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Articles |
1
Department of Chemical Pathology and
2
Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR.
a Author for correspondence. Fax 852-2194-6171; e-mail loym{at}cuhk.edu.hk
Background: Recently, much interest has developed in the potential use of plasma DNA as a diagnostic and monitoring tool. We hypothesized that plasma DNA is increased in patients with trauma and may be prognostic in such patients.
Methods: We studied 84 patients who had sustained an acute blunt traumatic injury. We measured plasma DNA by a real-time quantitative PCR assay for the ß-globin gene. Blood samples were collected at a median time of 60 min following injury. Blood samples were also obtained from 27 control subjects.
Results: The median plasma DNA concentrations in the control,
minor/moderate trauma (Injury Severity Score <16; n = 47), and
major trauma (Injury Severity Score 
16; n = 37) groups were 3154
kilogenome-equivalents/L, 13 818 kilogenome-equivalents/L, and
181 303 kilogenome-equivalents/L, respectively. Plasma DNA
concentrations in patients with adverse outcomes, including acute lung
injury, acute respiratory distress syndrome, and death, had 11.6- to
12-fold higher plasma DNA concentrations than those who did not develop
these complications. At a cutoff of 232 719 kilogenome-equivalents/L,
the sensitivities of plasma DNA analysis for the prediction of acute
lung injury, acute respiratory distress syndrome, and death were
100% (95% confidence interval, 100–100%), 100% (95% confidence
interval, 100–100%), and 78% (95% confidence interval, 40–97%),
respectively. The respective specificities were 81% (95% confidence
interval, 71–89%), 80% (95% confidence interval, 70–88%), and
82% (95% confidence interval, 71–90%).
Conclusions: Plasma DNA is increased after trauma and may be a potentially valuable prognostic marker for these patients.
The following articles in journals at HighWire Press have cited this article:
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  C.-H. Lu, W.-N. Chang, N.-W. Tsai, Y.-C. Chuang, C.-R. Huang, and H.-C. Wang The value of serial plasma nuclear and mitochondrial DNA levels in adult community-acquired bacterial meningitis QJM, March 1, 2010; 103(3): 169 - 175. [Abstract] [Full Text] [PDF]
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 H. Goldshtein, M. J Hausmann, and A. Douvdevani A rapid direct fluorescent assay for cell-free DNA quantification in biological fluids Ann Clin Biochem, November 1, 2009; 46(6): 488 - 494. [Abstract] [Full Text] [PDF]
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 E C W Hung, R W K Chiu, and Y M D Lo Detection of circulating fetal nucleic acids: a review of methods and applications J. Clin. Pathol., April 1, 2009; 62(4): 308 - 313. [Abstract] [Full Text] [PDF]
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J. Beck, H. B. Urnovitz, J. Riggert, M. Clerici, and E. Schutz Profile of the Circulating DNA in Apparently Healthy Individuals Clin. Chem., April 1, 2009; 55(4): 730 - 738. [Abstract] [Full Text] [PDF]
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K. Saukkonen, P. Lakkisto, V. Pettila, M. Varpula, S. Karlsson, E. Ruokonen, K. Pulkki, and for the Finnsepsis Study Group Cell-Free Plasma DNA as a Predictor of Outcome in Severe Sepsis and Septic Shock Clin. Chem., June 1, 2008; 54(6): 1000 - 1007. [Abstract] [Full Text] [PDF]
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 M. P. Langford, T. B. Redens, N. R. Harris, S. Lee, S. K. Jain, S. Reddy, and R. McVie Plasma Levels of Cell-Free Apoptotic DNA Ladders and Gamma-Glutamyltranspeptidase (GGT) in Diabetic Children Exp Biol Med, October 1, 2007; 232(9): 1160 - 1169. [Abstract] [Full Text] [PDF]
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I. G. Fatouros, A. Destouni, K. Margonis, A. Z. Jamurtas, C. Vrettou, D. Kouretas, G. Mastorakos, A. Mitrakou, K. Taxildaris, E. Kanavakis, et al. Cell-Free Plasma DNA as a Novel Marker of Aseptic Inflammation Severity Related to Exercise Overtraining Clin. Chem., September 1, 2006; 52(9): 1820 - 1824. [Abstract] [Full Text] [PDF]
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K.C. A. Chan, A. B.Y. Hui, N. Wong, T. K. Lau, T. N. Leung, K.-W. Lo, and Y.M. D. Lo Investigation of the Genomic Representation of Plasma DNA in Pregnant Women by Comparative Genomic Hybridization Analysis: A Feasibility Study Clin. Chem., December 1, 2005; 51(12): 2398 - 2401. [Full Text] [PDF]
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S. Holdenrieder, P. Stieber, L. Y.S. Chan, S. Geiger, A. Kremer, D. Nagel, and Y.M. D. Lo Cell-Free DNA in Serum and Plasma: Comparison of ELISA and Quantitative PCR Clin. Chem., August 1, 2005; 51(8): 1544 - 1546. [Full Text] [PDF]
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S. Holdenrieder, S. Mueller, and P. Stieber Stability of Nucleosomal DNA Fragments in Serum Clin. Chem., June 1, 2005; 51(6): 1026 - 1029. [Full Text] [PDF]
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K.C. A. Chan, S.-W. Yeung, W.-B. Lui, T. H. Rainer, and Y.M. D. Lo Effects of Preanalytical Factors on the Molecular Size of Cell-Free DNA in Blood Clin. Chem., April 1, 2005; 51(4): 781 - 784. [Full Text] [PDF]
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 C. S. Roberts, H.-C. Pape, A. L. Jones, A. L. Malkani, J. L. Rodriguez, and P. V. Giannoudis Damage Control Orthopaedics. Evolving Concepts in the Treatment of Patients Who Have Sustained Orthopaedic Trauma J. Bone Joint Surg. Am., February 1, 2005; 87(2): 434 - 449. [Full Text] [PDF]
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 T.-S. Wong, D. L.-W. Kwong, J. S.-T. Sham, W. I. Wei, Y.-L. Kwong, and A. P.-W. Yuen Quantitative Plasma Hypermethylated DNA Markers of Undifferentiated Nasopharyngeal Carcinoma Clin. Cancer Res., April 1, 2004; 10(7): 2401 - 2406. [Abstract] [Full Text] [PDF]
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T. H. Rainer, N. Y.L. Lam, N. B.Y. Tsui, E. K.O. Ng, R. W.K. Chiu, G. M. Joynt, and Y.M. D. Lo Effects of Filtration on Glyceraldehyde-3-Phosphate Dehydrogenase mRNA in the Plasma of Trauma Patients and Healthy Individuals Clin. Chem., January 1, 2004; 50(1): 206 - 208. [Full Text] [PDF]
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N. Y.L. Lam, T. H. Rainer, R. W.K. Chiu, G. M. Joynt, and Y.M. D. Lo Plasma Mitochondrial DNA Concentrations after Trauma Clin. Chem., January 1, 2004; 50(1): 213 - 216. [Full Text] [PDF]
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 N. Jiang, C. F. Reich III, and D. S. Pisetsky Role of macrophages in the generation of circulating blood nucleosomes from dead and dying cells Blood, September 15, 2003; 102(6): 2243 - 2250. [Abstract] [Full Text] [PDF]
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N. Y.L. Lam, T. H. Rainer, L. Y.S. Chan, G. M. Joynt, and Y.M. D. Lo Time Course of Early and Late Changes in Plasma DNA in Trauma Patients Clin. Chem., August 1, 2003; 49(8): 1286 - 1291. [Abstract] [Full Text] [PDF]
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E. K.O. Ng, T. N. Leung, N. B.Y. Tsui, T. K. Lau, N. S. Panesar, R. W.K. Chiu, and Y.M. D. Lo The Concentration of Circulating Corticotropin-releasing Hormone mRNA in Maternal Plasma Is Increased in Preeclampsia Clin. Chem., May 1, 2003; 49(5): 727 - 731. [Abstract] [Full Text] [PDF]
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M. H.M. Chan, K. M. Chow, A. T.C. Chan, C. B. Leung, L. Y.S. Chan, K. C.K. Chow, C. W. Lam, and Y.M. D. Lo Quantitative Analysis of Pleural Fluid Cell-free DNA as a Tool for the Classification of Pleural Effusions Clin. Chem., May 1, 2003; 49(5): 740 - 745. [Abstract] [Full Text] [PDF]
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T. H. Rainer, L. K.S. Wong, W. Lam, E. Yuen, N. Y.L. Lam, C. Metreweli, and Y.M. D. Lo Prognostic Use of Circulating Plasma Nucleic Acid Concentrations in Patients with Acute Stroke Clin. Chem., April 1, 2003; 49(4): 562 - 569. [Abstract] [Full Text] [PDF]
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R. W. K. Chiu, L. L. M. Poon, T. K. Lau, T. N. Leung, E. M. C. Wong, and Y. M. D. Lo Effects of Blood-Processing Protocols on Fetal and Total DNA Quantification in Maternal Plasma Clin. Chem., September 1, 2001; 47(9): 1607 - 1613. [Abstract] [Full Text] [PDF]
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Compiled by David E. Bruns, Editor (dbruns@aacc.org) Clin. Chem., April 1, 2001; 47(4): 797 - 797. [Full Text] [PDF]
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