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Natoli RM, Malek S. Fracture-related infection blood-based biomarkers: Diagnostic strategies. Injury 2024; 55 Suppl 6:111823. [PMID: 39164161 DOI: 10.1016/j.injury.2024.111823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/30/2024] [Accepted: 08/10/2024] [Indexed: 08/22/2024]
Abstract
Fracture-related infections are significant postoperative complications that carry substantial patient burden and additional healthcare costs. Despite their impact on outcome, early diagnosis of these infections remains challenging due to current available tests lacking acceptable diagnostic parameters. This review compiles existing information on blood-based biomarkers that have been evaluated as early diagnostic tools and highlights the challenges in their reliability. To begin to overcome these challenges new avenues of biomarker discovery utilizing "omics" technologies and novel analytical methods are being investigated in recent years. It appears that, despite their complexity, these newer approaches may be the future in biomarker discovery for fracture-related infection diagnosis.
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Affiliation(s)
- Roman M Natoli
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Sarah Malek
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
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Panizzi L, Vignes M, Dittmer KE, Waterland MR, Rogers CW, Sano H, McIlwraith CW, Riley CB. Infrared Spectroscopy of Synovial Fluid Shows Accuracy as an Early Biomarker in an Equine Model of Traumatic Osteoarthritis. Animals (Basel) 2024; 14:986. [PMID: 38612225 PMCID: PMC11011100 DOI: 10.3390/ani14070986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Osteoarthritis is a leading cause of lameness and joint disease in horses. A simple, economical, and accurate diagnostic test is required for routine screening for OA. This study aimed to evaluate infrared (IR)-based synovial fluid biomarker profiling to detect early changes associated with a traumatically induced model of equine carpal osteoarthritis (OA). Unilateral carpal OA was induced arthroscopically in 9 of 17 healthy thoroughbred fillies; the remainder served as Sham-operated controls. The median age of both groups was 2 years. Synovial fluid (SF) was obtained before surgical induction of OA (Day 0) and weekly until Day 63. IR absorbance spectra were acquired from dried SF films. Following spectral pre-processing, predictive models using random forests were used to differentiate OA, Sham, and Control samples. The accuracy for distinguishing between OA and any other joint group was 80%. The classification accuracy by sampling day was 87%. For paired classification tasks, the accuracies by joint were 75% for OA vs. OA Control and 70% for OA vs. Sham. The accuracy for separating horses by group (OA vs. Sham) was 68%. In conclusion, SF IR spectroscopy accurately discriminates traumatically induced OA joints from controls.
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Affiliation(s)
- Luca Panizzi
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand; (L.P.); (C.W.R.)
| | - Matthieu Vignes
- School of Mathematical and Computational Sciences, Massey University, Palmerston North 4442, New Zealand;
| | - Keren E. Dittmer
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand; (L.P.); (C.W.R.)
| | - Mark R. Waterland
- School of Natural Sciences, Massey University, Palmerston North 4442, New Zealand;
| | - Chris W. Rogers
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand; (L.P.); (C.W.R.)
- School of Agriculture and Environment, Massey University, Palmerston North 4442, New Zealand
| | - Hiroki Sano
- Veterinary Specialty Hospital Hong Kong, G/F—2/F 165-171 Wan Chai Road, Wan Chai, Hong Kong, China;
| | - C. Wayne McIlwraith
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, CO 80523, USA;
| | - Christopher B. Riley
- Department of Clinical Studies, Ontario Veterinary College, Guelph, ON N1G 2W1, Canada
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Panizzi L, Vignes M, Dittmer K, Waterland M, Rogers C, Sano H, McIlwraith C, Pemberton S, Owen M, Riley C. Infrared spectroscopy of serum fails to identify early biomarker changes in an equine model of traumatic osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100297. [DOI: 10.1016/j.ocarto.2022.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022] Open
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Utility of Plasma Protein Biomarkers and Mid-infrared Spectroscopy for Diagnosing Fracture-related Infections: A Pilot Study. J Orthop Trauma 2022; 36:e380-e387. [PMID: 35452050 DOI: 10.1097/bot.0000000000002379] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To compare a large panel of plasma protein inflammatory biomarkers and mid-infrared (MIR) spectral patterns in patients with confirmed fracture-related infections (FRIs) with those in controls without infection. DESIGN Prospective case-control study. SETTING Academic, Level 1 trauma center. PATIENTS Thirteen patients meeting confirmatory FRI criteria were matched to 13 controls based on age, time after surgery, and fracture region. INTERVENTION Plasma levels of 49 proteins were measured using enzyme-linked immunosorbent assay techniques. Fourier transform infrared spectroscopy of dried films was used to obtain MIR spectra of plasma samples. MAIN OUTCOME MEASUREMENTS The main outcome measurements included plasma protein levels and MIR spectra of samples. RESULTS Multivariate analysis-based predictive model developed using enzyme-linked immunosorbent assay-based biomarkers had sensitivity, specificity, and accuracy of 69.2% ± 0.0%, 99.9% ± 1.0%, and 84.5% ± 0.6%, respectively, with platelet-derived growth factor-AB/BB, C-reactive protein, and MIG selected as the minimum number of variables explaining group differences ( P < 0.05). Sensitivity, specificity, and accuracy of the predictive model based on MIR spectra were 69.9% ± 6.2%, 71.9% ± 5.9%, and 70.9% ± 4.8%, respectively, with 6 wavenumbers as explanatory variables ( P < 0.05). CONCLUSIONS This pilot study demonstrates the feasibility of using a select panel of plasma proteins and Fourier transform infrared spectroscopy to diagnose FRIs. Preliminary data suggest that the measurement of these select proteins and MIR spectra may be potential clinical tools to detect FRIs. Further investigation of these biomarkers in a larger cohort of patients is warranted. LEVEL OF EVIDENCE Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Malek S, Marini F, Rochat MC, Béraud R, Wright GM, Riley CB. Infrared spectroscopy of synovial fluid as a potential screening approach for the diagnosis of naturally occurring canine osteoarthritis associated with cranial cruciate ligament rupture. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100120. [DOI: 10.1016/j.ocarto.2020.100120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 12/16/2022] Open
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Macotpet A, Pattarapanwichien E, Chio-Srichan S, Daduang J, Boonsiri P. Attenuated total reflection Fourier transform infrared as a primary screening method for cancer in canine serum. J Vet Sci 2020; 21:e16. [PMID: 31940695 PMCID: PMC7000890 DOI: 10.4142/jvs.2020.21.e16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 08/27/2019] [Accepted: 11/09/2019] [Indexed: 11/28/2022] Open
Abstract
Cancer is a major cause of death in dogs worldwide, and the incidence of cancer in dogs is increasing. The attenuated total reflection Fourier transform infrared spectroscopic (ATR-FTIR) technique is a powerful tool for the diagnosis of several diseases. This method enables samples to be examined directly without pre-preparation. In this study, we evaluated the diagnostic value of ATR-FTIR for the detection of cancer in dogs. Cancer-bearing dogs (n = 30) diagnosed by pathologists and clinically healthy dogs (n = 40) were enrolled in this study. Peripheral blood was collected for clinicopathological diagnosis. ATR-FTIR spectra were acquired, and principal component analysis was performed on the full wave number spectra (4,000–650 cm−1). The leave-one-out cross validation technique and partial least squares regression analysis were used to predict normal and cancer spectra. Red blood cell counts, hemoglobin levels and white blood cell counts were significantly lower in cancer-bearing dogs than in clinically healthy dogs (p < 0.01, p < 0.01 and p = 0.03, respectively). ATR-FTIR spectra showed significant differences between the clinically healthy and cancer-bearing groups. This finding demonstrates that ATR-FTIR can be applied as a screening technique to distinguish between cancer-bearing dogs and healthy dogs.
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Affiliation(s)
- Arayaporn Macotpet
- Division of Companion Animal Medicine, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Ekkachai Pattarapanwichien
- Division of Pathobiology, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sirinart Chio-Srichan
- Synchrotron Light Research Institute, University Avenue, Nakhon Ratchasima 30000, Thailand
| | - Jureerut Daduang
- Centre for Research and Development of Medical Diagnostic Laboratories, Biosensor Research Group for Non-Communicable Disease and Infectious Disease, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Patcharee Boonsiri
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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Infrared spectroscopy of serum as a potential diagnostic screening approach for naturally occurring canine osteoarthritis associated with cranial cruciate ligament rupture. Osteoarthritis Cartilage 2020; 28:231-238. [PMID: 31682906 DOI: 10.1016/j.joca.2019.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/16/2019] [Accepted: 10/18/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate infrared (IR) spectroscopy of serum as a screening tool to differentiate dogs affected by naturally occurring osteoarthritis (OA) associated with cranial cruciate ligament rupture (CrCLR) and controls. METHOD 104 adult dogs with CrCLR (affected group) and 50 adult control dogs were recruited for this prospective observational study. Serum samples were collected preoperatively from CrCLR dogs and from a subset of these dogs at 4-, and 12-week post-surgical intervention to stabilize the affected stifles. Serum was collected once from control dogs. Dry films were made from serum samples, and IR absorbance spectra acquired. Data preprocessing, principal component analysis and multivariate analysis of covariance were performed to separate samples from the two groups, and to evaluate temporal differences. Weighted logistic regression with L1 regularization method was used to develop a predictive model. Model performance based on an independent test set was evaluated. RESULTS Spectral data analysis revealed significant separation between the sera of CrCLR and control dogs (P < 0.0001), but not amongst different time points in the OA group. The sensitivity, specificity, AUC and accuracy of the test set were 84.62%, 96.15%, 93.20% and 92.31% respectively. CONCLUSIONS These findings confirm the potential of IR-spectroscopy of serum with chemometrics methods to differentiate controls from dogs with OA associated with CrCLR. This is the first step in development of an economic, and comparatively simple IR-based screening serum test for OA. Utility of this tool as a clinical screening and diagnostic test requires further investigation and validation.
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Burns J, Hou S, Riley CB, Shaw RA, Jewett N, McClure JT. Use of Fourier-transform infrared spectroscopy to quantify immunoglobulin G concentrations in alpaca serum. J Vet Intern Med 2014; 28:639-45. [PMID: 24417433 PMCID: PMC4858009 DOI: 10.1111/jvim.12258] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 09/24/2013] [Accepted: 10/23/2013] [Indexed: 11/28/2022] Open
Abstract
Background Rapid, economical, and quantitative assays for measurement of camelid serum immunoglobulin G (IgG) are limited. In camelids, failure of transfer of maternal immunoglobulins has a reported prevalence of up to 20.5%. An accurate method for quantifying serum IgG concentrations is required. Objective To develop an infrared spectroscopy‐based assay for measurement of alpaca serum IgG and compare its performance to the reference standard radial immunodiffusion (RID) assay. Animals One hundred and seventy‐five privately owned, healthy alpacas. Methods Eighty‐two serum samples were collected as convenience samples during routine herd visits whereas 93 samples were recruited from a separate study. Serum IgG concentrations were determined by RID assays and midinfrared spectra were collected for each sample. Fifty samples were set aside as the test set and the remaining 125 training samples were employed to build a calibration model using partial least squares (PLS) regression with Monte Carlo cross validation to determine the optimum number of PLS factors. The predictive performance of the calibration model was evaluated by the test set. Results Correlation coefficients for the IR‐based assay were 0.93 and 0.87, respectively, for the entire data set and test set. Sensitivity in the diagnosis of failure of transfer of passive immunity (FTPI) ([IgG] <1,000 mg/dL) was 71.4% and specificity was 100% for the IR‐based method (test set) as gauged relative to the RID reference method assay. Conclusions and Clinical Importance This study indicated that infrared spectroscopy, in combination with chemometrics, is an effective method for measurement of IgG in alpaca serum.
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Affiliation(s)
- J Burns
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
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Riley CB, McClure JT, Low-Ying S, Dolenko BK, Somorjai RL, Shaw RA. Feasibility of infrared spectroscopy with pattern recognition techniques to identify a subpopulation of mares at risk of producing foals diagnosed with failure of transfer of passive immunity. Aust Vet J 2012; 90:387-91. [PMID: 23004229 DOI: 10.1111/j.1751-0813.2012.00979.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the feasibility of a serum-based test using infrared spectroscopy to identify a subpopulation of mares at risk of producing foals susceptible to failure of passive transfer of immunity (FPT) because of mare-associated factors. MATERIALS AND METHODS Serum was collected from post-parturient mares (n = 126) and their foals at 24-72 h of age. A radial immunodiffusion IgG test was used to determine each foal's serum IgG concentration. Infrared absorbance spectra of dam sera were collected in the wave number range of 400-4000 cm(-1). Following data preprocessing, pattern recognition techniques were used to identify spectroscopic information capable of distinguishing between mares with FPT foals and those with normal foals. The sensitivity and specificity of infrared spectroscopy to detect risk-positive mares were calculated. RESULTS Five wave number regions were identified as optimal for distinguishing between the two groups of mares: 740.9-785.2 cm(-1), 796.8-816.0 cm(-1), 970.4-993.5 cm(-1), 1371.6-1406.3 cm(-1) and 1632.0-1659.0 cm(-1). Based upon the infrared spectroscopic information within these discriminatory subregions, the spectra provided the risk status of the mares with a classification success rate of 81.0%. The sensitivity of the classification system was 85.7% and specificity was 80.0%. CONCLUSION This preliminary study demonstrates that infrared spectra of dam serum have the potential to provide the basis for a new periparturient screening method for a subpopulation of mares at risk of having a foal susceptible to FPT. Further development may provide an economic and rapid technique for the pre-parturient assessment of mares.
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Affiliation(s)
- C B Riley
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia 5371, Australia.
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de Grauw JC, Donabédian M, van de Lest CHA, Perona G, Robert C, Lepage O, Martin-Rosset W, van Weeren PR. Assessment of synovial fluid biomarkers in healthy foals and in foals with tarsocrural osteochondrosis. Vet J 2011; 190:390-5. [PMID: 21216637 DOI: 10.1016/j.tvjl.2010.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 11/26/2010] [Accepted: 12/02/2010] [Indexed: 10/18/2022]
Abstract
Although alterations in biomarkers of cartilage turnover in synovial fluid (SF) have been demonstrated in horses with osteochondrosis (OC), there have been few investigations of such alterations in animals <1 year old. In this study tarsocrural SF samples from foals aged 18, 22 and 52 weeks of age were assessed for: (1) 'turnover' biomarkers of type II collagen (CPII and C2C) and proteoglycan (CS846 and glycosaminoglycans [GAG]); (2) matrix metalloproteinase (MMP) activity; (3) insulin-like growth factor (IGF)-1; (4) transforming growth factor (TGF)-β1; (5) prostaglandin (PG) E(2); and (6) leukotriene B(4). Using a linear mixed model, the concentration of biomarkers was compared between animals that developed or did not develop radiographic evidence of OC at 24 or 48 weeks of age. The CPII:C2C ratio tended to be higher in OC-affected joints compared to controls at all ages, and this difference was statistically significant at 22 weeks of age. The concentrations of CS846 and IGF-1, and the CS846:GAG ratio were reduced in OC-affected joints relative to controls at 18 weeks of age only. At 52 weeks of age, the PGE(2) concentration was lower in joints with OC. Overall, there appears to be a consistent anabolic shift in type II collagen turnover in juvenile joints affected by OC. Aberrant proteoglycan turnover is not a hallmark of the late repair of this lesion but reduced concentrations of IGF-1 in SF may be associated with early-stage lesions.
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Affiliation(s)
- J C de Grauw
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM, Utrecht, The Netherlands.
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Third International Workshop on Equine Osteochondrosis, Stockholm, 29-30th May 2008. Equine Vet J 2010; 41:504-7. [DOI: 10.2746/042516409x431902] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Wang TD, Triadafilopoulos G, Crawford JM, Dixon LR, Bhandari T, Sahbaie P, Friedland S, Soetikno R, Contag CH. Detection of endogenous biomolecules in Barrett's esophagus by Fourier transform infrared spectroscopy. Proc Natl Acad Sci U S A 2007; 104:15864-9. [PMID: 17901200 PMCID: PMC2000401 DOI: 10.1073/pnas.0707567104] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Indexed: 11/18/2022] Open
Abstract
Fourier transform infrared (FTIR) spectroscopy provides a unique molecular fingerprint of tissue from endogenous sources of light absorption; however, specific molecular components of the overall FTIR signature of precancer have not been characterized. In attenuated total reflectance mode, infrared light penetrates only a few microns of the tissue surface, and the influence of water on the spectra can be minimized, allowing for the analyses of the molecular composition of tissues. Here, spectra were collected from 98 excised specimens of the distal esophagus, including 38 squamous, 38 intestinal metaplasia (Barrett's), and 22 gastric, obtained endoscopically from 32 patients. We show that DNA, protein, glycogen, and glycoprotein comprise the principal sources of infrared absorption in the 950- to 1,800-cm(-1) regime. The concentrations of these biomolecules can be quantified by using a partial least-squares fit and used to classify disease states with high sensitivity, specificity, and accuracy. Moreover, use of FTIR to detect premalignant (dysplastic) mucosa results in a sensitivity, specificity, positive predictive value, and total accuracy of 92%, 80%, 92%, and 89%, respectively, and leads to a better interobserver agreement between two gastrointestinal pathologists for dysplasia (kappa = 0.72) versus histology alone (kappa = 0.52). Here, we demonstrate that the concentration of specific biomolecules can be determined from the FTIR spectra collected in attenuated total reflectance mode and can be used for predicting the underlying histopathology, which will contribute to the early detection and rapid staging of many diseases.
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Affiliation(s)
- Thomas D Wang
- Division of Gastroenterology, Stanford University School of Medicine, Palo Alto Veterans Affairs Health Care System, Palo Alto, CA 94304, USA.
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