Non-invasive Sampling of Human Body Fluids Using In Vivo SPME

Noninvasive body fluids offer attractive sources to gain insights into human health. The in vivo solid-phase microextraction (SPME) technique is a fast and versatile sample preparation technique for the noninvasive sampling of human body fluids in various fields. This chapter summarizes the applications of SPME coupled with mass spectrometry (MS)-based approaches for noninvasive investigations of human body fluids, including urine, sweat, and saliva. New features of noninvasive SPME sampling and MS-based analysis are highlighted, and the prospects on their further development are also discussed.

In Vivo Solid-Phase Microextraction and Applications in Environmental Sciences

Solid-phase microextraction (SPME) is a well-established sample-preparation technique for environmental studies. The application of SPME has extended from the headspace extraction of volatile compounds to the capture of active components in living organisms via the direct immersion of SPME probes into the tissue (in vivo SPME). The development of biocompatible coatings and the availability of different calibration approaches enable the in vivo sampling of exogenous and endogenous compounds from the living plants and animals without the need for tissue collection. In addition, new geometries such as thin-film coatings, needle-trap devices, recession needles, coated tips, and blades have increased the sensitivity and robustness of in vivo sampling. In this paper, we detail the fundamentals of in vivo SPME, including the various extraction modes, coating geometries, calibration methods, and data analysis methods that are commonly employed. We also discuss recent applications of in vivo SPME in environmental studies and in the analysis of pollutants in plant and animal tissues, as well as in human saliva, breath, and skin analysis. As we show, in vivo SPME has tremendous potential for the targeted and untargeted screening of small molecules in living organisms for environmental monitoring applications.

An exploratory study demonstrating that salivary cytokine profiles are altered in children with small area thermal injury

Serum can be used to investigate changes in cytokine concentration following burn injury in children, however for children receiving treatment in an outpatient setting, blood is not routinely collected and therefore cannot be used for monitoring. The aim of this study was to investigate the use of saliva as a non-invasive tool for predicting burn outcomes by measuring the concentration of salivary cytokines in children with small area burns. A multiplex cytokine assay was used to measure 17 cytokines in the saliva of paediatric patients with burns (n = 20) and healthy controls (n = 20). After the removal of cytokines that had >30% of samples below the assay lower detection limit, six cytokines including IL-1β, IL-4, IL-7, IL-8, MCP-1 and TNFα were analysed for association with burns. IL-1β and IL-4 were found to be significantly elevated in the paediatric burn patients compared to healthy controls. Interestingly, IL-1β was also significantly elevated in scald burns, compared to contact burns. In addition, biologically meaningful differences in cytokine concentration were identified in patients with different burn characteristics, which warrant further investigation. This exploratory study provides evidence that cytokines can be detected in the saliva of children and that salivary cytokine profiles differ between healthy controls and children with burns. Overall, this study demonstrates the value of saliva for the investigation of cytokines and its potential application in paediatric diagnostics, specifically in situations where blood collection is not appropriate.

Spatially resolved sampling for untargeted metabolomics: A new tool for salivomics

Saliva is a complex bodily fluid composed of metabolites secreted by major and minor glands, as well as by-products of host oral cells, oral bacteria, gingival crevicular fluid, and exogenous compounds. Major salivary glands include the paired parotid, submandibular, and sublingual glands. The secreted fluids of the salivary glands vary in composition, flow rate, site of release, and clearance suggesting that different types of saliva fulfill different functions and therefore can provide unique biological information. Consequently, for the comprehension of the functionality of the salivary components, spatially resolved investigations are warranted. To understand and comprehensively map the highly heterogeneous environment of the oral cavity, advanced spatial sampling techniques for metabolomics analysis are needed. Here, we present a systematic evaluation of collection devices for spatially resolved sampling aimed at untargeted metabolomics and propose a comprehensive and reproducible collection and analysis protocol for the spatially resolved analysis of the human oral metabolome.

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Systematic evaluation of collection devices for untargeted metabolomics of saliva

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Spatially resolved sampling of saliva in the human oral cavity

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Enabling location-specific oral metabolomics

Insights into the structure-performance relationships of extraction materials in sample preparation for chromatography

Sample preparation is one of the most crucial steps in analytical processes. Commonly used methods, including solid-phase extraction, dispersive solid-phase extraction, dispersive magnetic solid-phase extraction, and solid-phase microextraction, greatly depend on the extraction materials. In recent decades, a vast number of materials have been studied and used in sample preparation for chromatography. Due to the unique structural properties, extraction materials significantly improve the performance of extraction devices. Endowing extraction materials with suitable structural properties can shorten the pretreatment process and improve the extraction efficiency and selectivity. To understand the structure-performance relationships of extraction materials, this review systematically summarizes the structural properties, including the pore size, pore shape, pore volume, accessibility of active sites, specific surface area, functional groups and physicochemical properties. The mechanisms by which the structural properties influence the extraction performance are also elucidated in detail. Finally, three principles for the design and synthesis of extraction materials are summarized. This review can provide systematic guidelines for synthesizing extraction materials and preparing extraction devices.

Amine/phenyl gradient derived base layer as a comprehensive extractive phase for headspace cooled in-tube microextraction of volatile organic compounds in saliva

A gradient derived base layer extractive phase was synthesized and applied for the determination of volatile organic compounds (VOCs) in saliva samples using the headspace cooled in-tube microextraction (HS-CITME) method. The base layers from three different sols of phenyltriethoxysilane (PTES), octyltrimethoxysilane (OTMS) and methyltrimethoxysilane (MTMS) as nonpolar precursors were individually dip coated on the stainless steel wires (SSW). Then, the hydrolyzed polar precursor aminopropyltriethoxysilane (APTES) reacted with the silanol groups already formed on the surface of SSWs via controlled rate infusion (CRI) method. The presence of polar and non-polar functional groups on the surface of substrate was evaluated by Fourier-transform infrared spectroscopy (FTIR) while the morphology and thickness of the most suitable gradient coating (amine/phenyl) were also investigated by scanning electron microscopy (SEM). Assessment of the gradient extractive phase efficiency was carried out determining a group of VOCs with different polarities coupled with gas chromatography-mass spectrometry (GCMS) and the improved performance of the synthesized base layer coatings was observed. Furthermore, a cooling device was designed and implemented to the extracting system to improve the efficiency by influencing the exothermic nature of process. The data were analyzed by principal component analysis (PCA), and hierarchical cluster analysis (HCA) and the results were interpreted by polarities of analytes. Finally, under the optimized conditions, the limits of detection (LOD) and limits of quantification (LOQ) were 0.15 and 0.50 ng L^-1, respectively. The intra-day and inter-day relative standard deviations (RSDs) at 5 and 50 ng L^-1 (n = 3) using a single extractive phase were 2-6 and 10-17, respectively. The data associated with RSDs% for three extractive phases were between 16 and 19 %. Eventually, the method was conveniently applied to the extraction of VOCs from saliva samples of smokers and satisfactory relative recoveries (RR%) (95-108 %) were achieved and low quantities of VOCs were detected.

Exploring the Lipidome: Current Lipid Extraction Techniques for Mass Spectrometry Analysis

In recent years, high-throughput lipid profiling has contributed to understand the biological, physiological and pathological roles of lipids in living organisms. Across all kingdoms of life, important cell and systemic processes are mediated by lipids including compartmentalization, signaling and energy homeostasis. Despite important advances in liquid chromatography and mass spectrometry, sample extraction procedures remain a bottleneck in lipidomic studies, since the wide structural diversity of lipids imposes a constrain in the type and amount of lipids extracted. Differences in extraction yield across lipid classes can induce a bias on down-stream analysis and outcomes. This review aims to summarize current lipid extraction techniques used for untargeted and targeted studies based on mass spectrometry. Considerations, applications, and limitations of these techniques are discussed when used to extract lipids in complex biological matrices, such as tissues, biofluids, foods, and microorganisms.

Comparison of headspace solid-phase microextraction and solvent extraction method for the simultaneous analysis of various soil fumigants in soil or water by gas chromatography-mass spectrometry

The quantity of soil fumigants has increased globally that has focused attention on their environmental behavior. However, simultaneous analysis of traces of fumigant residues is often unreported because analysis methods are not readily available to measure them at low concentrations. In this study, typical solvent extraction methods were compared with headspace solid-phase microextraction methods. Both methods can be used for simultaneously measuring the concentrations of five commonly used soil fumigants in soil or water. The solvent extraction method showed acceptable recovery (76-103%) and intraday relative standard deviations (0.8-11%) for the five soil fumigants. The headspace solid-phase microextraction method also showed acceptable recovery (72-104%) and precision rates (1.3-17%) for the five soil fumigants. The solvent extraction method was more precise and more suitable for analyzing relatively high fumigant residue levels (0.05-5 μg/g) contained in multiple soil samples. The headspace solid-phase microextraction method, however, had a much lower limits of detection (0.09-2.52 μg/kg or μg/L) than the solvent extraction method (5.8-29.2 μg/kg), making headspace solid-phase microextraction most suitable for trace analysis of these fumigants. The results confirmed that the headspace solid-phase microextraction method was more convenient and sensitive for the determination of fumigants to real soil samples.

Saliva and Oral Diseases

Saliva is a fascinating biological fluid which has all the features of a perfect diagnostic tool. In fact, its collection is rapid, simple, and noninvasive. Thanks to several transport mechanisms and its intimate contact with crevicular fluid, saliva contains hundreds of proteins deriving from plasma. Advances in analytical techniques have opened a new era-called "salivaomics"-that investigates the salivary proteome, transcriptome, microRNAs, metabolome, and microbiome. In recent years, researchers have tried to find salivary biomarkers for oral and systemic diseases with various protocols and technologies. The review aspires to provide an overall perspective of salivary biomarkers concerning oral diseases such as lichen planus, oral cancer, blistering diseases, and psoriasis. Saliva has proved to be a promising substrate for the early detection of oral diseases and the evaluation of therapeutic response. However, the wide variation in sampling, processing, and measuring of salivary elements still represents a limit for the application in clinical practice.

Metabolomic Status of The Oral Cavity in Chronic Periodontitis

Chronic periodontitis is an inflammatory disease of tooth-supporting tissues associated with Porphyromonas gingivalis. Expansion and invasion of this bacterium into the periodontium is associated with changes in the metabolome of the oral cavity.

MATERIALS AND METHODS

Metabolomics analysis of mouth washout and tongue swab samples based on proton nuclear magnetic resonance (¹H-NMR) method was employed to determine metabolic status of the oral cavity in chronic periodontal disease.

RESULTS

Mouth washout extracts contained a total of 23 metabolites and tongue swab extracts contained 17. Identified metabolites partially overlap with the content of saliva and gingival crevicular fluid. The colonization of the oral cavity of patients with periodontitis by bacteria was manifested in the change in levels of eight metabolites.

CONCLUSION

NMR-based metabolomics analysis is a potentially useful methodological approach for monitoring the pathological processes observed in the oral cavity in the course of periodontitis.

Solid-phase microextraction: An appealing alternative for the determination of endogenous substances - A review

The determination of endogenous substances is of great significance for obtaining important biotic information such as biological components, metabolic pathways and disease biomarkers in different living organisms (e.g. plants, insects, animals and humans). However, due to the complex matrix and the trace concentrations of target analytes, the sample preparation procedure is an essential step before the analytes of interest are introduced into a detection instrument. Solid-phase microextraction (SPME), an emerging sample preparation technique that integrates sampling, extraction, concentration, and sample introduction into one step, has gained wide acceptance in various research fields, including in the determination of endogenous compounds. In this review, recent developments and applications of SPME for the determination of endogenous substances over the past five years are summarized. Several aspects, including the design of SPME devices (sampling configuration and coating), applications (in vitro and in vivo sampling), and coupling with emerging instruments (comprehensive two-dimensional gas chromatography (GC × GC), ambient mass spectrometry (AMS) and surface enhanced Raman scattering (SERS)) are involved. Finally, the challenges and opportunities of SPME methods in endogenous substances analysis are also discussed.

Miniaturized sample preparation methods for saliva analysis

Saliva, as the first body fluid encountering with the exogenous materials, has good correlation with blood and plays an important role in bioanalysis. However, saliva has not been studied as much as the other biological fluids mainly due to restricted access to its large volumes. In recent years, there is a growing interest for saliva analysis owing to the emergence of miniaturized sample preparation methods. The purpose of this paper is to review all microextraction methods and their principles of operation. In the following, we examine the methods used to analyze saliva up to now and discuss the potential of the other microextraction methods for saliva analysis to encourage research groups for more focus on this important subject area.

Rapid Characterization of the Human Breast Milk Lipidome Using a Solid-Phase Microextraction and Liquid Chromatography-Mass Spectrometry-Based Approach

Human breast milk (HBM) is a biofluid consisting of various biomolecules such as proteins, lipids, carbohydrates, minerals and bioactive substances. Due to its unique and complex composition, HBM provides not only nutritional components required for the growth of the infant, but also additional protection against infections. Global insight into the composition of HBM is crucial to understanding the health benefits infants receive from breastfeeding and could be used to improve the composition of milk formula for babies that cannot be breastfed. To improve global profiling of the HBM lipidome, a new analytical approach based on solid-phase microextraction (SPME) and liquid chromatography-mass spectrometry (LC-MS) was developed. The new extraction method allows for the rapid and simple extraction of a broad range of lipids directly from HBM samples. Moreover, the optimized two-step lipid extraction protocol ensures high lipidome coverage without using toxic solvents such as chloroform. The use of liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-Q-TOF-MS) and an automated search of a lipid database allows comprehensive identification of the lipids contained in HBM. The demonstrated analytical approach based on SPME sample preparation and LC-Q-TOF-MS is rapid, free of toxic solvents, and suited for the qualitative analysis of the HBM lipid composition.

The Saliva Exposome for Monitoring of Individuals' Health Trajectories

BACKGROUND

There is increasing evidence that environmental, rather than genetic, factors are the major causes of most chronic diseases. By measuring entire classes of chemicals in archived biospecimens, exposome-wide association studies (EWAS) are being conducted to investigate associations between a myriad of exposures received during life and chronic diseases.

OBJECTIVES

Because the intraindividual variability in biomarker levels, arising from changes in environmental exposures from conception onwards, leads to attenuation of exposure-disease associations, we posit that saliva can be collected repeatedly in longitudinal studies to reduce exposure-measurement errors in EWAS.

METHODS

From the literature and an open-source saliva-metabolome database, we obtained concentrations of 1,233 chemicals that had been detected in saliva. We connected salivary metabolites with human metabolic pathways and PubMed Medical Subject Heading (MeSH) terms, and performed pathway enrichment and pathway topology analyses.

RESULTS

One hundred ninety-six salivary metabolites were mapped into 49 metabolic pathways and connected with human metabolic diseases, central nervous system diseases, and neoplasms. We found that the saliva exposome represents at least 14 metabolic pathways, including amino acid metabolism, TCA cycle, gluconeogenesis, glutathione metabolism, pantothenate and CoA biosynthesis, and butanoate metabolism.

CONCLUSIONS

Saliva contains molecular information worthy of interrogation via EWAS. The simplicity of specimen collection suggests that saliva offers a practical alternative to blood for measurements that can be used to characterize individual exposomes. https://doi.org/10.1289/EHP1011.

Review of geometries and coating materials in solid phase microextraction: Opportunities, limitations, and future perspectives

The development of new support and geometries of solid phase microextraction (SPME), including metal fiber assemblies, coated-tip, and thin film microextraction (TFME) (i.e. self-supported, fabric and blade supported), as well as their effects on diffusion and extraction rate of analytes were discussed in the current review. Application of main techniques widely used for preparation of a variety of coating materials of SPME, including sol-gel technique, electrochemical and electrospinning methods as well as the available commercial coatings, were presented. Advantages and limitations of each technique from several aspects, such as range of application, biocompatibility, availability in different geometrical configurations, method of preparation, incorporation of various materials to tune the coating properties, and thermal and physical stability, were also investigated. Future perspectives of each technique to improve the efficiency and stability of the coatings were also summarized. Some interesting materials including ionic liquids (ILs), metal organic frameworks (MOFs) and particle loaded coatings were briefly presented.

The emerging landscape of salivary diagnostics

Saliva contains a variety of biomolecules, including DNA, coding and noncoding RNA, proteins, metabolites and microbiota. The changes in the salivary levels of these molecular constituents can be used to develop markers for disease detection and risk assessment. Use of saliva as an early-detection tool is a promising approach because collection of saliva is easy and noninvasive. Here, we review recent developments in salivary diagnostics, accomplished using salivaomics approaches, including genomic, transcriptomic, proteomic, metabolomic and microbiomic technologies. Additionally, we illustrate the mechanisms of how diseases distal from the oral cavity can lead to the appearance of discriminatory biomarkers in saliva, and discuss the relevance of these markers for translational and clinical applications.

Determining the presence of asthma-related molecules and salivary contamination in exhaled breath condensate

Background

Researchers investigating lung diseases, such as asthma, have questioned whether certain compounds previously reported in exhaled breath condensate (EBC) originate from saliva contamination. Moreover, despite its increasing use in ‘omics profiling studies, the constituents of EBC remain largely uncharacterized. The present study aims to define the usefulness of EBC in investigating lung disease by comparing EBC, saliva, and saliva-contaminated EBC using targeted and untargeted mass spectrometry and the potential of metabolite loss from adsorption to EBC sample collection tubes.

Methods

Liquid chromatography mass spectrometry (LC-MS) was used to analyze samples from 133 individuals from three different cohorts. Levels of amino acids and eicosanoids, two classes of molecules previously reported in EBC and saliva, were measured using targeted LC-MS. Cohort 1 was used to examine contamination of EBC by saliva. Samples from Cohort 1 consisted of clean EBC, saliva-contaminated EBC, and clean saliva from 13 healthy volunteers; samples were analyzed using untargeted LC-MS. Cohort 2 was used to compare eicosanoid levels from matched EBC and saliva collected from 107 asthmatic subjects. Samples were analyzed using both targeted and untargeted LC-MS. Cohort 3 samples consisted of clean-EBC collected from 13 subjects, including smokers and non-smokers, and were used to independently confirm findings; samples were analyzed using targeted LC-MS, untargeted LC-MS, and proteomics. In addition to human samples, an in-house developed nebulizing system was used to determine the potential for EBC samples to be contaminated by saliva.

Results

Out of the 400 metabolites detected in both EBC and saliva, 77 were specific to EBC; however, EBC samples were concentrated 20-fold to achieve this level of sensitivity. Amino acid concentrations ranged from 196 pg/mL – 4 μg/mL (clean EBC), 1.98 ng/mL – 6 μg/mL (saliva-contaminated EBC), and 13.84 ng/mL – 1256 mg/mL (saliva). Eicosanoid concentration ranges were an order of magnitude lower; 10 pg/mL – 76.5 ng/mL (clean EBC), 10 pg/mL – 898 ng/mL (saliva-contaminated EBC), and 2.54 ng/mL – 272.9 mg/mL (saliva). Although the sample size of the replication cohort (Cohort 3) did not allow for statistical comparisons, two proteins and 19 eicosanoids were detected in smoker vs. non-smoker clean-EBC.

Conclusions

We conclude that metabolites are present and detectable in EBC using LC-MS; however, a large starting volume of sample is required.

Electronic supplementary material

The online version of this article (doi:10.1186/s12931-017-0538-5) contains supplementary material, which is available to authorized users.

Applications of Fourier Transform Ion Cyclotron Resonance (FT-ICR) and Orbitrap Based High Resolution Mass Spectrometry in Metabolomics and Lipidomics

Metabolomics, along with other "omics" approaches, is rapidly becoming one of the major approaches aimed at understanding the organization and dynamics of metabolic networks. Mass spectrometry is often a technique of choice for metabolomics studies due to its high sensitivity, reproducibility and wide dynamic range. High resolution mass spectrometry (HRMS) is a widely practiced technique in analytical and bioanalytical sciences. It offers exceptionally high resolution and the highest degree of structural confirmation. Many metabolomics studies have been conducted using HRMS over the past decade. In this review, we will explore the latest developments in Fourier transform mass spectrometry (FTMS) and Orbitrap based metabolomics technology, its advantages and drawbacks for using in metabolomics and lipidomics studies, and development of novel approaches for processing HRMS data.

Development of high throughput 96-blade solid phase microextraction-liquid chromatrography-mass spectrometry protocol for metabolomics

In metabolomics, the workflow for quantitative and comprehensive metabolic mapping of cellular metabolites can be a very challenging undertaking. Sampling and sample preparation play a significant role in untargeted analysis, as they may affect the composition of the analyzed metabolome. In the current work, different solid phase microextraction (SPME) coating chemistries were developed and applied to provide simultaneous extraction of a wide range of both hydrophobic and hydrophilic cellular metabolites produced by a model organism, Escherichia coli. Three different LC-MS methods were also evaluated for analysis of extracted metabolites. Finally, over 200 cellular metabolites were separated and detected with widely varying hydrophobicities ranging within -7 < log P < 15, including amino acids, peptides, nucleotides, carbohydrates, polycarboxylic acids, vitamins, phosphorylated compounds, and lipids such as hydrophobic phospholipids, prenol lipids, and fatty acids at the stationary phase of the E. coli life cycle using the developed 96-blade SPME-LC-MS method.

In vivo and ex vivo SPME: a low invasive sampling and sample preparation tool in clinical bioanalysis

Solid phase microextraction (SPME) is well-established technology in bioanalysis. Current review discusses the features of SPME, which determine the non- or low-invasiveness of the method in biomedical analysis. In the first section we analyze the factors, which have significant influence on the SPME sampling device performance in the view of sampling safety and efficiency. In the later sections applicability of various SPME approaches for analysis of easily accessible samples routinely used for analysis (e.g., urine, blood) as well as limited availability samples (tissues) is discussed. Moreover, the examples of sampling alternative matrices such as hair, saliva, sweat or breath are presented. The advantages and limitation of the technology in the view of future development of SPME are also reviewed.

Global metabolomic analysis of human saliva and plasma from healthy and diabetic subjects, with and without periodontal disease

Recent studies suggest that periodontal disease and type 2 diabetes mellitus are bi-directionally associated. Identification of a molecular signature for periodontitis using unbiased metabolic profiling could allow identification of biomarkers to assist in the diagnosis and monitoring of both diabetes and periodontal disease. This cross-sectional study identified plasma and salivary metabolic products associated with periodontitis and/or diabetes in order to discover biomarkers that may differentiate or demonstrate an interaction of these diseases. Saliva and plasma samples were analyzed from 161 diabetic and non-diabetic human subjects with a healthy periodontium, gingivitis and periodontitis. Metabolite profiling was performed using Metabolon's platform technology. A total of 772 metabolites were found in plasma and 475 in saliva. Diabetics had significantly higher levels of glucose and α-hydroxybutyrate, the established markers of diabetes, for all periodontal groups of subjects. Comparison of healthy, gingivitis and periodontitis saliva samples within the non-diabetic group confirmed findings from previous studies that included increased levels of markers of cellular energetic stress, increased purine degradation and glutathione metabolism through increased levels of oxidized glutathione and cysteine-glutathione disulfide, markers of oxidative stress, including increased purine degradation metabolites (e.g. guanosine and inosine), increased amino acid levels suggesting protein degradation, and increased ω-3 (docosapentaenoate) and ω-6 fatty acid (linoleate and arachidonate) signatures. Differences in saliva between diabetic and non-diabetic cohorts showed altered signatures of carbohydrate, lipid and oxidative stress exist in the diabetic samples. Global untargeted metabolic profiling of human saliva in diabetics replicated the metabolite signature of periodontal disease progression in non-diabetic patients and revealed unique metabolic signatures associated with periodontal disease in diabetics. The metabolites identified in this study that discriminated the periodontal groups may be useful for developing diagnostics and therapeutics tailored to the diabetic population.

Low invasive in vivo tissue sampling for monitoring biomarkers and drugs during surgery

The techniques currently used for drug, metabolite, and biomarker determination are based on sample collection, and therefore they are not suitable for repeated analysis because of the high invasiveness. Here, we present a novel method of biochemical analysis directly in organ during operation without need of a separate sample collection step: solid-phase microextraction (SPME). The approach is based on flexible microprobe coated with biocompatible extraction phase that is inserted to the tissue with no damage or disturbance of the organ. The method was evaluated during lung and liver transplantations using normothermic ex vivo liver perfusion (NEVLP) and ex vivo lung perfusion (EVLP). The study demonstrated feasibility of the method to extract wide range of endogenous compounds and drugs. Statistical analysis allowed observing metabolic changes of lung during cold ischemic time, perfusion, and reperfusion. It was also demonstrated that the level of drugs and their metabolites can be monitored over time. Based on the methylprednisolone as a selected example, the impairment of enzymatic properties of liver was detected in the injured organs but not in healthy control. This finding was supported by changes in pathways of endogenous metabolites. The SPME probe was also used for analysis of perfusion fluid using stopcock connection. The evaluation of biochemical profile of perfusates demonstrated potential of the approach for monitoring organ function during ex vivo perfusion. The simplicity of the device makes it convenient to use by medical personnel. With the microprobe, different areas of the organ or various organs can be sampled simultaneously. The technology allows assessment of organ function by biochemical profiling, determination of potential biomarkers, and drug monitoring. The use of this method for preintervention analysis could enhance the decision-making process for the best possible personalized approach, whereas post-transplantation monitoring would be used for graft assessments and fast response in case of organ failure.

Potential input from metabolomics for exploring and understanding the links between environment and health

Humans may be exposed via their environment to multiple chemicals as a consequence of human activities and use of synthetic products. Little knowledge is routinely generated on the hazards of these chemical mixtures. The metabolomic approach is widely used to identify metabolic pathways modified by diseases, drugs, or exposures to toxicants. This review, based on the state of the art of the current applications of metabolomics in environmental health, attempts to determine whether metabolomics might constitute an original approach to the study of associations between multiple, low-dose environmental exposures in humans. Studying the biochemical consequences of complex environmental exposures is a challenge demanding the development of careful experimental and epidemiological designs, in order to take into account possible confounders associated with the high level of interindividual variability induced by different lifestyles. The choices of populations studied, sampling and storage procedures, statistical tools used, and system biology need to be considered. Suggestions for improved experimental and epidemiological designs are described. Evidence indicates that metabolomics may be a powerful tool in environmental health in the identification of both complex exposure biomarkers directly in human populations and modified metabolic pathways, in an attempt to improve understanding the underlying environmental causes of diseases. Nevertheless, the validity of biomarkers and relevancy of animal-to-human extrapolation remain key challenges that need to be properly explored.