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Issue link: https://clinicalomics.epubxp.com/i/827649
www.clinicalomics.com May/June 2017 Clinical OMICs 27 continued Dr. Kulasingam. "But now a typical run will identify 5,000 to 7,000 proteins. So the depth of analysis has increased, and it is not just data-dependent acquisitions, but also quantification on the same instrument." Hurdles for Broader MS Adoption While many larger academic medical centers may be using MS on a regular basis, its broader adoption in the diagnos- tics labs of health systems and larger hospitals may yet rely of future developments, Mylchreest noted. "Healthcare testing labs may be reluctant to adapt this technology based on high cost of initial investment, per- ceived complexity and the talent (specialized resources) required to develop and validate protocols," he said. Dr. Kulasingam notes automation is one improvement that will help spur adoption of mass spec in hospital labs, while another would be protocols and systems that are rep- licable run after run. "For protein work, very few, and only highly specialized academic institutions have it, primarily because it requires expertise to operate it" she said. "In a clinical diagnostic set- ting, it is not automated, and sample processing is still vari- able. Those things need to be automated before it can enter a clinical diagnostics lab." These concerns are being addressed by MS suppliers, however, to make the analytical technique more broadly accessible, noted Dr. Mylchreest. "To address some of these challenges, MS systems are becoming more intuitive, with simple method development steps allowing operation by non specialists, and emerging technologies that will automate sample preparation steps." Research Spurs Wider Adoption According to Jose Castro-Perez, Ph.D., director of global markets, health sciences with Waters, mass spectrometry today is an underused technology in clinical research labs. But it is one that can play a significant role to help guide early treatment and preventative care, especially diseases that are significantly caused, or influenced, by an individ- ual's lifestyle. "Research labs around the world are now embracing this technology to help them discover new biomarkers that can be converted to clinically actionable assays that can deliver benefit to patients," Dr. Castro-Perez said. Two examples are type 2 diabetes and cardiovascular disease. For type 2 diabetes diagnosis today, many doctors collect data on fasting plasma glucose tests and/or oral glucose tolerance tests, but at this point the test may be too late for prevention. Using mass spectrometry in the man- ner described below, may be more effective for predicting patients with a propensity for developing the disease. "The doctor takes a blood sample, and (using mass spec- trometry) measures a panel of metabolites that are indicative of insulin resistance," Dr. Castro-Perez said. "If you can do that, you can save billions of dollars in healthcare, because some of these diseases are preventable. A lot of these dis- eases are affected by lifestyle and lack of exercise. The other side of the coin is that, in some cases, a genetic predisposi- tion may lead to undesirable cardiovascular effects due to Waters Corperation (continued on next page) Today's generation of mass spectrometers provides researchers with the ability to identify thousands of proteins in a single run, while also providing quantitation on the same instrument.