1-123-025 TimeGroup:START RAW_FILE_NAME=DS1-123-025+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-025-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-025+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-025-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-025-neg_oxylipinsCSF.mzXML; ID=52 SUBJECT_SAMPLE_FACTORS 1289 DS1-123-039 TimeGroup:START RAW_FILE_NAME=DS1-123-039+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-039-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-039+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-039-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-039-neg_oxylipinsCSF.mzXML; ID=53 SUBJECT_SAMPLE_FACTORS 1323 DS1-123-051 TimeGroup:START RAW_FILE_NAME=DS1-123-051+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-051-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-051+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-051-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-051-neg_oxylipinsCSF.mzXML; ID=54 SUBJECT_SAMPLE_FACTORS 1210 DS1-123-076 TimeGroup:START RAW_FILE_NAME=DS1-123-076+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-076-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-076+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-076-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-076-neg_oxylipinsCSF.mzXML; ID=55 SUBJECT_SAMPLE_FACTORS 1252 DS1-123-081 TimeGroup:START RAW_FILE_NAME=DS1-123-081+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-081-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-081+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-081-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-081-neg_oxylipinsCSF.mzXML; ID=56 SUBJECT_SAMPLE_FACTORS 1296 DS1-123-085 TimeGroup:START RAW_FILE_NAME=DS1-123-085+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-085-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-085+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-085-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-085-neg_oxylipinsCSF.mzXML; ID=57 SUBJECT_SAMPLE_FACTORS 1181 DS1-123-099 TimeGroup:START RAW_FILE_NAME=DS1-123-099+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-099-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-099+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-099-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-099-neg_oxylipinsCSF.mzXML; ID=58 SUBJECT_SAMPLE_FACTORS 1243 DS1-123-109 TimeGroup:START RAW_FILE_NAME=DS1-123-109+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-109-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-109+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-109-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-109-neg_oxylipinsCSF.mzXML; ID=59 SUBJECT_SAMPLE_FACTORS 1194 DS1-123-114 TimeGroup:START RAW_FILE_NAME=DS1-123-114+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-114-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-114+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-114-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-114-neg_oxylipinsCSF.mzXML; ID=60 SUBJECT_SAMPLE_FACTORS 1326 DS1-123-130 TimeGroup:START RAW_FILE_NAME=DS1-123-130+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-130-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-130+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-130-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-130-neg_oxylipinsCSF.mzXML; ID=61 SUBJECT_SAMPLE_FACTORS 1326 DS1-123-142 TimeGroup:START RAW_FILE_NAME=DS1-123-142+pos_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-142-neg_metabolomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-142+pos_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-142-neg_lipidomicsCSF.mzXML; RAW_FILE_NAME=DS1-123-142-neg_oxylipinsCSF.mzXML; ID=62 #COLLECTION CO:COLLECTION_SUMMARY lumbar puncture for serum and CSF collection (stored at -80°C) CO:SAMPLE_TYPE CSF #TREATMENT TR:TREATMENT_SUMMARY A total of 180 candidates volunteered between September 26, 2017, and January TR:TREATMENT_SUMMARY 13, 2020. The study was conducted in three centers. Two Italian centers, the TR:TREATMENT_SUMMARY ‘IRCCS Casa Sollievo della Sofferenza’ Research Hospital (Site 1) and the TR:TREATMENT_SUMMARY ‘Santa Maria di Terni’ Hospital (Site 2) recruited patients and performed TR:TREATMENT_SUMMARY the MRI examinations. The Multiple Sclerosis Centre of the Neurocentre of TR:TREATMENT_SUMMARY Southern Switzerland (Site 3) performed the magnetic resonance imaging (MRI) TR:TREATMENT_SUMMARY analysis. The ICVI of the ACT was performed at Site 2. Screening was done one TR:TREATMENT_SUMMARY month prior to enrolment in the study. The run-in period started after the TR:TREATMENT_SUMMARY screening examination (Run-in-START) and lasted three months (Run-in-END). After TR:TREATMENT_SUMMARY screening in the two recruiting centers (as above), n= 15 subjects with active TR:TREATMENT_SUMMARY and non-active SPMS suffering from progressive disability were found to be TR:TREATMENT_SUMMARY eligible, consented, and were assigned a unique identification number. TR:TREATMENT_SUMMARY Participants, nine females and six males, had a mean age of 50 years (range: TR:TREATMENT_SUMMARY 38–57), and were recruited in similar proportions by the two study sites. The TR:TREATMENT_SUMMARY mean EDSS was 7.6 (range 7–8), mean disease duration was 23 years (range TR:TREATMENT_SUMMARY 14–30), and mean time from diagnosis to secondary progression was 10 years TR:TREATMENT_SUMMARY (range: 1–20). The hNSC-SPMS study was advertised using the website of the TR:TREATMENT_SUMMARY hospitals and social media (eg Facebook and Twitter). The first patient TR:TREATMENT_SUMMARY selection was performed based on the documentation provided. Selected patients TR:TREATMENT_SUMMARY were then summoned in Site 1 and Site 2 (as above) for a first pre-screening TR:TREATMENT_SUMMARY meeting with the clinicians. Patients who agreed to participate were then TR:TREATMENT_SUMMARY subjected to the screening visit for the clinical trial. Following the surgical TR:TREATMENT_SUMMARY procedure, follow-up visits were performed monthly up to 12 months. Before TR:TREATMENT_SUMMARY transplantation, all patients underwent the following examinations (at both TR:TREATMENT_SUMMARY Run-in-START and Run-in-END): physical and neurological exams; vital signs; TR:TREATMENT_SUMMARY pregnancy tests (in fertile women); haematological and urine tests; lumbar TR:TREATMENT_SUMMARY puncture for serum and CSF collection (stored at -80°C); #SAMPLEPREP SP:SAMPLEPREP_SUMMARY Extraction of metabolites and lipids from serum and cerebrospinal fluid (CSF) SP:SAMPLEPREP_SUMMARY was as follows: 40 µL CSF or serum was aliquoted into 2mL deep well plates SP:SAMPLEPREP_SUMMARY followed by an addition of 360 µL cold MeOH:MeCN:H2O (5:3:2, v:v:v). Plates SP:SAMPLEPREP_SUMMARY were then placed on a shaker at 4°C and plate shaker was set to 400 RPM for 30 SP:SAMPLEPREP_SUMMARY minutes. Insoluble material was pelleted by centrifugation (4000 RPM, 10 min) SP:SAMPLEPREP_SUMMARY and supernatants were isolated for analysis by UHPLC-MS. All 96-well plate SP:SAMPLEPREP_SUMMARY pipetting was done using Integra MINI 96 (Integra Biosciences). #CHROMATOGRAPHY CH:CHROMATOGRAPHY_SUMMARY Lipidomics Negative CH:INSTRUMENT_NAME Thermo Vanquish CH:COLUMN_NAME Phenomenex Kinetex C18 (30 x 2.1mm, 1.7um) CH:COLUMN_TEMPERATURE 50 CH:FLOW_GRADIENT 0 min - 0.3ml/min - 10%B, 3 min - 0.3ml/min - 95%B, 4.2min - 0.3ml/min -95%B, CH:FLOW_GRADIENT 4.3min - 0.45ml/min - 10%B, 4.9min - 0.4ml/min - 10%B, 5 min - 0.3ml/min 10%B CH:FLOW_RATE 0.3-.45ml/min CH:SOLVENT_A 75:25 H2O:ACN 5mM NH4OAc CH:SOLVENT_B 90:10 iPrOH:ACN 5mM NH4OAc CH:CHROMATOGRAPHY_TYPE Reversed phase #ANALYSIS AN:ANALYSIS_TYPE MS #MS MS:INSTRUMENT_NAME Thermo Q Exactive Orbitrap MS:INSTRUMENT_TYPE Orbitrap MS:MS_TYPE ESI MS:MS_COMMENTS Software for Feature Assignments - Lipidsearch MS:ION_MODE NEGATIVE #MS_METABOLITE_DATA MS_METABOLITE_DATA:UNITS Peak area MS_METABOLITE_DATA_START Samples DS1-123-005 DS1-123-032 DS1-123-035 DS1-123-046 DS1-123-057 DS1-123-070 DS1-123-072 DS1-123-094 DS1-123-100 DS1-123-103 DS1-123-125 DS1-123-134 DS1-123-139 DS1-123-146 DS1-123-027 DS1-123-031 DS1-123-058 DS1-123-063 DS1-123-073 DS1-123-093 DS1-123-111 DS1-123-124 DS1-123-136 DS1-123-148 DS1-123-011 DS1-123-018 DS1-123-037 DS1-123-043 DS1-123-080 DS1-123-083 DS1-123-105 DS1-123-127 DS1-123-007 DS1-123-021 DS1-123-028 DS1-123-042 DS1-123-050 DS1-123-071 DS1-123-087 DS1-123-102 DS1-123-106 DS1-123-116 DS1-123-117 DS1-123-123 DS1-123-131 DS1-123-133 DS1-123-145 DS1-123-001 DS1-123-003 DS1-123-014 DS1-123-015 DS1-123-025 DS1-123-039 DS1-123-051 DS1-123-076 DS1-123-081 DS1-123-085 DS1-123-099 DS1-123-109 DS1-123-114 DS1-123-130 DS1-123-142 Factors TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU1 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU12 TimeGroup:FU6 TimeGroup:FU6 TimeGroup:FU6 TimeGroup:FU6 TimeGroup:FU6 TimeGroup:FU6 TimeGroup:FU6 TimeGroup:FU6 TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:REND TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START TimeGroup:START FA(14:0) 250664.0000 257212.1200 265230.7200 863759.1900 170718.9100 465402.7500 321224.4100 315093.5300 209473.5500 694322.2500 122748.0600 183977.4800 344365.4100 203515.8000 429809.3800 916001.0000 730656.2500 269129.8400 683429.6900 292686.5000 449309.2200 150352.1700 273854.2800 501342.4700 277975.9400 220022.1700 298991.0300 282750.2200 365631.5900 267835.2200 275265.2800 304357.2800 203860.2300 245882.8300 209302.8800 198879.7500 292227.5900 167665.0600 318213.6600 152361.8400 1774145.6200 191294.8000 214837.3000 295944.4700 321438.5300 201888.1100 1084341.8800 193487.3900 176450.5500 165059.5800 363877.5900 930080.6900 1385560.3800 384150.5000 207460.3300 205428.0800 151633.3600 212252.6700 4690865.5000 207235.8800 201562.3600 270811.1900 FA(16:0) 137125.7500 131485.0200 172929.0500 194353.2300 130978.0000 233522.1400 184380.1200 165595.7700 102059.7200 185674.5500 98351.0600 153031.6700 155336.1200 67159.3900 55234.4400 120950.8200 114317.9800 102190.5600 222529.0800 103234.6900 84108.8500 140835.3600 94088.5900 156007.0500 108742.2900 117967.9800 132413.1400 99461.9900 160691.1600 106335.9100 175052.4800 117969.9900 159319.0200 125173.4000 78070.7300 101521.3100 171806.8800 103663.4000 109434.7900 101603.2100 199967.5800 91247.4100 160556.4800 148952.7300 143419.7000 99879.2900 215642.7500 155606.8600 108877.0000 84966.8800 182568.1100 94077.6900 90957.2700 208040.7700 158357.4800 143851.7000 186343.5500 311783.9700 163003.1200 109178.2700 113894.6200 216953.6700 FA(17:0) 4094720.7500 5854821.5000 3967436.0000 4409892.5000 2971215.2500 4154387.2500 2840520.0000 5631397.5000 2851239.2500 4268486.5000 2914059.2500 3098545.7500 4843930.5000 3654654.2500 3856739.2500 3501614.2500 4011999.2500 6121609.5000 5159766.0000 4910020.5000 3470912.7500 4281275.5000 2956774.0000 5536347.0000 2730552.2500 2986358.0000 7615621.5000 2562040.7500 4911662.0000 5093872.0000 3738459.2500 4066191.2500 4952945.5000 3560761.7500 3771211.0000 2981587.7500 3729264.7500 3770781.0000 5143252.0000 2411343.7500 6077805.5000 3186549.0000 1938671.0000 7494853.5000 1932456.3800 2411059.7500 7694902.5000 4118448.2500 3824759.7500 3291745.0000 4865164.5000 6853460.0000 4145769.0000 3587275.2500 2447342.7500 3457672.2500 4393954.5000 2329928.0000 3414883.0000 3473246.0000 3913058.0000 4295608.5000 FA(18:0) 1212435.0000 903743.8100 1368015.6200 1637301.0000 886660.8100 1293998.3800 1081878.1200 2022184.3800 775239.0600 1697331.0000 644496.6900 945235.6900 1859688.0000 999306.2500 876431.4400 1197564.1200 1429329.3800 1656156.1200 1798504.0000 1966314.3800 908704.9400 1387635.7500 834379.6900 982930.9400 868489.5000 436268.1200 1216759.5000 589667.3800 1913501.5000 1182341.3800 1616352.6200 1662164.3800 1122017.5000 1080451.3800 1172384.5000 1208306.1200 1504242.3800 923065.1900 1044979.3100 600789.8100 1570597.1200 998301.6900 793712.0000 1273753.1200 499183.7800 678075.7500 2709000.0000 907690.1900 976989.1900 693790.3800 1617929.0000 1795906.6200 1456753.8800 714525.4400 436451.9700 1011160.6900 1086011.6200 779112.9400 1336410.1200 793294.0600 1256572.5000 1590151.3800 FA(18:1) 733938.5000 921674.9400 666128.0000 922603.7500 556259.0000 669661.1900 590813.6900 867710.0600 819011.6900 804492.1900 534505.0600 842661.8100 1118824.0000 917924.8100 628145.3100 854505.0600 722258.8100 716527.5000 927271.2500 695749.5600 798346.3100 980950.4400 639263.5600 961011.5000 525009.3100 490128.1600 935902.1900 604630.7500 1116225.5000 815235.1900 807841.7500 712034.0000 764756.4400 773191.8100 697202.6900 643658.0600 841381.7500 567084.7500 949900.0000 679588.5600 1001277.5600 871695.0000 566696.3800 816076.5000 400936.5000 554212.3100 1287860.5000 548929.1200 873583.5000 1067210.2500 977316.2500 1173229.3800 1027605.9400 748582.8100 536168.1900 1123793.6200 796806.1900 619019.7500 927918.8100 810284.0000 672177.8800 1062866.2500 FA(18:2) 9319032.0000 10814317.0000 10199320.0000 13854365.0000 13840897.0000 8903895.0000 8543302.0000 13981355.0000 6477544.5000 13649344.0000 5117693.5000 8755185.0000 15968011.0000 6566486.5000 9568505.0000 11822861.0000 11961907.0000 12986528.0000 15971344.0000 13461381.0000 9497763.0000 18297690.0000 8336373.5000 6890375.5000 7415188.0000 6649057.5000 7425971.5000 7041426.5000 16190636.0000 10787411.0000 10428367.0000 13287976.0000 8739776.0000 9836083.0000 9720657.0000 7222272.5000 10752406.0000 6002413.5000 8586346.0000 5698710.5000 14143615.0000 7638280.5000 8341958.0000 9615159.0000 5170022.5000 5637462.5000 23629536.0000 7945246.5000 6413615.5000 7054169.5000 12516440.0000 20375234.0000 9696996.0000 8669279.0000 5010617.5000 9233504.0000 8608467.0000 5018604.5000 12696868.0000 6753389.5000 13986313.0000 9928093.0000 FA(20:0) 1882167.0000 1918514.0000 1495723.0000 2382157.7500 1392367.7500 1138261.2500 1474447.5000 1876924.5000 1385888.3800 2728673.2500 1038277.0000 1625556.3800 2017670.5000 1100600.5000 2429826.7500 2285469.2500 1489634.0000 1747647.8800 1845999.6200 2333347.7500 1634778.0000 1384982.6200 1667166.1200 1369409.6200 1479109.5000 1768306.1200 1504363.0000 1774144.6200 1829251.5000 1422915.3800 1529371.6200 1910100.1200 2090479.1200 1494669.8800 1642198.3800 2062515.6200 1558048.8800 1156072.1200 1860392.5000 1595526.5000 1859418.6200 1222734.3800 1085759.3800 1788519.8800 1009223.0000 1568790.3800 2405525.7500 1720424.5000 1297965.6200 1199854.5000 1743011.6200 1957155.3800 1769677.8800 1471151.0000 1693328.1200 1488129.6200 1247685.8800 1215861.1200 2165895.2500 1377772.1200 2166321.5000 1666786.5000 MS_METABOLITE_DATA_END #METABOLITES METABOLITES_START metabolite_name pubchem_id inchi_key kegg_id other_id other_id_type ri ri_type moverz_quant FA(14:0) 2.096 227.202 FA(16:0) 2.367 255.233 FA(17:0) 2.870 269.249 FA(18:0) 2.602 283.264 FA(18:1) 2.426 281.249 FA(18:2) 2.267 279.233 FA(20:0) 3.098 311.296 METABOLITES_END #END