NMR-based pharmacometabonomics: A new approach to personalised medicine

Metabonomics has been used for a long time to help to understand drug metabolism, drug safety, drug efficacy, and the etiology and progression of disease states, and is thus of central importance to drug discovery and development. In the past 8 years the new area of pharmacometabonomics has emerged, which enables some degree of prediction of both the effects of drugs upon animals and humans, and conversely, the effects of the animals and humans upon the drug, prior to dosing that drug, based on a mathematical model of pre-dose metabolite profiles. In this respect pharmacometabonomics is the metabolic profiling equivalent of pharmacogenomics, which itself can enable some degree of prediction of drug effects prior to dosing, based on genomic profiles. Pharmacometabonomics has the twin advantages of sampling the actual metabolic status of a person or animal prior to dosing, and of simultaneously sampling the metabolites influenced by both host and environmental factors, such as microbiome-related metabolism. It is envisaged that pharmacometabonomics will be used alongside pharmacogenomics in the future in order to help deliver the promise of personalised medicine for patients: something that is still nascent rather than fully delivered