When will you be able to apply your research findings and what steps do you still have to take?
Simon: We recently received funding from the Federal Ministry of Education and Research. We are collaborating with the Fraunhofer Institute for Microtechnology and Microsystems (IMM) in Mainz, Bytec, R-Biopharm AG, and intensive care physicians in hope to develop a rapid analysis system. It's critical for us to get a whole blood assay to perform a DNA analysis, because we have recognized the importance of a pre-analysis: after the blood draw, there is often a certain nonchalance. After all, you now have your blood sample but technically you already affect the sample the moment you take it. The nature of the coagulation inhibitor and whether you perform a less invasive capillary blood sampling or venous blood sampling has a strong impact on the cfDNA levels – all this on top of concerns about the sample stability under realistic storage conditions in the clinical routine of an emergency room. Ideally, process steps should be reduced to an absolute minimum and deliver sensitive quantification of cfDNA directly via the full blood count – which is our goal. I predict it will take another five years of development to get there.
You studied cfDNA even prior to the pandemic. Did COVID-19 take you by surprise and prompted you to change your research focus?
Simon: As it happens, we had already switched before the outbreak. Our previous research method can detect gene doping in competitive sports, but it is incredibly complex. Given that athletes currently use conventional drugs for doping, use of the method was not sensible. That's why we started to measure indicators for colorectal cancer in the blood even pre-pandemic. One question we wanted to explore was whether someone with cancer releases more or fewer DNA fragments when he/she is physically active. The finding was that while the person releases DNA like all humans in response to stress, it is not DNA that comes from the tumor but stems from immune cells, while the circulating tumor DNA even dilutes, relatively speaking.
That is why DNA found in the bloodstream has been of great interest to us for quite some time. The COVID-19 pandemic has essentially validated and accelerated the issue, because we now know that these levels are relevant as highly responsive stress markers. Some hospitalized COVID-19 patients have increased values that even competitive athletes will never achieve - these are cfDNA dimensions that suggest an enormously increased risk of thrombosis. That's because DNA is sticky, negatively charged, and binds positively charged proteins: Immune cells can eject their DNA, forming a "mesh" of sticky strands to capture and immobilize bacteria and viruses - but if they do this too much, they release too much genetic material, resulting in an increased risk of thrombosis. Our measurements are a great tool in these situations and can hopefully help improve prognosis and outcomes, as it facilitates better medical equipment and medication planning.
Let's take a look back at MEDICA: How did you like the trade fair?
Simon: It was great that we were able to attend MEDICA in person, because you could effortlessly visit all exhibition booths and engage with people. I was especially interested in the research facilities and the respective research undertaken by the individual countries. But it also broke my heart in a way because I know how crowded the MEDICA trade show floors usually are when there is no pandemic.