Cell-free nucleic acid patterns in disease prediction and monitoring—hype or hope?

Abstract

Interest in the use of cell-free nucleic acids (CFNAs) as clinical non-invasive biomarker panels for prediction and prevention of multiple diseases has greatly increased over the last decade. Indeed, circulating CFNAs are attributable to many physiological and pathological processes such as imbalanced stress conditions, physical activities, extensive apoptosis of different origin, systemic hypoxic-ischemic events and tumour progression, amongst others. This article highlights the involvement of circulating CFNAs in local and systemic processes dealing with the question, whether specific patterns of CFNAs in blood, their detection, quantity and quality (such as their methylation status) might be instrumental to predict a disease development/progression and could be further utilised for accompanying diagnostics, targeted prevention, creation of individualised therapy algorithms, therapy monitoring and prognosis. Presented considerations conform with principles of 3P medicine and serve for improving individual outcomes and cost efficacy of medical services provided to the population.

Carotenoids in Cancer Metastasis—Status Quo and Outlook

“…At the level of secondary prevention, cancer patients should undergo predictive diagnostics estimating individual metastatic potential. Recently prominent examples have been presented in the literature [ 164 , 170 , 171 ]. Various carotenoids, including β-carotene, lycopene, and retinoids and their receptors, can effectively fight against premalignant lesions in the role of secondary cancer prevention [ 172 , 173 , 174 , 175 ].…”

Voice perturbations under the stress overload in young individuals: phenotyping and suboptimal health as predictors for cascading pathologies

“…Further, predictive machine learning models should be developed that allows for detecting a suboptimal health condition based on voice recordings, ideally in an automated manner using digital biomarkers. C. Follow-up stratification and monitoring of individuals in suboptimal health conditions identified by specialised surveys under point A and/or by AI under point B are recommended utilising disease specific cell-free nucleic acids (cfDNA, ctDNA, mtDNA, miRNA) combined with metabolic patterns detected in body fluids [43,[104][105][106].…”

“…To this end, severely affected cells and tissues intrinsically secrete cell-free nucleic acids [106] such as mitochondrial DNA fragments [107]. It has been demonstrated that COVID-19 patients with increased levels of mtDNA are at elevated death risk, necessity of ICU care and intubation [107].…”

Mitochondriopathies as a Clue to Systemic Disorders—Analytical Tools and Mitigating Measures in Context of Predictive, Preventive, and Personalized (3P) Medicine

“…Liquid biopsy is a non-invasive or minimally-invasive, cost-effective, painless, precise, and real-time analysis of specific biomarkers obtained from non-solid tissues (biofluids), such as blood, urine, tears, and/or cerebrospinal fluid [ 7 , 8 , 9 , 10 ]. In this review, we discuss the applicability of liquid biopsy to the overall management of mitochondriopathies and disorders known to be associated with mitochondrial dysfunction.…”

“…In this review, we discuss the applicability of liquid biopsy to the overall management of mitochondriopathies and disorders known to be associated with mitochondrial dysfunction. Further, based on the accumulated knowledge on the pathomechanisms of mitochondrial injury, we exemplify health conditions that might be involved in the “vicious circle” of mitochondrial damage, which would allow the paradigm shift from reactive measures (treatment of clinically manifested pathologies) to the advanced concepts of predictive approach, targeted prevention, and the personalization of medical services [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”