This document discusses various biomarkers used in medicine. It describes ancient biomarkers like uroscopy and body temperature, as well as more modern tests like the erythrocyte sedimentation rate test developed in 1897. Biomarkers have been used to diagnose and monitor diseases like Lyme disease, Alzheimer's, and cancers. Imaging biomarkers allow observation of disease locations and progression. Limitations include the qualification process and practical challenges of sample collection and storage. Biomarkers also have applications in diagnosing conditions like glomerular hematuria and aging.

1. Credit: © Thinkstock
Anonymous - Reprinted in:
Professor Edmund Biernacki
(1866 - 1911)
Credits: LymeDiseaseGuide.org
Image courtesy of European Lung Foundation
Credit: Disney’s Hollywood Studio

2. BIOMARKERS
King F.Wong, Jana Haaser, Katharina Segers,Viola Knapp

3. CONTENTS
Ancient Biomarkers
• Uroscopy
• Body temperature
Erythrocyte sedimentation rate test (ESR)
Lyme Disease’s Biomarker
Present Biomarkers
• Bloot test
• Imaging
Limitations
Diagnosis of Glomerular Hematuria
Biomarkers for Alzheimer’s Disease
Sniffing cancers
Biomarkers for Aging

4. ANCIENT BIOMARKERS 1
Uroscopy, study of colour and
taste of urine (Buckland,
Raymond 2003)
indicator for diabetics
1500BC

5. ANCIENT BIOMARKERS 2
body temperature
fever, a symptom for disease
Picture of fever, remedy.com 11/2014

6. ERYTHROCYTE SEDIMENTATION
RATETEST (ESR)
phase separation diagnostics
traced back to ancient Greek
(Fåhraeus 1929)
developed by Edmund Biernacki
in 1897 (Biernacki 1897)
Still an major indicator for
serious diseases
1897 AD

7. LYME DISEASE’S BIOMARKER 1
A disease caused by tick carried
pathogen, Borrelia burgdorferi
(Shapiro, ED 2014)
Was thought antibodies are the
only biomarkers

8. LYME DISEASE’S BIOMARKER 2
CRP, a much more effective
biomarker for monitoring
progress of treatment(YC Wong,
1996)
1996 AD

9. More generally a biomarker is anything that can be used
as an indicator of a particular disease state or some
other physiological state of an organism. Including
screening, diagnosis, prognosis and monitoring course
of disease or response to therapy.
(Dr.A. Mandal 2014)

10. MODERN BIOMARKERS IN
BLOOD
2015 AD
Biochemistry
BioLab, 2015

11. IMAGING BIOMARKERS
• Visible biomarkers, found with e.g. microscopy, ultrasound, X-ray,
CT, MRI, PET… (John R. Ball, 2010)
• Exact disease focus and development observable, followup
possible
• Relatively non-invasive

12. Richard G.Abramson 2015

13. LIMITATIONS
a) Qualification process (John R. Ball, 2010)
1) Analytical validation: is it possible to
measure BM feasibly, accurately and
precisely?
2) Qualification: is the BM a good indicator
of the process? BM = clinical endpoint?
3) Utilisation: do the results of 1) and 2)
support using this BM in the intended
application?
b) Practical problems: collection, processing
and storage of samples

14. DIAGNOSIS OF GLOMERULAR
HEMATURIA
First report of variations in size
and shape of erythrocytes in the
urine sediment was made in 1948
(Larcom RC Jr 1948)
Dysmorphic RBC indicates
glomerular hematuria (Y.C.Wong
1987)
Haber MH, Blomberg D, Galagan K, Glassy EF,Ward PCJ.Eds. Color Atlas of the
Urinary Sediment.An Illustrated Field Guide Based on Proficiency Testing. CAP
Press and Publications.2010

15. Fig. 1 Source: Köhler H. et al . Kidney International 1991;40:115-120 Courtesy of Dr.Y.
Aniwatangkoora 2013

16. BIOMARKERS FOR ALZHEIMER’S
DISEASE 1
Cerebrospinal fluid protein
(Alzheimer’s Association, 2015)
Proteins in blood
Genetic risk profiling
Brain imaging- ß-amyloid

17. BIOMARKERS FOR ALZHEIMER’S
DISEASE 2
ß-amyloid indicator in main
development
Radioactive compound binded to
amyloid
Alzheimer Forschung Initative e.V. 2015

18. SNIFFING CANCERS
- Cancer produce volatile organic compounds
- Distinguish odour in urine/ sweat/ breath /
stool
- Excellent olfactory acuity
- High accuracy even for early cancer
o Bladder cancer
o Prostate cancer
o Breast cancer

19. BIOMARKERS FOR AGEING 1
• Ageing = complex process controlled by genetic, environmental, and behavioral factors reduced repair/
regeneration of cells
• Ageing of mammals on molecular level poorly understood
• Well-defined ageing biomarker could
o Help predict progression of ageing-related conditions (e.g. Diabetes II)
o Be used as surrogate marker in anti-aging therapeutics
o Predict toxicity of harmful therapies (e.g. chemo- or radiotherapy, surgery)
o Determine donor suitability for transplants
(A*STAR Press Release 2015)

20. BIOMARKERS FOR AGEING 2
• Research mostly into tumour repressor molecules p16INK4a
and Arf, and p38MAPK
• Expression increases in aging mammals, other cell cycle
repressors stay mostly constant
• Decreased ageing observed in tissues of GM mice
• Easily measured, useable in many cell types
• (J. Krishnamurthy 2004, E.Wong 2009)

21. THANKYOU