The Role of Metabolomics in Neonatal and Pediatric Laboratory Medicine.

Laboratory Medicine Service, IRCCS AOU San Martino-IST, University-Hospital, National Institute for Cancer Research, Genova, Italy.
Clinica chimica acta; international journal of clinical chemistry (Impact Factor: 2.82). 09/2013; 426. DOI: 10.1016/j.cca.2013.08.020
Source: PubMed


Metabolomics consists of the quantitative analysis of a large number of low molecular mass metabolites involving substrates or products in metabolic pathways existing in all living systems. The analysis of the metabolic profile detectable in an human biological fluid allows to instantly identify changes in the composition of endogenous and exogenous metabolites caused by the interaction between specific physiopathological states, gene expression, and enviroment. In pediatrics and neonatology, metabolomics offers new encouraging perspectives for the improvement of critically ill patients outcome, for the early recognition of metabolic profiles associated with the development of diseases in the adult life, and for delivery of individualized medicine. In this view, nutrimetabolomics, based on the recognition of specific cluster of metabolites associated with nutrition and pharmacometabolomics, based on the capacity to personalize drug therapy by analyzing metabolic modifications due to therapeutic treatment may open new frontiers in the prevention and in the treatment of pediatric and neonatal diseases. This review summarize the most relevant results published in the literature on the application of metabolomics in pediatric and neonatal clinical settings. However, there is the urgent need to standardize physiological and preanalytical variables, analytical methods, data processing, and result presentation, before to establish the definitive clinical value of results.

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Available from: Michele Mussap, Feb 07, 2014
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    • "The analysis of the metabolic profile observable in a body fluid allows the immediate identification of changes in the composition of endogenous and exogenous metabolites that may be correlated with specific pathophysiological states, gene expression and interaction with the environment [7]. To date, very few publications have dealt with metabolomics and sepsis in adults and children [8] and none in neonates. In our work we performed a metabolomic analysis to assess variations of metabolites preceding the onset of early and late sepsis in neonates for the purpose of identifying a metabolic state leading to the onset of infection. "
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    ABSTRACT: The purpose of this article is to study one of the most significant causes of neonatal morbidity and mortality: neonatal sepsis. This pathology is due to a bacterial or fungal infection acquired during the perinatal period. Neonatal sepsis has been categorized into two groups: early onset if it occurs within 3-6 days and late onset after 4-7 days. Due to the not-specific clinical signs, along with the inaccuracy of available biomarkers, the diagnosis is still a major challenge. In this regard, the use of a combined approach based on both nuclear magnetic resonance ((1)H-NMR) and gas-chromatography-mass spectrometry (GC-MS) techniques, coupled with a multivariate statistical analysis, may help to uncover features of the disease that are still hidden. The objective of our study was to evaluate the capability of the metabolomics approach to identify a potential metabolic profile related to the neonatal septic condition. The study population included 25 neonates (15 males and 10 females): 9 (6 males and 3 females) patients had a diagnosis of sepsis and 16 were healthy controls (9 males and 7 females). This study showed a unique metabolic profile of the patients affected by sepsis compared to non-affected ones with a statistically significant difference between the two groups (p = 0.05).
    Early human development 03/2014; 90 Suppl 1:S78-83. DOI:10.1016/S0378-3782(14)70024-6 · 1.79 Impact Factor
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    ABSTRACT: This chapter reviews articles on NMR and lipids published between June 2011 and May 2012. The number of papers devoted to NMR utilization to investigate lipids, their structures, behavior in native and artificial membranes, interactions with proteins and peptides, as well as with low molecular weight compounds, and biomedical applications is quite large (over 1100 articles in Pub-Med) although we included here only a selection of those papers that were accessible and peer-reviewed. The reviewed material has been arranged in sections devoted to the structure and function of lipids in membranes, their roles in membrane-related processes including membrane fusion and lipid-mediated signal transduction, interactions of lipids with membrane and soluble proteins, peptides and antibiotics, lipid metabolomics, visualization of lipid related processes in biomedicine, diagnosis and therapy, as well as methodological approaches.
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