[Inherited metabolic diseases: benefits of metabolomics]

Both hope and illusion, the recent progress in biology has raised our expectations that one day it will be possible to introduce a biological sample into an apparatus which will then deliver in a few minutes thousands of qualitative and quantitative data concerning the genome, transcriptome, proteome and metabolome, thereby contributing to diagnosis and follow-up of diseases which are now difficult to identify. Such machines do not exist yet and, in any case, should be associated with the appropriate and adequate clinical work on the disease and with the patient. This << total >> approach is of course being pushed by the recent decoding of the genomes of several species (genomics), the development of high throughput analysis of mRNAs (transcriptomics), and the efforts to identify the protein products on a large scale (proteomics). Wide sectors of medicine are waiting for the results of these new medium and high throughput technological approaches, for example, in order to identify early markers of diseases. The object of this article is to present a biochemist's point of view on hereditary metabolic diseases (also referred to as inborn errors of metabolism), a field of medicine and research covering very diverse clinical and biochemical aspects. Significant advances will be made possible by improving the present methods of analysis of the metabolome which establishes a link between genotypes and phenotypes, an area now called metabolomics. The contribution of proteomics will be important as well but will still require some time.