Review for 10.1186/s12876-025-03714-4 (2025)

Title: Significance and Clinical Utility of Targeted Metabolomic Analysis of Serum Bile Acid
Profiles for Early Diagnosis of Patients with Acute Pancreatitis
Version: 1 Date: 14 Dec 2024
Reviewer's report:
This study is innovative in the field of acute pancreatitis, utilizing metabolomics to analyze bile
acid profiles, filling the gap in early diagnosis. The experimental data are clear, and the potential
of bile acids as biomarkers is proposed. However, the sample size and grouping information
are insufficient, and the statistical analysis lacks discussion of non-significant results. The
experimental design lacks detailed control of confounding factors, and the exploration of
mechanisms is relatively superficial. While the protective role of TUDCA is proposed, its
clinical application potential is not discussed in depth, and the future research directions are
somewhat limited. Nevertheless, the innovative ideas and potential applications presented in this
study have significant academic value, providing strong theoretical support for future research
in related fields.
1.Expansion of the Introduction:
In the introduction, it would be beneficial to further expand the discussion on the physiological
and pathological roles of bile acids in acute pancreatitis, referencing existing literature to
clarify which bile acid metabolites might be associated with the onset or progression of acute
pancreatitis. This will help deepen the theoretical foundation of the article and enhance its
academic value.
2.Rationale for the Choice of Bile Acids:
The article mentions the study of bile acid metabolites but does not clearly list the specific bile
acids chosen for study. It would be helpful to provide a detailed list of the bile acids to be studied
and, if possible, explain why these particular bile acids were selected, referencing existing
literature or prior research. This will increase the transparency of the study and strengthen the
scientific rationale behind the selection.
3.Discussion of Existing Diagnostic Markers:
While the introduction mentions the limitations of current diagnostic markers for acute
pancreatitis (such as serum amylase, lipids, APACHE-II score, etc.), it does not provide a
detailed analysis of how these markers perform and their limitations in different stages or
clinical contexts. The background discussion appears somewhat general. It would be beneficial
to include a more thorough analysis of the existing markers, explaining their shortcomings in
early diagnosis of acute pancreatitis, and thereby highlighting the advantages of bile acids in
this field.
4.Clarification of Patient Grouping:
The article mentions dividing acute pancreatitis patients into mild, moderate, and severe groups
but does not clearly describe how patients were grouped based on the severity of the disease.
Please provide more detailed information about the grouping criteria, especially how the severity
of the disease was diagnosed. Additionally, please ensure the specific sample sizes are clearly
stated to avoid any ambiguity. For example, the phrase “In this study, 25 patients with mild
acute pancreatitis (MAP), moderate-to-severe acute pancreatitis (MSAP), and severe acute
pancreatitis (SAP)” should be more precise.
5.Choice and Validation of Data Analysis Methods:
The use of PCA, OPLS-DA, and other methods for data analysis lacks an explanation of
why these methods were chosen, particularly how the stability and accuracy of the models
were validated. It is suggested to provide more information about the validation of the data
analysis methods, such as cross-validation and stability testing, to ensure the reliability and
reproducibility of the results.
6.Biological Interpretation of Bile Acids and Clinical Indicators:
For the bile acids that show significant correlations with clinical indicators, it would be beneficial
to provide a more in-depth biological explanation, exploring the potential roles of these bile
acids in the onset and progression of acute pancreatitis. This will add further academic depth to
the article and extend the analysis beyond simple clinical associations.
7.Improvement of Figure F1:
For Figure F1, it is recommended to revise the figure to ensure it is accurate, detailed, and
aesthetically pleasing. Since figures are an important part of the manuscript, their clarity and
appearance play a crucial role in effectively conveying the research findings.
8.Reference Selection:
The reference list could benefit from incorporating more recent studies. It would be helpful to
include a broader selection of up-to-date sources to reflect the latest advancements and trends in
the field. This would enhance the relevance of the article and demonstrate the authors' awareness
of the current state of research.
9.Language Refinement:
There are a few areas where the language could be refined for clarity and fluency. Some
sentences could be rephrased to improve readability and precision. A thorough review of the
manuscript for language clarity would help ensure the ideas are communicated effectively.
These suggestions aim to enhance the theoretical depth, transparency, and academic value of
the article, while also improving the reliability and reproducibility of the data analysis. Thank
you for your hard work, and I look forward to seeing the manuscript further refined to showcase
its strong research contributions.