In this section, we will discuss the most common workflow structures that are implemented to combine both targeted and untargeted metabolomics, in addition, we will present and discuss SQUAD analysis workflows. Interestingly, many researchers have been combining the two approaches in their work without identifying the workflow, others have identified it as “combining the two approaches” or called it “semi-targeted” or “pseudo-targeted” metabolomics.
4.2.1. Combined Targeted and Untargeted Metabolomics
In the last decade, researchers recognized the importance of merging the targeted and the untargeted approaches to have comprehensive and informative coverage benefiting from the accurate measurement of specific targets and the discovery aspect that allows for data retro mining. In 2010, Pinel et al. discussed the potential of implementing profiling approaches (untargeted) as valuable tools for combating the illegal use of growth promoters in cattle breeding besides the traditional MS
2 targeted approach. This is because the latter fails when faced with new xenobiotic growth-promoting agents or new ways of application, such as the administration of low-dose cocktails. In this context, screening strategies allowing the detection of the physiological response resulting from the administration of anabolic compounds are promising approaches to detect misuse [
50]. The discussions at that time were about combining the outcome of the two approaches that are run on different platforms rather than one platform.
Combining results from the two approaches was also used in the natural products field to determine the bioavailability of known and unknown biologically active phytochemicals [
52,
53]. Another methodology based on HRAM analysis was developed using targeted and untargeted screening strategies to discover potential biomarkers for the reliable detection of food product adulteration [
54,
55,
56]. Many other studies from various research fields have also benefited from combining MS-based data from targeted and untargeted approaches [
57,
58,
59,
60,
61,
62,
63,
64,
65,
66,
67], and even NMR-targeted data with MS-untargeted analysis [
68]. Melnik et al. 2017, for example, developed a platform coupling targeted and untargeted metabolomics via splitting the flow from one UPLC into an orbitrap DDA-based discovery and a triple-quadrupole (TQ) MRM quantitation method to study the association between the metabolome and microbiome of human fecal samples [
69].
Professor Oliver Fiehn demonstrated in 2016 an example of how to use GC-MS-based metabolomics for the integration of targeted assays for absolute quantification of specific metabolites with untargeted metabolomics to discover novel compounds in biological samples, i.e., blood, urine, cell culture, and homogenized tissue [
70]. External reference standards were used for the identification and absolute quantitation of targeted compounds, complemented by database annotations using large spectral libraries and validated standard operating procedures for the discovery and semi-quantification of non-targeted compounds in Fiehn’s study. In the same year, professor Fiehn and Tomas Cajka discussed in a review paper whether novel MS techniques, such as ultrahigh resolution detection, DDA MS
2 fragmentation methods, and ion mobility, have advanced enough so that selectivity and sensitivity of untargeted analyses can enable the acquisition of hypothesis-driven validation studies on accurate mass profiling methods rather than classic TQ MRM [
27]. They concluded that, although advances in MS have had a big impact on overall metabolomics and lipidomics workflow, there is still a need for further improvement in metabolomics and lipidomics platforms for the merging of targeted and untargeted analyses. Remarkably, among the future directions they discussed is moving from HPLC to 2.1 mm UHPLC or 1 mm microflow LC chromatography to increase sample throughput and sensitivity. Also, using advanced full spectra collection MS
1 systems with an increased mass resolving power, enabling polarity switching or collection of both MS
1 and MS
2 (DDA or DIA) without significant loss of signal intensity. Additionally, there is an urgent need for databases with validated sets of MRM transitions for targeted metabolites in addition to larger libraries of MS
2 spectra for compound identification in untargeted metabolomics and statistical tools to assess probabilities for the correct molecular annotation [
27].
In his article, Dr. Bertrand Rochat discussed why LC-HRMS (like the one an orbitrap can offer) will become a key instrument in clinical labs [
71]. He highlighted that advanced HRMS instruments can perform sensitive and reliable quantifications of a large variety of analytes in MS
1 full scan or, if needed, in a more targeted SIM or MS
2 mode. Since these platforms record high-quality MS
1 full scans, researchers can use those to get a global picture of a sample extract as virtually all ionized compounds are detected. Dr. Rochat expected that the use of one MS platform from targeted quantification to untargeted metabolomics will streamline workflows in the clinical environment, but after setting the basis in quantitative LC-HRMS analysis. He also added that only LC-MS analysis performed with HRMS allows efficient simultaneous Quan/Qual metabolomics analysis, which makes HRMS the instrument of choice for research projects [
71].
Increased interest was shown by researchers to do both targeted and untargeted metabolomics in a single injection that can benefit situations with limited biological samples like the study of mouse optic nerves to study neurological visual diseases using GC-MS [
72]. In 2018, Coene et al. presented a single LC-MS method that can be applied for holistic metabolic profiling in the plasma of individual suspected inborn errors of metabolism to detect and measure biomarkers, but also to simultaneously perform an untargeted assay [
73]. They called this method “Next-generation metabolic screening”.
4.2.2. Pseudo-targeted Metabolomics
The pseudo-targeted metabolomics is another term that was used to describe the approach combining the advantages of untargeted and targeted analyses. Chen et al. proposed a pseudo-targeted approach to perform serum metabolomic analysis using a UHPLC/TQMS system operated in the MRM mode, for which the MRM ion pairs were acquired from the serum samples through untargeted tandem MS using UHPLC/Q-TOF MS/MS [
49]. This approach was called pseudo-targeted since no standards or IS were used to determine the MRM transitions and to make calibration curves. A similar pseudo-targeted approach was later applied by Xu et al. who used a UPLC-HRMS (i.e., Q Exactive; Thermo Fisher Scientific) platform to perform untargeted analysis on urine to select targets and determine their MRM ion pairs before quantification on a QTRAP mass spectrometer coupled to LC. In this study, the MRM ion pairs were also determined by searching relevant databases [
74]. Another similar analysis, which is called pseudo-targeted metabolomics, was developed for the identification and visualization of common pathogens by analyzing a QC sample (mix of different bacterial strains) on a hybrid Quadrupole-Orbitrap mass spectrometer to select analytes for quantitation via an MRM analysis on TQ MS [
75]. Deng et al. also developed a pseudo-targeted approach to study metabolic changes in Asian plum (Prunus salicina) fruits in response to gummosis disease using a QTRAP for untargeted profiling followed by quantification of selected metabolites using MRM mode [
76].
The described approaches for pseudo-targeted are using two MS instruments, but Wang et al. managed to develop a new strategy for pseudo-targeted metabolomics that could be achieved on one LC/Q-TOFMS instrument (i.e., SYNAPT G2-Si Q-TOF MS; Waters Corp.) [
77]. The MS is operated in the multiple ion monitoring (MIM) modes with time-staggered ion lists (tsMIM). Full scan-based untargeted analysis was applied to extract the target ions. After peak alignment and ion fusion, a stepwise ion-picking procedure was used to generate the ion lists for subsequent single MIM and tsMIM metabolite pseudo-quantitation. A hybrid Q-Orbitrap instrument was also used for metabolites profiling and quantitation (i.e., pseudo-targeted metabolomics on one platform) to reveal the effects of polyphenols extracted from different tea samples on the metabolic regulation of inflammatory response at the cellular level [
78]. The acquired HRAM data in this study enabled the confident and accurate identification of targets of biological interest to measure the dynamic changes of metabolites. This led to the discovery that the treatment with selenium-enriched green tea, for example, can play an immune protective role at a lower concentration and be involved in three unique pathways of antioxidant enzyme activation, including phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism, and CoA biosynthesis [
78].
4.2.3. Semi-targeted Metabolomics
Among other terms, “semi-targeted” have been heavily used by the community to describe the work combining the advantages of both targeted and untargeted metabolomics. However, this term is also used to describe different approaches that do not necessarily have the same aim. This might be misleading to users who are looking to develop a comprehensive metabolomics approach.
Dunn et al., have considered semi-targeted metabolomics as an approach for the confident chemical identification and structural elucidation of detected metabolites (i.e., qualitative) via the utilization of authentic chemical standards and methods that provide high accuracy, precision, and selectivity. Moreover, this approach is using MS data for semi-quantitation (relative quantitation) [
48]. Interestingly, Li et al. have used the same approach of creating a plant metabolite spectral library using 544 authentic standards, which increased the efficiency of identification for untargeted metabolomic studies but called the approach a pseudo-targeted method [
79]. A multi-platform (2D LC-MS/MS and NMR) protocol was also used for the aim of identification of natural compounds of the Mediterranean marine sponge
Crambe crambe. In this protocol, the semi-targeted term was used to describe the level of identification, which benefited from using NMR, rather than increased metabolite recovery [
80]. Similarly, other analyses were done for the confident annotation of lipids using HRAM [
81], QTRAP [
82], QTOF [
83,
84], or metabolites using DI-FT-ICR-MS coupled with pathway enrichment analysis [
85] but still calling these approaches semi-targeted lipidomics or metabolomics. In another example, MS
2 spectra of metabolites resulting from a QTRAP instrument were compared with references MS
2 spectra for the confident annotation of potential biomarkers of fertility decline in elderly women, which might help in finding the corresponding traditional Chinese medicine treatment and exploring its mechanism of action [
86]. Moreover, a method that used tandem MS coupled to capillary electrophoresis (CE) technique was used for improved annotation of unknown compounds utilizing both the MS/MS fragmentation patterns and CE migration time (86), yet calling the approach semi-targeted metabolomics. Bayle et al., on the other hand, performed a multi-platform approach using both liquid and gas chromatography coupled to MS to improve the coverage of the physiochemical diverse nutrient markers in plasma. They called their approach semi-targeted metabolomics since it enabled the quantitation of desired metabolites and the discovery of new features resulting from a metabolic change [
87].
Improvements to the hybrid quadruple-orbitrap technologies regarding scan speed and sensitivity have been considered as a milestone, which would enable an accurate and improved throughput semi-targeted analysis that combines both the quantitation and the discovery on a single platform without significant sacrifice of analytical fidelity [
29,
30]. Such improvements have enabled the profiling of compounds with largely varying abundances while maintaining high mass accuracy and resolving power. HRAM coupled to capillary ion chromatography was for example used for a powerful semi-targeted approach for the analysis of metabolites related to the energy metabolism pathways (e.g., di- and triphosphates and organic acids) that are poorly resolved with conventional metabolomics analytical techniques [
88]. This method is called a semi-targeted analysis since it combined the quantitation of the selected metabolites using their authentic standards but also performs a discovery untargeted analysis on the acquired data. Similarly, an integrated semi-targeted metabolomics platform was incorporated for high throughput metabolite identification and quantitation to reveal distinct metabolic dysregulation in pleural effusion caused by tuberculosis and malignancy utilizing an orbitrap-based MS with DDA MS
2 acquisition [
51]. GC coupled to orbitrap MS also showed an ability to perform quantitative as well as qualitative analyses (called semi-targeted) to measure the differences in metabolite profiles in pigmented rice grains that might provide insight into the enhanced antioxidant capacities of those grains [
89]. These studies demonstrated that the high selectivity of HRAM technology is crucial for the analysis of isobars but also low abundant metabolites in complex backgrounds.
Other MS platforms were also used to perform semi-targeted metabolomics in the sense of combining the outcome of both targeted and untargeted analysis from a single injection on TOF-based MS [
53] or a two-injection strategy [
90]. The latter example presents using triple quad MS data with UV detection and RT information (comparison with standards or data from literature) for metabolomics profiling followed by a second injection for relative quantification via SIM mode UPLC-MS analyses.
4.2.4. Simultaneous Quantitation and Discovery (SQUAD) Analysis
Many of the presented approaches in previous sections consist of multiple injection strategies, either on different platforms or on the same platform. These multi-injections are practiced, normally, performing untargeted profiling (preferably on an HRMS) to provide information on potential targets to be quantified via an MRM, SRM, or SIM mode in a second injection.
SQUAD analysis is a promising alternative, offering a way to strike the balance between untargeted and targeted approaches in one single experiment. The SQUAD workflow begins in much the same way as targeted approaches, where researchers annotate and quantify a pre-selected group of metabolites in a sample. However, the data can then be reanalyzed (or retro-mined) to look for global metabolic changes that were not part of the original focus,
Figure 3. SQUAD analysis can, therefore, identify other biologically meaningful metabolic changes that the scientist may not have been aware of in their signaling pathway of interest.
SQUAD analysis utilizes pooled mixes as quality control (QC) samples to evaluate the stability and robustness of the analytical system, to be used for correction and normalization, but also to collect compound fragmentation information that could be used for the structure elucidation of unknown metabolites. Like untargeted metabolomics, it is crucial to acquire high-resolution and accurate mass data to enable confident unknown annotation in SQUAD analysis. In addition, HRMS mass spectrometers facilitate the resolution of low abundant metabolites in a complex matrix, therefore, it is a good choice in this approach. The recent advancement in Orbitrap Tribrid mass spectrometers is a golden opportunity to perform a SQUAD analysis utilizing the sensitive linear ion trap for the quantitation of metabolites without sacrificing the discovery portion of the untargeted assay performed on the high-resolution accurate mass orbitrap analyzer,
Figure 4. This fast alternating eliminates the variability of using multiple instruments and the need to re-inject limited biological samples. Tribrid platforms enable various methods for MS
2 fragmentation (e.g., HCD, CID, and UVPD) and even allow the MSn fragmentation capability that brings MS-based unknown identification to a higher accuracy level. Hybrid-based orbitrap instruments, on the other hand, have also improved their scanning speed making polarity switching feasible even with high throughput LC and GC methods. This indeed allows higher recovery of the metabolome features once used for a SQUAD analysis, while still being able to have enough MS
1 scans for peak quantification and perform MS
2 fragmentation for structural elucidation. Samples can be profiled in both polarities in a single injection while the QC pools are used for deep fragmentation analysis individually. This increases throughput while maintaining both the targeted and nontargeted analysis integrity.
UHPLC-MS-based SQUAD can be more popular than GC-MS-based workflows since LC-MS methods require less complicated sample preparation (e.g., no derivatization steps are required) and their increased ability to identify and measure a broader range of compounds. But this does limit the SQUAD approach to LC-MS only, GC-MS, for example, can be used to identify volatile and semi-volatile compounds for metabolic investigations.
The quantitation part of the SQUAD workflow is flexible, and it is up to the user to define its level. If both the isotopically labeled internal standards (IS) and unlabeled standards are used to make calibration curves, and the IS are spiked into the samples at known concentrations to correct for variations in ionization efficiency, then it is an absolute quantitation of metabolites. However, a dedicated IS for each metabolite of interest may not always be feasible due to high costs or limited availability. Standards only, thus, are used to make calibration curves to determine how signal intensity responds as a function of analyte concentration and the range of linearity of this relationship [
91]. Finally, a relative quantitation (relative quantification is performed) with respect to a reference sample can also be achieved. It’s crucial to remind that absolute quantitation, when feasible, is of a greater value since it enables measurement of the thermodynamics of metabolic reactions [
92], and the molecular dynamics underlying the flow of atoms through a metabolic network [
93]. The ability to compare results across instruments and laboratories is also more robust when doing absolute quantitation as ionization and instrumentation variabilities are adjusted using stable labeled coeluting standards.
Opportunities for SQUAD Analysis
One of the biggest strengths of SQUAD analysis is the ability to perform targeted and untargeted analysis in a single sample injection, which is particularly advantageous for laboratories that have limited access to samples, time, and resources. This also offers a powerful and efficient way to gain more knowledge from valuable biological samples. SQUAD analysis on HRMS platforms also allows discovery in clinical studies, since they record high-quality MS1 full scans and improved their ability to perform sensitive and reliable quantifications of a large variety of analytes in MS1 full scans as well. The development of intelligence-driven data acquisition strategies enables scientists to dive deeper into the sample while providing an overview of known metabolites. Koelmel et al., for example, developed an LC-MS/MS DDA with an automated exclusion list (i.e., IE-Omics) for expanding lipidome coverage. A more advanced and intuitive method was developed by Thermo Fisher Scientific, i.e., AcquireX, which extends intelligence-driven mass spectrometry through experimental connectivity by integrating independent experiments into an automated workflow that enhances real-time, selective LC-MSn data acquisition for efficient and comprehensive sample and study characterization. With five different routines, the AcquireX data acquisition workflow extends productivity to all small-molecule applications, from comprehensive structural annotation to screening. These methods maximize the number of relevant compounds interrogated by MS2 and offer several benefits to users, including integrating independent experiments into automated workflows. This thereby increases the efficiency and ease of use of LC-MS-based SQUAD analysis.
In addition to clinical applications, the SQUAD approach can also be used in bacterial metabolism analysis. The human gut microbiota plays an important role in human physiological processes such as nutrient digestion and the regulation of the immune system [
5]. Therefore, measuring traditional microbiota metabolites (e.g., short-chain fatty acids and bile acids) in the gut and simultaneously performing a discovery-based analysis can provide a better understanding of the activity of gut microbes, and further, inform us of their impact on human health. SQUAD can also be utilized toward microbial metabolism and pharmacomicrobiomics (i.e., study the interaction between xenobiotics, or foreign compounds, and the gut microbiome). This would provide information on how the individual gut microbiome informs drug efficacy in patient cohorts.
The metabolic engineering field can also benefit from SQUAD analysis. The new workflow could be used to identify metabolic pathway bottlenecks and to identify diagnostic biomarkers. Such biomarkers can be utilized to optimize microbial growth rate, increase strain tolerance, improve stress regulation and adaptation, improve substrate utilization and uptake, and increase product titer/rate/yield. At the same time, SQUAD will be providing quantitative information about the desired production like any traditional targeted approach.
SQUAD-based analyses are also expected to play an important role in the natural products (e.g., flavonoids, steroids, etc.) field, especially when performed on platforms that provide multiple fragmentation methods and solutions for intelligent MS fragmentations for unknown identification. Orbitrap Tribrid mass spectrometers offer CID and HCD but also the UVPD fragmentation method, which produces fragment ions indicative of double bond locations and other unique structurally diagnostic information for analysis of various compound classes, including lipids and glucuronides. Moreover, they offer real-time library search, which uses Real-Time MS2 spectral matching against spectral libraries for decision-based MSn triggering. This leads to higher confidence in metabolite annotation and improved characterization of unknowns.
Barriers to Adopting SQUAD
Despite the clear advantages that SQUAD analysis offers for metabolomics; its adoption might be restricted by barriers that need to be addressed by vendors and researchers to enable its wider application in laboratories. The first barrier is the availability of pure and diverse chemical standards, and labeled standards needed to perform confident identification and, optionally, accurate absolute quantitation. These authentic standards are used to confirm the identity of metabolites by matching multiple properties such as separation retention time, accurate molecular mass, and MS fragmentation patterns. While many of these authentic metabolite standards are commercially available, many of them are not. The main barrier, thus, is the need for custom chemical synthesis, when true unknown compounds are identified, which significantly increases the cost. The untargeted part of SQUAD workflows, however, can help the community by providing insights toward important and relevant metabolites to be synthesized, which could then feed the targeted part of future SQUAD studies.
Second, high-quality data must be obtained to ensure a confident interpretation of the results. Therefore, choosing a platform with high mass accuracy, high resolution, and biological and statistical robustness is essential to ensure confident annotation of unknown metabolites and accurate differential analysis. Orbitrap-based MS and ToF-based MS with high-resolution mode can be utilized for this task but not the low-resolution mass spectrometers such as QQQ and quadrupole trap, with orbitraps being superior in this regard. Finally, data processing is another key component of SQUAD analysis, and retro-mining data requires powerful data analysis capabilities. These solutions should be able to enable fast data processing and analysis with accurate quantification of metabolites. They should also facilitate differential analysis and confident metabolite annotation utilizing high-quality spectral libraries and databases for accurate discovery analysis. In addition, such solutions should offer metabolic pathway analysis for accurate biological interpretation of acquired data.