Lipidomics in Clinical Diagnostics

Judging from the steadily growing number of research publications, clinical trials conducted, and commercial entities entering the market, clinical lipidomics is rapidly gaining traction. Indeed, a variety of lipid markers are already being used for routine clinical diagnostics. Examples include triglycerides, cholesterols, bile acids, vitamin D metabolites, and the latest addition: ceramides. These current lipid-based clinical diagnostics rely on single markers or small panels. Broad, comprehensive lipidomics however, as a systems-level scale depiction of (patho)physiological processes, holds enormous promise for future applications in personalized health and precision medicine. What would it take to bring such comprehensive lipidomic readouts, comprising dozens if not hundreds of lipid metabolites, to the clinics? And where could this be of clinical utility? Using inflammatory markers as example, we discuss clinical promises and barriers such as analytical quality and clinical validation. Possible solutions including community-driven efforts toward workflow harmonization and first attempts to establish reference values will be discussed. We end with an overview of existing lipid-based diagnostic applications, for a variety of disease areas.