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Liquid biopsy reveals collateral tissue damage in cancer
Asael Lubotzky, Hai Zemmour, Daniel Neiman, Marc Gotkine, Netanel Loyfer, Sheina Piyanzin, Bracha-Lea Ochana, Roni Lehmann-Werman, Daniel Cohen, Joshua Moss, Judith Magenheim, Maureen F. Loftus, Lauren Brais, Kimmie Ng, Raul Mostoslavsky, Brian M. Wolpin, Aviad Zick, Myriam Maoz, Albert Grinshpun, Anatoli Kustanovich, Chen Makranz, Jonathan E. Cohen, Tamar Peretz, Ayala Hubert, Mark Temper, Azzam Salah, Shani Avniel-Polak, Simona Grozinsky-Glasberg, Kirsty L. Spalding, Ariel Rokach, Tommy Kaplan, Benjamin Glaser, Ruth Shemer, Yuval Dor
Asael Lubotzky, Hai Zemmour, Daniel Neiman, Marc Gotkine, Netanel Loyfer, Sheina Piyanzin, Bracha-Lea Ochana, Roni Lehmann-Werman, Daniel Cohen, Joshua Moss, Judith Magenheim, Maureen F. Loftus, Lauren Brais, Kimmie Ng, Raul Mostoslavsky, Brian M. Wolpin, Aviad Zick, Myriam Maoz, Albert Grinshpun, Anatoli Kustanovich, Chen Makranz, Jonathan E. Cohen, Tamar Peretz, Ayala Hubert, Mark Temper, Azzam Salah, Shani Avniel-Polak, Simona Grozinsky-Glasberg, Kirsty L. Spalding, Ariel Rokach, Tommy Kaplan, Benjamin Glaser, Ruth Shemer, Yuval Dor
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Research Article Cell biology Oncology

Liquid biopsy reveals collateral tissue damage in cancer

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Abstract

Cancer inflicts damage to surrounding normal tissues, which can culminate in fatal organ failure. Here, we demonstrate that cell death in organs affected by cancer can be detected by tissue-specific methylation patterns of circulating cell-free DNA (cfDNA). We detected elevated levels of hepatocyte-derived cfDNA in the plasma of patients with liver metastases originating from different primary tumors, compared with cancer patients without liver metastases. In addition, patients with localized pancreatic or colon cancer showed elevated hepatocyte cfDNA, suggesting liver damage inflicted by micrometastatic disease, by primary pancreatic tumor pressing the bile duct, or by a systemic response to the primary tumor. We also identified elevated neuron-, oligodendrocyte-, and astrocyte-derived cfDNA in a subpopulation of patients with brain metastases compared with cancer patients without brain metastasis. Cell type–specific cfDNA methylation markers enable the identification of collateral tissue damage in cancer, revealing the presence of metastases in specific locations and potentially assisting in early cancer detection.

Authors

Asael Lubotzky, Hai Zemmour, Daniel Neiman, Marc Gotkine, Netanel Loyfer, Sheina Piyanzin, Bracha-Lea Ochana, Roni Lehmann-Werman, Daniel Cohen, Joshua Moss, Judith Magenheim, Maureen F. Loftus, Lauren Brais, Kimmie Ng, Raul Mostoslavsky, Brian M. Wolpin, Aviad Zick, Myriam Maoz, Albert Grinshpun, Anatoli Kustanovich, Chen Makranz, Jonathan E. Cohen, Tamar Peretz, Ayala Hubert, Mark Temper, Azzam Salah, Shani Avniel-Polak, Simona Grozinsky-Glasberg, Kirsty L. Spalding, Ariel Rokach, Tommy Kaplan, Benjamin Glaser, Ruth Shemer, Yuval Dor

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Figure 4

Plasma concentrations of brain-derived cfDNA.

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Plasma concentrations of brain-derived cfDNA.
(A–C) Brain cfDNA levels i...
(A–C) Brain cfDNA levels in healthy controls (n = 127), cancer patients (localized and non-brain-metastatic, n = 113), and cancer patients with metastases to the brain (n = 29). Shown are the average levels in plasma of 4 neuronal markers (A), 3 oligodendrocyte markers (B), and 3 astrocyte markers (C). Each dot represents 1 plasma sample. Numbers in the figure indicate samples with 0/above 0 cfDNA molecules with a brain-derived signature. Statistical significance was measured by Kruskal-Wallis test with Dunn’s post hoc correction for multiple comparisons. (D–F) Brain cfDNA levels as in A–C, expressed as percentage of cfDNA derived from the indicated brain cell type. Statistical significance was measured by Kruskal-Wallis test with Dunn’s post hoc correction for multiple comparisons. (G–I) ROC curve for the diagnosis of brain collateral damage in plasma of cancer patients with brain metastasis compared to cancer patients without brain metastases. (G) Neuronal markers; AUC 0.75, 95% CI = 0.66 to 0.84; P < 0.0001. (H) Oligodendrocyte markers; AUC 0.81; 95% CI = 0.72 to 0.89; P < 0.0001. (I) Astrocyte markers; AUC 0.72, 95% CI = 0.63 to 0.81; P < 0.0001. (J) Plasma concentrations of total cfDNA in the same donors as in A–C. Statistical significance was measured by Kruskal-Wallis test with Dunn’s post hoc correction for multiple comparisons.

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