Current Status and Emerging Trends in Colorectal Cancer Screening and Diagnostics

Colorectal cancer (CRC) is a prevalent and potentially fatal disease categorized based on its high incidences and mortality rates, which raised the need for effective diagnostic strategies for the early detection and management of CRC. While there are several conventional cancer diagnostics available, they have certain limitations that hinder their effectiveness. Significant research efforts are currently being dedicated to elucidating novel methodologies that aim at comprehending the intricate molecular mechanism that underlies CRC. Recently, microfluidic diagnostics have emerged as a pivotal solution, offering non-invasive approaches to real-time monitoring of disease progression and treatment response. Microfluidic devices enable the integration of multiple sample preparation steps into a single platform, which speeds up processing and improves sensitivity. Such advancements in diagnostic technologies hold immense promise for revolutionizing the field of CRC diagnosis and enabling efficient detection and monitoring strategies. This article elucidates several of the latest developments in microfluidic technology for CRC diagnostics. In addition to the advancements in microfluidic technology for CRC diagnostics, the integration of artificial intelligence (AI) holds great promise for further enhancing diagnostic capabilities. Advancements in microfluidic systems and AI-driven approaches can revolutionize colorectal cancer diagnostics, offering accurate, efficient, and personalized strategies to improve patient outcomes and transform cancer management

From tools and databases to clinically relevant applications in miRNA research

While especially early research focused on the small portion of the human genome that encodes proteins, it became apparent that molecules responsible for many key functions were also encoded in the remaining regions. Originally, non-coding RNAs, i.e., molecules that are not translated into proteins, were thought to be composed of only two classes (ribosomal RNAs and transfer RNAs). However, starting from the early 1980s many other non-coding RNA classes were discovered. In the past two decades, small non-coding RNAs (sncRNAs) and in particular microRNAs (miRNAs), have become essential molecules in biological and biomedical research. In this thesis, five aspects of miRNA research have been addressed. Starting from the development of advanced computational software to analyze miRNA data (1), an in-depth understanding of human and non-human miRNAs was generated and databases hosting this knowledge were created (2). In addition, the effects of technological advances were evaluated (3). We also contributed to the understanding on how miRNAs act in an orchestrated manner to target human genes (4). Finally, based on the insights gained from the tools and resources of the mentioned aspects we evaluated the suitability of miRNAs as biomarkers (5). With the establishment of next-generation sequencing, the primary goal of this thesis was the creation of an advanced bioinformatics analysis pipeline for high-throughput miRNA sequencing data, primarily focused on human. Consequently, miRMaster, a web-based software solution to analyze hundreds sequencing samples within few hours was implemented. The tool was implemented in a way that it could support different sequencing technologies and library preparation techniques. This flexibility allowed miRMaster to build a consequent user-base, resulting in over 120,000 processed samples and 1,5 billion processed reads, as of July 2021, and therefore laid out the basis for the second goal of this thesis. Indeed, the implementation of a feature allowing users to share their uploaded data contributed strongly to the generation of a detailed annotation of the human small non-coding transcriptome. This annotation was integrated into a new miRNA database, miRCarta, modelling thousands of miRNA candidates and corresponding read expression profiles. A subset of these candidates was then evaluated in the context of different diseases and validated. The thereby gained knowledge was subsequently used to validate additional miRNA candidates and to generate an estimate of the number of miRNAs in human. The large collection of samples, gathered over many years with miRMaster was also integrated into a web server evaluating miRNA arm shifts and switches, miRSwitch. Finally, we published an updated version of miRMaster, expanding its scope to other species and adding additional downstream analysis capabilities. The second goal of this thesis was further pursued by investigating the distribution of miRNAs across different human tissues and body fluids, as well as the variability of miRNA profiles over the four seasons of the year. Furthermore, small non-coding RNAs in zoo animals were examined and a tissue atlas of small non-coding RNAs for mice was generated. The third goal, the assessment of technological advances, was addressed by evaluating the new combinatorial probe-anchor synthesis-based sequencing technology published by BGI, analyzing the effect of RNA integrity on sequencing data, analyzing low-input library preparation protocols, and comparing template-switch based library preparation protocols to ligation-based ones. In addition, an antibody-based labeling sequencing chemistry, CoolMPS, was investigated. Deriving an understanding of the orchestrated regulation by miRNAs, the fourth goal of this thesis, was pursued in a first step by the implementation of a web server visualizing miRNA-gene interaction networks, miRTargetLink. Subsequently, miRPathDB, a database incorporating pathways affected by miRNAs and their targets was implemented, as well as miEAA 2.0, a web server offering quick miRNA set enrichment analyses in over 130,000 categories spanning 10 different species. In addition, miRSNPdb, a database evaluating the effects of single nucleotide polymorphisms and variants in miRNAs or in their target genes was created. Finally, the fifth goal of the thesis, the evaluation of the suitability of miRNAs as biomarkers for human diseases was tackled by investigating the expression profiles of miRNAs with machine learning. An Alzheimer's disease cohort with over 400 individuals was analyzed, as well as another neurodegenerative disease cohort with multiple time points of Parkinson's disease patients and healthy controls. Furthermore, a lung cancer cohort covering 3,000 individuals was examined to evaluate the suitability of an early detection test. In addition, we evaluated the expression profile changes induced by aging on a cohort of 1,334 healthy individuals and over 3,000 diseased patients. Altogether, the herein described tools, databases and research papers present valuable advances and insights into the miRNA research field and have been used and cited by the research community over 2,000 times as of July 2021.Während insbesondere die frühe Genetik-Forschung sich auf den kleinen Teil des menschlichen Genoms konzentrierte, der für Proteine kodiert, wurde deutlich, dass auch in den übrigen Regionen Moleküle kodiert werden, die für viele wichtige Funktionen verantwortlich sind. Ursprünglich ging man davon aus, dass nicht codierende RNAs, d. h. Moleküle, die nicht in Proteine übersetzt werden, nur aus zwei Klassen bestehen (ribosomale RNAs und Transfer-RNAs). Seit den frühen 1980er Jahren wurden jedoch viele andere nicht-kodierende RNA-Klassen entdeckt. In den letzten zwei Jahrzehnten sind kleine nichtcodierende RNAs (sncRNAs) und insbesondere microRNAs (miRNAs) zu wichtigen Molekülen in der biologischen und biomedizinischen Forschung geworden. In dieser Arbeit werden fünf Aspekte der miRNA-Forschung behandelt. Ausgehend von der Entwicklung fortschrittlicher Computersoftware zur Analyse von miRNA-Daten (1) wurde ein tiefgreifendes Verständnis menschlicher und nicht-menschlicher miRNAs entwickelt und Datenbanken mit diesem Wissen erstellt (2). Darüber hinaus wurden die Auswirkungen des technologischen Fortschritts bewertet (3). Wir haben auch dazu beigetragen, zu verstehen, wie miRNAs koordiniert agieren, um menschliche Gene zu regulieren (4). Schließlich bewerteten wir anhand der Erkenntnisse, die wir mit den Tools und Ressourcen der genannten Aspekte gewonnen hatten, die Eignung von miRNAs als Biomarker (5). Mit der Etablierung der Sequenzierung der nächsten Generation war das primäre Ziel dieser Arbeit die Schaffung einer fortschrittlichen bioinformatischen Analysepipeline für Hochdurchsatz-MiRNA-Sequenzierungsdaten, die sich in erster Linie auf den Menschen konzentriert. Daher wurde miRMaster, eine webbasierte Softwarelösung zur Analyse von Hunderten von Sequenzierproben innerhalb weniger Stunden, implementiert. Das Tool wurde so implementiert, dass es verschiedene Sequenzierungstechnologien und Bibliotheksvorbereitungstechniken unterstützen kann. Diese Flexibilität ermöglichte es miRMaster, eine konsequente Nutzerbasis aufzubauen, die im Juli 2021 über 120.000 verarbeitete Proben und 1,5 Milliarden verarbeitete Reads umfasste, womit die Grundlage für das zweite Ziel dieser Arbeit geschaffen wurde. Die Implementierung einer Funktion, die es den Nutzern ermöglicht, ihre hochgeladenen Daten mit anderen zu teilen, trug wesentlich zur Erstellung einer detaillierten Annotation des menschlichen kleinen nicht-kodierenden Transkriptoms bei. Diese Annotation wurde in eine neue miRNA-Datenbank, miRCarta, integriert, die Tausende von miRNA-Kandidaten und entsprechende Expressionsprofile abbildet. Eine Teilmenge dieser Kandidaten wurde dann im Zusammenhang mit verschiedenen Krankheiten bewertet und validiert. Die so gewonnenen Erkenntnisse wurden anschließend genutzt, um weitere miRNA-Kandidaten zu validieren und eine Schätzung der Anzahl der miRNAs im Menschen vorzunehmen. Die große Sammlung von Proben, die über viele Jahre mit miRMaster gesammelt wurde, wurde auch in einen Webserver integriert, der miRNA-Armverschiebungen und -Wechsel auswertet, miRSwitch. Schließlich haben wir eine aktualisierte Version von miRMaster veröffentlicht, die den Anwendungsbereich auf andere Spezies ausweitet und zusätzliche Downstream-Analysefunktionen hinzufügt. Das zweite Ziel dieser Arbeit wurde weiterverfolgt, indem die Verteilung von miRNAs in verschiedenen menschlichen Geweben und Körperflüssigkeiten sowie die Variabilität der miRNA-Profile über die vier Jahreszeiten hinweg untersucht wurde. Darüber hinaus wurden kleine nichtkodierende RNAs in Zootieren untersucht und ein Gewebeatlas der kleinen nichtkodierenden RNAs für Mäuse erstellt. Das dritte Ziel, die Einschätzung des technologischen Fortschritts, wurde angegangen, indem die neue kombinatorische Sonden-Anker-Synthese-basierte Sequenzierungstechnologie, die vom BGI veröffentlicht wurde, bewertet wurde, die Auswirkungen der RNA-Integrität auf die Sequenzierungsdaten analysiert wurden, Protokolle für die Bibliotheksvorbereitung mit geringem Input analysiert wurden und Protokolle für die Bibliotheksvorbereitung auf der Basis von Template-Switch mit solchen auf Ligationsbasis verglichen wurden. Darüber hinaus wurde eine auf Antikörpern basierende Labeling-Sequenzierungschemie, CoolMPS, untersucht. Das vierte Ziel dieser Arbeit, das Verständnis der orchestrierten Regulation durch miRNAs, wurde in einem ersten Schritt durch die Implementierung eines Webservers zur Visualisierung von miRNA-Gen-Interaktionsnetzwerken, miRTargetLink, verfolgt. Anschließend wurde miRPathDB implementiert, eine Datenbank, die von miRNAs und ihren Zielgenen beeinflusste Pfade enthält, sowie miEAA 2.0, ein Webserver, der schnelle miRNA-Anreicherungsanalysen in über 130.000 Kategorien aus 10 verschiedenen Spezies bietet. Darüber hinaus wurde miRSNPdb, eine Datenbank zur Bewertung der Auswirkungen von Einzelnukleotid-Polymorphismen und Varianten in miRNAs oder ihren Zielgenen, erstellt. Schließlich wurde das fünfte Ziel der Arbeit, die Bewertung der Eignung von miRNAs als Biomarker für menschliche Krankheiten, durch die Untersuchung der Expressionsprofile von miRNAs anhand von maschinellem Lernen angegangen. Eine Alzheimer-Kohorte mit über 400 Personen wurde analysiert, ebenso wie eine weitere neurodegenerative Krankheitskohorte mit Parkinson-Patienten an mehreren Zeitpunkten der Krankheit und gesunden Kontrollen. Außerdem wurde eine Lungenkrebskohorte mit 3.000 Personen untersucht, um die Eignung eines Früherkennungstests zu bewerten. Darüber hinaus haben wir die altersbedingten Veränderungen des Expressionsprofils bei einer Kohorte von 1.334 gesunden Personen und über 3.000 kranken Patienten untersucht. Insgesamt stellen die hier beschriebenen Tools, Datenbanken und Forschungsarbeiten wertvolle Fortschritte und Erkenntnisse auf dem Gebiet der miRNA-Forschung dar und wurden bis Juli 2021 von der Forschungsgemeinschaft über 2.000 Mal verwendet und zitiert

Establishment of predictive blood-based signatures in medical large scale genomic data sets : Development of novel diagnostic tests

Increasing data has led to tremendous success in discovering molecular biomarkers based on high throughput data. However, the translation of these so-called genomic signatures into clinical practice has been limited. The complexity and volume of genomic profiling requires heightened attention to robust design, methodological details, and avoidance of bias. During this thesis, novel strategies aimed at closing the gap from initially promising pilot studies to the clinical application of novel biomarkers are evaluated. First, a conventional process for genomic biomarker development comprising feature selection, algorithm and parameter optimization, and performance assessment was established. Using this approach, a RNA-stabilized whole blood diagnostic classifier for non-small cell lung cancer was built in a training set that can be used as a biomarker to discriminate between patients and control samples. Subsequently, this optimized classifier was successfully applied to two independent and blinded validation sets. Extensive permutation analysis using random feature lists supports the specificity of the established transcriptional classifier. Next, it was demonstrated that a combined approach of clinical trial simulation and adaptive learning strategies can be used to speed up biomarker development. As a model, genome-wide expression data derived from over 4,700 individuals in 37 studies addressing four clinical endpoints were used to assess over 1,800,000 classifiers. In addition to current approaches determining optimal classifiers within a defined study setting, randomized clinical trial simulation unequivocally uncovered the overall variance in the prediction performance of potential disease classifiers to predict the outcome of a large biomarker validation study from a pilot trial. Furthermore, most informative features were identified by feature ranking according to an individual classification performance score. Applying an adaptive learning strategy based on data extrapolation led to a datadriven prediction of the study size required for larger validation studies based on small pilot trials and an estimate of the expected statistical performance during validation. With these significant improvements, exceedingly robust and clinically applicable gene signatures for the diagnosis and detection of acute myeloid leukemia, active tuberculosis, HIV infection, and non-small cell lung cancer are established which could demonstrate disease-related enrichment of the obtained signatures and phenotype-related feature ranking. In further research, platform requirements for blood-based biomarker development were exemplarily examined for micro RNA expression profiling. The performance as well as the technical sample handling to provide reliable strategies for platform implementation in clinical applications were investigated. Overall, all introduced methods improve and accelerate the development of biomarker signatures for molecular diagnostics and can easily be extended to other high throughput data and other disease settings

From gene to function: using new technologies for solving old problems.

Recent advances in DNA sequencing have changed the field of genomics as well as that of proteomics making it possible to generate gigabases of genome and transcriptome sequence data at substantially lower cost than it was possible just ten years ago. In recent years, many high-throughput technologies have been developed to interrogate various aspects of cellular processes, including sequence and structural variation and the transcriptome, epigenome, proteome and interactome. These Next Generation Sequencing (NGS) experimental technologies are more mature and accessible than the computational tools available for individual researchers to move, store, analyse and present data in a user-friendly and reproducible fashion. My research work is placed in this scenario and focuses on the analysis of data produced by NGS technologies as well as on the development of new tools aimed at solving the different problems that arise during NGS data analysis. In order to achieve this aim, my group and I have dealt with several open biomedical problems in collaboration with different research groups of the Sapienza University. Some of these experiments have already given interesting results but mostly have represented the occasion and starting point for the development of new tools able to improve some crucial steps of the analyses, solve problems derived by the system complexity and make the results easier to understand for the researchers. Some examples are IsomirT, a tool for the small RNA-Seq analysis and isomiR identification, Phagotto, a tool for analysing deep sequencing data derived from phage-displayed libraries and FIDEA, a web server for the functional interpretation of differential expression analysis. Recent reports have demonstrated that individual microRNAs can be heterogeneous in length and/or sequence producing multiple mature variants that have been dubbed isomiRs. IsomirT is a useful tool to improve and simplify the search for isomiRs starting directly from the results of a miRNA-sequencing experiment. By using it, we observed the behaviour of isomiRs in different cell types and in different biological replicates. Our results indicate that the distribution of the microRNA variants is similar among replicates and different among cells/tissues suggesting that the isomiRs have a functional role in the cell. The use of the NGS technologies for the analysis of antibody selected sequences both using phage display libraries and in vitro selection processes is becoming increasingly popular. By using these technologies, the experimental group headed by prof. Felici has introduced a new experimental pipeline, named PROFILER, aimed at significantly empowering the analysis of antigen-specific libraries. A key step to exploit this idea has been to develop a new tool, Phagotto, for processing and analysing the data derived by sequencing. PROFILER, in combination with Phagotto, seems ideally suited to streamline and guide rational antigen design, adjuvant selection, and quality control of newly produced vaccines. The publicly available web server FIDEA allows experimentalists to obtain a functional interpretation of the results derived from differential expression analysis and to test their hypothesis quickly and easily. The tool performs an enrichment analysis i.e. an analysis of specific properties that are distributed in a non random fashion in the up-regulated and down-regulated genes, taken both together and separately. It has been shown to be very useful and is being heavily used from scientists all over the world, more than 1500 requests for analysis have been submitted to the server in six months. Furthermore, during the course of the PhD I implemented pipelines for the speeding up and optimization of protocols for NGS data analysis and applied them to biomedical projects. Of course not all the proteins have a complete functional annotation and consequently the issue of predicting the function of proteins with a partial or no functional annotation arises. This can be done both by exploiting the 3D structure of the protein or by inferring the function directly from the sequence. A real challenge, however, is the assessment of the accuracy of existing methods. In this context the help that critical assessment experiments can give is essential. We have had the possibility to be involved, as assessors, in the world wide experiment CASP (Critical Assessment of protein Structure Prediction). In particular, we are involved in the assessment of the residue-residue contacts in which the participant groups provide a list of predicted contacts between residues that hopefully can be used as constraints to fold the protein. We proposed and implemented new methodologies to understand which method works better and where future efforts should be focused

One-class SVM and supervised machine learning models for uncovering associations of non-coding RNA with diseases

The study of MicroRNAs (miRNAs), long non-coding RNAs (lncRNAs) and gene interactions may be expected to provide new technologies to serve as valuable biomarkers for personalized treatments of diseases and to aid in the prognosis of certain conditions. These molecules act at the genome level by regulating or suppressing their protein expression functions. The primary challenge in the study of these non-coding molecules involves the necessity of finding labeled data indicating positive and negative interactions when predicting interactions using machine-learning or deep-learning techniques. However, usually we end up with a scenario of unbalanced data or unstable scenarios for using these models. An additional problem involves the extraction of features derived from the binding of these non-coding RNAs and genes. This binding process usually occurs fully or partially in animal genetics, which leads to considerable complexity in studying the process. Therefore, the main objective of the present work is to demonstrate that it is possible to use features extracted for miRNAs sequences in the development of diseases such as breast cancer, breast neoplasms, or if there is any influence with immune genes related to the SARS-COV-2. We performed experiments focusing on the erb-b2 receptor tyrosine kinase 2 (ERBB2) gene involved in breast cancer. For this purpose, we gathered miRNA-mRNA information from the binding between these two genetic molecules. In this part of our research, we applied a One-Class SVM and an Isolation Forest to discriminate between weak interactions, outliers given by the one-class model, and strong interactions that could occur between miRNA and mRNA (messenger RNA). Additionally, this study aimed to differentiate between breast cancer cases and breast neoplasm conditions. In this section we used the information encoded in lncRNAs. The additional feature used in this part was the frequency of k-mers, i.e., small portions of nucleotides, along with the data from the energy released in miRNA folding. The models used to discriminate between these diseases were One-Class SVM, SVM, and Random Forest. In the final part of the present work, we described a subset of probable miRNA binding with SARS-COV-2 RNA, focusing on those miRNAs with a relationship with genes involved in the immunological system of the human body. The models used as classifiers were One-Class SVM, SVM, and Random Forest. The results obtained in the present study are comparable to those found in the current literature and demonstrate the feasibility of using one-class models combined with features from the coupling of non-coding genes or mRNAs and their relationships with forms of breast cancer and viral infections. This work is expected to establish a basis for future avenues of research to apply one-class machine-learning models with feature extraction based on genomic sequences to the study of the relationship between non-coding RNAs and various diseases.School of ComputingPh. D. (Computing

Development of a simple artificial intelligence method to accurately subtype breast cancers based on gene expression barcodes

>Magister Scientiae - MScINTRODUCTION: Breast cancer is a highly heterogeneous disease. The complexity of achieving an accurate diagnosis and an effective treatment regimen lies within this heterogeneity. Subtypes of the disease are not simply molecular, i.e. hormone receptor over-expression or absence, but the tumour itself is heterogeneous in terms of tissue of origin, metastases, and histopathological variability. Accurate tumour classification vastly improves treatment decisions, patient outcomes and 5-year survival rates. Gene expression studies aided by transcriptomic technologies such as microarrays and next-generation sequencing (e.g. RNA-Sequencing) have aided oncology researcher and clinician understanding of the complex molecular portraits of malignant breast tumours. Mechanisms governing cancers, which include tumorigenesis, gene fusions, gene over-expression and suppression, cellular process and pathway involvementinvolvement, have been elucidated through comprehensive analyses of the cancer transcriptome. Over the past 20 years, gene expression signatures, discovered with both microarray and RNA-Seq have reached clinical and commercial application through the development of tests such as Mammaprint®, OncotypeDX®, and FoundationOne® CDx, all which focus on chemotherapy sensitivity, prediction of cancer recurrence, and tumour mutational level. The Gene Expression Barcode (GExB) algorithm was developed to allow for easy interpretation and integration of microarray data through data normalization with frozen RMA (fRMA) preprocessing and conversion of relative gene expression to a sequence of 1's and 0's. Unfortunately, the algorithm has not yet been developed for RNA-Seq data. However, implementation of the GExB with feature-selection would contribute to a machine-learning based robust breast cancer and subtype classifier. METHODOLOGY: For microarray data, we applied the GExB algorithm to generate barcodes for normal breast and breast tumour samples. A two-class classifier for malignancy was developed through feature-selection on barcoded samples by selecting for genes with 85% stable absence or presence within a tissue type, and differentially stable between tissues. A multi-class feature-selection method was employed to identify genes with variable expression in one subtype, but 80% stable absence or presence in all other subtypes, i.e. 80% in n-1 subtypes. For RNA-Seq data, a barcoding method needed to be developed which could mimic the GExB algorithm for microarray data. A z-score-to-barcode method was implemented and differential gene expression analysis with selection of the top 100 genes as informative features for classification purposes. The accuracy and discriminatory capability of both microarray-based gene signatures and the RNA-Seq-based gene signatures was assessed through unsupervised and supervised machine-learning algorithms, i.e., K-means and Hierarchical clustering, as well as binary and multi-class Support Vector Machine (SVM) implementations. RESULTS: The GExB-FS method for microarray data yielded an 85-probe and 346-probe informative set for two-class and multi-class classifiers, respectively. The two-class classifier predicted samples as either normal or malignant with 100% accuracy and the multi-class classifier predicted molecular subtype with 96.5% accuracy with SVM. Combining RNA-Seq DE analysis for feature-selection with the z-score-to-barcode method, resulted in a two-class classifier for malignancy, and a multi-class classifier for normal-from-healthy, normal-adjacent-tumour (from cancer patients), and breast tumour samples with 100% accuracy. Most notably, a normal-adjacent-tumour gene expression signature emerged, which differentiated it from normal breast tissues in healthy individuals. CONCLUSION: A potentially novel method for microarray and RNA-Seq data transformation, feature selection and classifier development was established. The universal application of the microarray signatures and validity of the z-score-to-barcode method was proven with 95% accurate classification of RNA-Seq barcoded samples with a microarray discovered gene expression signature. The results from this comprehensive study into the discovery of robust gene expression signatures holds immense potential for further R&F towards implementation at the clinical endpoint, and translation to simpler and cost-effective laboratory methods such as qtPCR-based tests

Computational Methods for the Analysis of Genomic Data and Biological Processes

In recent decades, new technologies have made remarkable progress in helping to understand biological systems. Rapid advances in genomic profiling techniques such as microarrays or high-performance sequencing have brought new opportunities and challenges in the fields of computational biology and bioinformatics. Such genetic sequencing techniques allow large amounts of data to be produced, whose analysis and cross-integration could provide a complete view of organisms. As a result, it is necessary to develop new techniques and algorithms that carry out an analysis of these data with reliability and efficiency. This Special Issue collected the latest advances in the field of computational methods for the analysis of gene expression data, and, in particular, the modeling of biological processes. Here we present eleven works selected to be published in this Special Issue due to their interest, quality, and originality