Mini Review ARTICLE
Metabolomics biomarkers: a strategy towards therapeutics improvement in ALS
- 1INSERM U930 Imagerie et Cerveau, France
- 2Centre Hospitalier Universitaire de Tours, France
- 3Federation des centres SLA de Tours et Limoges, LITORALS, France
- 4Hôpitaux Universitaires Pitié Salpêtrière, France
- 5INSERM U1146 Laboratoire d'Imagerie Biomédicale, France
- 6Northern Ireland Centre for Stratified Medicine, Ulster University, United Kingdom
- 7Laboratoire de Biochimie et de Biologie moléculaire, CHU de Tours, France
Biomarkers research in amyotrophic lateral sclerosis (ALS) holds the promise of improving ALS diagnosis, follow-up of patients and clinical trials outcomes. Metabolomics have a big impact on biomarkers identification. In this mini-review, we provide the main findings of metabolomics studies in ALS and discuss the most relevant therapeutics attempts that targeted some prominent alterations found in ALS, like glutamate excitotoxicity, oxidative stress, alterations in energetic metabolism and creatinine levels. Metabolomics studies have reported putative diagnosis or prognosis biomarkers, but discrepancies among these studies did not allow validation of metabolic biomarkers for clinical use in ALS. In this context, we wonder whether metabolomics knowledge could improve ALS therapeutics. As metabolomics identify specific metabolic pathways modified by disease progression and/or treatment, we support that adjuvant or combined treatment should be used to rescue these pathways, creating a new perspective for ALS treatment. Some ongoing clinical trials are already trying to target these pathways. As clinical trials in ALS have been disappointing and considering the heterogeneity of the disease presentation, we support the application of a pharmaco-metabolomic approach to evaluate the individual response to drug treatments and their side effects, enabling the development of personalized treatments for ALS. We suggest that the best strategy to apply metabolomics for ALS therapeutics progress is to establish a metabolic signature for ALS patients in order to improve the knowledge of patient metabotypes, to choose the most adequate pharmacological treatment, and to follow the drug response and side effects, based on metabolomics biomarkers.
Keywords: ALS (Amyotrophic lateral sclerosis), Metabolomics (OMICS), pharmacometabolomics, Creatinine (Cr), Therepeutical approaches
Received: 08 Aug 2018;
Accepted: 07 Dec 2018.
Edited by:Rodrigo Franco, University of Nebraska-Lincoln, United States
Reviewed by:Chiara F. Valori, Deutsche Zentrum für Neurodegenerative Erkrankungen, Helmholtz-Gemeinschaft Deutscher Forschungszentren (HZ), Germany
Cristian Bonvicini, Centro San Giovanni di Dio Fatebenefratelli (IRCCS), Italy
Copyright: © 2018 Lanznaster, de Assis, Corcia, Pradat and BLASCO. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. HELENE BLASCO, INSERM U930 Imagerie et Cerveau, Tours, France, email@example.com