January 10, 2014
New ‘Fluid Biopsy’ Technique May Predict When Heart Attack Will Occur
Brett Smith for redOrbit.com - Your Universe Online
A new “fluid biopsy” technique could be used to detect the early warning signs of a heart attack and save countless lives in the process.According to a report in the journal Physical Biology, the novel technique involves identifying circulating endothelial cells (CEC), which are thought to be markers for inflammation and high blood clot risk.
"The goal of this paper was to establish evidence that these circulating endothelial cells can be detected reliably in patients following a heart attack and do not exist in healthy controls—which we have achieved," said study author Peter Kuhn, a cell biologist at The Scripps Research Institute (TSRI). "Our results were so significant relative to the healthy controls that the obvious next step is to assess the usefulness of the test in identifying patients during the early stages of a heart attack."
Endothelial cells line the walls of the arteries and have been strongly connected to an elevated heart attack risk when circulating in the bloodstream. They are believed to enter the bloodstream when plaque builds up, bursts and ulcerates, causing inflammation in the arteries. This process can result in blood clot formation and possibly a heart attack.
According to their report, the study team devised a method, called the High-Definition Circulating Endothelial Cell (HD-CEC) assay, to identify and describe CECs in samples taken from 79 patients who had suffered a heart attack at the time of sampling. The team also analyzed samples from two control groups, which included 25 healthy patients and seven patients being treated for cardiovascular disease.
The technique was able to detect CECs by their unique morphology and their reactions with particular antibodies. The team found significantly elevated levels of CECs in the heart attack patients compared to the control groups and the cells were detected with high sensitivity and high specificity.
The researchers also compared their method with a commercially available test, which has been approved by the Food and Drug Administration (FDA) for the counting of circulating tumor cells in cancer patients.
The team’s novel test was able to show a higher specificity for CECs compared to the commercially available test because it used a direct analysis and was free of bias caused by an enrichment stage.
"Our assay effectively analyzes millions of cells, which is more work but guarantees that you are analyzing all of the potential cells," Kuhn said.
Mike Knapton, an associate medical director of prevention and care at the British Heart Foundation, told BBC News that the new study is most likely the first step on the path toward a possible new treatment regimen for cardiovascular disease.
"In the short to medium term, it is unlikely to change how people in the UK are treated as we already have good ways to treat and diagnose heart attacks, and targets to ensure rapid pain-to-treatment times,” said Knapton, who was not involved in the study.
"This study appears to be laying the groundwork for future research to see if this test could be used to identify patients in the early stages of a heart attack,” he added.