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Vadla GP, Daghat B, Patterson N, Ahmad V, Perez G, Garcia A, Manjunath Y, Kaifi JT, Li G, Chabu CY. Combining plasma extracellular vesicle Let-7b-5p, miR-184 and circulating miR-22-3p levels for NSCLC diagnosis and drug resistance prediction. Sci Rep 2022; 12:6693. [PMID: 35461372 PMCID: PMC9035169 DOI: 10.1038/s41598-022-10598-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 04/05/2022] [Indexed: 01/04/2023] Open
Abstract
Low-dose computed tomography (LDCT) Non-Small Cell Lung (NSCLC) screening is associated with high false-positive rates, leading to unnecessary expensive and invasive follow ups. There is a need for minimally invasive approaches to improve the accuracy of NSCLC diagnosis. In addition, NSCLC patients harboring sensitizing mutations in epidermal growth factor receptor EGFR (T790M, L578R) are treated with Osimertinib, a potent tyrosine kinase inhibitor (TKI). However, nearly all patients develop TKI resistance. The underlying mechanisms are not fully understood. Plasma extracellular vesicle (EV) and circulating microRNA (miRNA) have been proposed as biomarkers for cancer screening and to inform treatment decisions. However, the identification of highly sensitive and broadly predictive core miRNA signatures remains a challenge. Also, how these systemic and diverse miRNAs impact cancer drug response is not well understood. Using an integrative approach, we examined plasma EV and circulating miRNA isolated from NSCLC patients versus screening controls with a similar risk profile. We found that combining EV (Hsa-miR-184, Let-7b-5p) and circulating (Hsa-miR-22-3p) miRNAs abundance robustly discriminates between NSCLC patients and high-risk cancer-free controls. Further, we found that Hsa-miR-22-3p, Hsa-miR-184, and Let-7b-5p functionally converge on WNT/βcatenin and mTOR/AKT signaling axes, known cancer therapy resistance signals. Targeting Hsa-miR-22-3p and Hsa-miR-184 desensitized EGFR-mutated (T790M, L578R) NSCLC cells to Osimertinib. These findings suggest that the expression levels of circulating hsa-miR-22-3p combined with EV hsa-miR-184 and Let-7b-5p levels potentially define a core biomarker signature for improving the accuracy of NSCLC diagnosis. Importantly, these biomarkers have the potential to enable prospective identification of patients who are at risk of responding poorly to Osimertinib alone but likely to benefit from Osimertinib/AKT blockade combination treatments.
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Affiliation(s)
- G P Vadla
- Division of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - B Daghat
- Division of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - N Patterson
- Division of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - V Ahmad
- Division of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - G Perez
- Division of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - A Garcia
- Division of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - Y Manjunath
- Department of Surgery, School of Medicine, University of Missouri, Columbia, MO, 65212, USA
| | - J T Kaifi
- Department of Surgery, School of Medicine, University of Missouri, Columbia, MO, 65212, USA
- Siteman Cancer Center, Washington University, St. Louis, MO, 63110, USA
| | - G Li
- Department of Surgery, School of Medicine, University of Missouri, Columbia, MO, 65212, USA
- Siteman Cancer Center, Washington University, St. Louis, MO, 63110, USA
| | - C Y Chabu
- Division of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA.
- Department of Surgery, School of Medicine, University of Missouri, Columbia, MO, 65212, USA.
- Siteman Cancer Center, Washington University, St. Louis, MO, 63110, USA.
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Sidiq Z, Hanif M, Chopra KK, Khanna A, Ahmad V, Vashistha H, Saini S, Dubey M. Random blinded rechecking of AFB smears in a pilot project at an intermediate reference laboratory. Int J Tuberc Lung Dis 2016; 20:252-6. [PMID: 26792480 DOI: 10.5588/ijtld.15.0481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In most developing countries, sputum smear microscopy for acid-fast bacilli remains the front line and often the only diagnostic tool for the diagnosis of tuberculosis (TB), making quality assurance of smear microscopy an important activity. OBJECTIVE To evaluate the results of a pilot study, where the random blinded rechecking for the entire state of Delhi was conducted at a reference laboratory. METHODOLOGY Slides from 25 Revised National Tuberculosis Control Programme designated districts (200 peripheral microscopy centres) in Delhi were re-read after proper coding by all the Senior Tuberculosis Laboratory Supervisors (STLS) at an intermediate reference laboratory under proper supervision. RESULTS Of 12,162 re-read slides, 204 discrepant results were found. Of these, 150 (73.5%) errors were attributed to the peripheral microscopy centres and 54 (26.5%) to STLS. High false-positive errors were observed at a frequency of 12/150 (8%), and high false-negative errors at a frequency of 38/150 (25%). Minor errors, i.e., low false-negative, low false-positive and quantification errors, were observed at frequencies of respectively 68/150 (45.3%), 17/150 (11.3%) and 15/150 (10.0%). CONCLUSION Greater stringency in the supervision of random blinded rechecking at the district level is essential to make smear rechecking more efficient and effective.
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Affiliation(s)
- Z Sidiq
- New Delhi Tuberculosis Centre, New Delhi, India
| | - M Hanif
- New Delhi Tuberculosis Centre, New Delhi, India
| | - K K Chopra
- New Delhi Tuberculosis Centre, New Delhi, India
| | - A Khanna
- State Tuberculosis Office, Delhi Government Dispensary, New Delhi, India
| | - V Ahmad
- New Delhi Tuberculosis Centre, New Delhi, India
| | - H Vashistha
- New Delhi Tuberculosis Centre, New Delhi, India
| | - S Saini
- New Delhi Tuberculosis Centre, New Delhi, India
| | - M Dubey
- New Delhi Tuberculosis Centre, New Delhi, India
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