Metabolic profiling offers new approach to personalized medicine

Metabolic profiling--an analysis of chemical reactions in the body--holds the promise of selecting the best drug at an optimum dose for a patient, according to a group of scientists in the U.K.

Today, most doctors rely on broad measures like weight, sex and age to determine which drug and dose is most likely to be effective. It's a notoriously hit-or-miss approach that commonly requires follow-up doctor visits and changes in drugs and dosing. But the scientists set out to determine if the chemicals created during the process of metabolism and then excreted in the urine could be a more effective tool for personalizing therapies.

To test their theory, scientists at Imperial College London and Pfizer took a urine test of 99 men who were given paracetamol, a common painkiller. What they found was that ascertaining the level of a compound in the urine--para-cresol sulphate--gave the scientists a clear picture of how the men would metabolize the drug. Higher levels of the compound, which is produced in the gut, indicated that men would metabolize the drug less effectively. They theorized that higher levels of the compound indicated that their bodies were depleted of sulphur, which many drugs rely on to work safely. Sulphur helps to detoxify the body. Engineering the bacteria in the gut could fine tune how a body metabolizes a drug.

"Pre-clinical studies had suggested it might be possible to predict how individuals would react to drugs by looking at their pre-dose metabolite profiles, but this is the first time that anyone has been able to show convincingly that such a test could work in humans," said Professor Jeremy Nicholson. "The beauty of the pre-dose metabolite profiling is that it can tap into both genetic and environmental factors influencing drug treatment outcomes."

- read the story from The Times
- check out the BBC report

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