Recent advances in point-of-care diagnostics for oral cancer

One-step detection of procollagen type III N-terminal peptide as a fibrosis biomarker using fluorescent immunosensor (quenchbody)

BACKGROUND

Procollagen type III N-terminal peptide (P-III-NP) is a fibrosis biomarker associated with liver and cardiac fibrosis. Despite the value of P-III-NP as a biomarker, its analysis currently relies on enzyme-linked immunosorbent assays (ELISA) and radioimmunoassays (RIA), which require more than 3 h. To facilitate early diagnosis and treatment through rapid biomarker testing, we developed a one-step immunoassay for P-III-NP using a quenchbody, which is a fluorescence-labeled immunosensor for immediate signal generation.

RESULTS

To create quenchbodies, the total mRNA of P-III-NP antibodies was extracted from early-developed hybridoma cells, and genes of variable regions were obtained through cDNA synthesis, inverse PCR, and sequencing. A single-chain variable fragment (scFv) with an N-terminal Cys-tag was expressed in E. coli Shuffle T7, resulting in a final yield of 9.8 mg L-1. The fluorescent dye was labeled on the Cys-tag of the anti-P-III-NP scFv using maleimide-thiol click chemistry, and the spacer arm lengths between the maleimide-fluorescent dyes were compared. Consequently, a TAMRA-C6-labeled quenchbody exhibited antigen-dependent fluorescence signals and demonstrated its ability to detect P-III-NP at concentrations as low as 0.46 ng mL-1 for buffer samples, 1.0 ng mL-1 for 2 % human serum samples.

SIGNIFICANCE

This one-step P-III-NP detection method provides both qualitative and quantitative outcomes within a concise 5-min timeframe. Furthermore, its application can be expanded using a 96-well platform and human serum, making it a high-throughput and sensitive method for testing fibrotic biomarkers.

CXCL9 mediating the effect of thyroid disorders on oral and oropharyngeal cancer risk: A mediation Mendelian randomization study

INTRODUCTION

The established association between thyroid disorders (TD) and its two main subtypes-hyperthyroidism and hypothyroidism-and the incidence of oral and oropharyngeal cancer (OCPC) has been substantiated. However, the direct causal relationship and potential intermediary mechanisms linking these conditions have not been clearly defined in prior studies.

MATERIAL & METHODS

This study employed univariate Mendelian randomization (MR) analysis to explore those relationship. Instrumental variables from genome-wide association study (GWAS) datasets for TD (n = 218,792), hyperthyroidism (n = 460,499), hypothyroidism (n = 213,990), and OCPC (n = 12,619), along with 41 intermediary inflammatory cytokines (n = 8293), were analyzed. Inverse variance weighting (IVW) method assessed the causal relationships, while summary MR analysis with pQTL datasets from decode and 91 inflammatory cytokines explored the cytokines' roles as biomarkers and therapeutic targets for OCPC. Multivariable MR (MVMR) analysis quantified the mediation effect of these cytokines in the TD-OCPC relationship.

RESULTS

UVMR analysis provided strong evidence for a causal relationship between TD (OR = 1.376, 95 % CI = 1.142-1.656, p = 0.001), hyperthyroidism (OR = 1.319, 95 % CI=1.129-1.541, p = 0.001), hypothyroidism (OR = 1.224, 95 % CI = 1.071-1.400, p = 0.003), and the risk of OCPC. CXCL9 was identified as a significant intermediary in mediating the risk of OCPC from TD and its two subtypes (OR = 1.218, 95 % CI = 1.016-1.461, P = 0.033), suggesting its potential as a predictive biomarker for OCPC. MVMR analysis further revealed that CXCL9 mediated 7.94 %, 14.4 %, and 18 % of the effects of TD, hyperthyroidism, and hypothyroidism on OCPC risk, respectively.

DISCUSSION

This study not only elucidated the potential causal relationships between TD including its two subtypes and OCPC risk, but also highlighted CXCL9 as a pivotal mediator in this association.

Genetically predicted gut microbiome and risk of oral cancer

PURPOSE

Mounting evidence suggests a possible link between gut microbiome and oral cancer, pointing to some potential modifiable targets for disease prevention. In the present study, Mendelian randomization (MR) was used to explore whether there was a causal link between gut microbiome and oral cancer.

METHODS

The single nucleotide polymorphisms (SNPs) significantly associated with gut microbiome were served as instrumental variables. MR analyses were performed using genetic approaches such as inverse variance weighting (IVW), MR Egger and weighted median, with IVW as the primary approach, supplemented by MR Egger and weighted median. Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) and MR-Egger regression were used to detect the presence of horizontal pleiotropy and identify outlier SNPs.

RESULTS

Causal effect estimates indicated that genetically predicted abundance of Prevotellaceae was associated with higher risk of oral cancer (odds ratio (OR) 1.80, 95% confidence interval (CI) 1.16-2.81, p = 0.009). There was no evidence of notable heterogeneity and horizontal pleiotropy.

CONCLUSION

Genetically derived estimates suggest that Prevotellaceae may be associated with the risk of oral cancer. Such robust evidence should be given priority in future studies and explore the underlying mechanisms.

Smartphone-based fluorescence spectroscopic device for cervical precancer diagnosis: a random forest classification of in vitro data

Cervical cancer can be treated and cured if diagnosed at an early stage. Optical devices, developed on smartphone-based platforms, are being tested for this purpose as they are cost-effective, robust, and field portable, showing good efficiency compared to the existing commercial devices. This study reports on the applicability of a 3D printed smartphone-based spectroscopic device (3D-SSD) for the early diagnosis of cervical cancer. The proposed device has the ability to evaluate intrinsic fluorescence (IF) from the collected polarized fluorescence (PF) and elastic-scattering (ES) spectra from cervical tissue samples of different grades. IF spectra of 30 cervical tissue samples have been analyzed and classified using a combination of principal component analysis (PCA) and random forest (RF)-based multi-class classification algorithm with an overall accuracy above 90%. The usage of smartphone for image collection, spectral data analysis, and display makes this device a potential contender for use in clinics as a regular screening tool.

Biosensor Design for the Detection of Circulating Tumor Cells Using the Quartz Crystal Resonator Technique

A new mass-sensitive biosensing approach for detecting circulating tumor cells (CTCs) using a quartz crystal resonator (QCR) has been developed. A mathematical model was used to design a ring electrode-based QCR to eliminate the Gaussian spatial distribution of frequency response in the first harmonic mode, a characteristic of QCRs, without compromising the sensitivity of frequency response. An ink-dot method was used to validate the ring electrode fabricated based on our model. Furthermore, the ring electrode QCR was experimentally tested for its ability to capture circulating tumor cells, and the results were compared with a commercially available QCR with a keyhole electrode. An indirect method of surface immobilization technique was employed via modification of the SiO₂ surface of the ring electrode using a silane, protein, and anti-EpCAM. The ring electrode successfully demonstrated eliminating the spatial nonuniformity of frequency response for three cancer cell lines, i.e., MCF-7, PANC-1, and PC-3, compared with the keyhole QCR, which showed nonuniform spatial response for the same cancer cell lines. These results are promising for developing QCR-based biosensors for the early detection of cancer cells, with the potential for point-of-care diagnosis for cancer screening.

Outlook of various diagnostics and nanodiagnostic techniques for COVID-19

The sudden outbreak of the coronavirus disease 2019 (COVID-19) pandemic has brought to the fore the existing threat of disease-causing pathogens that affect public health all over the world. It has left the best healthcare systems struggling to contain the spread of disease and its consequences. Under challenging circumstances, several innovative technologies have emerged that facilitated quicker diagnosis and treatment. Nanodiagnostic devices are biosensing platforms developed using nanomaterials such as nanoparticles, nanotubes, nanowires, etc. These devices have the edge over conventional techniques such as reverse transcription-polymerase chain reaction (RT-PCR) because of their ease of use, quicker analysis, possible miniaturization, and scope for use in point-of-care (POC) treatment. This review discusses the techniques currently used for COVID-19 diagnosis, emphasizing nanotechnology-based diagnostic devices. The commercialized nanodiagnostic devices in various research and development stages are also reviewed. The advantages of nanodiagnostic devices over other techniques are discussed, along with their limitations. Additionally, the important implications of the utility of nanodiagnostic devices in COVID-19, their prospects for future development for use in clinical and POC settings, and personalized healthcare are also discussed.

Identification of Potential miRNA-mRNA Regulatory Network in the Development of Oral Cancer

Background

Oral cancer is a difficult question in modern medical system, and there are few effective strategies to completely heal these diseases. This research investigated the miRNA-mRNA network in oral cancer development via bioinformatics excavation.

Methods

GSE28100 and GSE23558 in the GEO database were selected for bioinformatics analysis. The datasets were analyzed with GEO2R to obtain the related matrix files. The hot plot and heatmap of the matrix files were drawn with R language. The MiRDIP database was applied to predict and screen the targets of miRNAs. The DEGs in the matrix files were analyzed with the DAVID database and visualized with R language for enrichment analysis. The PPI-network of the DEGs was established with the STRING database and Cytoscape. Besides, the miRNA-mRNA was visualized by Cytoscape.

Results

35 genes were identified as the DEGs in GES28100. 1651 genes were identified as the DEGs in GSE23558. 143 common genes in the targets of miRNAs in GSE28100 and the DEGs in GSE the targets of DEGs in GES28100 and common genes were enriched in the PI3K/AKT pathway, MAPK pathway, etc. The DEGs in GSE28100 and GSE23558 were involved in the regulations of transcription from RNA polymerase II promoter and DNA transcription. The DEGs in GSE28100 and GSE23558 were established with the miRNA-mRNA network.

Conclusion

This research identified miR-15b-5p, miR-199a-3p, miR-21-5p, miR-424-5p, and miR-454-3p as the biomarker of oral cancer and established the miRNA-mRNA network in oral progression.

Diagnostic accuracy of Raman spectroscopy in oral squamous cell carcinoma

Background

Raman spectroscopy (RS) has shown great potential in the diagnosis of oral squamous cell carcinoma (OSCC). Although many single-central original studies have been carried out, it is difficult to use RS in real clinical settings based on the current limited evidence. Herein, we conducted this meta-analysis of diagnostic studies to evaluate the overall performance of RS in OSCC diagnosis.

Methods

We systematically searched databases including Medline, Embase, and Web of Science for studies from January 2000 to March 2022. Data of true positives, true negatives, false positives, and false negatives were extracted from the included studies to calculate the pooled sensitivity, specificity, accuracy, positive and negative likelihood ratios (LRs), and diagnostic odds ratio (DOR) with 95% confidence intervals, then we plotted the summary receiver operating characteristic (SROC) curve and the area under the curve (AUC) to evaluate the overall performance of RS. Quality assessments and publication bias were evaluated by Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) checklist in Review Manager 5.3. The statistical parameters were calculated with StataSE version 12 and MetaDiSc 1.4.

Results

In total, 13 studies were included in our meta-analysis. The pooled diagnostic sensitivity and specificity of RS in OSCC were 0.89 (95% CI, 0.85–0.92) and 0.84 (95% CI, 0.78–0.89). The AUC of SROC curve was 0.93 (95% CI, 0.91–0.95).

Conclusions

RS is a non-invasive diagnostic technology with high specificity and sensitivity for detecting OSCC and has the potential to be applied clinically.

Arecoline Is Associated With Inhibition of Cuproptosis and Proliferation of Cancer-Associated Fibroblasts in Oral Squamous Cell Carcinoma: A Potential Mechanism for Tumor Metastasis

Background

Metastatic disease remains the primary cause of death in patients with oral squamous cell carcinoma (OSCC), especially those who use betel nut. The different steps of the metastatic cascade rely on reciprocal interactions between cancer cells and the tumor microenvironment (TME). Cancer-associated fibroblasts (CAFs) are regarded as a significant component in the TME of OSCC. However, the precise mechanisms regulating CAFs in OSCC are poorly understood.

Methods

Thirteen genes related to the arecoline were analyzed to explore the significant ones involved in arecoline-related OSCC metastasis. The GSE139869 (n = 10) and The Cancer Genome Atlas (TCGA)-OSCC data (n = 361) were mined for the identification of the differentially expressed genes. The least absolute shrinkage and selection operator (LASSO) regression was performed to identify the independent prognostic signatures. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were conducted to explore the functional enrichment of selected genes, and gene set enrichment analysis of cuproptosis-related genes was completed. Spearman’s analysis and Tumor Immune Estimation Resource (TIMER) were used to visualize the correlation between the infiltration of CAFs and the gene expression. The correlation analysis of the cells and different genes, including CAF infiltration and transcripts per million expression, was assessed. The relationship between arecoline and CAFs was confirmed by cell counting kit-8 assay (CCK-8). CancerSEA was searched to identify the single-cell phenotype.

Result

Arecoline-associated fibrosis-related OSCC differentially expressed genes (AFOC-DEGs), namely, PLAU, IL1A, SPP1, CCL11, TERT, and COL1A2, were screened out and selected from the Gene Expression Omnibus (GEO) database and TCGA database. AFOC-DEGs were highly expressed in OSCC, which led to poor survival of patients. Functional enrichment analysis, protein–protein interaction network construction, and Spearman’s correlation analysis all suggested that AFOC-DEGs were closely associated with cuproptosis. Cellular experiments demonstrated that arecoline stimulation could significantly increase the cell viability of CAFs. Single-sample Gene Set Enrichment Analysis (ssGSEA) results showed that GLS and MTF1 were highly expressed when fibroblasts proliferated at high enrichment levels. In addition, analysis of single-cell sequencing results suggested that OSCC cells with high expression of AFOC-DEGs were associated with OSCC metastasis.

Conclusion

We found a close association between arecoline, cuproptosis, and CAFs, which might play an important role in the metastasis of OSCC.

NIR II Light-Response Au Nanoframes: Amplification of a Pressure- and Temperature-Sensing Strategy for Portable Detection and Photothermal Therapy of Cancer Cells

Quantitative detection of cancer cells using portable devices is promising for the development of simple, fast, and point-of-care cancer diagnostic techniques. However, how to further amplify the detection signal to improve the sensitivity and accuracy of detecting cancer cells by portable devices remains a challenge. To solve the problem, we, for the first time, synthesized folic-acid-conjugated Au nanoframes (FA-Au NFs) with amplification of pressure and temperature signals for highly sensitive and accurate detection of cancer cells by portable pressure meters and thermometers. The resulting Au NFs exhibit excellent near-infrared (NIR) photothermal performance and catalase activity, which can promote the decomposition of NH₄HCO₃ and H₂O₂ to generate corresponding gases (CO₂, NH₃, and O₂), thereby synergistically amplifying pressure signals in a closed reaction vessel. At the same time, Au NFs with excellent peroxidase-like activity can catalyze the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) to produce TMB oxide (oxTMB) with a strong photothermal effect, thereby cooperating with Au NFs to amplify the photothermal signal. In the presence of cancer cells with overexpressing folate receptors (FRs), the molecular recognition signals between FA and FR can be converted into amplified pressure and temperature signals, which can be easily read by portable pressure meters and thermometers, respectively. The detection limits for cancer cells using pressure meters and thermometers are 6 and 5 cells/mL, respectively, which are better than other reported methods. Moreover, such Au NFs can improve tumor hypoxia by catalyzing the decomposition of H₂O₂ to produce O₂ and perform photothermal therapy of cancer. Together, our work provides new insight into the application of Au NFs to develop a dual-signal sensing platform with amplification of pressure and temperature signals for portable and ultrasensitive detection of cancer cells as well as personalized cancer therapy.