Several studies have shown robust evidence between the chronic systemic inflammation (CSI) and increasing risk of various non-communicable diseases (NCDs) and mortality.  As opposed to an acute inflammatory response that is characterised as a temporary upregulation of inflammatory activity in response to a threat (e.g., bacterial infection), the CSI is a low-grade, non-infective state triggered by certain social, psychological, environmental and biological factors.  The prolonged CSI leads to major alterations in organs and fatal impairment of immune system of an individual, which triggers the onset and development of hypertension, hyperglycemia, type II diabetes, autoimmune diseases, cardiovascular disease, chronic kidney disease, several types of malignancies, depression and sarcopenia.  Since the NCDs significantly affect individuals (e.g., reduced life expectancy, poor quality of life), household (e.g., increased health expenditure), and macroeconomy (e.g., losses in economic growth), early diagnosis and timely treatment to intervene the CSI and risk factors associated with NCDs become critical.

The C-reactive protein (CRP) and cytokines (e.g., interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor-α) provide valuable insights on inflammatory activity.  Recent research has investigated the detection and quantification of these markers in body fluids other than serum such as urine, sweat, saliva, and exhaled breath of patients with various NCDs.  A non-invasive (digital) biomarker would help alleviate multiple burdens from invasive blood tests and contribute to the self-management of patients.  Furthermore, it would add significant value to clinicians and caregivers by enabling meaningful treatment and effective prevention of future events.

Hence, this project aims to investigate 1) to what extent biomarkers indicating the presence of health-damaging chronic inflammation can be measured non-invasively; 2) to what extent these biomarkers can be digitalized applying AI/ML algorithms.

Photo credit: B-cell interacting with a virus, AdobeStock_485544281.

1. Furman, D., Campisi, J., Verdin, E., Carrera-Bastos, P., Targ, S., Franceschi, C., Ferrucci, L., Gilroy, D. W., Fasano, A., Miller, G. W., Miller, A. H., Mantovani, A., Weyand, C. M., Barzilai, N., Goronzy, J. J., Rando, T. A., Effros, R. B., Lucia, A., Kleinstreuer, N., & Slavich, G. M. (2019). Chronic inflammation in the etiology of disease across the life span. Nat Med, 25(12), 1822-1832. https://doi.org/10.1038/s41591-019-0675-0
2. Jagannath, B., Lin, K. C., Pali, M., Sankhala, D., Muthukumar, S., & Prasad, S. (2020). A Sweat-based Wearable Enabling Technology for Real-time Monitoring of IL-1beta and CRP as Potential Markers for Inflammatory Bowel Disease. Inflamm Bowel Dis, 26(10), 1533-1542. https://doi.org/10.1093/ibd/izaa191
3. Pay, J. B., & Shaw, A. M. (2019). Towards salivary C-reactive protein as a viable biomarker of systemic inflammation. Clin Biochem, 68, 1-8. https://doi.org/10.1016/j.clinbiochem.2019.04.006
4. Asfuroglu, A., Balci, M., Aslan, Y., Senel, C., Guzel, O., Kilinckaya, M. F., Turhan, T., & Tuncel, A. (2021). What Is the Interaction between Urine C-Reactive Protein, Prostatic Inflammation, and Doxazosin Treatment in Patients with Benign Prostatic Hyperplasia? A Pilot Study. Urol Int, 1-5. https://doi.org/10.1159/000518474

Measuring and digitalizing biomarkers indicating the presence of health-damaging chronic inflammation.

Jinjoo Shim, MSc & Filipe Barata, PhD

Dr. med. Oliver Distler, Prof. Dr. Dr. Caroline Ospelt & Dr. med. Maria-Sinziana Muraru-Carbune (University Hospital Zurich)

Study design in early 2022; Pilot study planned in later 2022