Clinica Chimica Acta最新文献

Background: The possible clinical utility of endocan, a novel inflammatory biomarker involved in the initiation and progression of atherosclerosis, is largely unknown. We aimed to evaluate its diagnostic and prognostic performance in chest pain patients presenting to the emergency department (ED).

Methods: We prospectively enrolled patients presenting with suspected myocardial infarction (MI) to the ED in an international multicenter study. Endocan, high-sensitivity C-reactive protein (hs-CRP), and high-sensitivity cardiac troponin T (hs-cTnT) were measured in blood samples obtained at presentation. Final diagnoses were centrally adjudicated by two independent cardiologists applying the 4th universal definition of MI and current guidelines. Non-ST-elevation MI (NSTEMI) was the diagnostic endpoint and 5-year cardiovascular death was the primary prognostic endpoint.

Results: Among 4728 patients, 843 (17.8 %) had NSTEMI. The diagnostic discrimination of endocan for NSTEMI was low (area under the curve (AUC) 0.585 [95 % CI: 0.563-0.607]. Its combination with hs-cTnT (0.939 [95 % CI: 0.931-0.947]) did not improve the discriminative performance of hs-cTnT alone (0.937 [95 % CI: 0.930-0.950]). Long-term prognostic accuracy of endocan was higher versus hs-CRP, but lower versus hs-cTnT (AUC 0.730 [0.710-0.760] vs 0.650 [0.620-0.680] vs 0.810 [0.790-0.830], respectively). Endocan was associated with an increased 5-year risk for cardiovascular mortality. However, it did not provide relevant incremental prognostic value when added on top of a base model that included SCORE2 risk factors and hs-cTnT.

Conclusion: Endocan has a low diagnostic accuracy for NSTEMI, and moderate long-term prognostic accuracy for cardiovascular death.

Clinical trial registration: ClinicalTrials.gov number, NCT00470587, https://clinicaltrials.gov/ct2/show/NCT00470587https://clinicaltrials.gov/ct2/show/NCT00470587.

Breast cancer, a leading cause of cancer-related mortality among women, necessitates the development of sensitive and specific diagnostic tools for early detection and personalized treatment. An aptamer-based biosensor (aptasensor) is a biosensor that utilizes aptamers as its biorecognition element such as single-stranded DNA or RNA molecules that are specifically selected to bind to a target molecule with high affinity. Aptasensors have emerged as promising alternatives to traditional methods, offering advantages such as high affinity, specificity, and ease of synthesis. This review provides an overview of recent advancements in aptasensor technology for breast cancer diagnostics, focusing on the detection of key biomarkers. In this review, first after an overview to different types of aptasensors, we discuss the different type of aptamer immobilization methods on sensor surfaces using covalent, adsorption, and thiol-based self-assembly techniques. Furthermore, we present different aptasensor platforms, including electrochemical and optical approaches, highlighting their design principles, performance characteristics, and clinical applications.

Autoimmune diseases (ADs) impact approximately 3% of the global population. It encompasses more than 80 chronic, often debilitating conditions resulting from immune system defects that lead the body to attack its tissues. Although many ADs are rare, their prevalence is rising. Despite advancements, ADs diagnosis and classification still rely heavily on clinical examination combined with conventional laboratory testing and imaging. Emerging proteomic screening, technologies now offer the potential to identify unique biomarkers for more precise diagnosis, classification, and treatment decisions. Protein profiling, an advancing area within proteomics, provides unparalleled insights into biological processes underlying these diseases. Thus, this review highlights recent developments in proteomic and genetic profiling for ADs pathogenesis, diagnosis, and treatment challenges, focusing on the clinical utility of proteomic techniques in prognosis, diagnosis, and therapeutic guidance. Notably, discovering new biomarkers through proteomic screening is crucial for creating robust multi-parameter assays, which enhance diagnostic accuracy and treatment decisions in ADs.

The detection of 17β-estradiol (E2), a potent endocrine-disrupting compound, is critical for both environmental monitoring and biomedical diagnostics. Traditional detection methods often suffer from limitations in sensitivity, selectivity, and cost-effectiveness. Aptasensors, which utilize aptamers as biorecognition elements, offer promising alternatives because of their high specificity, stability, and adaptability. This paper explores recent advancements in aptasensor technologies for E2 detection, highlighting optical, electrochemical, and surface-enhanced Raman scattering (SERS)-based platforms. The integration of nanomaterials such as gold nanoparticles, carbon dots, and conductive polymers significantly enhances sensor performance, achieving ultralow detection limits and broad dynamic ranges. By leveraging these innovations, aptasensors provide scalable solutions for real-time monitoring of E2 in environmental, food, and clinical samples, paving the way for improved endocrine regulation and public health safety.

Sickle cell disease (SCD) is a severe hereditary hemoglobinopathy with the highest burden in sub-Saharan Africa. Timely diagnosis via newborn screening is critical to enabling low-cost, life-saving interventions, yet its implementation remains inconsistent worldwide. This study assessed the performance and analytical stability of dried blood spot (DBS) samples collected on Guthrie cards for quantifying hemoglobin S (Hb S), using three high-performance liquid chromatography (HPLC) platforms and one capillary electrophoresis system. Simulated neonatal samples at three Hb S concentrations (non-carrier, carrier, and affected) were analyzed at three timepoints (immediate, 1 week, and 2 weeks post-collection). Across all methods, Hb S quantification was highly reproducible, with inter-timepoint variation remaining within the predefined critical threshold for the vast majority of the measurements. While minor discrepancies were observed for fetal hemoglobin (Hb F), all methods correctly classified samples for SCD screening purposes. These findings confirm that Guthrie card-based DBS is a robust and practical matrix for Hb S detection, suitable for transport and delayed analysis-even across different analytical platforms. Limitations include the use of spiked rather than native SCD neonatal samples and ambient-temperature shipping. Nonetheless, the results support broader adoption of DBS in SCD screening programs, particularly in low-resource or decentralized settings, and highlight the need for further standardization of Hb F quantification.

The irreversibility and lethality of Spinal Muscular Atrophy (SMA) underscore the urgency of newborn screening, as diagnostic delay in neonates causes irreversible motor neuron degeneration and poor outcomes. Current SMA detection methods are hindered by high costs, dependence on specialized equipment, and technical complexity, restricting their implementation in primary care setting. Here, we proposed a fast and sensitive SMA-(Recombinase Polymerase Amplification) RPA-Cas12a detection assay based on suboptimal protospacer adjacent motif (sPAM) and 3'-end ssDNA-modified crRNA, named SPSMC. The crRNA is designed based on the sPAM to enhance the specificity of SMN1 gene detection. The competition between RPA and Cas12a digestion for target DNA was resolved by using 3'-end ssDNA-modified crRNA. With ALB as a reference gene, this method can detect DNA at concentrations as low as 1.8 pM within 1 h. The sensitivity and specificity of the proposed method in differentiating SMA patients from non-SMA individuals were both 100 %. This strategy has been used for the detection of the SMN1 gene, which saves time, reduces contamination risks, and offers new possibilities for future point-of-care screening of SMA. In addition, the SPSMC system was successfully adapted to SMA lateral flow assay format and validated using 66 clinical samples, demonstrating 100 % sensitivity and specificity. The method is straightforward to perform, requires no bulky equipment, maintains full portability, and is more suitable for large-scale neonatal screening scenarios compared with traditional methods.

Background: Biological reference intervals (RIs) are fundamental tools in clinical diagnostics, traditionally derived from geographically and ethnically homogeneous populations, predominantly of Western origin. Such generalized RIs often fail to account for variations arising from genetic, environmental, and lifestyle factors, which can impact clinical decision-making and contribute to health inequities, particularly in countries across Africa, India, and many other Southeast Asian nations. This scoping review investigates ethnicity-based variations in RIs for a range of biomarkers to highlight the importance of population-specific RIs.

Methods: Adhering to the Joanna Briggs Institute (JBI) guidelines, this scoping review examined the literature on ethnicity-based RI variations across multiple biomarkers, including Von Willebrand factor, C-reactive protein, thyroid-stimulating hormone, albumin, creatinine, and more. Studies were identified via searches in MEDLINE (via PubMed), Embase, Scopus, and Web of Science up to December 30, 2024. Eligibility was determined using the Population-Concept-Context (PCC) framework, focusing on observational studies analysing ethnicity-specific differences. Data extraction and charting were performed using CADIMA software, with independent review by two authors to ensure consistency.

Results: Out of 4,514 articles, a total of 15 studies met the inclusion criteria, encompassing multi-ethnic populations. Significant variations in biomarker levels were observed across ethnic groups, highlighting the inadequacy of generalized RIs. Notable differences included variations in lipid profiles, vitamin B12, and anti-Mullerian hormone levels. Regional distribution analysis highlighted gaps in research from underrepresented ethnic populations.

Conclusion: This review emphasizes the critical need for ethnicity-specific RIs to improve diagnostic accuracy and promote equitable healthcare outcomes. Further research should focus on developing robust methodologies for establishing inclusive and representative RIs.

Traumatic brain injury (TBI) poses a significant global health challenge, leading to high mortality and morbidity rates. Despite extensive research, effective diagnostic and therapeutic strategies remain limited. This review explores the emerging roles of exosomal non-coding RNAs (ncRNAs) as biomarkers and therapeutic agents in TBI. Exosomes, small extracellular vesicles secreted by various cell types, facilitate intercellular communication and carry diverse ncRNAs that modulate gene expression and cellular functions. The pathogenesis of TBI involves complex inflammatory cascades, in which exosomal ncRNAs play pivotal roles in neuroinflammation, neuronal apoptosis, and secondary injury mechanisms. Key ncRNAs, including long non-coding RNAs (lncRNAs) and microRNAs (miRNAs), have been identified as potential biomarkers for diagnosing TBI and predicting outcomes. Additionally, exosomal ncRNAs derived from mesenchymal stem cells (MSCs) show promise in promoting neuroprotection and enhancing recovery through various mechanisms. The review highlights the potential of exosomal ncRNAs in addressing critical unmet needs in TBI management, emphasizing their stability, accessibility, and relevance to disease pathophysiology. However, challenges in standardization, validation, and regulatory pathways must be addressed to facilitate their clinical application. This comprehensive examination underscores the transformative potential of exosomal ncRNAs in TBI diagnosis and treatment, paving the way for future research and clinical innovations.