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A new approach to elusive diagnoses

It's been just over a year since my favorite aunt died of pancreatic cancer. I've been thinking about her a lot this week - about the pumpkin pie she baked for my fourth birthday, the Mt. Baker hike when we picked so many wild blueberries that we didn't make it back to the car until dark, the hilarious story she told about her big orange cat getting skunked. She was gracious and glamorous, and she knew how to laugh about things like moldy leftovers unearthed from the depths of the fridge.

Like most pancreatic cancer patients, my aunt wasn't diagnosed until it was too late. The cancer galloped right past her chemotherapy and she died just four months after her diagnosis. She spent the end of her life in a lot of pain.

That's why it was a bittersweet experience to interview Stanford biostatistics expert Atul Butte, MD, PhD, about his latest research. In a paper published today in PLoS Computational Biology, Butte's team has validated a new method for creating blood tests for hard-to-diagnose diseases, potentially including early-stage cancers.

Butte's team took a nifty approach to this work: First, they examined publicly-available data sets on how mRNA levels change in disease. mRNA is the molecule that encodes orders from our genes - sort of like the pad a waitress uses to write down what you want for dinner. Cells use mRNA to figure out what proteins to manufacture. Butte's team used mRNA data to get clues about which proteins might leak into the blood and signal that a disease is starting. The team checked the resulting list of proteins against blood samples from real patients.

The immediate result, described in the release I wrote, is a promising new diagnostic for early-stage organ rejection in transplant patients. Right now, monitoring transplanted organs is invasive and expensive, and it doesn't catch rejection episodes until after they damage the transplanted organ. Butte's work could soon change that, saving many transplant patients from the agony of having their transplanted organ fail.

And, during our conversation, Butte mentioned that the same method of comparing public mRNA data to proteins in patients' blood could soon be used to develop early-stage diagnostic tools for diseases like pancreatic cancer.

A new diagnostic test won't give me my aunt back, but it would help other families. She would have liked that.

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