Top 10 Diagnostics News Stories of 2018
Listicle Dec 24, 2018
Image credit: Imperial College London
2018 brought us sweat sensors, a point-of-care device which indicates mild traumatic brain injury, promising diagnostic epi-signatures, and serious advances in 3D medical imaging. In case you missed them, here's a wrap-up of the most-read diagnostics news stories we covered this year.
1. Usefulness of Clock-drawing Test Assessed in Patients with High Blood Pressure
Normal, moderate, and severe cognitive impairment on the clock drawing test. Credit: Cardiovascular Institute of Buenos Aires, Argentina/European Society of Cardiology
University/Institute: Cardiovascular Institute of Buenos Aires, Argentina.
Presented during the European Society of Cardiology Conference 2018
In a nutshell: The clock-drawing test is a simple tool used to screen people for signs of neurological problems. People with high blood pressure and impaired cognitive function have an increased risk of developing dementia within five years, yet cognitive function is not routinely monitored. Consequently, the ‘Heart-Brain Study’ in Argentina evaluated the usefulness of the clock-drawing test in this group, compared to a standard examination process. A higher prevalence of cognitive impairment was identified by the clock-drawing test (36%)
Author insights: “Our study suggests that the clock drawing test should be preferred over the MMSE (Mini-Mental State Examination) for early detection of executive dysfunction in patients with high blood pressure, particularly in middle age. We think the score on the clock drawing test can be considered a surrogate measure of silent vascular damage in the brain and identifies patients at greater risk of developing dementia. In our study more than one-third of patients were at risk.”
2. Got Tingly Feet? 6 Biomarkers for Polyneuropathy Risk Identified
Image credit: Pixabay
University/Institute: German Center for Diabetes Research
Link to paper, published in: Diabetes
In a nutshell: ‘Polyneuropathy’ refers to a range of conditions caused by damage or disease affecting peripheral nerves, often first indicated by tingly sensations in the feet. Affecting approximately 30% of people with diabetes, polyneuropathy often goes diagnosed. In the hope of enabling early detection, associations between biomarkers of inflammation and distal sensorimotor polyneuropathy (DSPN) were assessed in 127 people with DSPN, and in 386 non-cases. Six biomarkers were highlighted, including three chemokines and three soluble forms of transmembrane receptors.
Author insights: "These findings could open new therapeutic perspectives. The goal could be to influence the immune system accordingly and thus ultimately prevent the development or progression of neuropathy." -Professor Dan Ziegler, Deputy Director of the Institute for Clinical Diabetology at DDZ.
3. Why Do Some People With Alzheimer's Neuropathology Not Have Dementia?
Image credit: Pixabay
University/Institute: University of Texas
Link to paper, published in: Journal of Alzheimer’s disease
In a nutshell: To understand why some individuals with ‘Alzheimer’s neuropathology’ retain their cognitive function, researchers studied postsynaptic protein signatures in donated human tissue. Using high-throughput electrophoresis and mass spectrometry, 15 proteins were identified that set the ‘protected’ group apart.
Author insights: “We don’t yet fully understand the exact mechanism(s) responsible for this protection. Understanding such protective biological processes could reveal new targets for developing effective Alzheimer’s treatments.” -Giulio Taglialatela, director of the Mitchell Center for Neurodegenerative Diseases.
4. Using Epigenetic Signatures and Machine Learning to Improve Diagnosis
Image credit: Pixabay
University/Institute: Greenwood Genetic Center
Link to paper, published in: The American Journal of Human Genetics
In a nutshell: Many developmental disorders in children present with a significant clinical overlap, making diagnosis difficult. Hypothesizing that primary errors associated with chromatin dysregulation will be reflected by DNA methylation signatures, blood samples from individuals with genetic disorders were examined. Specific (but partially overlapping) DNA methylation ‘epi-signatures’ were found to be associated with these syndromes. The team also showed that a machine learning tool can be built to concurrently screen for multiple syndromes, highlighting its potential clinical use.
Author insights: "Many of the disorders we studied have clinical overlap, which makes sense as the genes causing each of these disorders all work within the same epigenetic machinery, determining the gene's expression and expression of other genes… What was interesting is that although the genes function is somewhat similar manners, nine of the disorders showed a unique epigenetic signature with minimal overlap." -Charles Schwartz, PhD, Director of Molecular Studies at GGC in Greenwood.
5. A World-first in 3D Medical Imaging
Image credit: UC Davis
University/Institute: UC Davis
Images were presented at the Radiological Society of North America, November, Chicago
In a nutshell: Images were released from EXPLORER; the world’s first medical imaging scanner that can capture a 3D picture of the whole human body at once. This combined position emission tomography (PET) and x-ray computed tomography (CT) scanner captures images 40 times faster than current PET scans, and can scan with a much lower radiation dose. Therefore, it is feasible to complete repeated studies on an individual, and is suitable for pediatric studies - making EXPLORER an attractive option for many avenues of research in diagnostics, pathology, and drug discovery.
Author insights: “The level of detail was astonishing, especially once we got the reconstruction method a bit more optimized. We could see features that you just don’t see on regular PET scans. And the dynamic sequence showing the radiotracer moving around the body in three dimensions over time was, frankly, mind-blowing. There is no other device that can obtain data like this in humans, so this is truly novel.” -Professor Ramsay Badawi, chief of nuclear medicine at UC Davis Health, vice chair for research in the Department of Radiology
“The tradeoff between image quality, acquisition time and injected radiation dose will vary for different applications, but in all cases, we can scan better, faster or with less radiation dose, or some combination of these.” – Professor Simon Cherry
6. Vitamin D Blood Test May One Day Speed Bipolar Diagnosis in Kids
Image credit: Pixabay
University/Institute: The Ohio State University
Link to paper, published in: Translational Psychiatry
In a nutshell: Potential biomarkers for bipolar disorder and major depressive disorder were sought in adolescents. This study consisted of 36 participants: 13 adolescents with bipolar disorder, 11 with major depressive disorder, and 13 non-mood controls. Circulating vitamin-D binding protein (DBP) was identified as a potential candidate marker of bipolar disorder; DBP levels were a third higher in adolescents with bipolar disorder, than those without.
Author insights: “We want to help psychiatrists and other doctors diagnose children early and accurately. Once bipolar disorder progresses, it is more challenging to treat” – Ouliana Ziouzenkova, Associate Professor of Human Nutrition.
7. Brain Injury Diagnosed With a Single Drop of Blood
Image credit: Pixabay
University/Institute: the University of Geneva
Link to paper, published in: Plos One
In a nutshell: A portable device that can diagnose mild traumatic brain injury might be a game-changer for accident-prone sporty types. ‘TBIcheck’ is a rapid point-of-care diagnostic test that measures biomarkers indicative of mild traumatic brain injury, in a single drop of blood, and indicates to the user whether they should return to the field/mountain/pitch, or head to the hospital. Identifying the most appropriate biomarkers is an ongoing process, but currently the best markers are reported to be H-FABP (heart fatty acid binding protein, an intracellular vascular and brain fatty-acid transporter) and GFAP (glial fibrillary acidic protein, an astrocyte-specific protein).
Author insights: “We wondered if it was possible to isolate certain proteins whose presence in the blood increases in the event of mild traumatic brain injury. Our idea was to find a way to do a quick examination that would allow, during a boxing or American football match for example, to determine whether the athlete can return to the field or if his condition requires hospitalization. The opposite of the CT Scan, an exam that lasts a long time and cannot be done anywhere.” -Jean-Charles Sanchez, Professor at the Department of Internal Medicine of Specialties and the Biomarkers Centre of the Faculty of Medicine of the UNIGE.
8. Diagnosing Diseases With A Wearable Sweat Sensor
Image credit: Sam Emaminejad/Stanford School of Medicine
University/Institute: Stanford School of Medicine
Link to paper, published in: Proceedings of the National Academy of Sciences of the United States of America
In a nutshell: A wristband-type wearable sensor has been developed to measure sweat constituents and electronically transmit the results for diagnosis. Collecting enough sweat to enable measurement is a challenge, therefore an iontophoresis interface was developed to induce sweat with various secretion profiles. To demonstrate the clinical value and feasibility of this platform, markers indicative of cystic fibrosis (sodium and chloride levels in sweat) and diabetes (glucose) were explored.
Author insights: “Just imagine if you use the wearable sweat sensor with people in clinical drug investigations; we could get a much better insight into how their chloride ions go up and down in response to a drug.” -Sam Emaminejade, assistant professor of electrical engineering at UCLA.
“For example, if I could sense that I’m coming down with a viral infection and my alarm goes off and says, ‘You’re coming down with a virus infection,’ I should go home and not decide I’ll push through it. It’s not about me, it’s about all of my colleagues. If everybody did that, diseases wouldn’t spread so quickly.” -Ronald W. Davis.
9. New Biomarkers Predict Outcome of Cancer Immunotherapy
Image credit: National Cancer Institute/Duncan Comprehensive Cancer Center at Baylor College of Medicine. Creator: Rita Elena Serda
University/Institute: the University of Zurich
Link to paper, published in: Nature Medicine
In a nutshell: Although immune point therapy has revolutionized cancer therapy, a large proportion of patients do not show durable responses. Therefore, predictive biomarkers are urgently needed to help predict the outcome of cancer immunotherapy. The frequency of a certain subtype of monocytes in was shown to be a strong predictor of progression-free and overall survival in response to this therapy.
Author insights: “White blood cells of patients should be analyzed for these biomarkers when making a decision about immunotherapy. This has the potential to dramatically increase the percentage of patients who will benefit from this type of therapy. At the same time, it makes it possible to directly move on to different therapeutic modalities in cases where immunotherapy won’t work – without losing valuable time.”
“Even before the start of a therapy, we observed a subtle and weak immune response in the blood mediated by cancer, and identified a small subpopulation of white blood cells to coincide with better therapy outcome,” Professor Burkhard Becher from the Institute of Experimental Immunology at UZH.
“Together with comprehensive, precisely structured biobanking, this study represents a major step towards precision medicine,” -Professor Mitch Levesque of the Department of Dermatology at the University Hospital Zurich.
10. Scan Detects Baby Brain Damage 2 Years Earlier
Image credit: Imperial College London
University/Institute: Imperial College London
Link to paper, published in: The Lancet Neurology
In a nutshell: Currently, doctors are unable to accurately assess the extent of a newborn baby’s brain damage, which affects one in 300 births (in the UK, usually a result of oxygen deprivation). This study showed that thalamic proton magnetic resonance spectroscopy biomarkers may enable better prediction of brain damage in newborns.
Author insights: “At the moment parents have an incredibly anxious two-year wait before they can be reliably informed if their child has any long-lasting brain damage. But our trial - the largest of its kind - suggests this additional test, which will require just 15 minutes extra in an MRI scan, could give parents an answer when their child is just a couple of weeks old. This will help them plan for the future, and get the care and resources in place to support their child’s long term development.”- Dr Sudhin Thayyil, Director of the Centre for Perinatal Neuroscience in Imperial’s Department of Medicine.
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