Circulating Cell-Free DNA and Preeclampsia: Hope For Patients With HELLP?

posted on Jan 03 by admin in the Uncategorized category

• A recent study published in BMC Medical Geneticsreviews whether or not the levels of cell-free DNA are related to preeclampsia.
• DNA is nucleic acid that contains the genetic instructions used in the development and functioning of all known living organisms. DNA is normally found in an inner portion of the cell known as the nucleus. Recent studies have looked at the importance of so-called “Cell-free” DNA in various disease states. Cell-free DNA is DNA which can be detected in circulating blood. Numerous reports in the literature suggest that levels cell-free DNA in the blood may be a more certain tumors in the detection of early stages of cancer .
• Levels of cell-free DNA are also potentially an important marker for pregnancies at risk for premature birth

The current study looks at whether or not cell-free DNA levels in pregnant patients are related to:

• the clinical characteristics of preeclampsia
• the standard laboratory tests seen in patients with preeclampsia
• markers of inflammation,
• endothelial activation or injury (in other words injury to the inner
• layer of blood vessels often seen in preeclampsia)
• oxidative stress and
• cell-free fetal DNA levels.

How the study was performed? Blood samples of 67 women with preeclampsia were compared to 70 pregnant women without preeclampsia. The analysis looked at levels of cell- free DNA as well as standard laboratory parameters tests obtained in pregnant patients. The study concluded that levels of cell-free maternal and fetal DNA were higher in mothers with preeclampsia as shown below: The quantity of cell-free DNA did not correlate to other lab findings in preeclampsia (with the exception of liver enzyme changes) and did not correlate to the clinical characteristics in the mothers (such as body mass index). The authors conclude that the increased levels of cell free DNA may be triggered by low-level liver damage seen in patients with preeclampsia.

• What does this mean for patients?Currently, there is not enough support for analyzing cell-free DNA in most patients with preeclampsia. However, we appear to be on the cusp of a number of technological breakthroughs involving DNA based diagnostic tests which will allow us to make much earlier diagnoses. In current day medicine, HELLP syndrome is the most severe form of preeclampsia. (HELLP stands for Hemolysis, Elevated Liver enxymes, and Low Platelets). In order for this diagnosis to be made, the patient’s preeclampsia must get to the point where the liver cells are severely damaged and leaking enzymes.
• The results of the current study provide hope that we may be close to a point where an analysis of cell-free DNA can give information about early liver damage in patients with preeclampsia before they get to the point of having HELLP syndrome.
• A full copy of the study can be found here: http://www.biomedcentral.com/content/pdf/1471-2350-10-120.pdf
• For further reading regarding the use of cutting edge diagnostic techniques I would recommend the following blog: http://thedecisiontree.com/blog/

And the following books.

• The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine
• The Future of Medicine: Megatrends in Health Care That Will Improve Your Quality of Life
• Genomic and Personalized Medicine, Two-Vol Set: V1-2