Researchers have developed what they call the bioenergetics health index (BHI) to measure how susceptible a person is to developing any of a myriad of conditions – including AIDS, cardiovascular diseases, diabetes and kidney disease – then use this new diagnostic tool to help devise an individualized treatment.

Bioenergetics, that branch of biochemistry that seeks to understand how energy is produced by cellular processes, has long been considered as an important area in understanding disease formation. Scientists in this field are focusing on an important part of the cell called the mitochondria, and how this structure is affected by pathological stressors. Because the mitochondria is sensitive to the earliest signs of systemic disease, studying this “powerhouse of the cell” could yield clues on how to stop a disease from progressing.

Researchers at the University of Alabama have developed a new biomarker called the Bioenergetic Health Index (BHI) that measures mitochondrial dysfunction, and how that makes a person susceptible to certain diseases. As explained in their study, which was published recently in Clinical Science, BHI as a biomarker can serve as a warning system for “disease progression in neurodegeneration, diabetes, cancer and cardiovascular disease.” 

“To calculate BHI, we measure oxygen used by a cell at rest and then under a defined metabolic stress – and then look at the difference between the two. We can use oxygen consumption as a marker of how much energy mitochondria are able to generate,” Victor Darley-Usmar, Ph.D., professor of pathology, director of the Mitochondrial Medicine Laboratory at UAB, and lead author of the study, told New Scientist. “The cell needs a certain level of energy to carry out basic functions and even more to deal with stressors like disease.”

Previously, measuring mitochondrial function was not feasible due to a lack of instrumentation and assay standardization. A typical blood draw would not be enough to provide the required number of cells to measure oxygen consumption. But the researchers at UAB Mitochondrial Medicine Laboratory and Seahorse Bioscience have developed a new blood test that could calculate BHI based on circulating white blood cells and platelets. With this new method, BHI could finally serve as an additional clinical tool in the diagnosis of at-risk populations, much like blood pressure readings could indicate hypertension or heart disease.      

“In clinical settings, patients’ BHI could be measured to determine their bioenergetic health baseline before they undergo different procedures,” Dr. Darley-Usmar said. 

Moreover, BHI could be combined with a person’s clinical history and genomics data, along with factors such as diet and exercise, to create a personalized medicine profile.

In a press release, the researchers cite, “for instance, in patients with diabetes, a low BHI could signal an increased risk of kidney damage even if other clinical indicators are only slightly elevated. Armed with the patient’s BHI, a physician could modify treatment to decrease risk of kidney failure.”

Darley-Usmar and his colleagues are currently conducting three pilot studies in patients with kidney disease, alcohol-related disease and HIV, and they claim that initial data are promising. BHI patterns may differ from one disease to another, and from one person to the next. The researchers hope for a better understanding of these patterns in future, longer-term studies.

“We hope that BHI will provide another tool for doctors to drill down to the underlying molecular mechanisms of the individual patient’s disease, and then choose the appropriate intervention,” Darley-Usmar said in the New Scientist article.