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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    • "A " pharmacometabolomics-aided pharmacogenomics " workflow includes sample acquisition and preparation, analysis (NMR or mass spectrometry technologies), data processing and data analysis (targeted and non-targeted) (Mussap et al., 2013). For those familiar with (pharmaco)metabolomics approaches, such an outline is not new. "
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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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