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Ni J, Liu Y, Hong H, Kong X, Han Y, Zhang L, Zhang Y, Zhang Y, Hua C, Wang Q, Wang X, Huang Y, YiKun W, Meili D. A novel fluorescent digitonin derivative for non-invasive skin cholesterol detection: potential application in atherosclerosis screening. RSC Adv 2022; 12:18397-18406. [PMID: 35799936 PMCID: PMC9214714 DOI: 10.1039/d2ra01982e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/27/2022] [Indexed: 12/03/2022] Open
Abstract
There is a great demand for the rapid and non-invasive atherosclerosis screening method. Cholesterol content in the epidermis of the skin is an early biomarker for atherosclerosis. Risk assessment of atherosclerosis can be achieved by measuring cholesterol in the epidermis. Here, we synthesised a new fluorescent digitonin derivative (FDD) for the non-invasive detection of skin cholesterol. The results of fluorescence spectroscopy studies indicated that the probe exhibited desirable selectivity for cholesterol. The proof-of-concept preclinical study confirmed that FDD can detect different concentrations of skin cholesterol; patients diagnosed with atherosclerotic cardiovascular disease and the at-risk atherosclerosis group exhibited higher skin cholesterol content than the normal group. The area under the ROC curve for distinguishing the normal/disease group was 0.9228 (95% confidence interval, 0.8938 to 0.9518), and the area under the ROC curve for distinguishing the normal/risk group was 0.9422 (95% confidence interval, 0.9178 to 0.9665). We anticipate that this non-invasive skin cholesterol test may be used as a risk assessment tool for atherosclerosis screening in a large population for further examination and intervention in high-risk populations. Digitonin was used to synthesise a fluorescence probe for the non-invasive detection of skin cholesterol. This non-invasive skin cholesterol method may be used as a risk assessment tool for atherosclerosis screening in a large population.![]()
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Affiliation(s)
- Jingshu Ni
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
- University of Science and Technology of China, Hefei, 230026, China
| | - Yong Liu
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
- University of Science and Technology of China, Hefei, 230026, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
| | - Haiou Hong
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Xiangyong Kong
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Yongsheng Han
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Lei Zhang
- Anhui Provincial Institute for Food and Drug Control, Hefei, 230051, China
| | - Yang Zhang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
- University of Science and Technology of China, Hefei, 230026, China
| | - Yuanzhi Zhang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
| | - Changyi Hua
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
| | - Quanfu Wang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
| | - Xia Wang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
| | - Yao Huang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
| | - Wang YiKun
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
| | - Dong Meili
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Provincial Engineering Laboratory for Medical Optical Diagnosis &Treatment Technology and Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
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Ni J, Hong H, Zhang Y, Tang S, Han Y, Fang Z, Zhang Y, Zhou N, Wang Q, Liu Y, Li Z, Wang Y, Dong M. Development of a non-invasive method for skin cholesterol detection: pre-clinical assessment in atherosclerosis screening. Biomed Eng Online 2021; 20:52. [PMID: 34074299 PMCID: PMC8170999 DOI: 10.1186/s12938-021-00889-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/18/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Establishing a high-accuracy and non-invasive method is essential for evaluating cardiovascular disease. Skin cholesterol is a novel marker for assessing the risk of atherosclerosis and can be used as an independent risk factor of early assessment of atherosclerotic risk. METHODS We propose a non-invasive skin cholesterol detection method based on absorption spectroscopy. Detection reagents specifically bind to skin cholesterol and react with indicator to produce colored products, the skin cholesterol content can be obtained through absorption spectrum information on colored products detected by non-invasive technology. Gas chromatography is used to measure cholesterol extracted from the skin to verify the accuracy and reliability of the non-invasive test method. A total of 342 subjects were divided into normal group (n = 115), disease group (n = 110) and risk group (n = 117). All subjects underwent non-invasive skin cholesterol test. The diagnostic accuracy of the measured value was analyzed by receiver-operating characteristic (ROC) curve. RESULTS The proposed method is able to identify porcine skin containing gradient concentration of cholesterol. The values measured by non-invasive detection method were significantly correlated with gas chromatography measured results (r = 0.9074, n = 73, p < 0.001). Bland-Altman bias was - 72.78 ± 20.03 with 95% limits of agreement - 112.05 to - 33.51, falling within the prespecified clinically non-significant range. We further evaluated the method of patients with atherosclerosis and risk population as well as normal group, patients and risk atherosclerosis group exhibited higher skin cholesterol content than normal group (all P < 0.001). The area under the ROC curve for distinguishing Normal/Disease group was 0.8642 (95% confidence interval, 0.8138 to 0.9146), meanwhile, the area under the ROC curve for distinguishing Normal/Risk group was 0.8534 (95% confidence interval, 0.8034 to 0.9034). CONCLUSIONS The method demonstrated its capability of detecting different concentration of skin cholesterol. This non-invasive skin cholesterol detection system may potentially be used as a risk assessment tool for atherosclerosis screening, especially for a large population.
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Affiliation(s)
- Jingshu Ni
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China
- University of Science and Technology of China, Hefei, 230026, China
| | - Haiou Hong
- Health Management Center, First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Yang Zhang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China
- University of Science and Technology of China, Hefei, 230026, China
| | - Shiqi Tang
- Health Management Center, Renmin Hospital of WuHan University, Wuhan, 430060, China
| | - Yongsheng Han
- Department of Cardiovascular Medicine, First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, China
| | - Zhaohui Fang
- Department of Endocrinology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, 230031, China
| | - Yuanzhi Zhang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
| | - Nan Zhou
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
| | - Quanfu Wang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
| | - Yong Liu
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China
- University of Science and Technology of China, Hefei, 230026, China
- Wanjiang Center for Development of Emerging Industrial Technology, Tongling, 244000, China
| | - Zhongsheng Li
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China
| | - YiKun Wang
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China.
- University of Science and Technology of China, Hefei, 230026, China.
| | - Meili Dong
- Anhui Provincial Engineering Technology Research Center for Biomedical Optical Instrument, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science , Chinese Academy of Sciences, Hefei, 230031, China.
- University of Science and Technology of China, Hefei, 230026, China.
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Tashakkor AY, Mancini GBJ. The relationship between skin cholesterol testing and parameters of cardiovascular risk: a systematic review. Can J Cardiol 2013; 29:1477-87. [PMID: 23850138 DOI: 10.1016/j.cjca.2013.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/10/2013] [Accepted: 04/10/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND A potential correlation between skin cholesterol levels obtained via skin biopsy and evidence of underlying atherosclerosis has been reported. With the availability of a noninvasive method of skin cholesterol measurement, multiple studies investigated the association of skin cholesterol and traditional cardiovascular risk factors. We provide a systematic review of clinical data to assist physicians counselling patients that have undergone skin cholesterol testing and to provide a framework for future research. METHODS Multiple electronic databases were systematically searched for studies published from 1970 through February 2013. Selection criteria included English language, peer-reviewed studies that quantitatively examined the relationship between noninvasively measured skin cholesterol levels and indices of vascular disease or cardiovascular risk factors in human subjects. RESULTS We identified 9 cohorts reported in 11 studies. The studies suggest that skin cholesterol does not correlate with traditional markers of cardiovascular disease such as serum lipid values and inflammatory markers, and integrated risk scores (Framingham and Prospective Cardiovascular Münster [PROCAM]). Single studies reported a significant relationship between skin cholesterol levels and evidence of underlying atherosclerosis as implied by positive exercise testing, invasive coronary angiography, increased calcium scores in Caucasian patients, and presence of carotid plaque detected using B-mode ultrasound. Two studies identified a significant relationship using B-mode measurements of carotid intima medial thickening. CONCLUSIONS Skin cholesterol might be a marker of underlying vascular atherosclerosis. Further prospective investigations are warranted to establish utility of this point-of-care test for identifying subjects warranting formal cardiovascular risk assessment.
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Affiliation(s)
- A Yashar Tashakkor
- Department of Medicine (Division of Cardiology), University of British Columbia, Vancouver, British Columbia, Canada
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Feingold KR. The outer frontier: the importance of lipid metabolism in the skin. J Lipid Res 2008; 50 Suppl:S417-22. [PMID: 18980941 DOI: 10.1194/jlr.r800039-jlr200] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The skin serves the vital function of providing a barrier between the hostile external environment and the host. While the skin has many important barrier functions, the two that are absolutely essential for survival are the barrier to the movement of water and electrolytes (permeability barrier) and the barrier against invasive and toxic microorganisms (antimicrobial barrier). Lipids play an essential role in the formation and maintenance of both the permeability and antimicrobial barriers. A hydrophobic extracellular lipid matrix in the stratum corneum composed primarily of ceramides, cholesterol, and free fatty acids provides the barrier to the movement of water and electrolytes. A variety of lipids, such as fatty alcohols, monoglycerides, sphingolipids, phospholipids, and in particular free fatty acids, have antimicrobial activity and contribute to the antimicrobial barrier. In addition to these essential functions, we will also review the ability of skin surface cholesterol to reflect alterations in systemic lipid metabolism and the risk of atherosclerosis.
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Affiliation(s)
- Kenneth R Feingold
- Metabolism Section, Department of Veterans Affairs Medical Center, University of California, San Francisco, CA 94121, USA.
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