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2017 ; 135
(17
): 1651-1664
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Emerging Affinity-Based Proteomic Technologies for Large-Scale Plasma Profiling
in Cardiovascular Disease
#MMPMID28438806
Smith JG
; Gerszten RE
Circulation
2017[Apr]; 135
(17
): 1651-1664
PMID28438806
show ga
Plasma biomarkers that reflect molecular states of the cardiovascular system are
central for clinical decision making. Routinely used plasma biomarkers include
troponins, natriuretic peptides, and lipoprotein particles, yet interrogate only
a modest subset of pathways relevant to cardiovascular disease. Systematic
profiling of a larger portion of circulating plasma proteins (the plasma
proteome) will provide opportunities for unbiased discovery of novel markers to
improve diagnostic or predictive accuracy. In addition, proteomic profiling may
inform pathophysiological understanding and point to novel therapeutic targets.
Obstacles for comprehensive proteomic profiling include the immense size and
structural heterogeneity of the proteome, and the broad range of abundance
levels, as well. Proteome-wide, untargeted profiling can be performed in tissues
and cells with tandem mass spectrometry. However, applications to plasma are
limited by the need for complex preanalytical sample preparation stages limiting
sample throughput. Multiplexing of targeted methods based on capture and
detection of specific proteins are therefore receiving increasing attention in
plasma proteomics. Immunoaffinity assays are the workhorse for measuring
individual proteins but have been limited for proteomic applications by long
development times, cross-reactivity preventing multiplexing, specificity issues,
and incomplete sensitivity to detect proteins in the lower range of the abundance
spectrum (below picograms per milliliter). Emerging technologies to address these
issues include nucleotide-labeled immunoassays and aptamer reagents that can be
automated for efficient multiplexing of thousands of proteins at high sample
throughput, coupling of affinity capture methods to mass spectrometry for
improved specificity, and ultrasensitive detection systems to measure
low-abundance proteins. In addition, proteomics can now be integrated with modern
genomics tools to comprehensively relate proteomic profiles to genetic variants,
which may both influence binding of affinity reagents and serve to validate the
target specificity of affinity assays. The application of deep quantitative
proteomic profiling to large cohorts has thus become increasingly feasible with
emerging affinity methods. The aims of this article are to provide the broad
readership of Circulation with a timely overview of emerging methods for affinity
proteomics and recent progress in cardiovascular medicine based on such methods.