Abstract
BackgroundAdolescent idiopathic scoliosis (AIS) which characterized by complex three-dimensional deformity of spine has been difficult to cure because of the unknown etiopathology and uncertainty of progression. Nowadays, circulating cell-free (ccf) DNA was found to be a potential biomarker for several benign and malignant diseases. However, whether ccf DNA can be a biomarker for AIS has not been reported yet. In this study, we investigate the circulating cell-free nuclear DNA (ccf n-DNA) and mitochondrial DNA (ccf mt-DNA) concentrations in the plasma of patients with AIS and controls (CT), and the changed plasma ccf n-DNA and ccf mt-DNA levels and their association with clinical parameters were assessed.MethodsThe plasma of peripheral blood from 69 AIS patients and 21 age-matched CT was collected for ccf DNA analysis. Quantitative PCR was used to detect ccf n-DNA and ccf mt-DNA levels, and correlation analyses between the ccf n-DNA and ccf mt-DNA levels and clinical characteristics were conducted. Receiver operator curves (ROC) were used to analyze the sensitivity and specificity of ccf n-DNA and ccf mt-DNA levels to different characteristics.ResultsThe plasma ccf n-DNA levels of both GAPDH and ACTB were significantly decreased in AIS patients compared with those in controls, while the plasma ccf mt-DNA levels did not changed. According to sex-related analyses, the ccf n-DNA levels in male CT-M was higher than that in female CT and male AIS, but the ccf n-DNA levels in female AIS was not significantly changed when compared with male AIS or female CT. However, the concentration of ccf mt-DNA in female AIS increased significantly when compared with male AIS. Surprisingly, Lenke type-related analyses suggested that Lenke type 1 patients had lower ccf n-DNA levels, whereas Lenke type 5 patients had higher ccf mt-DNA levels compared with those of controls. However, a lower sensitivity and specificity of AIS predicted by ccf n-DNA or ccf mt-DNA levels was observed, whether in total, by sex, or by Lenke type.ConclusionAlthough with no/little predictive accuracy of AIS/progressed AIS by ccf DNA levels, significantly changed plasma ccf DNA levels were observed in AIS patients compared with those in controls.
Highlights
Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity disease with a prevalence of 0.47–5.2% worldwide [1]
Neither an age difference nor a sex difference was observed between controls and AIS patients (Table 1 and Additional file 1)
The AIS males (AIS-M) group consisted of 11 Lenke type 1 (L1), 4 Lenke type 5 (L5), 1 Lenke type 2 (L2), 0 Lenke type 3 (L3), 1 Lenke type 4 (L4), and 0 Lenke type 6 (L6) patients, whereas the AIS females (AIS-F) group had 29 L1, 20 L5, 1 L2, 1 L3, 1 L4 and 0 L6 patients
Summary
Adolescent idiopathic scoliosis (AIS) is a complex spinal deformity disease with a prevalence of 0.47–5.2% worldwide [1]. Estrogen was found to increase the incidence of scoliosis and curve severity in the pubescent bipedal rat scoliosis animal model [7]. These results suggest that sex influences the development and progression of AIS. Adolescent idiopathic scoliosis (AIS) which characterized by complex three-dimensional deformity of spine has been difficult to cure because of the unknown etiopathology and uncertainty of progression. We investigate the circulating cell-free nuclear DNA (ccf n-DNA) and mitochondrial DNA (ccf mt-DNA) concentrations in the plasma of patients with AIS and controls (CT), and the changed plasma ccf n-DNA and ccf mt-DNA levels and their association with clinical parameters were assessed
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