Hebrew University of Jerusalem researchers Dr. Ronen Sadeh and Prof. Nir Friedman have develop a simple blood test (liquid biopsy) that they say could replace nearly all cancer screenings within a decade.
The test relies on a natural process whereby every day millions of cells in our body die and are replaced by new cells. When cells die, their DNA is fragmented and some of these DNA fragments reach the blood and can be detected by DNA sequencing methods. However, all our cells have the same DNA sequence, and thus simply sequencing the DNA cannot identify from which cells it originated. While the DNA sequence is identical between cells, the way the DNA is organized in the cell is substantially different. The DNA is packaged into nucleosomes, small repeating structures that contain specialized proteins called histones. On the histone proteins, the cells write a unique chemical code that can tell us the identity of the cell and even the biological and pathological processes that are going on within it. In recent years, numerous studies have successfully developed a process where this information can be identified and thus reveal abnormal cell activity.
Currently many cancer screenings are done through biopsies, in which tissue samples are extracted by doctors. However, biopsies are often invasive, painful and ineffective as they can only be administered at sufficiently advanced disease stage, making it, in some cases, too late for intervention.
The test could drastically reduce cancer cases by catching them early, as regular blood tests are practical in a way that regular screenings are not, said Dr. Ronen Sadeh, of Hebrew University’s Grass Center for Bioengineering, who led the study together with Prof. Nir Friedman.
A company, called Senseera, has been set up, headed by Dr Ronen Sadeh and will be involved in clinical trials in partnership with major pharmaceutical companies and promote the technology. The new method has been tested already on 1,000 people in Israel and the US, and give identical results to those of doctors deploying traditional diagnoses. The method now published in prestigious peer-reviewed journal Nature Biotechnology. https://www.nature.com/articles/s41587-020-00775-6 . Sadeh said the article gives hope that the test could replace biopsies, mammograms, colonoscopies, and various other procedures currently conducted to detect cancer.
The main innovation, according to Sadeh, is the analysis of both DNA sequence and other information that gives a layer of insight on genetic activity beyond the sequence, known as epigenetic information.
“We don’t just look at the DNA sequence, which is the main focus of normal liquid biopsies, but also at details like the way DNA is packed and regulated inside the cell, which can tell us a lot,” he said.
Sadeh said that it is impossible to constantly screen everyone for all cancers, but because blood is always circulating in the body, it “picks up information from every organ,” which just needs to be “captured and interpreted.”
In order to do this, his test deploys molecular biology to create an investigative method that uses specific antibodies to “capture epigenetic information,” which is then fed into a machine developed to analyze the information.
“Blood is constantly circulating the body and and is currently picking up information from all tissue,” he said. “We already use this information for various tests like liver enzyme tests but the information is very general; it just points to a general problem if one exists. “By extracting very detailed data, we can tell where cancer is and can also identify additional diseases — liver diseases, immune diseases, and others,” Sadeh said. “We are optimistic that the technology will be used to advance health and save lives.”
“Liquid biopsies” that can detect cancer from blood already exist, but they are not yet in widespread use, and crucially only indicate whether there is cancer, without providing a detailed picture of where it is found.
“Our new technology can tell you not only whether you have a tumor, but also its exact location in the body,” Sadeh mentioned. “It can also differentiate between similar types of tumors to help doctors make better decisions on how to treat patients.” He predicted: “Within ten years, we hope it could be a test people do regularly and routinely in order to monitor for cancer, and monitor the health of their organs for other diseases too.”
Sadeh added: “Screening would be easier, more generic and less expensive, so there would be more screening and this would save lives.”
Prof. Noam Shomron, a cancer expert from Tel Aviv University who is unconnected with the research, said that while many scientists around the world are working on next-generation blood tests for cancer, this one is “worth the buzz.”
He said: “There are many scientific labs around the world running similar experiments, though this team has its own unique perspective.” Shomron added that the ability to pinpoint where cancer is located is a new contribution to the field, and said that Sadeh and his colleagues have come up with “a wonderful idea and a wonderful approach.”
Source: Times of Israel Feb 8 2021
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