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Neuropathic pain is a condition that causes major chronic pain in millions of people worldwide. The reasons that cause this pain to persist remain unclear, and treatment has been inhibited by a lack of understanding of the chemical basis of this pain. Researchers have recently implicated dimethylsphingosine (DMS) as a molecule that is associated with inducing neuropathic pain. The group, led by Garry Patti from Washington University, St. Louis (MI, USA), used metabolomics to implicate DMS. The use of metabolomics to track small molecules such as amino acids, sugars and vitamins allows an alternative approach to determining the differences exhibited between healthy and diseased cells. Patti explained this further: “These are the molecules that are actually being transformed during cellular activity, and tracking them provides more direct information on what is happening at a biochemical level.” Gary Siuzdak from the Scripps Research Center for Metabolomics (CA, USA) explained the strategy used in this set of experiments: “The idea was to apply metabolomic analysis to understand the biochemical basis of the neuropathic pain condition and reveal potential therapeutic targets. We call this approach therapeutic metabolomics.” The group used rats as models for neuropathic pain. Samples were taken from the blood plasma, spinal cord and injured tibial leg nerve. These were analyzed and the metabolites compared with healthy controls. The potential importance of metabolomics as a novel approach to solving vexing biological issues was highlighted by Siuzdak: “We’re very excited about this therapeutic metabolomics approach. In fact, we are already involved in several other projects in which metabolites are giving us a direct indication of disease biochemistry and potential treatments.” Speaking to Expert Review of Proteomics, Patti further commented that: “Our study demonstrates the biological and thera peutic insight that can be gained from using untargeted metabolomics not only to unbiased profile known pathways, but also to identify physiologically important metabolites that have yet to be characterized.” Referring back to the issues concerning neuropathic pain, Patti explained that: “This is the first characterization and quantitation of DMS as a naturally occurring compound. We think that this is a big step forward in understanding and treating neuropathic pain, and also a solid demonstration of the power of metabolomics.” Research is now likely to shift towards looking for the enzymes involved in synthesizing DMS along with potential drug targets.