血浆游离DNA的临床应用新进展

血浆游离DNA(Plasma cell-free DNA,cf-DNA)游离于细胞外的机体内源性DNA,cf-DNA广泛存在于血液、脑脊液、滑膜液、支气管肺泡灌洗液和羊水等体液中。多数血浆DNA与蛋白质结合成为复合物,仅有少部分为游离的片段,受实验方法灵敏性和特异性的限制,cf-DNA的研究进展缓慢。随着分子检测技术的发展,虽然在健康人群的血浆中也可测量到一定量的cf-DNA,但是cf-DNA被发现在肿瘤、自身免疫性疾病、创伤和炎性反应等病理过程中有改变。目前cf-DNA在肿瘤的诊断和预后分析、产前诊断、感染性疾病等中均有应用价值。     

血循环DNA在淋巴瘤中的研究进展

近年来血循环DNA用于基因诊断已成为研究热点,血循环DNA是指血浆中具有DNA双螺旋结构的核苷酸片段,逐渐成为一项新的肿瘤标记物。研究发现肿瘤患者血循环DNA较正常人有很大差异,不同疾病条件下其含量有不同程度的升高,且逐渐成为替代当前需采集肿瘤组织作为标本的无创方法。尽管血循环DNA的来源尚不清楚,通过监测血循环DNA总水平变化及相关肿瘤基因的异常改变,可以实现恶性肿瘤的早期诊断及预后评估。特别是许多国外文献报道,它与淋巴瘤的关系非常密切,无论血循环DNA的定性或定量研究,包括淋巴瘤常见的基因重排或者病毒相关血浆DNA,与淋巴瘤的诊断、治疗反应及预后直接相关。现将近几年国内外血循环DNA在淋巴瘤中的应用进行综述,对研究前景做简单展望。     

阿尔茨海默病血液分子诊疗生物标志物的开发应用

目前,阿尔茨海默病(老年痴呆症)的早期诊断分型以及早期介入治疗尚无好的办法与手段,因此急需开发具备个性化分子诊断的血液分子诊疗生物标志物。为解决以上问题,可以对血浆中已存在的与炎症免疫相关或者免疫抑制相关的因子加以甄别鉴定以确定血浆中可用的分子诊疗生物标志物,并检测其与痴呆症基因风险因子的关联性,从而探讨个体化分子诊断的可行性。通过上述研究可发现新的临床检测阿尔茨海默病的血浆生物标志物组合,还可能阐明阿尔茨海默病病程中免疫抑制的调控作用,为进一步的研究及开发应用奠定坚实的基础。     

非小细胞肺癌患者血中DNA片段的检测、定量及临床意义的研究

目的探讨非小细胞肺癌患者血中游离DNA片段在临床上早期诊断、分期、预后方面的意义。方法随机采集2004年10月至12月大连医科大学附属二院经病理确诊的初治Ⅲ、Ⅳ期非小细胞肺癌患者的血标本15份,门诊健康体检者血标本15份,通过酚/氯仿提取法定量检测两组的血浆DNA片段,进行对照比较,分析非小细胞肺癌组内各因素(包括与诊断相关的肿瘤标记物,与预后相关的年龄、性别、一般状况及病理类型、疾病分期、免疫指标、是否转移等)与血浆游离DNA片段水平的相关性。结果非小细胞肺癌组血浆游离DNA片段水平高于正常健康对照组,其血浆游离DNA片段的均值分别为:(384.8±99.36)μg/ml与(13.9±3.60)μg/ml,差异有显著性,Ⅲ期与Ⅳ期非小细胞肺癌患者的血浆游离DNA片段差异有显著性,均值分别为:(290.4±91.82)μg/ml与(481.2±196.44)μg/ml,且非小细胞肺癌患者的血浆游离DNA片段与肿瘤标记物CA199、CYFRA21-1、ALP呈正相关性;在预后因素分析中,显示非小细胞肺癌患者的血浆游离DNA片段水平与一般状态、免疫状态、病理类型及是否存在远处转移等因素有明显相关性,其中与一般状态、免疫状态呈负相关,与远处转移呈正相关,与性别、年龄、治疗疗效等因素无相关性。结论非小细胞肺癌患者血中的游离DNA片段水平较健康人高,且不同病期有一定差异,可能与患者自身状态、病理分型、疾病状态有关;游离DNA片段可以作为检测非小细胞肺癌的特异性指标,还可以替代一般状态、免疫状态、病理类型、是否存在远处转移等指标评价远期预后,并有取材方便、检测时间短、可以定量分析的优点,对临床有一定的指导意义和应用价值。     

急性肺损伤的生物标记物

急性呼吸窘迫综合征(ARDS)和急性肺损伤(ALI)多由低氧性呼吸衰竭引起,导致高通透性肺水肿,临床上有较高的发病率与死亡率。近十年来,针对血浆和支气管肺泡灌洗液中相关生物标记物的研究为探索急性肺损伤的病理生理机制指明了新的方向。个别生物标记物已在一些大型、多中心ARDS试验中得到证实。但迄今仍没有一个或一组生物标记物常规应用于临床。随着人类对ALI发病机制理解的进一步深入,或许不久的将来,生物标记物会真正应用于评估疾病的严重程度和预后。本文将概述近年来ALI相关生物标记物的研究进展。     

晚期胃肠道肿瘤患者血浆游离DNA片段的检测、定量

目的探讨肿瘤患者循环血液中DNA改变,及对提高肿瘤患者治愈率和生存率的临床实际意义。方法随机采集了2004年10月~12月大连医科大学附属二院经病理确诊的初治晚期胃、大肠癌患者的血标本18份,门诊健康体检者血标本16份,通过酚/氯仿提取法定量检测两组的血浆DNA片段,进行对照比较,分析健康人与晚期胃肠道肿瘤患者血浆游离DNA片段水平的差异、晚期胃肠道肿瘤患者血浆游离DNA片段水平与预后相关指标的相关性。结果晚期胃肠道肿瘤组血浆游离DNA片段水平高于正常健康对照组,其血浆游离DNA片段的均值分别为(346.3±81.62)μg/m l与(27.6±6.91)μg/m l,差异有显著性;胃癌、大肠癌患者两组间的血浆游离DNA片段差异无显著性,均值分别为:(350.8±110.92)μg/m l与(357.1±126.26)μg/m l;在预后相关指标的各因素中,晚期胃肠道肿瘤患者的血浆游离DNA片段水平与免疫状态、是否存在远处转移有明显相关性,其中与免疫状态呈负相关,与远处转移呈正相关。结论晚期胃肠道肿瘤患者血中的游离DNA片段水平较健康人高,可能与患者自身状态、病理分型、疾病状态有关;游离DNA片段可以作为检测晚期胃肠道肿瘤的特异性指标,还可以替代免疫状态及是否存在远处转移等指标评价远期预后,并有取材方便、检测时间短、可以定量分析的优点,对临床有一定的指导意义和应用价值。     

综述:脑衰老与阿尔茨海默病症状出现前阶段

脑衰老可分为生理性增龄变化与病理性变化,后者与阿尔茨海默病(Alzheimer's disease,AD)等神经退行性疾病的发生有关．生理性脑衰老与AD在发病早期具有相似的表现形式、病变特征、生化改变和发病机制．其共同的分子机制是异常蛋白质蓄积,提示两者有着相似的病理学基础,脑衰老可能是AD等神经退行性改变的最初级阶段,病理性脑衰老因素可能促进AD等神经退行性疾病的发生发展．临床前期AD(preclinical AD,PCAD)患者的脑、血液和脑脊液中可以检测到AD特定的生物标记物,但AD的临床症状并没有出现,因此也被称为“症状出现前AD(presymptomatic AD)”．PCAD和对照组比较,氧化应激指标和高度不溶性Aβ42并没有显著性升高,寻找早期PCAD发病过程中新的可用于临床早期诊断的生物标记物、药物靶点将成为我们的关注重点．     

促红细胞生成素的抗炎症作用研究进展

促红细胞生成素是一种造血因子,临床中广泛应用于治疗各种原因造成的贫血。近年的研究发现,EPO具有多种非造血生物作用．其中对各组织以及全身炎症反应的保护作用已成为目前的研究热点之一。但目前EPO抗炎症作用相关的机制尚不明确。本文对EPO的抗炎症作用及其可能机制作一综述,并对EPO在临床中的应用前景进行了展望。     

宫颈癌肿瘤标志物的研究进展

宫颈癌相关肿瘤标志物是宫颈癌组织和细胞由于癌基因及其产物的异常表达所产生的抗原和生物活性物质,包括蛋白质、酶、激素、癌基因产物等.近年来肿瘤标志物成为肿瘤基础和临床应用的一个十分活跃的领域.其对宫颈癌的辅助诊断、判别类型、估计预后、评价疗效、定位诊断、靶向治疗等均具有重要指导意义.目前与宫颈癌有关的生物标记物有数十种,包括人乳头状瘤病毒感染、细胞周期调节蛋白、细胞凋亡相关因子等.随着研究的深入,这些生物标记物在临床上已显示出广阔的应用前景.     

非人类灵长类恒河猴衰老与热量限制抗衰老研究进展

非人类灵长类恒河猴是研究人类衰老和热量限制抗衰老的理想模型。与人类衰老一样,恒河猴由于增龄性神经内分泌、免疫、神经系统、心血管系统等衰老,出现相应的老年病。热量限制能有效地延缓恒河猴原发性衰老和继发性衰老。其机制可能是调节代谢相关的信号通路,抑制氧化应激-炎性衰老-DNA损伤;同时激活DNA损伤修复。然而,不同的实验设计、饲养环境、饮食组成和遗传背景等可能对热量限制抗长生命周期恒河猴原发性衰老和继发性衰老作用存在不同的影响。优化实验设计,控制这些变量,缩短实验周期将更有利于明确CR抗衰老的作用及其机制。     

Fatal outcome in bacteremia is characterized by high plasma cell free DNA concentration and apoptotic DNA fragmentation: a prospective cohort study

Introduction

Recent studies have shown that apoptosis plays a critical role in the pathogenesis of sepsis. High plasma cell free DNA (cf-DNA) concentrations have been shown to be associated with sepsis outcome. The origin of cf-DNA is unclear.

Methods

Total plasma cf-DNA was quantified directly in plasma and the amplifiable cf-DNA assessed using quantitative PCR in 132 patients with bacteremia caused by Staphylococcus aureus, Streptococcus pneumoniae, ß-hemolytic streptococcae or Escherichia coli. The quality of cf-DNA was analyzed with a DNA Chip assay performed on 8 survivors and 8 nonsurvivors. Values were measured on days 1–4 after positive blood culture, on day 5–17 and on recovery.

Results

The maximum cf-DNA values on days 1–4 (n = 132) were markedly higher in nonsurvivors compared to survivors (2.03 vs 1.26 ug/ml, p<0.001) and the AUCROC in the prediction of case fatality was 0.81 (95% CI 0.69–0.94). cf-DNA at a cut-off level of 1.52 ug/ml showed 83% sensitivity and 79% specificity for fatal disease. High cf-DNA (>1.52 ug/ml) remained an independent risk factor for case fatality in a logistic regression model. Qualitative analysis of cf-DNA showed that cf-DNA displayed a predominating low-molecular-weight cf-DNA band (150–200 bp) in nonsurvivors, corresponding to the size of the apoptotic nucleosomal DNA. cf-DNA concentration showed a significant positive correlation with visually graded apoptotic band intensity (R = 0.822, p<0.001).

Conclusions

Plasma cf-DNA concentration proved to be a specific independent prognostic biomarker in bacteremia. cf-DNA displayed a predominating low-molecular-weight cf-DNA band in nonsurvivors corresponding to the size of apoptotic nucleosomal DNA.     

A genome-wide association study identifies UGT1A1 as a regulator of serum cell-free DNA in young adults: The Cardiovascular Risk in Young Finns Study

Introduction

Circulating cell-free DNA (cf-DNA) is a useful indicator of cell death, and it can also be used to predict outcomes in various clinical disorders. Several innate immune mechanisms are known to be involved in eliminating DNA and chromatin-related material as part of the inhibition of potentially harmful autoimmune responses. However, the exact molecular mechanism underlying the clearance of circulating cf-DNA is currently unclear.

Methods

To examine the mechanisms controlling serum levels of cf-DNA, we carried out a genome-wide association analysis (GWA) in a cohort of young adults (aged 24–39 years; n = 1841; 1018 women and 823 men) participating in the Cardiovascular Risk in Young Finns Study. Genotyping was performed with a custom-built Illumina Human 670 k BeadChip. The Quant-iT^TM high sensitivity DNA assay was used to measure cf-DNA directly from serum.

Results

The results revealed that 110 single nucleotide polymorphisms (SNPs) were associated with serum cf-DNA with genome-wide significance (p<5×10⁻⁸). All of these significant SNPs were localised to chromosome 2q37, near the UDP-glucuronosyltransferase 1 (UGT1) family locus, and the most significant SNPs localised within the UGT1 polypeptide A1 (UGT1A1) gene region.

Conclusion

The UGT1A1 enzyme catalyses the detoxification of several drugs and the turnover of many xenobiotic and endogenous compounds by glucuronidating its substrates. These data indicate that UGT1A1-associated processes are also involved in the regulation of serum cf-DNA concentrations.     

Serum circulating cell free DNA as potential diagnostic and prognostic biomarker in non small cell lung cancer

BackgroundNon-small cell lung cancer (NSCLC) is leading cause of cancer related death and the survival rate for patients with NSCLC remain poor so early diagnosis of NSCLC represents the best opportunity for cure. Cell-free DNA (cf-DNA) is extracellular nucleic acids found in cell-free plasma/serum of humans, given the recent approval of a liquid biopsy in lung cancer, the use of circulating tumor DNA as a novel non-invasive diagnostic and prognostic biomarker is promising.ObjectivesStudying whether the concentrations of circulating Cell Free DNA in serum can be used as a diagnostic and prognostic biomarker for NSCLC patients.MethodThis study was carried out on 140 subjects included 60 patients with non small cell lung cancer,40 patients with Chronic Obstructive Pulmonary Disease (COPD) and 40 healthy controls. Quantitative analysis of serum circulating cf-DNA was done b y AlU-based quantitative real time PCR. Serum level of CEA was measured by ELISA.ResultsNSCLC patients demonstrated significantly higher values of each of ALU 215, ALU 247, and DNA integrity than both COPD patients and controls. On ROC curve analysis, the total accuracy of ALU 247, ALU 115, DNA integrity (92.1%, 83.6%, 56.4%) at cutoff points (325, 565 & 0.48) respectively. On combining both DNA integrity and CEA, improved sensitivity to 93.3% was noted. For NSCLC patients, ALU 115 & ALU 247 increased significantly with more advanced stage and highest level was noticed in metastatic patients. Regarding survival there was better overall survival among patients with low DNA integrity.ConclusionSerum cf-DNA concentrations and integrity index may be valuable tool in early diagnosis of NSCLC and prediction of prognosis of those patients.     

SELDI-TOF serum proteomics and breast cancer: which perspective?

Despite the efforts of recent years, clinicians still lack reliable biomarkers for diagnosis, prognosis and prediction of clinical outcomes in breast cancer patients. Owing to the large number of people potentially involved in the management of this clinical problem, the search for noninvasive and repeatable laboratory assays has been intensive. Recently, the proteomic profiling performed by SELDI-TOF mass spectrometry, has been proposed in order to identify new clusters of serum markers that could be potentially useful in breast cancer management. The purpose of this special report is to review the literature on SELDI-TOF technology applied on serum coming from healthy people and breast cancer patients, in order to verify the clinical applicability of such approach. We conclude that potential new biomarkers, first of all for early diagnosis of breast cancer, need to be validated in larger clinical series.     

DNA methylation signatures in circulating cell-free DNA as biomarkers for the early detection of cancer

Detecting cell-free DNA(cfDNA) or circulating tumor DNA(ctDNA) in plasma or serum could serve as a "liquid biopsy", which would be useful for numerous diagnostic applications. cfDNA methylation detection is one of the most promising approaches for cancer risk assessment. Here, we reviewed the literature related to the use of serum or plasma circulating cell-free DNA for cancer diagnosis in the early stage and their power as future biomarkers.     

Biomarker Discovery in Human Prostate Cancer: an Update in Metabolomics Studies

Prostate cancer (PCa) is the most frequently diagnosed cancer and the second leading cause of cancer death among men in Western countries. Current screening techniques are based on the measurement of serum prostate specific antigen (PSA) levels and digital rectal examination. A decisive diagnosis of PCa is based on prostate biopsies; however, this approach can lead to false-positive and false-negative results. Therefore, it is important to discover new biomarkers for the diagnosis of PCa, preferably noninvasive ones. Metabolomics is an approach that allows the analysis of the entire metabolic profile of a biological system. As neoplastic cells have a unique metabolic phenotype related to cancer development and progression, the identification of dysfunctional metabolic pathways using metabolomics can be used to discover cancer biomarkers and therapeutic targets. In this study, we review several metabolomics studies performed in prostatic fluid, blood plasma/serum, urine, tissues and immortalized cultured cell lines with the objective of discovering alterations in the metabolic phenotype of PCa and thus discovering new biomarkers for the diagnosis of PCa. Encouraging results using metabolomics have been reported for PCa, with sarcosine being one of the most promising biomarkers identified to date. However, the use of sarcosine as a PCa biomarker in the clinic remains a controversial issue within the scientific community. Beyond sarcosine, other metabolites are considered to be biomarkers for PCa, but they still need clinical validation. Despite the lack of metabolomics biomarkers reaching clinical practice, metabolomics proved to be a powerful tool in the discovery of new biomarkers for PCa detection.     

Finding biomarkers for non-small cell lung cancer diagnosis and prognosis

Despite of several decades of efforts,lung cancer remains one of most deadly diseases,with a 5-year survival rate approximately 15％ worldwide.In China,the situation is even worse.Although there is no o...     

In vitro non-homologous DNA end joining assays—The 20th anniversary

DNA double-strand breaks (DSBs) are the most serious forms of DNA damage in cells. Unrepaired or misrepaired DSBs account for some of the genetic instabilities that lead to mutations or cell death, and consequently, to cancer predisposition. In human cells non-homologous DNA end joining (NHEJ) is the main repair mechanism of these breaks. Systems for DNA end joining study have been developing during the last 20 years. New assays have some advantages over earlier in vitro DSBs repair assays because they are less time-consuming, allow the use of clinical material and examination of the joining DNA ends produced physiologically in mammalian cells. Proteins involved in NHEJ repair pathway can serve as biomarkers or molecular targets for anticancer drugs. Results of studies on NHEJ in cancer could help to select potent repair inhibitors that may selectively sensitize tumor cells to ionizing radiation (IR) and chemotherapy. Here, we review the principles and practice of in vitro NHEJ assays and provide some insights into the future prospects of this assay in cancer diagnosis and treatment.