Advances in clinical chemistry最新文献

Lupus nephritis (LN) or renal involvement of systemic lupus erythematosus (SLE), is a common manifestation occurring in at least 50 % of SLE patients. LN remains a significant source of morbidity, often leading to progressive renal dysfunction and is a major cause of death in SLE. Despite these challenges, advances in the understanding of the pathogenesis and genetic underpinnings of LN have led to a commendable expansion in available treatments over the past decade. This chapter provides a foundation for the understanding LN pathogenesis, diagnosis, and epidemiology, and guides the reader through recent advances in biomarkers, genetic susceptibility of this intricate condition.

Traumatic brain injury (TBI) represents a significant public health concern. Besides the initial primary injury, a defining point of TBI is causing secondary, delayed damage through inflammatory biochemical processes. Among the complications arising from this inflammatory response, coagulopathy emerges as a critical concern. With an overall prevalence of 32.7 %, TBI-induced coagulopathy significantly contributes to increased mortality rates and unfavorable patient outcomes, through its clinical manifestations, such as progressive hemorrhagic injury (PHI). This chapter investigates biomarkers capable of accurately detecting coagulopathy and PHI in TBI, evaluating their potential utility based on statistical evidence from various studies and exploring their possible association in the biochemical processes guiding or following TBI-induced coagulopathy. Notably, glucose emerges as a standout candidate, exhibiting a sensitivity of 91.5 % and specificity of 87.5 % for predicting coagulopathy. Furthermore, interleukin-33, with a sensitivity of 93.3 % and specificity of 66.7 %, and galectin-3, with a sensitivity of 67.7 % and specificity of 85.5 %, are promising for PHI. Despite these encouraging findings, significant efforts remain necessary to translate biomarker diagnostic utility into clinical practice effectively. Further research and validation studies are imperative to elucidate the intricate biochemical processes underlying TBI-induced coagulopathy and to refine the clinical application of biomarkers for improved patient management and outcomes in real-world settings.

Tuberculosis (TB) remains a major global health challenge due to its high mortality rate. Several factors contribute significantly including delayed diagnosis, emergence of drug resistance, and biofilm formation. Although various diagnostic methods are available for TB, such as sputum smear microscopy, culture techniques, and real-time polymerase chain reaction (PCR). They have notable limitations, including false positives and negatives, timeliness, and high cost. Therefore, there is an urgent need for an early and accurate diagnostic approach to control the infection. MicroRNA (miRNA)-based diagnostics have emerged as a promising alternative, offering the potential for earlier detection and reduced false-positivity. However, this field is still in development and requires specialized tools to accelerate miRNA research, streamline the process, and facilitate the creation of innovative diagnostic methods. To address this need, the MicroRNA Disease Databank (MDDB) was developed as a centralized platform providing extensive miRNA-related information. Freely accessible at https://mddb.nitrr.ac.in/., MDDB offers comprehensive details on miRNA locations, associated disease characteristics, probe sequences, and molecular mechanisms. This resource aims to support the development of novel miRNA-based diagnostic biomarkers. This article provides an in-depth overview of the MDDB tool, highlighting its construction, features, and accessibility. Currently, MDDB focuses on host miRNAs relevant to TB, allowing researchers to quickly access critical miRNA data. By leveraging this resource, researchers will potentially accelerate the development of effective diagnostic biomarkers for TB and other chronic diseases in the future.

Celiac disease (CD) is a chronic autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals. Current diagnostic methods rely on serological markers, histological examination of duodenal biopsies, and HLA genotyping. However, these approaches have limitations. Advancements in serology have introduced novel autoantibodies beyond tissue transglutaminase (tTG) and endomysial antibodies (EMA), such as neo-epitope tTG and transglutaminase isoforms. Genetic and epigenetic markers, including non-HLA risk alleles, DNA methylation patterns, and non-coding RNAs, provide deeper insights into CD susceptibility. Additionally, cytokine profiling and immune response markers, such as pro-inflammatory and anti-inflammatory cytokines, chemokines, and adhesion molecules, reflect disease pathophysiology and may serve as diagnostic and prognostic tools. Gut microbiota alterations and metabolomic signatures further highlight immune dysregulation and metabolic changes in CD, offering potential biomarkers for diagnosis and disease monitoring. Protein and peptide biomarkers, including intestinal fatty acid-binding protein (I-FABP), plasma citrulline, and regenerating gene Ia (REG Ia), provide insights into intestinal damage and mucosal healing. Furthermore, emerging technologies such as point-of-care testing (POCT) and nanoparticle-based assays enhance diagnostic precision. The objective of this chapter is to provide a comprehensive review of emerging biomarkers and novel technologies that can improve the diagnosis and monitoring of CD. Emphasis is placed on advances in serology, genetic and epigenetic profiling, immune and cytokine markers, metabolomics, and gut microbiota analysis. The chapter also discusses the integration of multi-omics approaches and artificial intelligence-driven analysis as future directions for refining diagnostic accuracy and enabling personalized disease management.

Exhaled breath analysis is gaining significant attention among researchers due to its non-invasive potential in early diagnosis and disease monitoring. Volatile organic compounds (VOCs) present in exhaled breath can provide useful information on the metabolic and biological processes occurring within the human body. Some VOCs in exhaled human breath have been identified as biomarkers and excess amounts of these VOCs are considered indicative of various associated diseases. Gas chromatography-mass spectrometry (GC-MS), proton-transfer-reaction mass spectrometry (PTR-MS), selected-ion flow-tube mass spectrometry (SIFT-MS), and others are well-known conventional techniques utilized for VOC detection. However, recent advancements in sensing devices based on optical, electrochemical, and chemoresistive materials have shown significant potential for replacing these conventional techniques without compromising accuracy and specificity. This chapter provides a basic understanding of VOCs and highlights the development of advanced vs conventional detection technologies.

Extracellular vesicles (EVs) have emerged as critical mediators of intercellular communication in cancer. These membranous structures, secreted by normal and cancerous cells, carry a cargo of bioactive molecules including microRNAs (miRNAs) that modulate various cellular processes. miRNAs are small non-coding RNAs that play pivotal roles in post-transcriptional gene regulation and have been implicated in cancer initiation, progression, and metastasis. In cancer, tumor-derived EVs transport specific miRNAs to recipient cells, modulating tumorigenesis, growth, angiogenesis, and metastasis. Dysregulation of miRNA expression profiles within EVs contributes to the acquisition of cancer hallmarks that include increased proliferation, survival, and migration. EV miRNAs influence the tumor microenvironment, promoting immune evasion, remodeling the extracellular matrix, and establishing pre-metastatic niches. Understanding the complex interplay between EVs, miRNAs, and cancer holds significant promise for developing novel diagnostic and therapeutic strategies. This chapter provides insights into the role of EV-mediated miRNA signaling in cancer pathogenesis, highlighting its potential as a biomarker for cancer detection, prognosis, and treatment response assessment.

Renal involvement in systemic lupus erythematosus (SLE), lupus nephritis (LN), is common and can result in significant morbidity, including progressive renal dysfunction, and even ultimately leading to death. LN is heterogeneous complicated by the immunologic component, and it is critical to accurately classify LN to direct optimal therapy. Accordingly, identification of objective markers is paramount in reflecting disease stage and monitoring treatment response. In part two of this series, we comprehensively examine LN disease classification, therapies and potential markers to guide therapeutic options.

Two-dimensional difference gel electrophoresis (2D-DIGE) has been a staple of protein studies for almost three decades since first described in 1997. Although the advent of omic technologies has greatly expanded protein research and discovery, 2D-DIGE has consistently been the mainstay in biomedical applications. Differential protein expression is a hallmark of many disease states and identification of these biomarkers can improve diagnosis, prognosis and treatment. In this review, we examine the use of 2D-DIGE in exploring the cellular environment in physiologic and pathophysiologic states. We highlight this technology in protein identification and quantification, functional modification and biochemical pathways of interest. 2D-DIGE remains a useful tool due low cost and high resolving power for comparative and quantitative purposes in assessing disease states and facilitating identification of unique and novel biomarkers.

Extracellular vesicles (EVs) are nanoscale particles released by cells into body fluids and serve as crucial mediators of intercellular communication. This chapter explores their biogenesis, cargo composition, and biological functions on target cells. It discusses the diverse molecular cargo of EVs that includes lipids, proteins, and nucleic acid and focuses on their sorting, analysis, and functional significance. It highlights their importance as biomarkers as diagnostic and prognostic tools, particularly their potential application in clinical chemistry. The chapter also provides an overview of the current techniques for isolating and characterizing EVs from various body fluids and recent technological advancements. It compares EV and liquid biopsy biomarkers, outlines their advantages and limitations, and examines their translational impact on personalized medicine. Furthermore, this chapter emphasizes the clinical relevance of EV biomarkers, especially in monitoring aging, evaluating anti-aging therapy, and diagnosing age-related diseases such as neurodegenerative, cardiovascular, and musculoskeletal disorders. The chapter concludes with a critical discussion about the potential of EV research to revolutionize clinical diagnostics, which unfortunately remains constrained by regulatory hurdles and a lack of standardization.