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DNA test could improve access to cervical screening

A six-step test for two high-risk types of HPV delivered results in 45 minutes and required just two pieces of equipment

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A DNA test for HPV infections could broaden access to cervical cancer screening, scientists have found.

Bioengineers from Rice University, Texas have shown that a low-cost, point-of-care DNA test for HPV could make cervical cancer screening more accessible in low and middle-income countries, where 90 per cent of deaths from cervical cancer occur.

HPV is a common virus spread by skin-to-skin contact. It is estimated that around eight in 10 people get it during their lifetime.

There are more than 200 types of HPV – around 40 types affect the anus and genitals and 14 of these are linked to some cancers.

Cervical cancer is the most common HPV-associated cancer. It kills more than 300,000 women globally every year, disproportionately affecting women in low- and middle-income countries such as South Africa, India, China and Brazil.

‘A mobile diagnostic van’

Researchers at Rice University, led by Professor Rebecca Richards-Kortum, spent more than two years developing a DNA testing platform to simplify the equipment needs and procedures for testing.

In a study, published in Science Translational Medicine, Richards-Kortum’s team and co-authors from the National Cancer Institute, the Mozambique Ministry of Health, Baylor College of Medicine and the University of Texas MD Anderson Cancer Center showed the platform could produce clinically relevant results on samples collected at both US clinical sites and at clinical field sites in Mozambique.

They demonstrated their six-step test for two high-risk types of HPV delivered results in 45 minutes and required just two pieces of equipment. One is a small centrifugee and the other is a purpose-built, dual-chamber heater called NATflow which allowed the researchers to use disposable cartridges to avoid false positives arising from workspace contamination.

Kathryn Kundrod, study first author and cancer prevention fellow at the National Cancer Institute, said: “We know what we need to do to prevent cervical cancer. It’s really a matter of access at this point, and that’s one reason this study is exciting from a global health perspective.

“It demonstrates a testing process that could potentially be combined with point-of-care diagnostic and treatment technologies to allow women who’ve never had access to be screened and treated in a single visit in settings like a small clinic or a mobile diagnostic van.”

Richards-Kortum, Rice’s Malcolm Gillis University Professor, professor of bioengineering and the founding director of the Rice360 Institute for Global Health Technologies, said: “The vast majority of disease detected through screening is precancerous, before the point at which people have cancer.

“That’s why screening programmes are so effective. People who are routinely screened very rarely progress to cervical cancer. It’s people who have never been screened in their lives, or who get screened on really infrequent intervals, who are really at risk.

“That’s why it’s so critical to address the disparities that exist and think about new ways to deliver screening, diagnosis and treatment.”

Kundrod said that if both the NATflow platform and test cartridges were produced on a large scale, each dual-chamber heater would cost an estimated US$500 and each test less than US$5.

She added: “The platform is the other thing that makes this exciting, because it can easily be adapted for DNA tests for other diseases.

“Preventing contamination has been a huge problem for DNA-based point-of-care tests. This is one of the first platforms to address that, and so far it’s the only one to solve that in a way where all the pieces can be easily manufactured with injection molding, which is important from a cost perspective.”

However, Kundrod said the team’s HPV test won’t be ready for widespread use until researchers modify it to detect more cancer-causing types of HPV and conduct additional clinical tests, adding that studies have consistently shown that HPV screening is the most effective way to prevent cervical cancer while DNA testing is the most effective way to screen for HPV infections.

Fertility

Researcher explores weight loss jab impact on PCOS

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Weight loss jabs are being studied to see if they could help women with polycystic ovary syndrome (PCOS)

The condition, which affects up to one in ten women, changes how the ovaries work and is linked to infertility and weight gain.

Dr Shagaf Bakour has won a £60,000 NHS research grant through Sandwell and West Birmingham NHS Trust to look at whether drugs such as Mounjaro and Ozempic might help.

“The research could lead to earlier support, better long-term health, and more joined-up care for a condition that affects many women but is still often overlooked,” she said.

Women with PCOS have higher levels of male hormones and can suffer from irregular periods and symptoms such as excess body or facial hair, the NHS said.

Associated weight gain can also lead to an increased risk of diabetes and heart problems.

Bakour, a gynaecologist and director of medical education at Aston Medical School, will work with a team to evaluate the effect of the weight loss medicines on metabolic and reproductive outcomes.

The drugs mimic a hormone called GLP-1, which suppresses appetite.

Bakour, alongside Dr Hoda Harb, a consultant obstetrician and gynaecologist at the NHS trust, will review existing evidence on their use and assess how they help patients with PCOS.

“The aim is to give women with PCOS evidence-informed, clearer treatment options and more consistent care,” she said.

“The project hopes to show whether these medicines can improve both general health and fertility health, while also helping local services develop clearer care pathways.

Prof Elizabeth Hughes, director of research and development at the NHS trust, said the effects of PCOS, including infertility, were “very emotive subjects”.

“We should be doing all we can within research and development to advance healthcare for women and to better help future generations with this condition,” she added.

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Diagnosis

Researchers teach AI to spot cancer risk by squeezing individual breast cells

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An AI tool could help spot breast cancer risk by analysing how individual breast cells behave when squeezed under stress, research suggests.

Researchers at City of Hope and the University of California, Berkeley, created a microfluidic platform that assesses women’s breast cancer risk at the cellular level.

The platform squeezes individual breast epithelial cells, which line breast tissue, to measure how they deform, recover and behave under stress.

Because more than 90 per cent of women do not have a known genetic predisposition to breast cancer or a family history of the disease, the researchers said the approach could help fill a key gap in risk assessment.

Mark LaBarge, professor in the department of population sciences at City of Hope, said: “For women with a known genetic risk factor for breast cancer, there are things you can do like follow a higher-risk screening protocol. For everybody else, you’re left wondering, ‘Am I at high risk?’

“By translating physical changes in cells into quantifiable data, this tool gives women something tangible to discuss with their doctors, not just risk estimates, but evidence drawn directly from their own cells.”

The researchers developed a machine learning algorithm that identifies and measures cells showing signs of accelerated ageing, generating an individual breast cancer risk score.

They said the platform uses simple electronics that could be easy and affordable to replicate on a large scale.

Lydia Sohn, chair in mechanical engineering at UC Berkeley, said: “Our team isn’t the first to measure the mechanical properties of cells; however, other approaches require advanced imaging technology that’s expensive, cumbersome and has limited availability.

“In contrast, MechanoAge uses computer chips that are simpler than an Apple Watch and ‘RadioShack parts’ that are cheap and easy to assemble, potentially making the device highly scalable.”

About 6 per cent of women who develop breast cancer carry known genetic mutations.

For women outside this group, risk is usually estimated indirectly using population models or measures such as breast density, which can both overestimate and underestimate individual risk.

The researchers said there is currently no non-genetic test that can identify women at higher risk of breast cancer.

Screening mammograms can detect cancer only once it has started to grow, but the MechanoAge platform aims to assess risk earlier by looking for physical changes in individual cells.

Using the platform, the researchers found that breast cells appear to have a “mechanical age” separate from a person’s chronological age, based on how the cells respond to stress.

They said this is the first time mechanical age has been quantified in biological cells.

Sohn said: “We learned that the older the mechanical age, as determined by how cells respond to being squeezed through our microfluidic device, the higher the risk for breast cancer.”

In this type of mechano-node-pore sensing, an electrical current is measured across a liquid-filled channel.

As cells pass through, they disrupt the current, generating measurements about their size and shape. By narrowing parts of the channel, researchers squeeze the cells and then measure how long each one takes to return to its normal shape.

The team found that cells from older women were stiffer and took longer to bounce back after being squeezed.

They also identified a subset of younger women whose cells behaved more like those from older women. These cells came from women with genetic mutations linked to a higher breast cancer risk.

The researchers then refined the algorithm to assign a risk score based on the cells’ measured mechanical and physical properties. They said it successfully identified women with known genetic risks.

The team then used it to compare cells from healthy women, women with a family history of breast cancer, and cells taken from the healthy breast of women with breast cancer in the other breast.

LaBarge said: “With accuracy, we were able to figure out which women were at high risk of breast cancer and which women didn’t seem to be.”

The work grew out of more than 12 years of collaboration between the two labs, combining engineering with cancer and ageing biology.

Sohn said: “It’s a true collaboration. We’ve learned a lot from each other.

LaBarge added: “In my view, this is what happens when you have a real collaboration that develops over a long time. This result is not what we imagined at the beginning.”

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Cancer

Experimental drug drowns triple-negative breast cancer cells in toxic fats

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An experimental drug slowed triple-negative breast cancer in mice by flooding tumour cells with toxic fats.

Triple-negative breast cancer lacks three common drug targets, making it one of the hardest-to-treat and most aggressive forms of the disease.

The compound, known as DH20931, appears to push cancer cells past their limits by triggering a surge in ceramides, fat-like molecules that place the cells under intense stress until they self-destruct.

In lab experiments, the drug also made standard chemotherapy more effective. When combined with doxorubicin, researchers were able to reduce the dose needed to kill cancer cells by about fivefold.

The drug targets an enzyme known as CerS2 to sharply increase production of these lipids and stress cancer cells. Healthy cells, by contrast, showed lower sensitivity to the drug in lab tests.

While the early results are promising, further preclinical and clinical trials would still be needed to determine the safety and effectiveness of DH20931 in humans.

Satya Narayan, a professor in the University of Florida’s College of Medicine, led the study with an international group of collaborators.

The researchers published their results on human-derived tumours on 21 April and presented their findings on combination therapy at the annual meeting of the American Association for Cancer Research in San Diego.

Narayan likened the drug’s effects to a home’s electrical system handling a power surge.

While healthy cells act like a properly grounded and installed circuit, cancer cells are more like a jumble of mismatched wires and faulty fuses. DH20931 overwhelms cells not with electricity, but with fats.

He said: “When that surge goes into the cancer cells, they cannot handle the amount of power they are getting. The fuses burn out, the cell can’t handle the surge and it dies.”

The compound was developed at the University of Florida in the lab of Sukwong Hong.

Hong, now a professor at the Gwangju Institute of Science and Technology in South Korea, created DH20931 as one of many drug candidates tested for efficacy in Narayan’s lab.

In the study, researchers implanted human triple-negative breast cancer tumours into mice and treated them with DH20931.

The drug significantly slowed tumour growth without causing noticeable weight loss or signs of toxicity in the animals. In separate lab experiments, it also showed activity against other breast cancer subtypes.

In addition to increasing lipid levels, DH20931 triggers a second stress signal by flooding cells with calcium.

Together, these effects disrupt the mitochondria, the structures that produce a cell’s energy, ultimately leading to cell death.

Narayan said: “It does not just follow one pathway but it goes through multiple pathways. It’s a two-hit hypothesis.

“These pathways are common in all breast cancer types and other solid tumours, so we think this drug can be useful not only in triple-negative breast cancer but potentially other cancers as well.”

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