Proteomic applications in pathology and laboratory medicine: Present state and future prospects.

• Clinical mass spectrometry (MS) traditionally focused on small molecule applications. • Quantitative protein MS overcomes a number of immunoassay interference phenomena. • Protein MS permits multiplexed quantitation and, in select cases, phenotyping. • Microbiology practice has been revolutionized by MS and new applications are forthcoming. • MS tissue imaging holds great promise for clinical application to anatomical pathology. Clinical mass spectrometry applications have traditionally focused on small molecules, particularly in the areas of therapeutic drug monitoring, toxicology, and measurement of endogenous and exogenous steroids. More recently, the use of matrix assisted laser desorption/ionization time of flight mass spectrometry for the identification of microbial pathogens has been widely implemented. Following this evolution, there has been an expanding role for the measurement of peptides and proteins in pathology and laboratory medicine. This review explores the current state of protein measurement by clinical mass spectrometry and the analytical strategies employed, as well as emerging applications in clinical chemistry, clinical microbiology and anatomical pathology. [ABSTRACT FROM AUTHOR]