Metabolic profiling promises to impact the management of many medical conditions, some of which were never expected to benefit from this approach. At the Barcelona conference, Stephen F. Kingsmore, M.B., C.h.B., B.A.O., president and CEO of the National Center for Genomic Resources, will talk about his work on metabolic biosignatures in sepsis patients. Sepsis, a complex systemic inflammatory response to infection, is diagnosed in 750,000 to 1 million patients in the U.S. annually and is fatal in up to 50% of them.
The clinical presentation of sepsis overlaps with that of noninfectious inflammatory conditions that also present with the so-called systemic inflammatory response syndrome, posing considerable diagnostic challenges, and many markers that are in use such as procalcitonin lack sufficient specificity.
During mass spectrometry analyses performed on the plasma metabolome, Dr. Kingsmore and collaborators described 43 biochemical differences, affecting several metabolic and biochemical pathways, that distinguish sepsis patients from those with nonseptic inflammatory manifestations. Furthermore, the investigators identified discrete metabolic differences, at presentation, between patients who were going to die 28 days later from sepsis and those who were going to survive.
“We found numerous metabolic changes in these patients at presentation in emergency departments that appear to be predictive of death, which is novel and unsuspected,” says Dr. Kingsmore. The ability to use metabolic profiling to guide diagnostic decisions in this patient group has the potential to provide an important screening tool for emergency rooms and underscores the increasing importance of considering metabolomics approaches in the systems biology investigation of complex medical conditions.
“Metabolomics is an area that has a lot of promise, but not a lot is known yet, and there are not yet a lot of thought-informing publications. I think the key need will be for a number of publications to appear that show the value of metabolic profiling,” predicts Dr. Kingsmore.