Clinical Implementation of Metabolomics

Metabolomics, which is also referred to as metabonomics, metabolic profiling or metabolic fingerprinting, is the comprehensive quantitative measurement of endogenous metabolites within a biological system (Fiehn, 2002; Kaddurah-Daouk et al, 2008; Spratlin et al, 2009). Detection of metabolites is in general carried out in cell extracts, tissue specimens, or various biological fluids including serum, plasma, urine and cerebrospinal fluid (CSF) by liquid chromatography mass spectrometry (LC-MS), gas chromatography–mass spectrometry (GCMS), capillary electrophoresis–mass spectrometry (CE-MS) or nuclear magnetic resonance spectroscopy (NMR). Metabolomics captures the status of diverse biochemical pathways in a particular situation and can define the metabolic status of an organism (Aranibar et al, 2011; DeFeo et al, 2011; Lu et al, 2008; Roux et al, 2011; Soga, 2007; Yuan et al, 2007). In clinical settings, biomarkers generated from metabolomics have become one of the most essential diagnostic criteria that can be objectively measured and evaluated as indicators of normal or pathological states, as well as a tool to assess responses to therapeutic interventions (Hunter, 2009; Spratlin et al, 2009; van der Greef et al, 2006; Zeisel, 2007). As we describe in this chapter, novel metabolomic markers, for instance, for cancer therapy, glucose intolerance, hepatic steatosis, nephrotic and psychiatric disorders, and their incorporation into clinical decision-making may considerably change future health care.