1
|
Ghosh SK, Man Y, Fraiwan A, Waters C, McKenzie C, Lu C, Pfau D, Kawsar H, Bhaskaran N, Pandiyan P, Jin G, Briggs F, Zender CC, Rezaee R, Panagakos F, Thuener JE, Wasman J, Tang A, Qari H, Wise-Draper T, McCormick TS, Madabhushi A, Gurkan UA, Weinberg A. Beta-defensin index: A functional biomarker for oral cancer detection. Cell Rep Med 2024; 5:101447. [PMID: 38442713 PMCID: PMC10983043 DOI: 10.1016/j.xcrm.2024.101447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/14/2023] [Accepted: 02/06/2024] [Indexed: 03/07/2024]
Abstract
There is an unmet clinical need for a non-invasive and cost-effective test for oral squamous cell carcinoma (OSCC) that informs clinicians when a biopsy is warranted. Human beta-defensin 3 (hBD-3), an epithelial cell-derived anti-microbial peptide, is pro-tumorigenic and overexpressed in early-stage OSCC compared to hBD-2. We validate this expression dichotomy in carcinoma in situ and OSCC lesions using immunofluorescence microscopy and flow cytometry. The proportion of hBD-3/hBD-2 levels in non-invasively collected lesional cells compared to contralateral normal cells, obtained by ELISA, generates the beta-defensin index (BDI). Proof-of-principle and blinded discovery studies demonstrate that BDI discriminates OSCC from benign lesions. A multi-center validation study shows sensitivity and specificity values of 98.2% (95% confidence interval [CI] 90.3-99.9) and 82.6% (95% CI 68.6-92.2), respectively. A proof-of-principle study shows that BDI is adaptable to a point-of-care assay using microfluidics. We propose that BDI may fulfill a major unmet need in low-socioeconomic countries where pathology services are lacking.
Collapse
Affiliation(s)
- Santosh K Ghosh
- Biological Sciences, Case School of Dental Medicine, Cleveland, OH, USA; Case Western Reserve University (CWRU), Cleveland, OH, USA.
| | - Yuncheng Man
- Department of Mechanical and Aerospace Engineering, CWRU, Cleveland, OH, USA
| | - Arwa Fraiwan
- Department of Mechanical and Aerospace Engineering, CWRU, Cleveland, OH, USA
| | | | - Crist McKenzie
- Division of Hematology/Oncology, University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Cheng Lu
- Center for Computational Imaging & Personalized Diagnostics, CWRU, Cleveland, OH, USA
| | - David Pfau
- School of Medicine, CWRU, Cleveland, OH, USA
| | - Hameem Kawsar
- Biological Sciences, Case School of Dental Medicine, Cleveland, OH, USA; Case Western Reserve University (CWRU), Cleveland, OH, USA
| | - Natarajan Bhaskaran
- Biological Sciences, Case School of Dental Medicine, Cleveland, OH, USA; Case Western Reserve University (CWRU), Cleveland, OH, USA
| | - Pushpa Pandiyan
- Biological Sciences, Case School of Dental Medicine, Cleveland, OH, USA; Case Western Reserve University (CWRU), Cleveland, OH, USA
| | - Ge Jin
- Biological Sciences, Case School of Dental Medicine, Cleveland, OH, USA; Case Western Reserve University (CWRU), Cleveland, OH, USA
| | - Farren Briggs
- Department of Population and Quantitative Health Sciences, CWRU, Cleveland, OH, USA
| | - Chad C Zender
- Department of Otolaryngology, University Hospital of Cleveland, Cleveland, OH, USA
| | - Rod Rezaee
- Department of Otolaryngology, University Hospital of Cleveland, Cleveland, OH, USA
| | - Fotinos Panagakos
- West Virginia University (WVU) School of Dentistry, Morgantown, WV, USA
| | - Jason E Thuener
- Department of Otolaryngology, University Hospital of Cleveland, Cleveland, OH, USA
| | - Jay Wasman
- Department of Pathology, University Hospital of Cleveland, Cleveland, OH, USA
| | - Alice Tang
- Otolaryngology, Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Hiba Qari
- Department of Diagnostic Sciences, WVU School of Dentistry, Morgantown, WV, USA
| | - Trisha Wise-Draper
- Division of Hematology/Oncology, University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | | | - Anant Madabhushi
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Umut A Gurkan
- Department of Mechanical and Aerospace Engineering, CWRU, Cleveland, OH, USA
| | - Aaron Weinberg
- Biological Sciences, Case School of Dental Medicine, Cleveland, OH, USA; Case Western Reserve University (CWRU), Cleveland, OH, USA.
| |
Collapse
|