1. Circulating Cell-Free
DNA and
Preeclampsia:
Hope For Patients With
HELLP?
Chukwuma I. Onyeije, M.D.
http://preeclampsiaonline.net

2. STUDY:
Relationship of circulating cell-
free DNA levels to cell-free fetal
DNA levels, clinical
characteristics and laboratory
parameters in preeclampsia

3. AUTHORS
Levente Lazar , Janos Rigo Jr ,
Balint Nagy , Krisztian Balogh ,
Veronika Mako , Laszlo
Cervenak , Miklos Mezes , Zoltan
Prohaszka and Attila Molvarec

4. CITATION:
BMC Medical Genetics 2009,
10:120doi:10.1186/1471-2350-10-
120
Published: 21 November 2009

5. Study Question:
Is cell-free DNA are
related to preeclampsia?

6. What is Cell-Free
DNA?

7. DNA is nucleic acid that
contains the genetic
instructions used in the
development and
functioning of all known
living organisms.

8. DNA is normally found in
an inner portion of the cell
known as the nucleus.

9. Recent studies have looked
at the importance of so-
called "Cell-free" DNA in
various disease states.

10. Cell-free DNA is DNA that can be
detected in circulating blood.

11. Numerous reports in the literature
suggest that levels cell-free DNA
in the blood may be a more certain
tumors in the detection of early
stages of cancer .

12. Levels of cell-free DNA are
also potentially an
important marker for
pregnancies at risk for
premature birth

13. 
The current study looks at whether or not
cell-free DNA levels in pregnant patients are
related to:
the clinical characteristics of preeclampsia
the standard laboratory tests seen in patients with
preeclampsia
markers of inflammation,
endothelial activation or injury (in other words injury
to the inner
layer of blood vessels often seen in preeclampsia)
oxidative stress and
cell-free fetal DNA levels

14. Study Design:

15. ➲ Blood samples of 67 women
with preeclampsia were
compared to 70 pregnant
women without preeclampsia.
➲The analysis looked at levels of
cell- free DNA as well as
standard laboratory parameters
tests obtained in pregnant
patients.

16. Conclusions

17. Cell-free maternal and fetal DNA were
higher in mothers with preeclampsia as
shown below:

19. The quantity of cell-free DNA did not
correlate to other lab findings in
preeclampsia (with the exception of
liver enzyme changes) and did not
correlate to the clinical characteristics
in the mothers (such as body mass
index).

20. The authors conclude that the
increased levels of cell free DNA may
be triggered by low-level liver damage
seen in patients with preeclampsia.

21. What does this
mean for patients?

22. Currently, there is not enough support
for analyzing cell-free DNA in most
patients with preeclampsia.

23. However, we appear to be on the
cusp of a number of technological
breakthroughs involving DNA based
diagnostic tests which will allow us to
make much earlier diagnoses.

24. In current day medicine, HELLP
syndrome is the most severe form of
preeclampsia. (HELLP stands for
Hemolysis, Elevated Liver enxymes, and
Low Platelets).

25. In order for this diagnosis to be made,
the patient's preeclampsia must get to
the point where the liver cells are
severely damaged and leaking
enzymes.

26. The results of the current study
provide hope that we may be close to
a point where an analysis of cell-free
DNA can give information about early
liver damage in patients with
preeclampsia before they get to the
point of having HELLP syndrome.

27. A full copy of the study
can be found here:
http://www.biomedcentral.com/content/pdf/1471-2350-10-
120.pdf

28. Further reading
http://thedecisiontree.com/blog/

29. The Decision Tree: Taking Control
of Your Health in the New Era of
Personalized Medicine

30. The Future of Medicine:
Megatrends in Health Care That
Will Improve Your Quality of Life

31. Genomic and Personalized
Medicine,