Dynamic proteome in enigmatic preeclampsia: an account of molecular mechanisms and biomarker discovery

The coevolution of genomics and proteomics has led to advancements in the field of diagnosis and molecular mechanisms of disease. Proteomics is now stepping into the field of obstetrics, where early diagnosis of pregnancy complication such as preeclampsia (PE) is imperative. PE is a multifactorial disease characterized by hypertension with proteinuria, which is a leading cause of maternal and neonatal morbidity and mortality occurring in 5-7% of pregnancies worldwide. This review discusses the probable molecular mechanisms that lead to PE and summarizes the proteomics research carried out in understanding the pathogenicity of PE, and for identifying the candidate biomarker for diagnosis of the disease.     

High-resolution biomarker discovery: Moving from large-scale proteome profiling to quantitative validation of lead candidates

Diverse proteomic techniques based on protein MS have been introduced to systematically characterize protein perturbations associated with disease. Progress in clinical proteomics is essential for personalized medicine, wherein treatments will be tailored to individual needs based on patient stratification using noninvasive disease monitoring procedures to reveal the most appropriate therapeutic targets. However, breakthroughs await the successful development and application of a robust proteomic pipeline capable of identifying and rigorously assessing the relevance of multiple candidate proteins as informative diagnostic and prognostic indicators or suitable drug targets involved in a pathological process. While steady progress has been made toward more comprehensive proteome profiling, the emphasis must now shift from in depth screening of reference samples to stringent quantitative validation of selected lead candidates in a broader clinical context. Here, we present an overview of the emerging proteomic strategies for high-throughput protein detection focused primarily on targeted MS/MS as the basis for biomarker verification in large clinical cohorts. We discuss the conceptual promise and practical pitfalls of these methods in terms of achieving higher dynamic range, higher throughput, and more reliable quantification, highlighting research avenues that merit additional inquiry.     

SILAC for biomarker discovery

SILAC has been employed in MS-based proteomics for nearly a decade. This method is based on cells in culture metabolically incorporating isotope-coded essential amino acids and allows the quantification of global protein populations to identify characteristic changes. Variations of this technique developed over the years allow the application of SILAC not only to cell culture derived samples but also to tissues and human specimens, making this powerful technique amenable to clinically relevant samples. In this review, we provide an overview of different SILAC-derived methods and their use in the identification and development of biomarkers.     

A qualitative proteome investigation of the sediment portion of human urine: Implications in the biomarker discovery process

Inherent to the biomarker discovery process is a comparative analysis of physiological states. It is therefore critical that the proteome detection protocol does not bias the analysis. With urine, the sediment portion, obtained upon thawing frozen urine, is routinely discarded prior to proteome analysis. However, our results demonstrate that such a practice inadvertently induces bias, having significant implications in the biomarker discovery process. We present the first proteome investigation of human urinary sediments, identifying 60 proteins in this phase by MS. Many sediment proteins were also detected in the urinary supernatant, indicating that several proteins partition between the two phases. This partitioning is dependant on the pH of the sample, as well as the degree of sample agitation. As a consequence of discarding the sediment portion of urine, the concentration of potential candidate biomarkers in the supernatant phase will be altered or, in other instances, may be completely removed from the sample. To minimize this, the pH of all samples should first be normalized, and the samples vigorously vortexed prior to discarding the sediments. For more comprehensive biomarker investigations, we suggest that urinary sediments be analyzed along with the supernatant proteins.     

Recognition of kidney glomerulus by dynamic programming matchingmethod

Dynamic programming was applied to locate the glomeruli in microscopic images of kidney tissue section. The glomeruli were modeled by a polygon whose sides could be varied within a given range of lengths. The objects were located by determining the best match of the model according to a so-called optimum criterion in which all possible shapes were evaluated at all possible positions in the input image. The best model was selected according to the maximum average gray level. To increase the probability of obtaining a closed contour, a distance criterion was added and the maximum gray-level requirement was relaxed somewhat. The optimum criterion was modified to include a directionality constraint in which the difference in angle between model segments and the edge values in the image was minimized, thereby increasing the performance of the method. A hierarchical multiresolution strategy was used to reduce calculation time. The cyclical property of a contour is also taken into account     

边界信息保持的全染色肾脏切片多粒度分割

目的 肾小球图像的准确分割对肾脏病理学的疾病诊断和定量分析起到关键作用,然而全染色肾脏切片图像存在由肾小球个体差异大导致的空间尺度和上下文形状变化大,以及图像分辨率过高的问题,给高精度、高性能分割任务带来挑战。为此,提出一种边界信息保持的全染色肾脏切片多粒度分割方法。方法 使用一种多粒度上下文的空间注意力机制生成多粒度和多形状变化的空间注意力图,以限制上下文特征,减弱背景对目标的影响,强化网络对目标的感知能力,使网络更多地关注小目标特征;将原图像切分为若干小图来解决全染色图像分辨率高的问题,使用增广路径边界补零策略处理卷积核存在的贡献偏移效应,解决了肾小球目标处于图像边界所导致的分割困难问题,保证图像块的信息无损失地向高层传递,提高处于图像块边界的肾小球目标的分割精度;进一步地,针对图像块拼接带来的边缘肾小球容易漏检、计算开销大的问题,采用特征复用的概率累积滑窗策略,同时提高了分割精度和效率。结果 在小鼠肾脏细胞切片和HuBMAP（human biomolecular atlas program）人体肾脏数据上,本文方法提高了分割精度,并使预测速度提高50%左右。结论 对于全染色肾脏切片的肾小球分割问题,多粒度上下文特征和增广路径边界补零策略解决了边界区域肾小球目标分割困难、分割精度低的问题,并通过概率累积滑窗策略提高分割速度,相较传统的分割方法有更优秀的性能。     

Non-invasive biomarker sampling and analysis of the exhaled breath proteome

Exhaled breath condensate (EBC) is a biological fluid that contains trace amounts of secreted pulmonary proteins, and is emerging as a potentially valuable and non-invasively obtained source of disease biomarkers. Proteome analysis of these samples could lead to the identification of prognostic indicators of airway diseases. The objective of this study was to develop a protocol for proteome analysis of EBC samples. In this report, an improved procedure for EBC sample preparation and concentration is presented, together with a method for comparison of the protein profiles between two groups. The presented approach enabled to study the condensed exhaled breath proteome for biomarker analysis, and revealed proteins not previously identified in an EBC proteomics approach. In a comparative pilot study, EBC protein profiles obtained from smokers and non-smokers showed distinct differences and are illustrative for its potential in clinical studies. EBC from smokers contained higher concentrations of the more abundant proteins, such as cytokeratins, compared to non-smokers, and calgranulin B was identified uniquely in EBC samples from smokers.     

Quantitative proteomic approaches for biomarker discovery

The rapid advances in proteomic technologies have made possible systematic analysis of hundreds to thousands of proteins in clinical samples with the promise of uncovering novel protein biomarkers for various disease conditions. We will discuss in this review article current MS and protein chip-based quantitative proteomic approaches and their application in biomarker discovery. The emphasis will be placed on new quantification strategies employing stable isotopic labeling coupled with MS/MS, and antibody-based protein chips and nanodevices. The strength and weakness of each technology are briefly highlighted.     

Applications of protein microarrays for biomarker discovery

The search for new biomarkers for diagnosis, prognosis, and therapeutic monitoring of diseases continues in earnest despite dwindling success at finding novel reliable markers. Some of the current markers in clinical use do not provide optimal sensitivity and specificity, with the prostate cancer antigen (PSA) being one of many such examples. The emergence of proteomic techniques and systems approaches to study disease pathophysiology has rekindled the quest for new biomarkers. In particular the use of protein microarrays has surged as a powerful tool for large-scale testing of biological samples. Approximately half the reports on protein microarrays have been published in the last two years especially in the area of biomarker discovery. In this review, we will discuss the application of protein microarray technologies that offer unique opportunities to find novel biomarkers.     

CE-MS-based proteomics in biomarker discovery and clinical application

CE-MS is applied in clinical proteomics for both the identification of biomarkers of disease and assessment of biomarkers in clinical diagnosis. The analysis is reproducible, fast, and requires only small sample volumes. However, successful CE-MS analysis depends on several critical steps that can be consolidated as follows: (i) proper sample preparation and fractionation, (ii) application of suitable capillary coating and appropriate CE-MS interfaces, to ensure the reproducibility and stability of the analysis, and (iii) an optimized clinical and statistical study design to increase the chances for obtaining clinically relevant results. In this review, we cover all these aspects, and present several examples of the application of CE-MS in clinical proteomics.     

Colorectal cancer proteomics, molecular characterization and biomarker discovery

Colorectal cancer (CRC) is a widespread disease, whose major genetic changes and mutations have been well characterized in the sporadic form. Much less is known at the protein and proteome level. Still, CRC has been the subject of multiple proteomic studies due to the urgent necessity of finding clinically relevant markers and to elucidate the molecular mechanisms underlying the progression of the disease. These proteomic approaches have been limited by different technical issues, mainly related with sensitivity and reproducibility. However, recent advances in proteomic techniques and MS systems have rekindled the quest for new biomarkers in CRC and an improved molecular characterization. In this review, we will discuss the application of different proteomic approaches to the identification of differentially expressed proteins in CRC. In particular, we will make a critical assessment about the use of 2-D DIGE, MS and protein microarray technologies, in their different formats, to identify up- or downregulated proteins and/or autoantibodies profiles that could be useful for CRC characterization and diagnosis. Despite a wide list of potential biomarkers, it is clear that more scientific efforts and technical advances are still needed to cover the range of low-abundant proteins, which may play a key role in CRC diagnostics and progression.     

Immunoproteomics: From biomarker discovery to diagnostic applications

Circulating antibodies reflect a molecular imprint of antigens that are related to autoimmune diseases, cancer or infection. Importantly, serum antibodies are useful clinical markers as they carry diagnostic information from all around the human body. Moreover, the amplification cascade governed by the humoral immune system causes a surplus of circulating antibodies after appearance of the corresponding (low abundance) antigen. In combination with the fact that antibodies are highly stable compared to many other serum proteins, they seem ideal to be implemented in clinical diagnostic assays for the detection of antigen-associated diseases. This review summarises advances in immunoproteomics with respect to technologies for biomarker discovery, with special emphasis on recently developed gel-free MS-based approaches, and looks forward to potential immunoproteomic applications in diagnostic medicine.     

Body fluid proteomics: Prospects for biomarker discovery

Many diseases are caused by perturbations of cellular signaling pathways and related pathway networks as a result of genetic aberrations. These perturbations are manifested by altered cellular protein profiles in the fluids bathing tissue/organs (i.e., the tissue interstitial fluid, TIF). A major challenge of clinical chemistry is to quantitatively map these perturbed protein profiles - the so-called "signatures of disease" - using modern proteomic technologies. This information can be utilized to design protein biomarkers for the early detection of disease, monitoring disease progression and efficacy of drug action. Here, we discuss the use of body fluids in the context of prospective biomarker discovery, and the marked 1000-1500-fold dilution of body fluid proteins, during their passage from TIF to the circulatory system. Further, we discuss proteomics strategies aimed at depleting major serum proteins, especially albumin, in order to focus on low-abundance protein/peptides in plasma. A major limitation of depletion strategies is the removal of low-molecular weight protein/peptides which specifically bind major plasma proteins. We present a prototype model, using albumin, for understanding the multifaceted nature of biomarker research, highlighting the involvement of albumin in Alzheimer's disease. This model underscores the need for a system-level understanding for biomarker research and personalized medicine.     

Proteomics is not only a biomarker discovery tool

The relatively young science of proteomics has been extensively used to identify biomarkers. However, a detailed and careful interpretation of proteomics data can also provide a clear picture of integrated biochemical systems, which can lead to a better comprehension of pathological processes. For example, the proteome analysis of human brain tissue from patients with schizophrenia, bipolar disorder, or multiple sclerosis compared with healthy controls has identified differentially expressed proteins that may not only be potential biomarkers but may also provide information that may increase the comprehension of these neurological disorders. Thus, proteomics is not only a biomarker discovery tool but can also identify potential players of relevance for diseases.     

CE-MS in biomarker discovery, validation, and clinical application

CE coupled MS (CE-MS) has become an increasingly employed technology in proteome analysis with focus on the identification of biomarker peptides in clinical proteomics. In this review, we will cover technical aspects of CE-MS coupling and highlight the improvements made in the last few years. We examine CE-MS from an application point of view, and evaluate its merits and vices for biomarker discovery and clinical applications. We discuss the principal theoretical and practical obstacles encountered when employing CE-MS (and most other proteomic technologies) for the analysis of body fluids for biomarker discovery. We will present several examples of a successful application of CE-MS for biomarker discovery, implications for disease diagnosis, prognosis, and therapy evaluation, and will discuss current challenges and possible future improvements.     

The interface between biomarker discovery and clinical validation: The tar pit of the protein biomarker pipeline

The application of "omics" technologies to biological samples generates hundreds to thousands of biomarker candidates; however, a discouragingly small number make it through the pipeline to clinical use. This is in large part due to the incredible mismatch between the large numbers of biomarker candidates and the paucity of reliable assays and methods for validation studies. We desperately need a pipeline that relieves this bottleneck between biomarker discovery and validation. This paper reviews the requirements for technologies to adequately credential biomarker candidates for costly clinical validation and proposes methods and systems to verify biomarker candidates. Models involving pooling of clinical samples, where appropriate, are discussed. We conclude that current proteomic technologies are on the cusp of significantly affecting translation of molecular diagnostics into the clinic.