The chirality of small metabolic molecules is important in controlling physiological processes and indicating the health status of humans. Abnormal enantiomeric ratios of chiral molecules in biofluids and tissues occur in many diseases, including cancers and kidney and brain diseases. Thus, chiral small molecules are promising biomarkers for disease diagnosis, prognosis, adverse drug-effect monitoring, pharmacodynamic studies and personalized medicine. However, it remains difficult to achieve cost-effective and reliable analysis of small chiral molecules in clinical procedures, in part owing to their large variety and low concentration. In this Review, we describe current and emerging techniques that detect and quantify small-molecule enantiomers and their biological importance.

小代谢分子的手性对于控制生理过程和指示人类健康状况非常重要。生物体液和组织中手性分子的对映体比例异常发生在许多疾病中，包括癌症以及肾脏和脑部疾病。因此，手性小分子是用于疾病诊断、预后、不良药效监测、药效学研究和个性化医疗的有前途的生物标志物。然而，在临床操作中仍然难以实现具有成本效益且可靠的小手性分子分析，部分原因是其种类繁多且浓度低。在这篇综述中，我们描述了检测和量化小分子对映体及其生物学重要性的当前和新兴技术。