HYPHENATED LIQUID CHROMATOGRAPHY TECHNIQUES IN CLINICAL METABOLOMICS: PRINCIPLES AND BIOMEDICAL APPLICATIONS

Clinical metabolomics refers to the rapid, broad-spectrum detection of all endogenous and environmental small-molecule metabolites in a biological system and their determination in complex biological samples. Precision medicine, biomarker discovery and personalised medicine are being advanced by this progress, much of which rests on hyphenated liquid chromatography systems, especially UHPLC-MS/MS and HRMS. Even though other methods are being developed, these remain the major platforms used to characterise the human metabolome. This review takes account of the basic principles, stationary-phase chemistries (reversed-phase and HILIC) and the ionisation interfaces that couple chromatography to mass spectrometry, together with the process safeguards clinical laboratories use to limit error from sample collection to finished analysis. This paper then looks at where these tools already impact patient care: the tracking of metabolic reprogramming in cancer; revealing disordered lipid metabolism in cardiometabolic disease; and enabling rapid newborn screening. The review concludes by examining the hurdles that remain, including cross-laboratory standardisation and what is required to advance this technology from the research bench to routine clinical use.