title: Metabolomics: Applications and Promise in Mycobacterial Disease.
abstract: Until recently, the study of mycobacterial diseases was trapped in culture-based technology that is more than a century old. The use of nucleic acid amplification is changing this, and powerful new technologies are on the horizon. Metabolomics, which is the study of sets of metabolites of both the bacteria and host, is being used to clarify mechanisms of disease, and can identify changes leading to better diagnosis, treatment, and prognostication of mycobacterial diseases. Metabolomic profiles are arrays of biochemical products of genes in their environment. These complex patterns are biomarkers that can allow a more complete understanding of cell function, dysfunction, and perturbation than genomics or proteomics. Metabolomics could herald sweeping advances in personalized medicine and clinical trial design, but the challenges in metabolomics are also great. Measured metabolite concentrations vary with the timing within a condition, the intrinsic biology, the instruments, and the sample preparation. Metabolism profoundly changes with age, sex, variations in gut microbial flora, and lifestyle. Validation of biomarkers is complicated by measurement accuracy, selectivity, linearity, reproducibility, robustness, and limits of detection. The statistical challenges include analysis, interpretation, and description of the vast amount of data generated. Despite these drawbacks, metabolomics provides great opportunity and the potential to understand and manage mycobacterial diseases.
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, University of Miami, Miami, Florida.
authors.forename: Mehdi
authors.identifier: http://orcid.org/0000-0001-5298-8442
authors.initials: M
authors.lastname: Mirsaeidi
authors.affiliation: 2 Department of Critical Care Medicine and.
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Banoei
authors.affiliation: 2 Department of Critical Care Medicine and.|3 Department of Medicine and Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada; and.
authors.forename: Brent W
authors.initials: BW
authors.lastname: Winston
authors.affiliation: 4 Division of Pulmonary and Critical Care Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Dean E
authors.initials: DE
authors.lastname: Schraufnagel
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D006801:Humans; D055432:Metabolomics / Q000379:methods*; D009164:Mycobacterium Infections / Q000175:diagnosis* / Q000628:therapy*; D057285:Precision Medicine / Q000379:methods*
chemical_list: D015415:Biomarkers
keywords: -omics; metabolomics; nontuberculous; tuberculosis