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 des vitreoretinalen Lymphoms mit zellfreier 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.

Autor im Rampenlicht: Weiterentwicklung der VRL-Diagnose durch zellfreie DNA-Extraktion aus Glaskörper 

Zellfreie DNA-Extraktion von Glaskörper- und Kammerwasserproben zur Diagnose und Überwachung des vitreoretinalen Lymphoms

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  

Zellfreie DNA-Extraktion und -Analyse aus Augenhumor

Zu Beginn fügen Sie 70 Mikroliter Konditionierungspuffer für jeden Milliliter des zellfreien übernatürlichen Verstoßes gegen den Augenhumor hinzu. Vortexen Sie die Reinigungsperlen, um sie gründlich zu vermischen. Als nächstes fügen Sie die Kügelchen zur Probe hinzu und wirbeln Sie dann die Proben- und Kügelchenmischungen vor.Diese Mischung bei 3000 g 15 Minuten bei Raumtemperatur zentrifugieren. Ohne das Pellet zu entfernen, extrahieren Sie das Supernat und fügen Sie dann dem Pellet ein gleiches Volumen Urinpellet-Verdauungspuffer hinzu. Pipettieren Sie die Lösung auf und ab, um das Pellet wieder zu suspendieren.Geben Sie nun Proteinase K in die resuspendierte Pelletmischung. Die Mischung wird 30 Minuten lang bei 55 Grad Celsius inkubiert und dann ein gleiches Volumen genomischer Lysepuffer in die Aufschlussmischung gegeben. Die Lösung gründlich vorziehen, um sie gut zu mischen.Setzen Sie nun die handelsübliche Schleudersäule in ein neues Sammelröhrchen. Geben Sie einen 200 Mikroliter Urin-DNA-Vorbereitungspuffer in die Spin-Säule. Bei 16.000 g eine Minute lang bei Raumtemperatur zentrifugieren und den Durchfluss verwerfen.Pipettieren Sie nun 700 Mikroliter Urin-DNA-Waschpuffer in die Säule und zentrifugieren Sie sie, wie gezeigt. Nachdem Sie den Durchfluss verworfen haben, überführen Sie die Spin-Säule in ein DNase-, RNase-freies Mikrozentrifugenröhrchen. Zum Schluss wird das entsprechende Volumen des DNA-Elutionspuffers direkt in die Säulenmatrix gegeben und drei bis fünf Minuten bei Raumtemperatur ruhen gelassen, dann erneut zentrifugiert, um zellfreie DNA zu erhalten.Die DNA-Ausbeute sowohl der zellulären als auch der zellfreien Bestandteile der Augenflüssigkeit war ähnlich. Es wurde eine PCR-Analyse der zellulären und zellfreien Komponenten einer vitreoretinalen Lymphom-assoziierten Mutation durchgeführt. In der zellfreien Komponente war eine höhere Mutationsrate vorhanden, was sich in einer erniedrigten Zyklusschwelle zeigte.

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 ...

Forschung

Krebsforschung

Separation of Cellular and Cell-Free Fractions of the Vitreous and Aqueous Humor for DNA Extraction

Trennung von zellulären und zellfreien Fraktionen des Glaskörpers und Kammerwassers für die DNA-Extraktion

Extraction and Analysis of DNA from the Cellular Component of the Eye Humor

Extraktion und Analyse von DNA aus der zellulären Komponente des Augenhumors