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Diagnostic testing leaps with three new tests

American scientists from Cleveland Clinic have formulated a color test to diagnose lung cancer. The chemical composition of a lung cancer patient is different from that of a healthy patient. On the basis of this knowledge, the scientists developed a sensor which has 36 dots to detect these chemical changes. When these dots come into contact with a person’s breath, they will change color depending on the chemicals in the breath. When tested on 122 participants, both healthy and not, it accurately detected lung cancer in three of the four with the disease. Thanks to this small and inexpensive sensor, doctors will be able to detect lung cancer at the early stages when it can be effectively treated.

In another study, Canadian researchers have determined that observing eye movement is effective in diagnosing FASD in children. Researchers from the University of Kingston, Ontario, evaluated the oculomotor performance of 12 children without FASD against that of 10 children with FASD. When the children were given different tasks, it was found that children with FASD had longer reaction times and also committed more directional errors. As their next step, the researchers aim to apply these findings to attention deficit hyperactivity disorder and other developmental disorders

Meanwhile, Australian scientists from the Howard Florey Institute, Melbourne, have developed a diagnostic test for Parkinson’s disease. This ‘gene-sequencing chip’ screens 17 genes including the six that have been previously linked to this disease. The test is a great development as currently, doctors diagnose on the basis of their observations. This often leads to inaccurate diagnoses. The chip will also enable researchers across Australia to conduct a gene-mapping study that will link more genes to Parkinson’s. The researchers are now planning to test this chip on 400 DNA samples collected from patients in Victoria and Tasmania.

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Diagnostic testing takes great strides

The United States Food and Drug Administration (FDA) approved a breast cancer test. Called the MammaPrint test, the breast cancer test formulated by Netherlands-based Agendia, is the first of its kind to be cleared. Using molecular technology, it predicts the replication of the cancer by analyzing the activity of genes located in the tumor. The test will help to gauge the probability of the breast cancer returning 5-10 years after the first diagnosis. Doctors, with the help of this test, can plan the appropriate follow-up for the patient. The approval of this test is of great significance to molecular-based medicine.

In another study, scientists found a way to develop a new, safer prenatal gene test to identify fetal abnormalities. Researchers from Ravgen Inc, USA, treated blood samples from 60 pregnant women with formaldehyde to increase the amount of DNA they can recover from them. Then, they analyzed the samples for variations known as single nucleotide polymorphisms (SNPs) in order to differentiate the mother’s DNA from the fetus’ DNA. After closely studying the samples, they established which fetuses were carrying disease-causing extra copies of chromosomes. They were successful in 58 samples which included two instances of Down’s syndrome. However, the researchers accept that their test is still in the nascent stages and needs more work before it can be applied clinically.

Meanwhile, the Chinese Food and Drug Administration has given its nod to a test for hepatitis C. The test is being called “diagnostic kit to hepatitis C antibody”. Its makers Worldwide claim that since it is developed from intact HCV virus, it is more accurate than other available tests. With this test, Worldwide aims to become the foremost company in the field of research and development of HCV diagnostics and therapeutics.

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Diagnostics on a roll

Researchers from the University Hospital Essen, Germany, understand that it is vital to have exact information regarding the severity of the tumor in the treatment of colorectal cancer. On conducting a study they found that combining the two imaging techniques of positron emission tomography (PET) and computed tomography (CT) is a better way to get this information. While CT alone diagnosed 52 per cent of the cases accurately, the CT/PET combination was accurate in 64 per cent of the cases. However, the researchers agree that further research is needed in this area.

Meanwhile, there is help at hand for doctors flummoxed by different diseases having similar symptoms. A gene chip called GreeneChip can swiftly identify infectious diseases caused by viruses, bacteria, fungi or parasites, using tissue, blood, urine and stool samples. With a comprehensive microbial sequence database, it will simultaneously screen for multiple diseases and provide an accurate and speedy diagnosis. However, it will take a while for the chip to become widely available.

Scientists from the Massachusetts Institute of Technology, USA, are in the process of developing an implant containing nanoparticles that can observe the tumor and tell doctors whether the chemotherapy is having an effect or whether they should administer other drugs.

Across the Atlantic, researchers from the University of Bristol, England, conducted a study and found that people taking antidepressant drugs that raise levels of the neurotransmitters serotonin and noradrenaline experience a boost in their sense of taste. Increased serotonin levels enhanced the ability to recognize sweet and bitter tastes while increased noradrenaline levels did the same for bitter and sour tastes. With this taste test, the researchers believe that doctors will be able to tell which neurotransmitter has been affected and thus prescribe the correct drug for the particular depression.

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Diagnostics leaps ahead

UK researchers have devised a new technique that could possibly save many children from dilated cardiomyopathy (DCM). Cardiologists from the Royal Brompton Hospital, UK, developed the technique whereby a dye called gadolinium is injected into the patient’s vein. When the patient undergoes a Magnetic Resonance Imaging scan, the special properties of gadolinium make the scar heart tissue appear conspicuous in the scan, enabling easy detection. Professor Dudley Pennell and his team tried this technique on 101 patients with and without scar tissue. At the end of two years, the researchers were able to better determine the chances of the patients being hospitalized. The researchers believe that their technique will now guide doctors as to decide whether drugs can cure a patient or implantation is needed.

Meanwhile, scientists at the National University of Singapore’s (NUS) Division of Bioengineering have devised a new screening technique to detect cancer cells before they become a threat to life. Called Near-Infra-Red (NIR) spectroscopic imaging, it uses autofluorescence to pierce surface tissues and spot the differences among normal, benign and cancerous cells. So far, results have shown that the non–invasive system has 94 per cent sensitivity and 100 per cent specificity. However, lead researcher Dr Huang Zhiwei accepts that more trials need to be conducted to test its reliability. Also, it will be another two years at least for it to be widely available.

In an effort to enhance diagnostic imaging and pathology services, the Australian government has agreed to substantially increase funding to pathology and radiology. This will ensure that Australians are able to afford high quality diagnostic services.

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New insights to battle prostate cancer

A new molecular diagnostic test that detects prostate cancer based on the presence of a certain gene was launched at the annual meeting of the British Association of Urological Surgeons Section of Oncology (BAUS). The test christened as PCA3 assay, is the discovery of Dr Marion Bussemakers. It works by detecting an over-expression of PCA3 mRNA in urine. According to the studies, PCA3 mRNA is over-expressed up to 60 to 100 times in more than 95 per cent of prostate cancer cases therefore, the test when used in combination with serum PSA will help to identify appropriate biopsy patients resulting in better detection and diagnosis of the disease.

A new study suggests that men with long-term diabetes have lower risk of prostate cancer. This hypothesis was derived from an analytical study using data from the National Health and Nutrition Examination Survey 2001 to 2002 to establish a link between diabetes and prostate-specific antigen (PSA) levels. The comparison showed that the average PSA levels were 21.6 per cent lower among men with diabetes to those without. However, Dr. Mona Saraiya from Centers for Disease Control and Prevention, Atlanta says that the accuracy of this thesis may be questionable.

Researchers at Johns Hopkins University predict that men consuming low cholesterol diet reduce chances of acquiring the most hostile form of prostate cancer. As a part of the study, the scientists measured plasma concentration of total cholesterol from samples of 698 men suffering from prostate cancer and another 698 men who were cancer-free. The results of the analysis revealed that low plasma cholesterol level ensured an overall lower prostate cancer risk.

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Dengue in news again

After India, it’s Pakistan that is now grappling with dengue. As of November 22, a total of 5,235 patients with symptoms similar to dengue fever had been admitted to different hospitals across Pakistan. To date 48 deaths have occurred from dengue fever in Pakistan.

Meanwhile, in India, the Petitions Committee of the Delhi Assembly has held the Municipal Corporation of Delhi and the Delhi Jal Board responsible for the outbreaks of dengue and vector-borne diseases in the capital. The report states that the corporation's failure to effectively de-silt open drainages has worked as breeding grounds for mosquitoes and insects that have given rise to diseases such as dengue, chikangunya and malaria. The government body has not yet reacted to the filed petition.

While Pakistan and India continue to be fraught with dengue worries, some developments in the sphere of dengue vaccine and diagnosis may offer relief in the future. The Pediatric Dengue Vaccine Initiative (PDVI), a program of the International Vaccine Institute (IVI) has decided to work in collaboration with Hawaii Biotech to develop a dengue vaccine for the global prevention of dengue fever. According to Harold Margolis, Director of the PDVI, the primary objective behind this joint venture is to ensure rapid introduction to dengue vaccines into the immunization programs in all affected areas as soon as a vaccine becomes available.

Bio-Rad India, subsidiary of Bio-Rad Laboratories USA, launched India’s first early dengue detection kit called Platelia Dengue NS1 Ag. The common test employed to detect dengue involved identifying the presence antibodies which are produced four to six days after the appearance of the first symptoms. However, this new kit is a time saving device as it checks for virus NS1 antigen which can be traced in the blood stream as soon as the first symptoms of dengue appear.

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Breakthroughs to counter-attack malaria

At a time when cerebral malaria is playing havoc in Nepal, research done in Malawi has found that the retina can be a very reliable way of diagnosing cerebral malaria. A research team led by Nick Beare of Royal Liverpool University Hospital in the United Kingdom has devised a new technique to diagnose cerebral malaria by identifying certain changes on the retina using a simple, quick and cheap eye test. The team observed the retinas of 45 children with cerebral malaria who were admitted to a hospital in Blantyre, Malawi. The observation revealed that the patients suffering from cerebral malaria had signs of either retinal bleeding, swelling of the optic nerve with white opaque patches or whitened blood vessels on the retina. Since the diagnosis is straightforward and cost-effective it is likely to prove a boon in African and Asian countries.

Another malaria related study in Malawi has suggested that chloroquine is effective against malaria. Chloroquine was withdrawn over a decade ago from Malawi due to parasite resistance to the drug. The research team working on this aspect says that the drug should not be re-introduced as a front-line treatment, but could be used as an intermittent therapy for pregnant women or in combination with other drugs.

In another positive development in the field of malaria treatment, a new experimental vaccine for malaria is on cards. Patricia Graves, an epidemiologist conducted an analysis using published studies to scrutinize the effectiveness of various drugs available in the market to curb malaria. Graves then carried out a trial for an experimental vaccine called RTS, which was administered to men from Gambia with a booster shot provided after a year. The results of the test showed a 65 per cent reduction in malaria attacks on those men who were given two dosages of the new RTS vaccine. Another clinical trial of RTS conducted on 5 to 9 year olds in Mozambique showed a 25 per cent decrease in the malarial attacks and a 50 per cent decrease in the number of severe malarial attacks among the vaccinated children.

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New landmarks in gene research

Researchers at Pennsylvania University have found that gene therapy can be used to treat HIV patients who have not responded well to drug therapy. In the preliminary test conducted on five HIV patients, it was observed that HIV levels in the patients’ blood dropped significantly on infusing genetically modified T cells carrying an altered version of HIV virus into the patients’ blood stream. The research is an important step in the future scope of gene therapy for the treatment of AIDS.

Meanwhile, a missing genetic link in the structural and electrical part of the heart has been discovered to explain the cause for sudden heart failure in many people. Researchers at Baylor College of Medicine (BCM) and Texas Children’s Hospital in Houston have found a gene called Caveolin-3, that has an instrumental impact on the heart’s electrical make up which governs the heart’s rhythm. An absence or a mutation of this gene can disturb the electrical balance thus causing structural changes in the heart, which can lead to heart arrest. The same results were observed in a similar study conducted by researchers at the Mayo Clinic in Rochester, Maryland and at the University of Wisconsin.

In a landmark development in the sphere of gene research and diagnosis, the world’s first gene-based test for diagnosis of breast cancer has been introduced. A Johnson & Johnson company called Veridex has introduced the test in Europe. The GeneSearch™ Breast LymphNode (BLN) test will not only provide early detection but will also aid in patient staging and monitoring.

A few small steps forward for diagnostics

The field of diagnostics is witnessing hopeful developments. Tests are being formulated to diagnose rheumatoid arthritis, breast cancer and Alzheimer’s disease at an early stage so as to increase the chances of successful treatment.

The United States Food and Drug Administration (FDA) has cleared an automated test for rheumatoid arthritis. Called the EliA CCP Assay, it measures the patient’s blood for cyclic citrullinated peptide (CCP) antibodies. The presence of these antibodies in the blood is a clear indicator of rheumatoid arthritis. Phadia US Inc has developed the tool as a more accurate alternative to the older laboratory tests. According to Michael Land, president and general manager, the clearance makes “a new test with superior performance characteristics” accessible to healthcare professionals.

Across the globe, in Australia, the firm Fermiscan is in the final stages of developing a test for breast cancer that will determine the presence of the disease by analyzing the patient’s hair. When the hair is exposed to a high-powered X-ray beam in a synchrotron, radiologists can examine the image for tiny structural changes that will help to detect breast cancer. It was proved to be more effective than mammograms as mammograms are not quite accurate when trying to diagnose breast cancer in young women.

Meanwhile, a test for diagnosing Alzheimer’s disease may soon become a reality. Using the cutting-edge process proteomics, researchers compared protein levels in the blood of the patients with those of healthy older people. These researchers, based at the Institute of Psychiatry, King's College London, found that levels of two specific types of proteins are quite high in patients suffering from Alzheimer’s disease. A blood test analyzing these levels would be able to predict the onset of Alzheimer’s disease even before the symptoms occur. This will aid the treatment of Alzheimer’s disease.

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