Verification of multimarkers for detection of early stage diabetic retinopathy using multiple reaction monitoring.
Diabetic retinopathy (DR) is a complication of diabetes and 80% of diabetes mellitus (DM) patients whose DM duration is over 10 years can be expected to suffer with DR. The diagnosis of DR depends on an ophthalmological examination, and no molecular methods of screening DR status exist. Nonproliferative diabetic retinopathy (NPDR) is the early DR which is hard to be noticed in early NPDR, showing significant cause of adult blindness in type 2 diabetes patients. Protein biomarkers have been valuable in the diagnosis of disease and the use of multiple biomarkers has been suggested to overcome the low specificity of single ones. For biomarker development, multiple reaction monitoring (MRM) has been spotlighted as an alternative method to quantify target proteins with no need for immunoassay. In this study, 54 candidate DR marker proteins from a previous study were verified by MRM in plasma samples from NPDR patients in 3 stages (mild, moderate and severe; 15 cases each) and diabetic patients without retinopathy (15 cases) as a control. Notably, 27 candidate markers distinguished moderate NPDR from type 2 diabetic patients with no diabetic retinopathy, generating AUC values (>0.7). Specifically, 28 candidate proteins underwent changes in expression as type 2 diabetic patients with no diabetic retinopathy progressed to mild and moderate NPDR. Further, a combination of 4 markers from these 28 candidates had the improved specificity in distinguishing moderate NPDR from type 2 diabetic patients with no diabetic retinopathy, yielding a merged AUC value of nearly 1.0. We concluded that MRM is a fast, robust approach of multimarker panel determination and an assay platform that provides improved specificity compared with single biomarker assay systems.
Department of Biomedical Engineering, Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University College of Medicine, 28 Yongon-Dong, Seoul 110-799, Korea.
Kyunggon
K
Kim
Sang Jin
SJ
Kim
Dohyun
D
Han
Jonghwa
J
Jin
Jiyoung
J
Yu
Kyong Soo
KS
Park
Hyeong Gon
HG
Yu
Youngsoo
Y
Kim
D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood*; D001798:Blood Proteins / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D003930:Diabetic Retinopathy / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D015415:Biomarkers; D001798:Blood Proteins