Name: Cell-Free DNA Extraction and Analysis from Eye Humor
Uploaded: 2024-01-12T12:55:00
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cell-free dna extraction and analysis from eye humor

Diagnose van vitreoretinaal lymfoom met behulp van celvrij DNA

Vitreoretinal lymphoma (VRL) is an aggressive lymphoma associated with primary central nervous system diffuse large B-cell lymphoma1,2,3. VRL is typically fatal due to its involvement in the central nervous system1,2. Although rare1,4, VRL often presents with symptoms similar to posterior uveitis and other vitreoretinal diseases4,5. Consequently, patients exhibiting uveitis symptoms require a diagnosis to either confirm or rule out VRL.
Recently, consensus criteria for diagnosing VRL were published, which involve a combination of clinical examination and laboratory findings6. Specimens commonly used to diagnose VRL include vitreous humor and, more recently, aqueous humor7. Vitreous humor is obtained through a surgical procedure called pars plana vitrectomy, which allows access to the posterior segment of the eye8.
In the presented protocol, both aqueous humor and vitreous humor specimens were collected for cellular and cfDNA extraction. After anesthetizing the patients and placing trocars approximately 4 mm from the corneal limbus, an aqueous humor sample of approximately 100-200 &#181;L was obtained using a 1 mL tuberculin syringe at the corneal limbus. For pseudophakic patients, undiluted vitreous was obtained by introducing sterile air into the infusion, enabling the collection of a larger amount of undiluted vitreous (up to 3.5 mL). In phakic patients, approximately 500 to 1000 &#181;L of undiluted vitreous was removed before turning on an infusion of balanced salt solution. In some cases, secondarily diluted vitreous (500 to 2,000 &#181;L) was collected by switching the infusion to fluid and placing the vitrector within the vitreous skirt to obtain this sample. The most dilute vitreous fraction was collected by preserving the cassette bag (Supplemental Figure 1) at the end of the surgery. Once this bag reached the pathology department, dilute vitreous was obtained from draining fluid out of this bag into conical tubes for subsequent DNA extraction.
Cytopathology of vitreous fluid is often considered the gold standard9. However, several studies have demonstrated limited sensitivity due to processing and minimal cellularity10,11,12. Flow cytometry can aid in identifying clonal B-cells but can also be limited by low cellularity and the fragility of large lymphoma cells13,14,15. Both cytopathology and flow cytometry requires intact whole cells. Many of these cells are destroyed during collection, storage, and processing. When molecular testing is performed using DNA extracted from intact cells (cellular DNA), it suffers from this same limitation. In addition, dividing the limited vitreous specimen for all of these tests reduces the amount of material available for each test.
Cell-free DNA (cfDNA) represents another source of DNA that does not require intact cells. cfDNA from vitreous specimens has been used for the detection of VRL16,17 as well as uveal melanoma18. In this protocol, cellular and cell-free DNA are extracted from vitreous and aqueous fluid to detect VRL.

Auteur in de schijnwerpers: VRL-diagnose bevorderen met behulp van celvrije DNA-extractie uit glasvocht 

Celvrije DNA-extractie van glasvocht en kamerwatermonsters voor diagnose en monitoring van vitreoretinaal lymfoom

With this research, we are attempting to use molecular testing of vitreous humor collected from the eye by vitrectomy to diagnose vitreoretinal lymphoma or VRL, which is an aggressive disease whose symptoms overlap those of common inflammatory ocular conditions. Cytopathology flow cytometry and molecular testing are current methods used to diagnose VRL. Published sensitivities of non molecular methods are 44 to 90%for cytopathology and 50 to 60%for flow cytometry, cytopathology, flow cytometry and molecular testing with cellular DNA requires intact neoplastic cells.That poses a problem in vitreous humor specimens because the volume and cellularity of these specimens is low and cells can be degraded by apoptosis as well as specimen collection, processing and storage. We found that cell-free DNA extracted from vitreous fluid specimens provides another source of DNA from molecular testing that does not require intact cells, and that also shows evidence of VRL and can be used to diagnose this lymphoma. Cell-free DNA extraction offers molecular testing without intact neoplastic cells.This allows maximizing the utility of vitreous specimens as intact cells can be reserved for cytopathology and flow cytometry while utilizing the remaining supernatant fluid that would otherwise be discarded for molecular testing.

Watch this Scientific Journal Video about Cell-Free DNA Extraction and Analysis from Eye Humor at JoVE.com

Cell-Free DNA Extraction and Analysis from Eye Humor  

Celvrije DNA-extractie en -analyse van ooghumor

Voeg om te beginnen 70 microliter conditioneringsbuffer toe voor elke milliliter van de celvrije supernate overtreding van de ooghumor. Draai de opruimkralen om goed te mengen. Voeg vervolgens de kralen toe aan het monster en draai vervolgens het monster en de kralenmengsels vortex.Centrifugeer dit mengsel op 3000 G gedurende 15 minuten bij kamertemperatuur. Zonder de pellet los te maken, extraheert u de supernaat en voegt u vervolgens een gelijk volume urinekorrelverteringsbuffer toe aan de pellet. Pipeteer de oplossing op en neer om de pellet opnieuw te suspenderen.Voeg nu proteïnase K toe aan het opnieuw gesuspendeerde pelletmengsel. Incubeer het mengsel gedurende 30 minuten bij 55 graden Celsius en voeg vervolgens een gelijk volume genomische lysisbuffer toe aan het digestiemengsel. Draai de oplossing grondig om het goed te mengen.Plaats nu de in de handel verkrijgbare spinkolom in een nieuwe opvangbuis. Voeg een 200 microliter urine DNA-voorbereidingsbuffer toe aan de spinkolom. Centrifugeer gedurende één minuut bij kamertemperatuur bij 16.000 G en gooi de doorstroom weg.Pipetteer nu 700 microliter urine DNA-wasbuffer naar de kolom en centrifugeer zoals gedemonstreerd. Nadat u de doorstroming hebt weggegooid, brengt u de spinkolom over naar een DNase, RNase-vrije microcentrifugebuis. Voeg ten slotte het juiste volume DNA-elutiebuffer rechtstreeks toe aan de kolommatrix en laat het drie tot vijf minuten op kamertemperatuur staan, en centrifugeer vervolgens opnieuw om celvrij DNA te verkrijgen.DNA-opbrengsten van zowel cellulaire als celvrije componenten van de oogvloeistoffen waren vergelijkbaar. PCR-analyse van de cellulaire en celvrije componenten van een met vitreoretinaal lymfoom geassocieerde mutatie werd uitgevoerd. Er was een hogere mutatiesnelheid aanwezig in de celvrije component, zoals blijkt uit een verlaagde cyclusdrempel.

Research

JoVE Journal

Cancer Research

Cell-Free DNA Extraction and Analysis from Eye Humor

Cell-Free DNA Extraction of Vitreous and Aqueous Humor Specimens for Diagnosis and Monitoring of Vitreoretinal Lymphoma

Vitreoretinal lymphoma (VRL) represents an aggressive lymphoma, often categorized as primary central nervous system diffuse large B-cell lymphoma. To ...