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      Skin Biomarkers for Cystic Fibrosis: A Potential Non-Invasive Approach for Patient Screening

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          Abstract

          Background

          Cystic fibrosis (CF) is a disabling genetic disease with an increased prevalence in European heritage populations. Currently, the most used technique for collection of CF samples and diagnosis is provided through uncomfortable tests, with uncertain results, mostly based on chloride concentration in sweat. Since CF mutation induces many metabolic changes in patients, exploring these alterations might be an alternative to visualize potential biomarkers that could be used as interesting tools for further diagnostic upgrade, prioritizing simplicity, low cost, and quickness.

          Methods

          This contribution describes an accurate strategy to provide potential biomarkers related to CF, which may be understood as a potential tool for new diagnostic approaches and/or for monitoring disease evolution. Therefore, the present proposal consists of using skin imprints on silica plates as a way of sample collection, followed by direct-infusion high-resolution mass spectrometry and multivariate data analysis, intending to identify metabolic changes in skin composition of CF patients.

          Results

          Metabolomics analysis allowed identifying chemical markers that can be traced back to CF in patients’ skin imprints, differently from control subjects. Seven chemical markers from several molecular classes were elected, represented by bile acids, a glutaric acid derivative, thyrotropin-releasing hormone, an inflammatory mediator, a phosphatidic acid, and diacylglycerol isomers, all reflecting metabolic disturbances that occur due to of CF.

          Conclusion

          The comfortable method of sample collection combined with the identified set of biomarkers represent potential tools that open the range of possibilities to manage CF and follow the disease evolution. This exploratory approach points to new perspectives about the development of diagnostic assay using biomarkers and the management CF.

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          Most cited references42

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          Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA.

          Overlapping complementary DNA clones were isolated from epithelial cell libraries with a genomic DNA segment containing a portion of the putative cystic fibrosis (CF) locus, which is on chromosome 7. Transcripts, approximately 6500 nucleotides in size, were detectable in the tissues affected in patients with CF. The predicted protein consists of two similar motifs, each with (i) a domain having properties consistent with membrane association and (ii) a domain believed to be involved in ATP (adenosine triphosphate) binding. A deletion of three base pairs that results in the omission of a phenylalanine residue at the center of the first predicted nucleotide-binding domain was detected in CF patients.
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            Metabolomics-based methods for early disease diagnostics.

            The emerging field of metabolomics, in which a large number of small-molecule metabolites from body fluids or tissues are detected quantitatively in a single step, promises immense potential for early diagnosis, therapy monitoring and for understanding the pathogenesis of many diseases. Metabolomics methods are mostly focused on the information-rich analytical techniques of NMR spectroscopy and mass spectrometry (MS). Analysis of the data from these high-resolution methods using advanced chemometric approaches provides a powerful platform for translational and clinical research and diagnostic applications. In this review, the current trends and recent advances in NMR- and MS-based metabolomics are described with a focus on the development of advanced NMR and MS methods, improved multivariate statistical data analysis and recent applications in the area of cancer, diabetes, inborn errors of metabolism and cardiovascular diseases.
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              A test for concentration of electrolytes in sweat in cystic fibrosis of the pancreas utilizing pilocarpine by iontophoresis.

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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/474389
                URI : http://frontiersin.org/people/u/425367
                URI : http://frontiersin.org/people/u/474341
                URI : http://frontiersin.org/people/u/506819
                URI : http://frontiersin.org/people/u/446284
                URI : http://frontiersin.org/people/u/465638
                Journal
                Front Pediatr
                Front Pediatr
                Front. Pediatr.
                Frontiers in Pediatrics
                Frontiers Media S.A.
                2296-2360
                10 January 2018
                2017
                : 5
                : 290
                Affiliations
                [1] 1Innovare Biomarkers Laboratory, Medicine and Experimental Surgery Nucleus, University of Campinas , Campinas, Brazil
                [2] 2Pediatric Department, University of Campinas , Campinas, Brazil
                [3] 3Clinical Pathology Department, University of Campinas , Campinas, Brazil
                Author notes

                Edited by: Musharraf Jelani, King Abdulaziz University, Saudi Arabia

                Reviewed by: Chee Yee Ooi, University of New South Wales, Australia; Saadullah Khan, Decision Research, United States

                *Correspondence: Rodrigo Ramos Catharino, rrc@ 123456fcm.unicamp.br

                Specialty section: This article was submitted to Genetic Disorders, a section of the journal Frontiers in Pediatrics

                Article
                10.3389/fped.2017.00290
                5767587
                29376041
                82f76ee0-9e45-4863-aee2-80fe820daaec
                Copyright © 2018 Esteves, de Aguiar Dias, de Oliveira Lima, de Oliveira, Rodrigues Melo, Delafiori, Souza Gomez, Ribeiro, Ribeiro, Levy and Catharino.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 07 November 2017
                : 18 December 2017
                Page count
                Figures: 2, Tables: 1, Equations: 0, References: 51, Pages: 8, Words: 5995
                Funding
                Funded by: Fundação de Amparo à Pesquisa do Estado de São Paulo 10.13039/501100001807
                Award ID: 14/00302-0, 11/50400-0, 15/06809-1, 16/17066-2
                Categories
                Pediatrics
                Original Research

                cystic fibrosis,cystic fibrosis transmembrane conductance regulator,screening,skin,biomarkers,metabolomics

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