Faculty Opinions recommendation of Use of multiple biomarkers to improve the prediction of death from cardiovascular causes.

COVID-19, also known as SARS-CoV-2 is a novel, respiratory virus currently plaguing humanity. Genetically, at its core, it is a single-strand positive-sense RNA virus. It is a beta-type Coronavirus and is distinct in its structure and binding mechanism compared to other types of coronaviruses. Testing for the virus remains a challenge due to the small market available for at-home detection. Currently, there are three main types of tests for biomarker detection: viral, antigen and antibody. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) remains the gold standard for viral testing. However, the lack of quantitative detection and turnaround time for results are drawbacks. This manuscript focuses on recent advances in COVID-19 detection that have lower limits of detection and faster response times than RT-PCR testing. The advancements in sensing platforms have amplified the detection levels and provided real-time results for SARS-CoV-2 spike protein detection with limits as low as 1 fg/mL in the Graphene Field Effect Transistor (FET) sensor. Additionally, using multiple biomarkers, detection levels can achieve a specificity and sensitivity level comparable to that of PCR testing. Proper biomarker selection coupled with nano sensing detection platforms are key in the widespread use of Point of Care (POC) diagnosis in COVID-19 detection.

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The Role of Imaging in Planning Treatment for Central Serous Chorioretinopathy

Pharmaceuticals ◽

10.3390/ph14020105 ◽

2021 ◽

Vol 14 (2) ◽

pp. 105

Author(s):

Stefano Da Pozzo ◽

Pierluigi Iacono ◽

Alessandro Arrigo ◽

Maurizio Battaglia Parodi

Keyword(s):

Central Serous Chorioretinopathy ◽

Therapeutic Strategy ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Subretinal Space ◽

Planning Treatment ◽

Multiple Biomarkers ◽

Effective Procedures

Central serous chorioretinopathy (CSC) is a controversial disease both in terms of clinical classification and choice of therapeutic strategy. Choroidal layers, retinal pigment epithelium (RPE), photoreceptors, and retina are involved to varying degrees. Beyond well-known symptoms raising the clinical suspect of CSC and slit-lamp fundus examination, multimodal imaging plays a key role in assessing the extent of chorioretinal structural involvement. Subretinal fluid (SRF) originating from the choroid leaks through one or multiple RPE defects and spreads into the subretinal space. Spontaneous fluid reabsorption is quite common, but in some eyes, resolution can be obtained only after treatment. Multiple therapeutic strategies are available, and extensive research identified the most effective procedures. Imaging has carved a significant role in guiding the choice of the most appropriate strategy for each single CSC eye. Multiple biomarkers have been identified, and all of them represent a diagnostic and prognostic reference point. This review aims to provide an updated and comprehensive analysis of the current scientific knowledge about the role of imaging in planning the treatment in eyes affected by CSC.

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POS0809 A BIOMARKER PROFILE AIDING AN EARLY DIAGNOSIS OF GIANT CELL ARTERITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2636 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 657.1-657

Author(s):

Y. Van Sleen ◽

P. Therkildsen ◽

A. Boots ◽

B. Dalsgaard Nielsen ◽

K. Van der Geest ◽

...

Keyword(s):

Giant Cell Arteritis ◽

Giant Cell ◽

Meta Analysis ◽

Youden Index ◽

Common Disease ◽

Platelet Counts ◽

Multiple Biomarkers ◽

Treatment Naïve ◽

Angiopoietin 2 ◽

Specific Symptoms

Background:Diagnosing patients with giant cell arteritis (GCA) remains difficult. Due to its non-specific symptoms, it is challenging to identify GCA in patients presenting with polymyalgia rheumatica (PMR), which is a more common disease (1). In addition, commonly used acute-phase markers fail to discriminate between GCA patients and (infectious) mimicry patients.Objectives:To investigate a selection of biomarkers for their utility in the accurate diagnosis of GCA in two cohorts.Methods:Treatment-naïve GCA patients participated in the Aarhus GCA/PMR cohort (N=52) and the Groningen GPS cohort (N=48). Symptoms and biomarker levels were compared to patients presenting phenotypically as isolated PMR, disease controls and healthy controls (HCs). Diagnosis or exclusion of diagnosis of GCA was based on clinical assessment and in the majority of cases aided by imaging. Serum/plasma levels of 12 biomarkers were measured by ELISA or Luminex.Results:In both the Aarhus and the GPS cohort, we found that weight loss, elevated erythrocyte sedimentation rate (ESR) and higher angiopoietin-2/-1 ratios but lower matrix metalloproteinase (MMP)-3 levels identify concomitant GCA in PMR patients (Figure 1). In addition, we confirmed (1) that elevated platelet counts are characteristic of GCA but not of GCA look-alikes, and that low MMP-3 and proteinase 3 (PR3) levels may help to discriminate GCA from other diseases (Figure 1). Multiple biomarkers of inflammation were found elevated in patient and disease control groups when compared to HCs.Conclusion:This study, performed in two independent cohorts, consistently shows the potential of angiopoietin-2/-1 ratios and MMP-3 levels to identify GCA in patients presenting with PMR. These biomarkers may be used to select which PMR patients require further diagnostic workup. Platelet counts may be used to discriminate GCA from GCA look-alike patients.Figure 1.Summary of the most important and consistent findings in both cohorts. A shows the four factors that perform best in discriminating GCA/PMR patients overlap from isolated PMR patients in both cohorts. B shows the four factors that perform best in discriminate GCA patients from GCA look-alike patients in both cohorts. Cut-off values for the biomarkers are calculated by the Youden index.References:[1]van der Geest, KSM, Sandovici M, Brouwer E, Mackie SL. Diagnostic accuracy of symptoms, physical signs, and laboratory tests for giant cell arteritis: A systematic review and meta-analysis. JAMA internal medicine. 2020.Disclosure of Interests:Yannick van Sleen: None declared, Philip Therkildsen: None declared, Annemieke Boots: None declared, Berit Dalsgaard NIelsen: None declared, Kornelis van der Geest: None declared, Peter Heeringa: None declared, Minke G. Huitema: None declared, M.D. Posthumus: None declared, Maria Sandovici: None declared, Erik Toonen Employee of: Is an employee of Hycult Biotech, Jannik Zijlstra: None declared, Ellen-Margrethe Hauge: None declared, Elisabeth Brouwer: None declared

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Chromium (VI) Uptake and Tolerance Potential in Cotton Cultivars: Effect on Their Root Physiology, Ultramorphology, and Oxidative Metabolism

BioMed Research International ◽

10.1155/2014/975946 ◽

2014 ◽

Vol 2014 ◽

pp. 1-12 ◽

Cited By ~ 25

Author(s):

M. K. Daud ◽

Lei Mei ◽

M. T. Variath ◽

Shafaqat Ali ◽

Cheng Li ◽

...

Keyword(s):

Transgenic Cotton ◽

Hybrid Line ◽

Dense Granules ◽

Ultrastructural Studies ◽

Chromium Vi ◽

Multiple Biomarkers ◽

Toxic Pollutant ◽

Different Levels ◽

Secondary Roots ◽

Cr Uptake

Chromium (Cr) is present in our environment as a toxic pollutant, which needs to be removed using phytoremediation technology. In present study, two transgenic cotton cultivars (J208, Z905) and their hybrid line (ZD14) were used to explore their Cr uptake and tolerance potential using multiple biomarkers approach. Four different levels of Cr (CK, 10, 50, and 100 μM) were applied. Cr caused a significant reduction in root/shoot length, number of secondary roots, and root fresh and dry biomasses at 100μM. Cr accumulated more in roots and was found higher in hybrid line (ZD14) as compared with its parent lines (J208, Z905) at all Cr stress levels (10, 50, and 100 μM). Cr translocation was less than 1 in all cultivars. Ultrastructural studies at 100 μM Cr showed an increase in number of nuclei and vacuoles and presence of Cr dense granules in dead parts of the cell (vacuoles/cell wall). Malondialdehyde (MDA), hydrogen peroxide (H2O2), total soluble proteins, superoxide dismutase (SOD), peroxidase (POD), ascorbate peroxidase (APX), catalase (CAT), and glutathione reductase (GR) as a whole were upregulated with elevated levels of Cr. Higher Cr uptake by roots, accelerated metabolism, and Cr sequestration in dead parts of the cell indicate that these cotton cultivars can be useful for Cr accumulation and tolerance.

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Multiple biomarkers based appraisal of deltamethrin induced toxicity in silver carp (Hypophthalmichthys molitrix)

Chemosphere ◽

10.1016/j.chemosphere.2018.09.145 ◽

2019 ◽

Vol 214 ◽

pp. 519-533 ◽

Cited By ~ 18

Author(s):

Sana Ullah ◽

Zhongqiu Li ◽

Muhammad Zain Ul Arifeen ◽

Shahid Ullah Khan ◽

Shah Fahad

Keyword(s):

Silver Carp ◽

Hypophthalmichthys Molitrix ◽

Multiple Biomarkers

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Multiple biomarkers covering distinct pathways for predicting outcomes after ischemic stroke

Neurology ◽

10.1212/wnl.0000000000006717 ◽

2018 ◽

Vol 92 (4) ◽

pp. e295-e304 ◽

Cited By ~ 7

Author(s):

Chongke Zhong ◽

Zhengbao Zhu ◽

Aili Wang ◽

Tan Xu ◽

Xiaoqing Bu ◽

...

Keyword(s):

Ischemic Stroke ◽

Primary Outcome ◽

Prognostic Significance ◽

Complement C3 ◽

Vascular Events ◽

Net Reclassification Improvement ◽

Increased Risk ◽

Multiple Biomarkers ◽

Novel Biomarkers ◽

Integrated Discrimination Improvement

ObjectiveTo study the prognostic significance of multiple novel biomarkers in combination after ischemic stroke.MethodsWe derived data from the China Antihypertensive Trial in Acute Ischemic Stroke, and 12 informative biomarkers were measured. The primary outcome was the combination of death and major disability (modified Rankin Scale score ≥3) at 3 months after ischemic stroke, and secondary outcomes included major disability, death, and vascular events.ResultsIn 3,405 participants, 866 participants (25.4%) experienced major disability or died within 3 months. In multivariable analyses, elevated high-sensitive C-reactive protein, complement C3, matrix metalloproteinase-9, hepatocyte growth factor, and antiphosphatidylserine antibodies were individually associated with the primary outcome. Participants with a larger number of elevated biomarkers had increased risk of all study outcomes. The adjusted odds ratios (95% confidence intervals) of participants with 5 elevated biomarkers were 3.88 (2.05–7.36) for the primary outcome, 2.81 (1.49–5.33) for major disability, 5.67 (1.09–29.52) for death, and 4.00 (1.22–13.14) for vascular events, compared to those with no elevated biomarkers. Simultaneously adding these 5 biomarkers to the basic model with traditional risk factors led to substantial reclassification for the combined outcome (net reclassification improvement 28.5%, p < 0.001; integrated discrimination improvement 2.2%, p < 0.001) and vascular events (net reclassification improvement 37.0%, p = 0.001; integrated discrimination improvement 0.8%, p = 0.001).ConclusionWe observed a clear gradient relationship between the numbers of elevated novel biomarkers and risk of major disability, mortality, and vascular events. Incorporation of a combination of multiple biomarkers observed substantially improved the risk stratification for adverse outcomes in ischemic stroke patients.

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