A Metabolomics Approach to Pharmacotherapy Personalization

Abstract

The optimization of drug therapy according to the personal characteristics of patients is a perspective direction in modern medicine. One of the possible ways to achieve such personalization is through the application of "omics" technologies, including current, promising metabolomics methods. This review demonstrates that the analysis of pre-dose metabolite biofluid profiles allows clinicians to predict the effectiveness of a selected drug treatment for a given individual. In the review, it is also shown that the monitoring of post-dose metabolite profiles could allow clinicians to evaluate drug efficiency, the reaction of the host to the treatment, and the outcome of the therapy. A comparative description of pharmacotherapy personalization (pharmacogenomics, pharmacoproteomics, and therapeutic drug monitoring) and personalization based on the analysis of metabolite profiles for biofluids (pharmacometabolomics) is also provided.

Keywords: mass spectrometry; metabolomics; personalized medicine; pharmacogenomics; pharmacometabolomics; therapeutic drug monitoring.

Figure 1

A schematic of the traditional (arrow A) and individual (arrow B) approaches to medical treatment.

Figure 2

A biological system represented as a complex interaction of the genome, transcriptome, proteome, and metabolome.

Figure 3

Factors that determine individual drug responses.

Figure 4

Mass spectrum of human blood plasma metabolites acquired by DIMS in the positive mode of micrOTOF-Q (BrukerDaltonik Ltd., Billerica, MA, USA). The labels indicate the different metabolite groups detected. The upper panel is a representative image of biodegradation (in this case, of vitamin A). The m/z values for mass peaks of vitamin A and its derivates (adducts, fragments, and multi-ions) are also presented.