There are an estimated 100000 protein transcripts and 1000-10000 metabolites that may similarly offer proteomic (protein analytes) or metabolomic (nonprotein metabolite) profiles of disease in tissue or biological fluids.67 The potential advantage of proteomics and metabolomics is the ability to detect subclinical parameters.94 The past two decades have produced serum-based proteins that monitor general disease conditions, for instance, CA-125 for ovarian cancer, CA-15-3 and 27.29 for breast cancer, CEA for ovarian, lung, breast, pancreas, and gastrointestinal cancers, and PSA for prostrate cancer.95 Further, clinical chemistry has likewise proven useful in providing metabolic profiles that can aid in diagnosis of a variety of diseased conditions.96 However, the complexity of the sample analyzed can greatly impact its predictive value. While the number of transcripts and metabolites increases possibilities, a disadvantage is that relevant biomarkers may be difficult to identify if obscured by more abundant proteins. Nevertheless, using advances such as laser scanning cytometry,64 combined liquid chromatography/mass spectroscopy (LC/MS), multiplex immunoassays (xMAP technology/Luminex),79,98,99 and array platforms (Ciphergen, Compugen, Icoria)79,100,101 to identify novel biomarkers in the proteome and metabolome holds much promise.
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