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Clinical Laboratories and Pathology Groups

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UK Researchers Develop Clinical Laboratory Diagnostic Skin Test for Parkinson’s Inspired by Woman’s Ability to Smell the Disease before Onset of Symptoms

An assay using mass spectrometry could go to clinical trial within two years

Dark Daily has regularly observed that humans generate a variety of volatile substances—particularly in breath—which can be used for diagnostic purposes. But what if people, like certain trained animals, could smell the presence of disease before the onset of symptoms? What types of clinical laboratory testing biomarkers could be developed based on human-generated volatile organic compounds?

In “Woman Who Can Smell Parkinson’s Disease in Patients Even Before Symptoms Appear May Help Researchers Develop New Clinical Laboratory Test,” Dark Daily covered the unique story of Joy Milne, a retired nurse from Perth, Scotland, who claimed she could “smell” her husband’s Parkinson’s disease a decade before he was diagnosed with the illness.

As strange as that may sound, Milne’s olfactory abilities were confirmed by researchers at the Center for Regenerative Medicine at the University of Edinburgh and have now led to a clinical laboratory diagnostic Parkinson’s test based on body odor.

Researchers at the University of Manchester (UM) in the United Kingdom (UK) say their “breakthrough” test to diagnose Parkinson’s disease “can diagnose disease from skin swabs in three minutes,” according to a university press release.

The researchers published their findings in JACS AU, a Journal of the American Chemical Society, titled, “Paper Spray Ionization Ion Mobility Mass Spectrometry of Sebum Classifies Biomarker Classes for the Diagnosis of Parkinson’s Disease.”

Perdita Barran, PhD and Joy Milne

Perdita Barran, PhD (right), head of the University of Manchester research team that developed the mass spectrometry Parkinson’s test, is shown above with Joy Milne (left), the retired nurse from Scotland who inspired Barran’s team to develop a new Parkinson’s biomarker and method for identifying it. “We are tremendously excited by these results which take us closer to making a diagnostic test for Parkinson’s Disease that could be used in clinic,” she said in a press release. A viable clinical laboratory test for Parkinson’s disease is greatly needed, as more than 10 million people worldwide currently live with the neurodegenerative disorder. (Photo copyright: University of Manchester.)

Using Mass Spectrometry to Analyze Sebum

The UM scientists hypothesized that the smell could be due to sebum, a light oily substance on skin that was going through a chemical change due to the Parkinson’s disease, Hull Daily Mail explained.

Increased sebum, which is produced by the sebaceous glands, is a hallmark of Parkinson’s, the researchers noted.

Their new method involves analysis of sebum using mass spectrometry, according to the JACS AU paper. The method, the researchers claim, makes it possible to diagnose Parkinson’s disease from skin swabs in three minutes.

“There are no cures for Parkinson’s, but a confirmatory diagnosis would allow [Parkinson’s patients] to get the right treatment and get the drugs that will help to alleviate their symptoms,” Perdita Barran, PhD, told the Hull Daily Mail. Barran is Chair of Mass Spectrometry in the Department of Chemistry and Director of the Michael Barber Centre for Collaborative Mass Spectrometry at UM’s Manchester Institute of Biotechnology. “What we are now doing is seeing if (hospital laboratories) can do what we’ve done in a research lab in a hospital lab,” she added.

Sebum Analyzed with Mass Spectrometry

Parkinson’s disease—the world’s fastest growing neurodegenerative disorder—needs “robust biomarkers” that could advance detection and head off onset of motor symptoms such as tremor, rigidity, and postural instability, the researchers note in their paper.

Their recent study builds on earlier 2019 findings they published in ACS Central Science about volatile compounds in sebum possibly being used as Parkinson’s biomarkers.

“Sebum is an underexplored biofluid, which is readily obtained from non-invasive skin swabs, which primarily consists of a mixture of triglycerides, cholesterol, free fatty acids, waxy esters,  and squalene,” the researchers explained in their JACS AU paper. 

The scientists sought, “to develop a method to analyze sebum in its native state to facilitate rapid assessment of the Parkinson’s disease status. Paper spray ionization mass spectrometry, which allows the direct analysis of compounds from paper, has previously been demonstrated to detect small molecules from unprocessed biofluids, such as blood and urine, but not to date with sebum,” they wrote.

The UM researchers used mass spectrometry to analyze sebum collected on cotton swabs from the backs of 79 people with Parkinson’s and 71 healthy individuals, BBC Scotland News reported.

Depanjan Sarkar, PhD, Research Associate, University of Manchester, further explained the technique in the UM news release:

  • Sebum is taken from the swab to filter paper cut in a triangle.
  • Using a solvent and voltage, sebum compounds transfer into the mass spectrometer.

“When we did this, we found more than 4,000 unique compounds of which 500 are different between people with Parkinson’s compared to the control participants,” Sarkar said.

Fatty Acids Make Assay Possible

Could fatty acids pave the way to an assay? The UM researchers believe so.

“We have identified two classes of lipids, namely [triglycerides] and diglycerides, as components of human sebum that are significantly differentially expressed in PD,” the researchers wrote in JACS AU. “Non-invasive sampling followed by PS-IM-MS [paper spray-ion mobility–mass spectrometry] analysis targeting these compounds could provide an inexpensive assay to support clinical phenotyping for the confirmatory diagnosis of Parkinson’s disease.”

A clinical trial for their test, which costs about $20, may be done within two years in Manchester area, the Daily Mail reported.

When Dark Daily reported in 2020 on Joy Milne’s unique ability to smell her husband’s Parkinson’s disease before it was formally diagnosed, we predicted a diagnostic test for Parkinson’s may be years away. And here it is, albeit with regulatory clearance needed following clinical trials.

It may in fact be possible to leverage sebum analysis to detect other diseases, the UM researchers noted.

For diagnostics developers, this story of Joy Milne and her husband Les Milne is a useful example of how, in tracking the life of a specific patient with a specific disease and close family members, researchers were able to identify a new class of biomarkers that could be used in a diagnostic assay.

It will be interesting to follow the University of Manchester researchers in their quest for a diagnostic mass spectrometry clinical laboratory test for Parkinson’s disease. According to Parkinson’s Foundation statistics, about 10 million people worldwide live with the neurodegenerative disorder. Such a new diagnostic test could be vitally important to medical laboratory care, and to patients and their families.

-Donna Marie Pocius

Related Information:

That’s Breathtaking; Meet the Woman Who Sniffed Out Her Husband’s Parkinson’s and Now Experts Have Created First Ever Test Based on Odor That Alerted Her

Parkinson’s Breakthrough Can Diagnose Disease from Skin Swabs in Three Minutes

Test for Parkinson’s is Developed Thanks to Woman Who Can Smell the Disease; It Has Been Years in the Making

Paper Spray Ionization Ion Mobility Mass Spectrometry of Sebum Classifies Biomarker Classes for the Diagnosis of Parkinson’s Disease

Discovery of Volatile Biomarkers of Parkinson’s Disease from Sebum

Parkinson’s Test: Woman Who Smelled Disease on Husband Helps Scientists

Woman Who Can Smell Parkinson’s Disease in Patients Even Before Symptoms Appear May Help Researchers Develop New Clinical Laboratory Test

Researchers Discover SARS-CoV-2 Makes Us Fat So It Can Invade Our Cells

Findings could lead to new clinical laboratory involvement in diagnostics targeted at overweight patients

Does the SARS-CoV-2 coronavirus make us fat so it can better take over our bodies? It sounds like the plot for a science fiction horror movie! But a team of scientists in the Pacific Northwest say that is exactly what the virus does, and their findings could lead to clinical laboratories playing a role in evaluating how the virus highjacks fat cells to aid in its invasion of humans.

Researchers at Oregon Health and Science University (OHSU) and the Department of Energy’s Pacific Northwest National Laboratory (PNNL) found that the coronavirus commandeers the body’s fat processing system to amass cellular storehouses of fat that enable it to take over a body’s molecular function and cause disease. 

They found that certain types of lipids support replication of the COVID-19 virus. Their study illustrates how lipids may play a more important role in the human body than scientists previously understood. 

The scientists published their findings in the journal Nature Communications, titled, “A Global Lipid Map Reveals Host Dependency Factors Conserved Across SARS-CoV-2 Variants.”

Fikadu Tafesse, PhD

“This is exciting work, but it’s the start of a very long journey,” said Fikadu Tafesse, PhD (left), Assistant Professor of Molecular Microbiology and Immunology, OHSU School of Medicine and corresponding author of the study in an OHSU press release. “We have an interesting observation, but we have a lot more to learn about the mechanisms of this disease.” Clinical laboratories may eventually be part of a new diagnostic process for overweight COVID-19 patients. (Photo copyright: Oregon Health and Science University.)

Does Obesity Promote COVID-19 Infection?

The OHSU and PNNL scientists performed their research by examining the effect of SARS-CoV-2 on more than 400 lipids in two different cell lines. They observed that individuals with a high body mass index (BMI) appear to be more sensitive to the COVID-19 virus.

The researchers discovered there is a tremendous shift in lipid levels in those cell lines when the virus was present, with some fats increasing by a massive 64 times! Nearly 80% of the fats in one cell line were changed by the virus and more than half of the fats were altered in the other cell line.

The lipids that were most affected by the COVID-19 virus were triglycerides which are critical to human health. Triglycerides are basically tiny bundles of fat that allow the body to store energy and maintain healthy cell membranes. When a body needs energy, these fat parcels are broken up into useful, raw materials to provide the required energy.

“Lipids are an important part of every cell. They literally hold us together by keeping our cells intact, and they’re a major source of energy storage for our bodies,” said Jennifer Kyle, PhD, in the OHSU press release. Kyle is a research scientist at PNNL who specializes in all stages of lipidomic research. “They are an attractive target for a virus,” she noted.

Stopping SARS-CoV-2 Replication

The scientists discovered that SARS-CoV-2 alters our fat-processing system by boosting the number of triglycerides in our cells and changing the body’s ability to utilize stored fat as fuel. The team also analyzed the effects of lipid levels in 24 of the virus’ 29 proteins. They identified several proteins that had a strong influence on triglyceride levels.

The team then searched databases and identified several compounds that interfered with the body’s fat-processing system by cutting off the flow of fatty fuel. They found that several of these compounds were successful at stopping the SARS-CoV-2 virus from replicating.

A synthetic organic compound known as GSK2194069, which selectively and potently inhibits fatty acid synthase (FAS), and a weight-loss medication called Orlistat, were both able to stop viral replication in the lab.

Although the scientists believe their work is an important step in understanding the SARS-CoV-2 coronavirus, they also note that their results occurred in cell culture (in vitro) and not in people (in vivo). Therefore, more research is needed to determine if the compounds will work in the same manner in human trials. 

“As the virus replicates, it needs a continuous supply of energy. More triglycerides could provide that energy in the form of fatty acids. But we don’t know exactly how the virus uses these lipids to its advantage,” Tafesse said in the press release.

“Our findings fill an important gap in our understanding of host dependency factors of coronavirus infection. … In light of the evolving nature of SARS-CoV-2, it is critical that we understand the basic biology of its life cycle in order to illuminate additional avenues for protection and therapy against this global pandemic pathogen, which spreads quickly and mutates with ease,” the OHSU/PNNL scientists wrote in Nature Communications.

More research is needed to validate the findings of this study and to better understand the dynamic between lipids and SARS-CoV-2 infection. However, it is reasonable to assume that, in the future, some COVID-19 patients may require a clinical laboratory work-up to determine how the coronavirus may be hijacking their fat cells to exacerbate the illness. 

JP Schlingman

Related Information:

COVID-19 Fattens Up Our Body’s Cells to Fuel Its Viral Takeover

A Global Lipid Map Reveals Host Dependency Factors Conserved Across SARS-CoV-2 Variants

CDC: Obesity, Race/Ethnicity, and COVID-19

The Bad News—and the Good—about Obesity and COVID-19

More Companies Pay for Employees to Have Genetic Tests in a Trend That Brings More Lab Test Volume to Medical Laboratories

As tests explore genetic markers related to excessive weight gain, and breast and ovarian cancer, companies as well as employees are seeing returns on investment and participation

In a development that is auspicious for medical laboratories, more genetic tests are making their way into more corporate health benefit plans. Big brands—from Aetna to Visa—are partnering with personalized health companies and clinical lab companies doing genetic testing as they support tests to help employees head-off health risks.

Employers’ sponsorship of genetic testing is a trend that could become more common, noted Fortune. But human resources and benefits experts say the offerings are still uncommon. There are also unresolved issues, such as when genetic test results are inconclusive or questionable.

For medical laboratories, the companies’ genetic testing benefits could prompt more test orders from healthcare consumers. Based on the results of their genetic tests, people might decide to make lifestyle changes, work toward prevention of chronic conditions, and take further tests to assess progress. (more…)

Fasting for Cholesterol Testing May Be Unnecessary: That Could Ease the Morning Rush of Patients at Clinical Laboratories

Clinical laboratories may see a reduction in the early-morning crowds of fasting patients who have come in for cholesterol testing

For the clinical laboratory testing industry, a new Canadian study suggesting that people may not need to fast before getting a cholesterol test could prove a boon for staffing and operations at patient service centers. That’s because fasting-patients crowd phlebotomy centers in the early morning hours to get their blood drawn so they can eat breakfast.

It is standard practice to require patients to fast before drawing blood specimens for a cholesterol test. However, based on a study involving 200,000 people, findings led researchers to conclude that a non-fasting lipid test would be a reasonable alternative for most people. (more…)