3Institute of Chemistry Timisoara of the Romanian Academy, No.24

Mass spectrometry (MS) was introduced into clinical laboratories, and first applied to the evaluation of children at risk of inborn errors of metabolism. For the analysis of macromolecules and in particular for proteins, glycoconjugates and polynucleotides, a major milestone was achieved with the development in 1987 of matrix assisted laser desorption ionization by Karas and Hillenkamp and in 1988 of electrospray ionization by J. Fenn. Over the past decade progress in mass spectrometry and its hyphenation with separation techniques has made these tools essential in life sciences. The use of MS is, however, not yet routine in many fields where it could influence clinical decisions. While medical research using MS is expanding, few applications have become part of the standard “bedside ” practice. This is partly because the transition of MS from a research tool to a reliable clinical diagnostic platform requires rigorous standardization, spectral quality control and assurance, standard operating procedures for robotic and automatic sample application, and standardized controls to ensure generation of highly reproducible spectra. Reliable identification of protein expression patterns an