title: Metabolomics: Perspectives on potential biomarkers in organ transplantation and immunosuppressant toxicity.
abstract: Organ transplantation is the treatment of choice for many end stage diseases. The development and appropriate use of new immunosupressants have considerably improved the outcome of patients in the last decades. However, noninvasive, sensitive and specific biomarkers for early detection of complications leading to graft dysfunction are still needed. Current transplantation monitoring mostly relies on non-specific biochemical tests whereas diagnosis of rejection is generally based on invasive procedures such as biopsies. New approaches based on large scale profiling of body fluids and tissues are needed to address the complexity and multifactorial aspect of organ transplantation complications. Metabolomics aim to characterize and quantify the metabolome, which is the collection of the low-molecular weight compounds rising from metabolic pathways. Extracted from tissues or detected in body fluids, the small molecules are measured using nuclear magnetic resonance spectroscopy or mass spectrometry. By profiling the downstream products of cellular activity, metabolomics is most likely to represent the immediate cellular response to stresses. Diagnostic applications have been proposed in cancer, cardiovascular diseases, kidney diseases, neurological diseases and many more. This review will focus on the potential applications of metabolomics in organ transplantation including follow up of graft function recovery, diagnostic of alloimmune rejection as well as monitoring of immunosuppressant toxicity.
authors.affiliation: Department of Clinical Biochemistry, Maisonneuve-Rosemont Hospital, 5415, boulevard de l'Assomption, Montréal, Québec H1T 2M4, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Bonneau
authors.affiliation: Department of Clinical Biochemistry, Haut Richelieu Hospital, 920, boulevard du Séminaire NordSaint-Jean-sur-Richelieu, Québec, J3A 1B7, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Tétreault
authors.affiliation: Department of Clinical Biochemistry, Maisonneuve-Rosemont Hospital, 5415, boulevard de l'Assomption, Montréal, Québec H1T 2M4, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Robitaille
authors.affiliation: Department of Nephrology, Maisonneuve-Rosemont Hospital, 5415, boulevard de l'Assomption, Montréal, Québec, H1T 2M4, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Boucher
authors.affiliation: Department of Clinical Biochemistry, Maisonneuve-Rosemont Hospital, 5415, boulevard de l'Assomption, Montréal, Québec H1T 2M4, Canada. Electronic address: vdeguire.hmr@ssss.gouv.qc.ca.
authors.forename: V
authors.initials: V
authors.lastname: De Guire
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D055432:Metabolomics; D016377:Organ Transplantation
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents
keywords: Biomarkers; Diagnostic; Immunosuppressants toxicity; Mass spectrometry; Metabolites; Metabolomics; NMR spectroscopy; Rejection; Toxicity; Transplantation