New Clue: Prediction from Cell-Free DNA

Yan Sanders

doi:10.3390/jcm9072307

Abstract

The main challenge for a positive long-term outcome in lung transplantation is the lack of early detection for chronic lung allograft dysfunction (CLAD). With advancements in technology, an increasing number of studies demonstrate that cell-free DNA (cfDNA) in body fluids could be used as a marker for disease diagnosis, prognosis or monitoring response to treatment. A previous report from this journal found the joint assessment of cfDNA and CXCL10 from brochoalveolar lavage (BAL) could determine the subphenotypes of CLAD and predict lung transplant survival. This is an exciting attempt in monitoring the progress for lung transplant recipients. More studies and better understanding of cfDNA are needed to develop an accessible and reliable biomarker to monitor the progress of CLAD to improve the long-term survival for lung transplant recipients.

Highlights

Lung transplantation is the treatment option for patients with end-stage lung diseases [1]
Compared to other solid organ transplantation, the long-term outcomes of lung transplant remain poor, which is largely due to the chronic lung allograft dysfunction (CLAD) that usually develops in half of the recipients at 5 years post-lung transplant [2]
Liquid biopsies usually refer to analysis of circulating nucleic acids, such as cell-free DNA [7]. cfDNA are the fragmented DNA found in the body fluid that is 150–200 base pair long from nucleases digested cellular DNA whose molecular origin remains poorly understood, but likely from apoptotic cells or tissues [8]. cfDNA can be found in many tissues, including blood, which is thought that cfDNA is a reflection of a person’s health and disease [8]

Summary

Introduction

Lung transplantation is the treatment option for patients with end-stage lung diseases [1]. Establishing diagnostic or prognostic biomarkers for CLAD diagnosis or prediction is crucial to improve long-term survival. Donor-derived cell-free DNA (dd-cfDNA) has been used as a noninvasive diagnostic test; the measurement of dd-cfDNA as a fraction of the total cfDNA can detect rejection in heart, lung, liver and kidney allografts [9,10].

Results

Conclusion