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The promise of metabolic phenotyping in gastroenterology and hepatology

Nature Reviews Gastroenterology & Hepatology volume 12, pages 458–471 (2015)Cite this article

Subjects

Key Points

  • Spectroscopically directed metabolic profiling has the potential to enhance current capabilities in patient stratification

  • Examples of the contribution of metabolic profiling to disease diagnostics and prognostics as applied to liver and digestive diseases are widely present in the literature

  • Metabolic profiling provides insights about the function of gut bacteria, which are known to be involved in a wide range of pathologies including IBD, obesity, fatty liver and colorectal cancer

  • Surgical metabonomics centred on mass-spectrometry-linked intelligent surgical devices have the potential to deliver clinically relevant chemical information in real-time to augment clinical decision-making

Abstract

Disease risk and treatment response are determined, at the individual level, by a complex history of genetic and environmental interactions, including those with our endogenous microbiomes. Personalized health care requires a deep understanding of patient biology that can now be measured using a range of '-omics' technologies. Patient stratification involves the identification of genetic and/or phenotypic disease subclasses that require different therapeutic strategies. Stratified medicine approaches to disease diagnosis, prognosis and therapeutic response monitoring herald a new dimension in patient care. Here, we explore the potential value of metabolic profiling as applied to unmet clinical needs in gastroenterology and hepatology. We describe potential applications in a number of diseases, with emphasis on large-scale population studies as well as metabolic profiling on the individual level, using spectrometric and imaging technologies that will leverage the discovery of mechanistic information and deliver novel health care solutions to improve clinical pathway management.

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Figure 1: Summary diagram detailing the workflow involved in metabolic phenotyping studies.
Figure 2: Molecular information recovery.
Figure 3: Potential health-care impacts of population screening and stratified medicine technologies.

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Acknowledgements

The MRC-NIHR National Phenome Centre is supported by the UK Medical Research Council (in association with National Institute for Health Research [England]) Grant MC_PC_12025. The financial support of Bruker Biospin, Waters Corporation, Metabometrix and Imperial College is also gratefully acknowledged by the MRC-NIHR National Phenome Centre.

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Authors and Affiliations

  1. Division of Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, SW7 2AZ, London, UK

    Elaine Holmes & Anisha Wijeyesekera

  2. Department of Medicine, Faculty of Medicine, Imperial College London, SW7 2AZ, London, UK

    Simon D. Taylor-Robinson

  3. Department of Surgery and Cancer, MRC-NIHR National Phenome Centre, Faculty of Medicine, Imperial College London, SW7 2AZ, London, UK

    Jeremy K. Nicholson

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  1. Elaine Holmes
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  2. Anisha Wijeyesekera
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Contributions

E.H., A.W., S.D.T.-R. and J.K.N. researched data for and wrote the article. E.H., A.W. and J.K.N. reviewed/edited the manuscript before submission and E.H. and J.K.N. made substantial contributions to discussion of content.

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Correspondence to Jeremy K. Nicholson.

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Analytical techniques for metabolic phenotyping and examples of clinical applications (PDF 123 kb)

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Holmes, E., Wijeyesekera, A., Taylor-Robinson, S. et al. The promise of metabolic phenotyping in gastroenterology and hepatology. Nat Rev Gastroenterol Hepatol 12, 458–471 (2015). https://doi.org/10.1038/nrgastro.2015.114

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