Objective Eosinophilic granulomatosis with polyangiitis (EGPA) was a rare systemic vasculitis characterized by eosinophilia, asthma, and necrotizing vasculitis. Metabolic dysregulation had been shown to participate in the pathogenesis of autoimmune diseases, but the plasma metabolic profile of EGPA remained unclear. This work was designed to systematically characterize the plasma metabolomic profiles of EGPA patients, identify differential metabolites that distinguish EGPA from bronchial asthma (BA), and explore their potential as biomarkers for differential diagnosis. Methods Ten patients with EGPA, ten patients with BA, and ten age- and gender-matched healthy controls (HCs) were enrolled. Untargeted metabolomics based on liquid chromatography/mass spectrometry (LC/MS) was performed to analyze the metabolic profiles of the three groups. Differential metabolites were identified using VIP > 1 and P 0.8). Four metabolites (cholesterol, 5-acetylamino-6-formylamino-3-methyluracil, 5-acetylamino-6-amino-3-methyluracil, and 3-methylxanthine) showed high diagnostic potential (AUC > 0.8) for distinguishing EGPA from BA. Conclusion This study revealed, for the first time, a distinct plasma metabolic profile in EGPA patients, with key pathways and candidate biomarkers identified. The metabolites with high diagnostic efficacy (AUC > 0.8) might serve as candidate diagnostic biomarkers for EGPA and its differentiation from BA. These observations provided novel insights into the metabolic basis of EGPA pathogenesis and might provide valuable references for the clinical management of this rare disease.
Su et al. (2026) studied this question.