Circulating cf-DNA: A promising, noninvasive tool for assessment of early cardio-metabolic risk

Abstract

In 1948, Mandel and colleagues were the first group to report the presence of circulating nucleic acids in the human bloodstream [1]. The origin of cell-free DNA (cf-DNA) is not fully understood, but apoptosis, necrotic death, cell lysis and active release are possible mechanisms of cf-DNA release into the blood circulation [2]. Circulating cf-DNA is a recent area of increased research interest, with nearly 9000 related papers in the PubMed library. This research has explored a wide range of topics, including the uses of circulating cf-DNA as a cancer prognostic factor, an indicator for intensive care unit admission, and a diagnostic marker of carcinogenesis, injury, sepsis and autoimmune disease [2e5]. The pathophysiological significance of circulating cf-DNA in cardiovascular disease has not received much attention until recently. However, scattered experimental and clinical studies have shed light upon this interesting issue [6e8]. Ten years ago, a clinical study by Chang et al. showed elevated circulating cf-DNA in patients with myocardial infarction [6]. Recently, an observational cohort study clearly demonstrated that plasma cf-DNA levels are a useful biomarker for predicting the outcome after out-of-hospital