Metabolomics as a diagnostic tool in gastroenterology

Abstract

Metabolomics has increasingly been applied in addition to other “omic” approaches in the study of the pathophysiology of different gastrointestinal diseases. Metabolites represent molecular readouts of the cell status reflecting a physiological phenotype. In addition, changes in metabolite concentrations induced by exogenous factors such as environmental and dietary factors which do not affect the genome, are taken into account. Metabolic reactions initiated by the host or gut microbiota can lead to “marker” metabolites present in different biological fluids that allow differentiation between health and disease. Several lines of evidence implicated the involvement of intestinal microbiota in the pathogenesis of inflammatory bowel disease (IBD). Also in irritable bowel syndrome (IBS), a role of an abnormal microbiota composition, so-called dysbiosis, is supported by experimental data. These compositional alterations could play a role in the aetiology of both diseases by altering the metabolic activities of the gut bacteria. Several studies have applied a metabolomic approach to identify these metabolite signatures. However, before translating a potential metabolite biomarker into clinical use, additional validation studies are required. This review summarizes contributions that metabolomics has made in IBD and IBS and presents potential future directions within the field.

Keywords: Metabolomics, Microbiota, Inflammatory bowel diseases, Irritable bowel syndrome

Core tip: Metabolic profiling is a powerful exploratory tool for understanding interactions between nutrients, the intestinal metabolism and the microbiota composition in health and disease and, to gain more insight in metabolic pathways. Metabolomics may advance our understanding, diagnosis and treatment of inflammatory bowel disease and irritable bowel syndrome. Metabolic reactions initiated by the host or gut microbiota can lead to “marker” metabolites present in different biological fluids that allow differentiation between health and disease. Disease-related mechanisms may be uncovered and verified, and candidate diagnostic biomarkers in biological samples are characterized.