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. 2019 Mar;98(12):e14863.
doi: 10.1097/MD.0000000000014863.

Circulating cell-free DNA as a potential marker in smoke inhalation injury

Yehiel Hayun  1 , Yaron Shoham  2 , Yuval Krieger  2 , Eldad Silberstein  2 , Amos Douvdevani  3 , Dean Ad-El  1
Affiliations

Circulating cell-free DNA as a potential marker in smoke inhalation injury

Yehiel Hayun et al. Medicine (Baltimore). 2019 Mar.

Abstract

Failure in evaluation of smoke inhalation injury (SII) is related to increased morbidity and mortality. Prognostic biomarkers that reflect the injury are undoubtedly needed. Cell-free DNA (CFD) concentrations are associated to the extent of tissue damage and inflammation in various pathologies. We have developed a simple assay for CFD quantification and previously found it prognostic in various pathologies including burns, lung disease, and sepsis. The aim of this study was to evaluate admission CFD as an injury severity marker in patients with SII.In a prospective study, we measured admission CFD levels in 18 SII patients and matched control subjects. Daily CFD levels were also performed in 4 hospitalized patients. Serum CFD levels were measured by our direct rapid fluorometric assay.Admission CFD levels of SII patients were significantly higher than those of healthy controls, 879 (236-3220) ng/mL vs. 339 (150-570) ng/mL, [median (range)], P < .0001. Admission CFD levels of hospitalized patients were significantly higher than those of nonhospitalized patients, 1517 (655-3220) ng/mL vs. 675 (236-1581) ng/mL, P < .05. Admission CFD positively correlated with hospitalization time (Rho = 0.578, P < .05) and was in linear correlation with CO poisoning (carboxyhemoglobin (COHb) levels, R = 0.621, P < .0001). Additionally, along with the recovery of hospitalized patients, we observed a matched reduction of CFD levels.CFD appears to be a potentially valuable marker for severity and follow-up of SII. We believe this rapid assay can help introduce the routine use of CFD measurement into daily practice.

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Conflict of interest statement

All authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Median admission cell-free DNA (CFD) levels of smoke inhalation patients (SII) versus controls. Circulating serum concentrations were measured using our fluorescent DNA assay in 18 SII patients and matched healthy controls. (B) Median admission CFD levels of hospitalized vs. nonhospitalized smoke inhalation patients.
Figure 2
Figure 2
Correlation between admission CFD concentrations and carboxyhemoglobin (COHb) levels. Full circles indicate hospitalized patients and hollow circles indicate discharged patients. Star indicates patient ventilated in ICU.
Figure 3
Figure 3
Daily CFD levels of four hospitalized patients (patient numbers 1, 6, 11, and 12).
See this image and copyright information in PMC

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