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WDA 2010 . Metabonomics. A New Potential Diagnostic Tool. David Huffman Western Michigan University. Current Challenges. Difficulty in diagnosis Symptoms not always specific Confusion with other disorders Speed of diagnosis To minimize complications Monitoring treatment regimen
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WDA 2010 Metabonomics A New Potential Diagnostic Tool David Huffman Western Michigan University
Current Challenges • Difficulty in diagnosis • Symptoms not always specific • Confusion with other disorders • Speed of diagnosis • To minimize complications • Monitoring treatment regimen • Short and long term effects Ala et al. Lancet 2007, 369, 397
Goals • Early diagnosis when clinical manifestions are mild • Predict neurological and liver function changes Metabonomics
Definition of terms METABOLITE is a small molecule whose concentration changes as a function of something; usually not a protein or enzyme METABOLOME is the repetoire of biochemicals present in cells, tissue, and body fluids An example would be blood glucose Metabonomics
Definition of terms METABOLOMICS is the global analysis of the type and quantity of all metabolites in biological fluids or tissue METABONOMICS is the study of metabolic responses to pathophysiological stimuli Metabonomics
Metabonomics “The relevance of metabonomics could be greatly enhanced if it were possible to identify an invariant part of the individual metabolome of a ‘healthy’ subject with respect to, for example, pathological states, in such a way as to perform prediction, early diagnosis and prognosis of pathologies.” Assfalg et al. Proc NatlAcadSci 2008, 105, 1420
Metabonomics “. . . traditional biomedical/clinical approaches are limited by the number of parameters as well as in their efficiency, and they provide only a fragmented perspective on the health status of an individual.” Assfalg et al. Proc NatlAcadSci 2008, 105, 1420
Current Biochemical TestsFor WD Typically don’t measure small metabolites • AST and ALT (Aminotransferases) • ALP (AlkPhosphatase) • Bilirubin, Albumin • INR, CBC • Serum Ceruloplasmin Roberts & SchilskyHepatology 2003, 37, 1475
Current Testing Methods “However, most clinical chemistry tests available today rely on old technologies that only measure a single chemical in blood, urine or other biofluid, and these tests are generally neither sensitive nor specific for any one particular disease. Comprehensive chemical analyses of urine or blood have simply never been done in a clinical setting before. ” Slupsky, Biomarkers Med. 2010, 4, 195
Prospect of Metabonomics • Measure a number of different metabolites simultaneously • Obtain a unique fingerprint of a individual in metabolic space and time • Develop new markers for WD diagnosis and monitoring Metabonomics
Metabolites Monitored • amino acids • amines • lipids • sugars and derivatives • nucleic acids • other metabolic intermediates Metabonomics
Metabonomic Phenotypes NMR Fingerprint from one individual*,‡ Multivariate Analysis of 21 Individuals *not actual data ‡urine has over 2500 different metabolites at >1 mM Assfalg et al. Proc NatlAcadSci 2008, 105, 1420
Metabotypes genes lifestyle etc. • The metabotype consists of a variable part (environment) and an invariant part (genetics + environment) • The invariant part persists for at least two-three years • The discovery of the existence of individual metabotypes has a strong biomedical potential Bernini, P.; Bertini, I.; Luchinat, C.; Nepi, S.; Saccenti, E.; Schäfer, H.; Schütz, B.; Spraul, M.; Tenori, L. Individual human phenotypes in metabolic space and time, J. Prot. Res. 2009
CeliacDiseaseMetabonomics After gluten-free diet the metabolic fingerprint reverts to normal Bertini, I.; Calabrò, A.; De Carli, V.; Luchinat, C.; Nepi, S.; Porfirio, B.; Renzi, D.; Saccenti, E.; Tenori, L.The metabonomic signature of celiac disease, J. Proteome Res. 2009,8(1), 170
Metabonomic Applications • New Markers for Disease • Facilitate rapid diagnosis • Monitor Maintenance Therapy • Pre/Post Drug Treatment • Pre/Post Surgery • Establish Parameters to Monitor Health • Routine Multivariate Analysis of body fluid or tissue Metabonomics
The Next Step • Establish a metabonomics study of WD patients Metabonomics
Current Funding National Science Foundation Metabonomics
Collaborators: IvanoBertini Claudio Luchinat