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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Inherit+Metab+Dis
2018 ; 41
(3
): 337-353
Nephropedia Template TP
gab.com Text
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Next-generation metabolic screening: targeted and untargeted metabolomics for the
diagnosis of inborn errors of metabolism in individual patients
#MMPMID29453510
Coene KLM
; Kluijtmans LAJ
; van der Heeft E
; Engelke UFH
; de Boer S
; Hoegen B
; Kwast HJT
; van de Vorst M
; Huigen MCDG
; Keularts IMLW
; Schreuder MF
; van Karnebeek CDM
; Wortmann SB
; de Vries MC
; Janssen MCH
; Gilissen C
; Engel J
; Wevers RA
J Inherit Metab Dis
2018[May]; 41
(3
): 337-353
PMID29453510
show ga
The implementation of whole-exome sequencing in clinical diagnostics has
generated a need for functional evaluation of genetic variants. In the field of
inborn errors of metabolism (IEM), a diverse spectrum of targeted biochemical
assays is employed to analyze a limited amount of metabolites. We now present a
single-platform, high-resolution liquid chromatography quadrupole time of flight
(LC-QTOF) method that can be applied for holistic metabolic profiling in plasma
of individual IEM-suspected patients. This method, which we termed
"next-generation metabolic screening" (NGMS), can detect >10,000 features in each
sample. In the NGMS workflow, features identified in patient and control samples
are aligned using the "various forms of chromatography mass spectrometry (XCMS)"
software package. Subsequently, all features are annotated using the Human
Metabolome Database, and statistical testing is performed to identify
significantly perturbed metabolite concentrations in a patient sample compared
with controls. We propose three main modalities to analyze complex, untargeted
metabolomics data. First, a targeted evaluation can be done based on identified
genetic variants of uncertain significance in metabolic pathways. Second, we
developed a panel of IEM-related metabolites to filter untargeted metabolomics
data. Based on this IEM-panel approach, we provided the correct diagnosis for 42
of 46 IEMs. As a last modality, metabolomics data can be analyzed in an
untargeted setting, which we term "open the metabolome" analysis. This approach
identifies potential novel biomarkers in known IEMs and leads to identification
of biomarkers for as yet unknown IEMs. We are convinced that NGMS is the way
forward in laboratory diagnostics of IEMs.