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Gaitsch H, Franklin RJM, Reich DS. Cell-free DNA-based liquid biopsies in neurology. Brain 2023; 146:1758-1774. [PMID: 36408894 PMCID: PMC10151188 DOI: 10.1093/brain/awac438] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/26/2022] [Accepted: 11/10/2022] [Indexed: 11/22/2022] Open
Abstract
This article reviews recent developments in the application of cell-free DNA-based liquid biopsies to neurological diseases. Over the past few decades, an explosion of interest in the use of accessible biofluids to identify and track molecular disease has revolutionized the fields of oncology, prenatal medicine and others. More recently, technological advances in signal detection have allowed for informative analysis of biofluids that are typically sparse in cells and other circulating components, such as CSF. In parallel, advancements in epigenetic profiling have allowed for novel applications of liquid biopsies to diseases without characteristic mutational profiles, including many degenerative, autoimmune, inflammatory, ischaemic and infectious disorders. These events have paved the way for a wide array of neurological conditions to benefit from enhanced diagnostic, prognostic, and treatment abilities through the use of liquid biomarkers: a 'liquid biopsy' approach. This review includes an overview of types of liquid biopsy targets with a focus on circulating cell-free DNA, methods used to identify and probe potential liquid biomarkers, and recent applications of such biomarkers to a variety of complex neurological conditions including CNS tumours, stroke, traumatic brain injury, Alzheimer's disease, epilepsy, multiple sclerosis and neuroinfectious disease. Finally, the challenges of translating liquid biopsies to use in clinical neurology settings-and the opportunities for improvement in disease management that such translation may provide-are discussed.
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Affiliation(s)
- Hallie Gaitsch
- NIH-Oxford-Cambridge Scholars Program, Wellcome-MRC Cambridge Stem Cell Institute and Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 1TN, UK
| | | | - Daniel S Reich
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
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2
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Műzes G, Bohusné Barta B, Szabó O, Horgas V, Sipos F. Cell-Free DNA in the Pathogenesis and Therapy of Non-Infectious Inflammations and Tumors. Biomedicines 2022; 10:biomedicines10112853. [PMID: 36359370 PMCID: PMC9687442 DOI: 10.3390/biomedicines10112853] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/09/2022] Open
Abstract
The basic function of the immune system is the protection of the host against infections, along with the preservation of the individual antigenic identity. The process of self-tolerance covers the discrimination between self and foreign antigens, including proteins, nucleic acids, and larger molecules. Consequently, a broken immunological self-tolerance results in the development of autoimmune or autoinflammatory disorders. Immunocompetent cells express pattern-recognition receptors on their cell membrane and cytoplasm. The majority of endogenous DNA is located intracellularly within nuclei and mitochondria. However, extracellular, cell-free DNA (cfDNA) can also be detected in a variety of diseases, such as autoimmune disorders and malignancies, which has sparked interest in using cfDNA as a possible biomarker. In recent years, the widespread use of liquid biopsies and the increasing demand for screening, as well as monitoring disease activity and therapy response, have enabled the revival of cfDNA research. The majority of studies have mainly focused on the function of cfDNA as a biomarker. However, research regarding the immunological consequences of cfDNA, such as its potential immunomodulatory or therapeutic benefits, is still in its infancy. This article discusses the involvement of various DNA-sensing receptors (e.g., absent in melanoma-2; Toll-like receptor 9; cyclic GMP-AMP synthase/activator of interferon genes) in identifying host cfDNA as a potent danger-associated molecular pattern. Furthermore, we aim to summarize the results of the experimental studies that we recently performed and highlight the immunomodulatory capacity of cfDNA, and thus, the potential for possible therapeutic consideration.
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Affiliation(s)
| | | | | | | | - Ferenc Sipos
- Correspondence: ; Tel.: +36-20-478-0752; Fax: +36-1-266-0816
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3
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New Perspectives on the Importance of Cell-Free DNA Biology. Diagnostics (Basel) 2022; 12:diagnostics12092147. [PMID: 36140548 PMCID: PMC9497998 DOI: 10.3390/diagnostics12092147] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022] Open
Abstract
Body fluids are constantly replenished with a population of genetically diverse cell-free DNA (cfDNA) fragments, representing a vast reservoir of information reflecting real-time changes in the host and metagenome. As many body fluids can be collected non-invasively in a one-off and serial fashion, this reservoir can be tapped to develop assays for the diagnosis, prognosis, and monitoring of wide-ranging pathologies, such as solid tumors, fetal genetic abnormalities, rejected organ transplants, infections, and potentially many others. The translation of cfDNA research into useful clinical tests is gaining momentum, with recent progress being driven by rapidly evolving preanalytical and analytical procedures, integrated bioinformatics, and machine learning algorithms. Yet, despite these spectacular advances, cfDNA remains a very challenging analyte due to its immense heterogeneity and fluctuation in vivo. It is increasingly recognized that high-fidelity reconstruction of the information stored in cfDNA, and in turn the development of tests that are fit for clinical roll-out, requires a much deeper understanding of both the physico-chemical features of cfDNA and the biological, physiological, lifestyle, and environmental factors that modulate it. This is a daunting task, but with significant upsides. In this review we showed how expanded knowledge on cfDNA biology and faithful reverse-engineering of cfDNA samples promises to (i) augment the sensitivity and specificity of existing cfDNA assays; (ii) expand the repertoire of disease-specific cfDNA markers, thereby leading to the development of increasingly powerful assays; (iii) reshape personal molecular medicine; and (iv) have an unprecedented impact on genetics research.
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Fathima N, Manorenj S, Vishwakarma SK, Khan AA. Role of cell-free DNA for predicting incidence and outcome of patients with ischemic stroke. World J Neurol 2022; 8:1-9. [DOI: 10.5316/wjn.v8.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/11/2022] [Accepted: 07/31/2022] [Indexed: 02/08/2023] Open
Abstract
Early diagnosis and prognosis of ischemic stroke remains a critical challenge in clinical settings. A blood biomarker can be a promising quantitative tool to represent the clinical manifestations in ischemic stroke. Cell-free DNA (cfDNA) has recently turned out to be a popular circulating biomarker due to its potential relevance for diagnostic applications in a variety of disorders. Despite bright outlook of cfDNA in clinical applications, very less is known about its origin, composition, or function. Several recent studies have identified cell-derived mitochondrial components including mitochondrial DNA (mtDNA) in the extracellular spaces including blood and cerebrospinal fluid. However, the time course of alterations in plasma mtDNA concentrations in patients after an ischemic stroke is poorly understood. DNA is thought to be freed into the plasma shortly after the commencement of an ischemic stroke and then gradually decreased. However, the importance of cell-free mtDNA (cf-mtDNA) in ischemic stroke is still unknown. This review summarizes about the utility of biomarkers which has been standardized in clinical settings and role of cfDNA including cf-mtDNA as a non-invasive potential biomarker of ischemic stroke.
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Affiliation(s)
- Nusrath Fathima
- Central Laboratory for Stem Cell Research and Translational Medicine, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Hyderabad 500058, Telangana, India
| | - Sandhya Manorenj
- Department of Neurology, Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad 500002, Telangana, India
| | - Sandeep Kumar Vishwakarma
- Central Laboratory for Stem Cell Research and Translational Medicine, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Hyderabad 500058, Telangana, India
| | - Aleem Ahmed Khan
- Central Laboratory for Stem Cell Research and Translational Medicine, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Hyderabad 500058, Telangana, India
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5
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Ershova ES, Shmarina GV, Porokhovnik LN, Zakharova NV, Kostyuk GP, Umriukhin PE, Kutsev SI, Sergeeva VA, Veiko NN, Kostyuk SV. In Vitro Analysis of Biological Activity of Circulating Cell-Free DNA Isolated from Blood Plasma of Schizophrenic Patients and Healthy Controls. Genes (Basel) 2022; 13:genes13030551. [PMID: 35328103 PMCID: PMC8955124 DOI: 10.3390/genes13030551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/09/2022] [Accepted: 03/17/2022] [Indexed: 12/11/2022] Open
Abstract
Schizophrenia is associated with low-grade systemic inflammation. Circulating cell-free DNA (c-cfDNA) belongs to the DAMP class. The major research question was: can the c-cfDNA of schizophrenic patients (sz-cfDNA) stimulate the DNA sensor genes, which control the innate immunity? We investigated the in vitro response of ten human skin fibroblast (HSF) lines to five DNA probes containing different amounts of a GC-rich marker (the ribosomal repeat) and a DNA oxidation marker (8-oxodG) including sz-cfDNA and healthy control c-cfDNA (hc-cfDNA) probes. After 1 h, 3 h, and 24 h of incubation, the expression of 6 protein genes responsible for cfDNA transport into the cell (EEA1 and HMGB1) and the recognition of cytosolic DNA (TLR9, AIM2, STING and RIG-I) was analyzed at the transcriptional (RT-qPCR) and protein level (flow cytometry and fluorescence microscopy). Additionally, we analyzed changes in the RNA amount of 32 genes (RT-qPCR), which had been previously associated with different cellular responses to cell-free DNA with different characteristics. Adding sz-cfDNA and hc-cfDNA to the HSF medium in equal amounts (50 ng/mL) blocked endocytosis and stimulated TLR9 and STING gene expression while blocking RIG-I and AIM2 expression. Sz-cfDNA and hc-cfDNA, compared to gDNA, demonstrated much stronger stimulated transcription of genes that control cell proliferation, cytokine synthesis, apoptosis, autophagy, and mitochondrial biogenesis. No significant difference was observed in the response of the cells to sz-cfDNA and hc-cfDNA. Sz-cfDNA and hc-cfDNA showed similarly high biological activity towards HSFs, stimulating the gene activity of TLR9 and STING DNA sensor proteins and blocking the activity of the AIM2 protein gene. Since the sz-cfDNA content in the patients’ blood is several times higher than the hc-cfDNA content, sz-cfDNA may upregulate pro-inflammatory cytokines in schizophrenia.
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Affiliation(s)
- Elizaveta S. Ershova
- Molecular Biology Laboratory, Research Centre for Medical Genetics, 115522 Moscow, Russia; (E.S.E.); (G.V.S.); (P.E.U.); (S.I.K.); (V.A.S.); (N.N.V.); (S.V.K.)
| | - Galina V. Shmarina
- Molecular Biology Laboratory, Research Centre for Medical Genetics, 115522 Moscow, Russia; (E.S.E.); (G.V.S.); (P.E.U.); (S.I.K.); (V.A.S.); (N.N.V.); (S.V.K.)
| | - Lev N. Porokhovnik
- Molecular Biology Laboratory, Research Centre for Medical Genetics, 115522 Moscow, Russia; (E.S.E.); (G.V.S.); (P.E.U.); (S.I.K.); (V.A.S.); (N.N.V.); (S.V.K.)
- Correspondence:
| | - Natalia V. Zakharova
- N.A. Alekseev Clinical Psychiatric Hospital No. 1, 117152 Moscow, Russia; (N.V.Z.); (G.P.K.)
| | - George P. Kostyuk
- N.A. Alekseev Clinical Psychiatric Hospital No. 1, 117152 Moscow, Russia; (N.V.Z.); (G.P.K.)
| | - Pavel E. Umriukhin
- Molecular Biology Laboratory, Research Centre for Medical Genetics, 115522 Moscow, Russia; (E.S.E.); (G.V.S.); (P.E.U.); (S.I.K.); (V.A.S.); (N.N.V.); (S.V.K.)
- Department of Physiology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Sergey I. Kutsev
- Molecular Biology Laboratory, Research Centre for Medical Genetics, 115522 Moscow, Russia; (E.S.E.); (G.V.S.); (P.E.U.); (S.I.K.); (V.A.S.); (N.N.V.); (S.V.K.)
| | - Vasilina A. Sergeeva
- Molecular Biology Laboratory, Research Centre for Medical Genetics, 115522 Moscow, Russia; (E.S.E.); (G.V.S.); (P.E.U.); (S.I.K.); (V.A.S.); (N.N.V.); (S.V.K.)
| | - Natalia N. Veiko
- Molecular Biology Laboratory, Research Centre for Medical Genetics, 115522 Moscow, Russia; (E.S.E.); (G.V.S.); (P.E.U.); (S.I.K.); (V.A.S.); (N.N.V.); (S.V.K.)
| | - Svetlana V. Kostyuk
- Molecular Biology Laboratory, Research Centre for Medical Genetics, 115522 Moscow, Russia; (E.S.E.); (G.V.S.); (P.E.U.); (S.I.K.); (V.A.S.); (N.N.V.); (S.V.K.)
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6
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Grosse GM, Blume N, Abu-Fares O, Götz F, Ernst J, Leotescu A, Gabriel MM, van Gemmeren T, Worthmann H, Lichtinghagen R, Imker R, Falk CS, Weissenborn K, Schuppner R, de Buhr N. Endogenous Deoxyribonuclease Activity and Cell-Free Deoxyribonucleic Acid in Acute Ischemic Stroke: A Cohort Study. Stroke 2022; 53:1235-1244. [PMID: 34991335 DOI: 10.1161/strokeaha.121.036299] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Cell-free DNA (cfDNA) and endogenous deoxyribonuclease activity are opposing mediators and might influence the inflammatory response following acute ischemic stroke. In this cohort study, we investigated the relation between these markers, circulating inflammatory mediators and clinical course including occurrence of stroke-associated infections (SAI) in patients with acute stroke. METHODS Ninety-two patients with stroke due to large vessel occlusion undergoing mechanical thrombectomy were prospectively recruited at Hannover Medical School from March 2018 to August 2019. Deoxyribonuclease activity, cfDNA, damage-associated molecular patterns, and circulating cytokines were measured in venous blood collected immediately before mechanical thrombectomy and 7 days later. Reperfusion status was categorized (sufficient/insufficient). Clinical outcome was evaluated using the modified Rankin Scale after 90 days, where a score of 3 to 6 was considered unfavorable. To validate findings regarding SAI, another stroke cohort (n=92) was considered with blood taken within 24 hours after stroke onset. RESULTS Patients with unfavorable clinical outcome had higher cfDNA concentrations. After adjustment for confounders (Essen Stroke Risk Score, National Institutes of Health Stroke Scale, and sex), 7-day cfDNA was independently associated with clinical outcome and especially mortality (adjusted odds ratio: 3.485 [95% CI, 1.001-12.134] and adjusted odds ratio: 9.585 [95% CI, 2.006-45.790]). No association was found between reperfusion status and cfDNA or deoxyribonuclease activity. While cfDNA concentrations correlated positively, deoxyribonuclease activity inversely correlated with distinct biomarkers. Baseline deoxyribonuclease activity was lower in patients who developed SAI compared with patients without SAI. This association was confirmed after adjustment for confounding factors (adjusted odds ratio: 0.447 [95% CI, 0.237-0.844]). In cohort 2, differences of deoxyribonuclease activity between patients with and without SAI tended to be higher with higher stroke severity. CONCLUSIONS The interplay of endogenous deoxyribonuclease activity and cfDNA in acute stroke entails interesting novel diagnostic and potential therapeutic approaches. We confirm an independent association of cfDNA with a detrimental clinical course after stroke due to large vessel occlusion. This study provides first evidence for lower endogenous deoxyribonuclease activity as risk factor for SAI after severe stroke.
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Affiliation(s)
- Gerrit M Grosse
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Nicole Blume
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Omar Abu-Fares
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Germany. (O.A.-F., F.G.)
| | - Friedrich Götz
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Germany. (O.A.-F., F.G.)
| | - Johanna Ernst
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Andrei Leotescu
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Maria M Gabriel
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Till van Gemmeren
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Hans Worthmann
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Ralf Lichtinghagen
- nstitute of Clinical Chemistry, Hannover Medical School, Germany. (R.L.)
| | - Rabea Imker
- Department of Biochemistry, University of Veterinary Medicine Hannover, Germany. (R.I., N.d.B.).,Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Germany. (R.I., N.d.B.)
| | - Christine S Falk
- Institute of Transplant Immunology, Hannover Medical School, Germany. (C.S.F.)
| | - Karin Weissenborn
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Ramona Schuppner
- Department of Neurology, Hannover Medical School, Germany. (G.M.G., N.B., J.E., A.L., M.M.G., T.v.G., H.W., K.W., R.S.)
| | - Nicole de Buhr
- Department of Biochemistry, University of Veterinary Medicine Hannover, Germany. (R.I., N.d.B.).,Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, Germany. (R.I., N.d.B.)
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Affiliation(s)
- Sarina R Falcione
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada
| | - Glen C Jickling
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada
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8
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Blouin AG, Ye F, Williams J, Askar M. A practical guide to chimerism analysis: Review of the literature and testing practices worldwide. Hum Immunol 2021; 82:838-849. [PMID: 34404545 DOI: 10.1016/j.humimm.2021.07.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/30/2021] [Accepted: 07/26/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Currently there are no widely accepted guidelines for chimerism analysis testing in hematopoietic cell transplantation (HCT) patients. The objective of this review is to provide a practical guide to address key aspects of performing and utilizing chimerism testing results. In developing this guide, we conducted a survey of testing practices among laboratories that are accredited for performing engraftment monitoring/chimerism analysis by either the American Society for Histocompatibility & Immunogenetics (ASHI) and/or the European Federation of Immunogenetics (EFI). We interpreted the survey results in the light of pertinent literature as well as the experience in the laboratories of the authors. RECENT DEVELOPMENTS In recent years there has been significant advances in high throughput molecular methods such as next generation sequencing (NGS) as well as growing access to these technologies in histocompatibility and immunogenetics laboratories. These methods have the potential to improve the performance of chimerism testing in terms of sensitivity, availability of informative genetic markers that distinguish donors from recipients as well as cost. SUMMARY The results of the survey revealed a great deal of heterogeneity in chimerism testing practices among participating laboratories. The most consistent response indicated monitoring of engraftment within the first 30 days. These responses are reflective of published literature. Additional clinical indications included early detection of impending relapse as well as identification of cases of HLA-loss relapse.
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Affiliation(s)
- Amanda G Blouin
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Fei Ye
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jenifer Williams
- Department of Pathology & Laboratory Medicine, Baylor University Medical Center, Dallas, TX, United States
| | - Medhat Askar
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States; Department of Pathology & Laboratory Medicine, Baylor University Medical Center, Dallas, TX, United States; Department of Pathology and Laboratory Medicine, Texas A&M Health Science Center College of Medicine, United States.
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Orbán-Kálmándi R, Szegedi I, Sarkady F, Fekete I, Fekete K, Vasas N, Berényi E, Csiba L, Bagoly Z. A modified in vitro clot lysis assay predicts outcomes and safety in acute ischemic stroke patients undergoing intravenous thrombolysis. Sci Rep 2021; 11:12713. [PMID: 34135389 PMCID: PMC8208992 DOI: 10.1038/s41598-021-92041-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/27/2021] [Indexed: 12/27/2022] Open
Abstract
The outcome of intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) is only favorable in ≈ 40% of acute ischemic stroke (AIS) patients. Moreover, in ≈ 6-8% of cases, intracerebral hemorrhage (ICH) develops. We tested whether a modification of clot lysis assay (CLA), might predict therapy outcomes and safety. In this prospective observational study, blood samples of 231 AIS patients, all receiving intravenous rt-PA, were taken before thrombolysis. Cell-free DNA (cfDNA), CLA and CLA supplemented with cfDNA and histones (mCLA) were determined from the blood samples. Stroke severity was determined by NIHSS on admission. ICH was classified according to ECASSII. Short- and long-term outcomes were defined at 7 and 90 days post-event according to ΔNIHSS and by the modified Rankin Scale, respectively. Stroke severity demonstrated a step-wise positive association with cfDNA levels, while a negative association was found with the time to reach 50% lysis (50%CLT) parameter of CLA and mCLA. ROC analysis showed improved diagnostic performance of the mCLA. Logistic regression analysis proved that 50%CLT is a predictor of short-term therapy failure, while the AUC parameter predicts ICH occurrence. A modified CLA, supplemented with cfDNA and histones, might be a promising tool to predict short-term AIS outcomes and post-lysis ICH.
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Affiliation(s)
- Rita Orbán-Kálmándi
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, Kálmán Laki Doctoral School, University of Debrecen, 98 Nagyerdei krt., Debrecen, 4032, Hungary
| | - István Szegedi
- Department of Neurology, Faculty of Medicine, University of Debrecen, 22 Móricz Zsigmond krt., Debrecen, 4032, Hungary
| | - Ferenc Sarkady
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, Kálmán Laki Doctoral School, University of Debrecen, 98 Nagyerdei krt., Debrecen, 4032, Hungary
| | - István Fekete
- Department of Neurology, Faculty of Medicine, University of Debrecen, 22 Móricz Zsigmond krt., Debrecen, 4032, Hungary
| | - Klára Fekete
- Department of Neurology, Faculty of Medicine, University of Debrecen, 22 Móricz Zsigmond krt., Debrecen, 4032, Hungary
| | - Nikolett Vasas
- Department of Radiology, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt., Debrecen, 4032, Hungary
| | - Ervin Berényi
- Department of Radiology, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt., Debrecen, 4032, Hungary
| | - László Csiba
- Department of Neurology, Faculty of Medicine, University of Debrecen, 22 Móricz Zsigmond krt., Debrecen, 4032, Hungary.,ELKH-DE Cerebrovascular and Neurodegenerative Research Group, 22 Móricz Zsigmond krt., Debrecen, 4032, Hungary
| | - Zsuzsa Bagoly
- Division of Clinical Laboratory Sciences, Department of Laboratory Medicine, Faculty of Medicine, Kálmán Laki Doctoral School, University of Debrecen, 98 Nagyerdei krt., Debrecen, 4032, Hungary. .,ELKH-DE Cerebrovascular and Neurodegenerative Research Group, 22 Móricz Zsigmond krt., Debrecen, 4032, Hungary.
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10
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Ungerer V, Bronkhorst AJ, Van den Ackerveken P, Herzog M, Holdenrieder S. Serial profiling of cell-free DNA and nucleosome histone modifications in cell cultures. Sci Rep 2021; 11:9460. [PMID: 33947882 PMCID: PMC8096822 DOI: 10.1038/s41598-021-88866-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 04/08/2021] [Indexed: 02/07/2023] Open
Abstract
Recent advances in basic research have unveiled several strategies for improving the sensitivity and specificity of cell-free DNA (cfDNA) based assays, which is a prerequisite for broadening its clinical use. Included among these strategies is leveraging knowledge of both the biogenesis and physico-chemical properties of cfDNA towards the identification of better disease-defining features and optimization of methods. While good progress has been made on this front, much of cfDNA biology remains uncharted. Here, we correlated serial measurements of cfDNA size, concentration and nucleosome histone modifications with various cellular parameters, including cell growth rate, viability, apoptosis, necrosis, and cell cycle phase in three different cell lines. Collectively, the picture emerged that temporal changes in cfDNA levels are rather irregular and not the result of constitutive release from live cells. Instead, changes in cfDNA levels correlated with intermittent cell death events, wherein apoptosis contributed more to cfDNA release in non-cancer cells and necrosis more in cancer cells. Interestingly, the presence of a ~ 3 kbp cfDNA population, which is often deemed to originate from accidental cell lysis or active release, was found to originate from necrosis. High-resolution analysis of this cfDNA population revealed an underlying DNA laddering pattern consisting of several oligo-nucleosomes, identical to those generated by apoptosis. This suggests that necrosis may contribute significantly to the pool of mono-nucleosomal cfDNA fragments that are generally interrogated for cancer mutational profiling. Furthermore, since active steps are often taken to exclude longer oligo-nucleosomes from clinical biospecimens and subsequent assays this raises the question of whether important pathological information is lost.
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Affiliation(s)
- Vida Ungerer
- Institute for Laboratory Medicine, German Heart Centre, Technical University of Munich, Lazarettstraße 36, 80636, Munich, Germany
| | - Abel J Bronkhorst
- Institute for Laboratory Medicine, German Heart Centre, Technical University of Munich, Lazarettstraße 36, 80636, Munich, Germany
| | | | - Marielle Herzog
- Belgian Volition SRL, 22 Rue Phocas Lejeune, Parc Scientifique Crealys, 5032, Isnes, Belgium
| | - Stefan Holdenrieder
- Institute for Laboratory Medicine, German Heart Centre, Technical University of Munich, Lazarettstraße 36, 80636, Munich, Germany.
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11
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Quantification of Circulating Cell Free Mitochondrial DNA in Extracellular Vesicles with PicoGreen™ in Liquid Biopsies: Fast Assessment of Disease/Trauma Severity. Cells 2021; 10:cells10040819. [PMID: 33917426 PMCID: PMC8067453 DOI: 10.3390/cells10040819] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/25/2022] Open
Abstract
The analysis of circulating cell free DNA (ccf-DNA) is an emerging diagnostic tool for the detection and monitoring of tissue injury, disease progression, and potential treatment effects. Currently, most of ccf-DNA in tissue and liquid biopsies is analysed with real-time quantitative PCR (qPCR) that is primer- and template-specific, labour intensive and cost-inefficient. In this report we directly compare the amounts of ccf-DNA in serum of healthy volunteers, and subjects presenting with various stages of lung adenocarcinoma, and survivors of traumatic brain injury using qPCR and quantitative PicoGreen™ fluorescence assay. A significant increase of ccf-DNA in lung adenocarcinoma and traumatic brain injury patients, in comparison to the group of healthy human subjects, was found using both analytical methods. However, the direct correlation between PicoGreen™ fluorescence and qPCR was found only when mitochondrial DNA (mtDNA)-specific primers were used. Further analysis of the location of ccf-DNA indicated that the majority of DNA is located within lumen of extracellular vesicles (EVs) and is easily detected with mtDNA-specific primers. We have concluded that due to the presence of active DNases in the blood, the analysis of DNA within EVs has the potential of providing rapid diagnostic outcomes. Moreover, we speculate that accurate and rapid quantification of ccf-DNA with PicoGreen™ fluorescent probe used as a point of care approach could facilitate immediate assessment and treatment of critically ill patients.
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Greytak SR, Engel KB, Parpart-Li S, Murtaza M, Bronkhorst AJ, Pertile MD, Moore HM. Harmonizing Cell-Free DNA Collection and Processing Practices through Evidence-Based Guidance. Clin Cancer Res 2020; 26:3104-3109. [PMID: 32122922 DOI: 10.1158/1078-0432.ccr-19-3015] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/25/2019] [Accepted: 02/25/2020] [Indexed: 12/18/2022]
Abstract
Circulating cell-free DNA (cfDNA) is rapidly transitioning from discovery research to an important tool in clinical decision making. However, the lack of harmonization of preanalytic practices across institutions may compromise the reproducibility of cfDNA-derived data and hamper advancements in cfDNA testing in the clinic. Differences in cellular genomic contamination, cfDNA yield, integrity, and fragment length have been attributed to different collection tube types and anticoagulants, processing delays and temperatures, tube agitation, centrifugation protocols and speeds, plasma storage duration and temperature, the number of freeze-thaw events, and cfDNA extraction and quantification methods, all of which can also ultimately impact subsequent downstream analysis. Thus, there is a pressing need for widely applicable standards tailored for cfDNA analysis that include all preanalytic steps from blood draw to analysis. The NCI's Biorepositories and Biospecimen Research Branch has developed cfDNA-specific guidelines that are based upon published evidence and have been vetted by a panel of internationally recognized experts in the field. The guidelines include optimal procedures as well as acceptable alternatives to facilitate the generation of evidence-based protocols by individual laboratories and institutions. The aim of the document, which is entitled "Biospecimen Evidence-based Best Practices for Cell-free DNA: Biospecimen Collection and Processing," is to improve the accuracy of cfDNA analysis in both basic research and the clinic by improving and harmonizing practices across institutions.
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Affiliation(s)
| | | | | | - Muhammed Murtaza
- Center for Noninvasive Diagnostics, Translational Genomics Research Institute, Phoenix, Arizona
| | | | - Mark D Pertile
- Victorian Clinical Genetics Services (VCGS), Parkville, Australia
| | - Helen M Moore
- Biorepositories and Biospecimen Research Branch, NCI, Bethesda, Maryland.
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Ullrich E, Heidinger P, Soh J, Villanova L, Grabuschnig S, Bachler T, Hirschböck E, Sánchez-Heredero S, Ford B, Sensen M, Rosales Rodriguez I, Schwendenwein D, Neumeister P, Zurl CJ, Krause R, Lorenz Khol J, Sensen CW. Evaluation of host-based molecular markers for the early detection of human sepsis. J Biotechnol 2020; 310:80-88. [PMID: 32017954 DOI: 10.1016/j.jbiotec.2020.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 01/18/2020] [Accepted: 01/27/2020] [Indexed: 12/12/2022]
Abstract
We have identified 24 molecular markers, based on circulating nucleic acids (CNA) originating from the human genome, which in combination can be used in a quantitative real-time PCR (qPCR) assay to identify the presence of human sepsis, starting two to three days before the first clinical signs develop and including patients who meet the SEPSIS-3 criteria. The accuracy was more than 87 % inside of the same patient cohort for which the markers were developed and up to 81 % in blind studies of patient cohorts which were not included in the marker development. As our markers are host-based, they can be used to capture bacterial as well as fungal sepsis, unlike the current PCR-based tests, which require species-specific primer sets for each organism causing human sepsis. Our assay directly uses an aliquot of cell-free blood as the substrate for the PCR reaction, thus allowing to obtain the diagnostic results in three to four hours after the collection of the blood samples.
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Affiliation(s)
- Elisabeth Ullrich
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria
| | | | - Jung Soh
- CNA Diagnostics Inc., Suite 300, 4838 Richard Road SW, Calgary, Alberta, T3E 6L1, Canada
| | - Laura Villanova
- Institute of Computational Biotechnology, Graz University of Technology, Petersgasse 14/V, 8010, Graz, Styria, Austria
| | - Stefan Grabuschnig
- Institute of Computational Biotechnology, Graz University of Technology, Petersgasse 14/V, 8010, Graz, Styria, Austria
| | | | | | - Sara Sánchez-Heredero
- Institute of Computational Biotechnology, Graz University of Technology, Petersgasse 14/V, 8010, Graz, Styria, Austria
| | - Barry Ford
- Defence Research and Development Canada, Suffield Research Centre, Suffield, P.O. box 4000 Stn Main, T1A 8K6, Medicine Hat, Alberta, Canada
| | - Maria Sensen
- Hochstraße 12, 8076, Vasoldsberg, Styria, Austria
| | | | | | - Peter Neumeister
- Clinical Division for Hematology, Medical University of Graz, Auenbruggerplatz 38D, 8036 Graz, Styria, Austria
| | - Christoph J Zurl
- Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/II, 8036, Graz, Styria, Austria
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Styria, Austria; BioTechMed Graz, Mozartgasse 12/II, 8010, Graz, Styria, Austria
| | - Johannes Lorenz Khol
- Department for Farm Animals and Veterinary Public Health, University Clinic for Ruminants, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria
| | - Christoph W Sensen
- Institute of Computational Biotechnology, Graz University of Technology, Petersgasse 14/V, 8010, Graz, Styria, Austria; CNA Diagnostics GmbH, Parkring 18, 8074, Grambach, Styria, Austria; BioTechMed Graz, Mozartgasse 12/II, 8010, Graz, Styria, Austria.
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Ershova ES, Konkova MS, Malinovskaya EM, Kutsev SI, Veiko NN, Kostyuk SV. Noncanonical Functions of the Human Ribosomal Repeat. RUSS J GENET+ 2020. [DOI: 10.1134/s1022795420010044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Oxidized Cell-Free DNA Role in the Antioxidant Defense Mechanisms under Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:1245749. [PMID: 31360293 PMCID: PMC6644271 DOI: 10.1155/2019/1245749] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/08/2019] [Indexed: 12/15/2022]
Abstract
The present study focuses on the investigation of the oxidized cell-free DNA (cfDNA) properties in several experimental models, including cultured cerebellum cells, peripheral blood lymphocytes (PBL), plasma, and hippocampus under an acute and chronic unpredictable stress model in rats. Firstly, our study shows that Spectrum Green fluorescence-labeled oxidized cfDNA fragments were transferred into the cytoplasm of 80% of the cerebellum culture cells; meanwhile, the nonoxidized cfDNA fragments do not pass into the cells. Oxidized cfDNA stimulates the antioxidant mechanisms and induction of transcription factor NRF2 expression, followed by an activation of NRF2 signaling pathway genes-rise of Nrf2 and Hmox1 gene expression and consequently NRF2 protein synthesis. Secondly, we showed that stress increases plasma cfDNA concentration in rats corresponding with the duration of the stress exposure. At the same time, our study did not reveal any significant changes of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) level in PBL of rats under acute or chronic stress, probably due to the significantly increased Nrf2 expression, that we found in such conditions. 8-oxodG is one of the most reliable markers of DNA oxidation. We also found an increased level of 8-oxodG in the hippocampal homogenates and hippocampal dentate gyrus in rats subjected to acute and chronic stress. Taken together, our data shows that oxidized cfDNA may play a significant role in systemic and neuronal physiological mechanisms of stress and adaptation.
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Abstract
Since its discovery in human blood plasma about 70 years ago, circulating cell-free DNA (cfDNA) has become an attractive subject of research as noninvasive disease biomarker. The interest in clinical applications has gained an exponential increase, making it a popular and potential target in a wide range of research areas.cfDNA can be found in different body fluids, both in healthy and not healthy subjects. The recent and rapid development of new molecular techniques is promoting the study and the identification of cfDNA, holding the key to minimally invasive diagnostics, improving disease monitoring, clinical decision, and patients' outcome.cfDNA has already given a huge impact on prenatal medicine, and it could become, in the next future, the standard of care also in other fields, from oncology to transplant medicine and cardiovascular diseases.
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Affiliation(s)
- Rossella Ranucci
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
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Regner A, Meirelles LDS, Ikuta N, Cecchini A, Simon D. Prognostic utility of circulating nucleic acids in acute brain injuries. Expert Rev Mol Diagn 2018; 18:925-938. [PMID: 30307786 DOI: 10.1080/14737159.2018.1535904] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Acute brain injuries represent major causes of morbidity and mortality worldwide. Nevertheless, therapeutic options are centered mainly on supportive care, and accurate prognosis prediction following traumatic brain injury (TBI) or stroke remains a challenge in clinical settings. Areas covered: Circulating DNA and RNA have shown potential as predictive molecules in acute brain injuries. In particular, plasma cell-free DNA (cfDNA) levels have been correlated to severity, mortality, and outcome after TBI and stroke. The real-time quantitative polymerase chain reaction (qPCR) is the most widely used technique for determination of cfDNA in brain injuries; however, to consider the use of cfDNA in emergency settings, a quicker and easier methodology for detection should be established. A recent study proposed detection of cfDNA applying a rapid fluorescent test that showed compatible results with qPCR. Expert commentary: As a promising perspective, detection of cfDNA levels using simple, rapid, and cheap methodology has potential to translate to clinic as a point-of-care marker, supporting the clinical decision-making in emergency care settings. Conversely, miRNA profiles may be used as signatures to determine the type and severity of injuries. Additionally, in the future, some miRNAs may constitute innovative neurorestorative therapies without the common hurdles associated with cell therapy.
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Affiliation(s)
- Andrea Regner
- a School of Medicine , Lutheran University of Brazil , Canoas , RS , Brazil.,b Graduate Program in Cellular and Molecular Biology Applied to Health (PPGBioSaúde) , Lutheran University of Brazil , Canoas , RS , Brazil
| | - Lindolfo da Silva Meirelles
- a School of Medicine , Lutheran University of Brazil , Canoas , RS , Brazil.,b Graduate Program in Cellular and Molecular Biology Applied to Health (PPGBioSaúde) , Lutheran University of Brazil , Canoas , RS , Brazil
| | - Nilo Ikuta
- b Graduate Program in Cellular and Molecular Biology Applied to Health (PPGBioSaúde) , Lutheran University of Brazil , Canoas , RS , Brazil
| | - Andre Cecchini
- a School of Medicine , Lutheran University of Brazil , Canoas , RS , Brazil.,b Graduate Program in Cellular and Molecular Biology Applied to Health (PPGBioSaúde) , Lutheran University of Brazil , Canoas , RS , Brazil.,c Neurosurgery Service , Cristo Redentor Hospital , Porto Alegre , Brazil
| | - Daniel Simon
- a School of Medicine , Lutheran University of Brazil , Canoas , RS , Brazil.,b Graduate Program in Cellular and Molecular Biology Applied to Health (PPGBioSaúde) , Lutheran University of Brazil , Canoas , RS , Brazil
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