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. 2025 Aug 11;21(5):107.
doi: 10.1007/s11306-025-02304-5.

Exploratory investigation of urinary alkanes and other volatile organic compounds in paediatric patients with tuberculous meningitis

Simon Isaiah  1 , Du Toit Loots  1 , A Marceline Tutu van Furth  1   2 , Regan Solomons  3 , Sabine van Elsland  3   4 , Martijn van der Kuip #  2 , Shayne Mason #  5
Affiliations

Exploratory investigation of urinary alkanes and other volatile organic compounds in paediatric patients with tuberculous meningitis

Simon Isaiah et al. Metabolomics. .

Abstract

Background: Tuberculous meningitis (TBM) is a disease caused by Mycobacterium tuberculosis (M. tb) infection of the brain. Alkanes and other volatile organic compounds (VOCs) are biologically important metabolites that are used by infectious mycobacteria species for growth and survival strategies.

Objective: This study investigated the altered alkanes and other VOCs in the urine from paediatric cases with TBM.

Method: We used untargeted gas chromatography coupled with time-of-flight mass spectrometry (GC-TOFMS) to analyse and compare all volatile, underivatised compounds present in the urine from 27 confirmed cases of paediatric TBM over a treatment period of six months, as well as a control group (n = 13).

Result: Four elevated alkanes (pentadecane, 5,7-dimethyl-undecane, 4,7-dimethyl-undecane, and 2,6-dimethyl-undecane), three alkenes (decreased 2,5-dimethyl-2-hexene and 4,4-dimethyl-1-pentene, and increased 3-methoxy-1-pentene), and three other VOCs of biological interest (decreased 2-butenoic acid methyl ester and 3-heptanone, and increased 2-pyrrolidinone) were identified as statistically significant. These volatile compounds remained perturbed during the TBM treatment.

Conclusion: This study discovered new systemic metabolic information about M. tb in the host and the role of alkanes and VOCs in the potential persistence of M. tb. We demonstrate the value of targeting alkanes and other VOCs for future metabolomics studies of M. tb.

Keywords: Alkanes; Gas chromatography coupled with time-of-flight mass spectrometry (GC-TOFMS); Metabolomics; Paediatric; Tuberculous meningitis (TBM); Urine; Volatile organic compounds (VOCs).

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Schematic study design depicting the metabolomics experimental workflow
Fig. 2
Fig. 2
Box plots of the four urinary alkanes identified as showing significant changes across the longitudinal TBM data set. The groups are shown as controls (C; red), baseline TBM (0; green), one month of TB treatment (1; blue), two months of TB treatment (2; light blue), three months of TB treatment (3; pink), four months of TB treatment (4; yellow), five months of TB treatment (5; purple), and six months of TB treatment (6; orange). All data are log-transformed
Fig. 3
Fig. 3
Box plots of six urinary compounds identified as showing significant changes across the longitudinal TBM data set. The groups are shown as controls (C; red), baseline TBM (0; green), one month of TB treatment (1; blue), two months of TB treatment (2; light blue), three months of TB treatment (3; pink), four months of TB treatment (4; yellow), five months of TB treatment (5; purple), and six months of TB treatment (6; orange). All data are log-transformed
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