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In a dried blood spot (DBS) test, a small amount of blood is taken, usually by pricking the fingertip. The sample is then dabbed onto special filter paper and dried at room temperature. The dried sample can easily be sent to a laboratory for analysis. The procedure is minimally invasive and requires only a small fingertip prick. This makes it less painful and more comfortable for patients compared to traditional blood draws. The dried blood samples are stable at room temperature, which promotes sample preservation through reduced enzymatic activity and microbial degradation. This stability also simplifies storage and transport, as the samples do not need to be refrigerated and are less biologically hazardous than liquid blood samples. Overall, the DBS test offers a convenient, cost-effective, and easily accessible method for blood sample collection and analysis.

The MSMM analytical method used for the dried blood spot test typically incorporates advanced mass spectrometry techniques such as liquid chromatography-tandem mass spectrometry (LC-MS/MS). This approach offers high precision and sensitivity in the detection and quantification of a wide range of biomarkers directly from dried blood spots. The method benefits from minimal sample preparation and can analyze very small sample volumes, making it ideal for the limited amount of blood collected on filter paper.

The MSMM analytical method used for the dried blood spot test typically incorporates advanced mass spectrometry techniques such as liquid chromatography-tandem mass spectrometry (LC-MS/MS). This approach offers high precision and sensitivity in the detection and quantification of a wide range of biomarkers directly from dried blood spots. The method benefits from minimal sample preparation and can analyze very small sample volumes, making it ideal for the limited amount of blood collected on filter paper.

Dried blood spot (DBS) samples analyzed with MSMM can measure a wide range of analytes, including hormones, therapeutics, metabolites, and infectious agents such as HIV, hepatitis B, and hepatitis C. These measurements are of significant clinical relevance for therapeutic drug monitoring, pharmacokinetics, toxicology, endocrinology, and the diagnosis of infectious diseases.

DBS with MSMM is preferable in situations such as home sample collection, patient care in remote areas, and situations where venous blood draws are difficult or impractical. This allows patients to collect samples themselves with minimal training and send them by mail to central laboratories, improving access to testing and follow-up care.

Compared to serum or plasma collection, DBS offers several advantages: It requires only a small amount of blood, which is drawn via a finger prick, making it less invasive and more convenient. DBS samples are stable at room temperature, simplifying storage and transport without refrigeration. Furthermore, it reduces the risk of biological hazards and logistical challenges, resulting in higher sample integrity and improved processing success rates, particularly in infectious disease screening and drug monitoring.

These properties make DBS with MSMM a practical, effective and reliable alternative sampling method for various clinical and research applications.

The laboratory workflow for dried blood spot (DBS) analysis with MSMM involves several meticulous steps to ensure sample integrity and reliable analysis. Upon receipt, DBS samples are visually inspected for quality based on factors such as sample size, uniformity, and saturation. The samples are then punched from the filter paper and prepared for mass spectrometric analysis, which often involves the extraction and elution of the analytes from the dried blood spot matrix. Quality control (QC) materials specifically designed for DBS are used to monitor test performance. Repeated testing verifies precision and accuracy. QC includes the evaluation of enzyme activities or analyte concentrations against stringent acceptance criteria and continuous monitoring using standardized DBS controls to ensure reproducibility over time.

Correlation data comparing DBS/MSMM results with conventional methods show good agreement for many analytes, including enzymes, drugs, and infection markers. Studies demonstrate stable enzyme activities and analyte recovery in properly stored DBS samples with minimal losses under varying temperature conditions. Detection of viral load for infections such as HIV and hepatitis using DBS has shown high sensitivity and specificity, although in some cases slightly lower than that of plasma. This confirms DBS as a viable alternative, particularly in cases of challenging plasma collection.

The scientific literature validating DBS/MSMM technology includes reports on newborn screening for lysosomal storage diseases using tandem mass spectrometry, studies on the detection of viral RNA in self-collected DBS samples, and review articles highlighting the accuracy, stability, and clinical utility of DBS samples analyzed by mass spectrometry. These confirm DBS/MSMM as a robust technique with strong analytical performance, suitable for diagnostic and therapeutic monitoring applications, and supported by regulatory approval in some contexts.

Overall, strict workflow protocols, rigorous quality control measures, and supporting correlation data with conventional tests confirm DBS/MSMM as a reliable method in clinical and research laboratories. In a DBS (Dry Blood Spot) test, a small amount of blood is drawn, usually by finger prick, dripped onto filter paper, and dried at room temperature. This minimally invasive method offers advantages such as high patient comfort. The dried sample is stable without refrigeration, which simplifies storage and transport and reduces degradation processes and biohazard risks.

The MSMM analytical method, which often utilizes mass spectrometric techniques such as tandem mass spectrometry (LC-MS/MS), offers high precision and sensitivity. It enables the simultaneous detection and quantification of multiple analytes from small blood volumes and surpasses conventional tests in accuracy, reproducibility, and throughput. This efficiency contributes to reliable diagnostics and research.
DBS with MSMM measures various analytes, including hormones, drugs, metabolites, and infectious agents. It is particularly suitable for home sample collection, remote patient diagnosis, and reducing the need for venous sampling. Compared to serum or plasma, DBS requires less blood, is easier to transport, and minimizes sample degradation and risks.

The laboratory workflow includes rigorous quality control using DBS-specific control materials, visual assessment of sample quality, and standardized extraction and testing procedures. Correlation studies confirm the good agreement between DBS/MSMM and conventional methods, establishing DBS as a reliable alternative. Scientific literature supports these findings with studies on enzyme assays, viral RNA detection, and metabolite analysis, confirming its clinical and scientific applicability.

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Dry Blood Spot (DBS) testing is subject to strict regulations and compliance standards to ensure accuracy, safety, and legal conformity. DBS samples must be collected, stored, transported, and analyzed as biological samples according to established protocols that meet biohazard management and chain of custody requirements.

Our DBS tests are based on methods that meet international standards, including laboratory accreditations such as ISO/IEC 17025, and follow industry guidelines such as those of the World Anti-Doping Agency (WADA) regarding sample integrity and analytical accuracy. The laboratories rigorously validate DBS tests and ensure that the results are equivalent to or better than those obtained with conventional blood testing methods.
Samples are securely packaged and shipped in accordance with biohazard transport regulations to ensure sample stability and prevent contamination. Strict adherence to patient data protection, ethical usage guidelines, and informed consent policies is maintained throughout all testing procedures.
By adhering to these regulations and quality standards, we guarantee that DBS tests with MSMM analysis are reliable, safe, and suitable for clinical and research applications worldwide.

If you have any questions, you can submit them via the contact form here. You can also contact us by email for technical support, or book a consultation appointment here.

For links to detailed reports, case studies, and webinars, please subscribe to the newsletter or visit this page in the future. There you will also find news and updates on research advances or regulatory changes related to dried blood spot testing and MSMM.

Frequently Asked Questions

The results of the Mimatest® dried blood spot analysis are determined using gas chromatography-mass spectrometry (GC-MS). They are therefore highly reliable and accurate, allowing for significantly more precise intervention by physicians or alternative practitioners to restore a healthy microbiome.

Mimatest® identifiziert, welche Mikroorganismen biologisch aktiv sind und wie sich ihre Anwesenheit funktionell im Körper widerspiegelt.

By quantifying specific microbial markers, the test reveals patterns of microbial balance or imbalance related to digestion, metabolism, immune function and inflammatory processes. This functional profiling helps identify clinically relevant changes in the microbiota and supports diagnostic evaluation and personalised clinical monitoring.

In medical diagnostics, the small intestine has traditionally received less attention than other parts of the gastrointestinal tract, mainly because it is difficult to access and examine directly. Its complex structure, the rapid movement of its contents and the dynamic interaction with digestive secretions make it challenging to assess its function using conventional methods.

As a result, important processes in the small intestine – particularly those involving interactions between the host and microbiota – have long been insufficiently considered in routine clinical assessment.

Mimatest® bietet einen minimalinvasiven Einblick in diese verborgene Welt, wobei nur kleine getrocknete Blutstropfen verwendet werden.

Der Dünndarm ist eines der metabolisch aktivsten Organe im Körper. Seine Lage und sein einzigartiges mikrobielles Ökosystem spielen eine entscheidende Rolle bei der Aufrechterhaltung des physiologischen Gleichgewichts.

Although it has a lower microbial density than the large intestine, its microbiota has a disproportionate influence on nutrient processing, metabolic regulation, immune signalling and pathogen defence. These microorganisms are uniquely adapted to local conditions such as bile acids and rapid transit times, and directly influence fat metabolism, gene expression in intestinal cells, and the integrity of the intestinal barrier.
Changes in this finely tuned ecosystem can significantly affect overall health. Conventional tests often fail to detect these subtle but crucial signals – Mimatest was specifically designed to detect them.

Mimatest® is based on Mass Spectrometry of Microbial Markers (MSMM/MMMS), a highly sensitive and specific analytical method. It detects species-specific chemical components of microorganisms—such as fatty acids, sterols, and aldehydes—in clinical samples.

These markers originate from living, metabolically active microbes, and their concentrations are directly proportional to the abundance of each microbial species, allowing quantitative analysis at the genus or species level.

Using GC-MS technology, Mimatest® can simultaneously analyze over 100 microbial markers in a single sample, with exceptional sensitivity (down to 10⁵ cells per gram and 0.01 ng/mL per marker).

The method has been validated against genetic approaches such as PCR and 16S rRNA sequencing and is grounded in decades of research in chromatography, lipid chemistry, microbiology, human microbiome science, and host–microbe interactions.

It can be applied to dried blood to assess small intestinal microbial activity, as well as to a wide range of other samples, including swabs, saliva, urine, wound discharge, and more.

Mimatest® delivers functional insights into the microbiota, enabling clinicians and researchers to assess microbial homeostasis, imbalances, infection dynamics, and overall microecological status—information that stool-based or DNA-only tests cannot provide on their own.

Discover the Science

Human health depends on a balanced relationship with our microorganisms. The microbiota – the totality of microbes that live in and on our bodies – includes bacteria in the small intestine, mouth, skin and other places, and weighs about 2–3 kg.

These microorganisms influence digestion, metabolism, immune function and protection against harmful pathogens.

Mimatest® bietet eine umfassende Analyse der Mikrobiota des Dünndarms und identifiziert, welche Mikrobenarten vorhanden sind, in welchem Verhältnis sie zueinander stehen und wie aktiv sie sind. So können Sie nachvollziehen, was im Gleichgewicht ist, was möglicherweise übermäßig wächst und was möglicherweise fehlt – und erhalten ein klares Bild Ihres Darmmikrobioms und dessen funktioneller Auswirkungen auf Ihre Gesundheit.

The gut microbiota plays a central role in almost all essential processes in the human body. It:

  • Provides the body with energy
  • Regulates the immune system, including cellular and humoral responses
  • Supports the detoxification of food additives and harmful compounds
  • Steuert die Darmbeweglichkeit und Peristaltik
  • Supplies the intestinal mucosa with nutrients and maintains it
  • Is involved in protein, fat and carbohydrate metabolism
  • Processes bile acids and bilirubin and regulates water and salt balance
  • Supports the regulation of body temperature
  • Produces vitamins, including B vitamins and vitamin K
  • Synthesises amino acids and small peptides
  • Contributes to cancer prevention and antioxidant activity
  • Protects against pathogens through competitive exclusion and antimicrobial substances
  • Maintains the integrity of the intestinal barrier and prevents leaky gut and systemic inflammation
  • Produces short-chain fatty acids, which are essential for gut and metabolic health
  • Affects hormone metabolism, including oestrogen and other important hormones
  • Modulates mood, behaviour and cognition via the gut-brain axis Influences blood lipid and glucose levels
  • Contributes to drug metabolism and therapeutic response

A stool test primarily reflects metabolic waste products and digestive activity in the large intestine. However, the most important steps in digestion and nutrient absorption take place in the small intestine, meaning that stool tests are unsuitable for assessing its microbial activity.

The results of stool tests can also be affected by transport conditions, storage time and temperature, which can distort the actual microbial picture.

Mimatest® hingegen ist eine Trockenblutanalyse, die die mikrobielle Aktivität im Dünndarm bewertet. Sie liefert präzise Informationen über die Anzahl, Aktivität und funktionellen Auswirkungen lebender, metabolisch aktiver Mikroorganismen. Da mikrobielle Marker in Trockenblut stabil sind, werden die Ergebnisse weitaus weniger durch Transport- oder Lagerbedingungen beeinflusst.

Dadurch kann Mimatest® Ungleichgewichte im Darm identifizieren und personalisierte Behandlungsentscheidungen genauer unterstützen als herkömmliche Stuhltests.

A healthy small intestine flora is balanced, diverse and metabolically active, with microorganisms present in appropriate numbers and composition. These microbes aid digestion and nutrient absorption and produce a variety of beneficial substances, including vitamins, amino acids, neurotransmitters, hormones, antibiotics, short-chain fatty acids, signalling molecules and genetic material.

They also maintain the integrity of the intestinal barrier, regulate immune responses and provide resistance to colonisation by pathogens.

In short, healthy small intestine flora is defined not only by which microbes are present, but also by how effectively and harmoniously they work together to support overall health.

Probiotics are living microorganisms that can have health benefits when consumed in sufficient quantities. They are often used to support microbial balance in the gut.

For decades, the use of probiotics has often been guided by stool tests, but these approaches frequently fail to produce lasting results. Many probiotic products lose their viability after opening, lack sufficient microbial diversity, or are unable to survive stomach acid, limiting their effectiveness in the small intestine.

Only a few formulations are specifically designed to survive digestion and effectively support the function of the small intestine. When selected and used correctly, high-quality probiotics can help restore microbial balance, promote self-regulation and improve long-term gut health.

Blood itself is normally sterile. Therefore, microbiome analysis of blood does not detect whole microorganisms, but rather traces of their biological material, including:

  • Processed bacterial fragments that are produced when bacteria from the intestinal mucosa enter the lymphatic system or bloodstream. This occurs when immune cells (phagocytes) engulf bacteria, digest them and release processed fragments that can enter the circulation via the lymphatic system.
  • Microbial metabolites, small molecules produced exclusively by gut microbes and not by human cells.

These bacterial fragments and metabolites are collectively referred to as microbial markers – chemical signals that indicate the presence and activity of microbes in the body.

Blood-based microbiome tests detect these circulating markers and provide insights into intestinal barrier integrity, immune activation, microbial translocation, and systemic inflammation.

Microbial metabolites and processed bacterial fragments are collectively referred to as microbial markers. Their quantity and relative proportion can be used to determine the composition and activity of microorganisms.

Blood samples are analysed using mass spectrometry to detect these microbial markers. In the laboratory, the sample is processed to extract its organic (lipid) fraction, followed by chemical derivatisation to improve detectability.

Gas chromatography-mass spectrometry (GC-MS) then separates and identifies the compounds based on their mass spectra, enabling precise quantification of microbial markers.
Researchers such as Osipov have developed extensive reference databases that link specific marker profiles to defined microbial taxa. Measuring these markers in the blood provides insights into the interactions between the host and the microbiome, as different microbial profiles are associated with specific health conditions and pathologies. For example, elevated levels of certain microbial fatty acids in the blood may indicate increased intestinal permeability, inflammation or dysbiosis.

Microorganisms contain species-specific fatty acids in their cell membranes, which act as biological ‘fingerprints’. Just as human fingerprints are unique, the composition and proportions of these fatty acids are genetically determined by microbial DNA and remain very stable over time.

These lipid profiles are synthesised according to genetic instructions, and even ancient bacteria preserved in sediments exhibit the same fatty acid patterns as their modern counterparts. Since each species has a unique and stable fatty acid signature, scientists can reliably identify microorganisms using these lipid fingerprints – similar to DNA-based identification methods such as PCR.

Although environmental factors may cause minor variations, the core fatty acid profile remains consistent, making microbial marker analysis a precise, reproducible and functionally informative approach to assessing the microbiome.

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