Category Archives: Medical Research

Biomarkers and Cancer: the Science and the Issues

What are Biomarkers? 

Glial cells with biomarkers

This image shows one way that biomarker proteins such as glial fibrillary acid protein can be labeled as a biomarker for normal development of human nerve cells.Photo courtesy of the National Institute of Neurological Disorders and Stroke (NINDS)

 

 

 

 

Imagine being told by your physician that you will likely have your first heart attack at 50 years with at least a 90% certainty.  It is not too surprising to hear that physicians provide health advice with patients based on a patient’s life style or family history.  However, there is a growing body of research that searches for molecular fingerprints that can accurately predict the occurrence of life-threatening disorders. These molecular fingerprints are called biomarkers.

Biomarker studies are not the same as the traditional DNA testing that identifies known alleles or mutations from the norm that are identified with genetic diseases. A variety of cellular and molecular parameters can be measures as biomarkers of cell and bodily activities. Biomarker research today is primarily targeted at predicting and treating diseases. However, biomarkers are also indicators of any physiological or environmental factor that elicits responses in specific cells, tissues, or organs. The journal Biomarker provides a good idea of the latitude of biomarker research.

Likely the fastest growing area of biomarker research is in cancer studies.  Cancer is a globally distributed disease that needs better treatment suited for targeting the cancer cells without causing needless harm to normal body cells.  The Biomarkers in Cancer journal is one of many biomarker journals that contain the latest findings on how biomarkers can predict the incidence of cancer and be used to find cancer treatments.

Official Definition of Biomarker
The National Cancer Institute at the United States National Institutes of Health defines biomarkers as “A biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or of a condition or disease. A biomarker may be used to see how well the body responds to a treatment for a disease or condition. Also called molecular marker and signature molecule.”

How are Biomarkers used in Cancer Research?

The occurrence of melanoma, as shown above, can be better and more simply predicted using biomarkers produced by the cancer cells. Image courtesy of the National Cancer Institute (NCI)

The occurrence of melanoma, as shown above, can be better and more simply predicted using biomarkers produced by the cancer cells. Image courtesy of the National Cancer Institute (NCI)

 

 

 

 

Cancer is unlike most other diseases because of the variety of factors can predispose a person to cancer.  A combination of environmental factors acting on various genetic and epigenetic errors can induce cancerous cells. More and more studies are showing One area of cancer biomarker research is to improve the easy at which the cancers can be detected.  For example, simpler ways of detecting prostate cancer are being developed through finding biomarkers in seminal fluids. This is much less invasive than blood tests and prostate biopsies.  Breast cancer has many causes one of which is caused by mutations in the brca genes. However, identification of the BRCA mutation does not necessarily predict the chance of developing breast cancer. Researchers are seeking a variety of biomarkers that accurately predict the factors that contribute to onset of breast cancer.

There are many types of cancers cause by a multitude of factors.  Biomarkers seem to be the best way to understand the molecular biology of cancer detection and treatment. There is a growing interest by pharmaceutical companies for designing biomarkers for a variety of diagnostic purposes. There will likely never be one biomarker profile that identifies all cancers. However, it hoped that biomarkers for specific cancers can catch cancers long before they develop.

What are the Issues with using Cancer Biomarkers?

Biomarker identification research is causing quite a commotion in the medical and scientific communities. Epidemiologists and physicians are currently debating the accuracy and precision of biomarkers. It is often difficult to predict the success rate of biomarker predictions. It will take many more studies on large populations of people to find strong correlations between biomarkers and the cancer cell’s biological processes. Issues of accuracy particularly bring up concerns about determining the probabilities of false positive and false negative results that can result in grave diagnostic errors for various diseases and inappropriate policies based on inappropriate associations between biomarkers and causative factors of disease.

Bioethicists, psychologists, and public health officials have many other concerns about biomarkers.   Probably, the biggest issue is the confidential nature of biomarker information.  It is possible that biomarker information about a person can accidently become publically available. Certain conditions carry social stigmas that a patient may wish to keep private. Also, a person’s employability and insurability can be hindered by certain conditions.

A variety of cell products and cell structures can be used as biomarkers for disease and changes in metabolic processes due to environmental factors and pharmaceuticals. Biomarkers are effective only if they accurately identify the condition they designed to detect. Image courtesy National Institute of General Medical Sciences (NIGMS)

A variety of cell products and cell structures can be used as biomarkers for disease and changes in metabolic processes due to environmental factors and pharmaceuticals. Biomarkers are effective only if they accurately identify the condition they designed to detect. Image courtesy National Institute of General Medical Sciences (NIGMS)

Biomarker information must be collected in a way to protect patient confidentiality. It important to avoid any negative consequences from diagnosing disease. Image courtesy of National Eye Institute (NEI).

Biomarker information must be collected in a way to protect patient confidentiality. It important to avoid any negative consequences from diagnosing disease.Image courtesy of National Eye Institute (NEI).

 

 

 

 

 

 

 

 

 

 

 

How do you teach the importance of cancer biomarkers in the biology curriculum?

Scientifically accurate resources are essential for teaching reliable and contemporary information related to biomarkers in cancer research.  All of the teaching resources mentioned in section are available on the American Physiological Society’s Life Science Teaching Resource Community (LifeSciTRC) website. Resources on the LifeSciTRC are peer reviewed and rated by instructors who testing the resources in their teaching.

Cancer biology is a fundamental component of the biological sciences core content. It can be used to reinforce the principles of cell structure, cell differentiation, and cell division. Strategies for diagnosing and treating cancer are use skills that are needed for STEM careers in the biomedical sciences and biotechnology. Students can be introduced to cancer biology using the Northwest Association for Biomedical Research BRCA1 and Breast Cancer website. A variety of resources about cell structure and function related to cancer are available at the Cold Spring Harbor Laboratory and Dolan DNA Learning Center. Am article called “Inflammation and Stem Cells in Gastrointestinal Carcinogenesis” provides good information about how measuring inflammation can lead to the discovery of cancer indicators.

Biomarker research is still an emerging science that applies information about biochemistry, cell differentiation, cell structure, embryology, genetics, and molecular biology. Plus, the issues raised by biomarker research is important for understanding the principles of bioethics and public health. A general resource giving specific examples of biomarker uses is available in the article “Detailing Deadly Effects of Household Air Pollution From Biomass Fuels Leads to Call For Studies Into Biomarkers of Exposure and Predictors of Respiratory Disease Adolescents“.

Students can then be given the following resources to read and hypothesize what type of biomarkers can be developed to predict health problems from the measurements used in the research studies:

The Vision and Change in Undergraduate Biology Education project encourages undergraduate biology faculty to encourage critical thinking and career skills exploration in their teaching. Biomarkers are an interesting topic that be used integrate higher order thinking and science careers skill into the biology curriculum.  Students should be encourage do find cancer and biomarker websites that can be submitted to the LifeSciTRC website as content and teaching resources.

All images are from the National Institutes of Health Image Bank at https://imagebank.nih.gov/.

shmaefsky

 

 

 

Brian Shmaefsky, PhD, is currently a professor of biology at Lone Star College – Kingwood, near Houston, TX. His research emphasis is in environmental physiology. He has served in leadership capacities for the American Institute of Biological Sciences, Biotechnology Institute, National Association of Biology Teachers, National Science Teachers Association, Society for College Science Teachers, and Academies of Science in Illinois, Oklahoma, and Texas. He has been a speaker at many local and international conferences on various topics including biotechnology, industrial hygiene, media relations, science education, sustainable development, workforce safety, and workforce training. Brian is LifeSciTRC Scholar, Fellow, and Advisory Board Member.

 

What About Vaccines?

vaccine“You have a question?” I ask.

“Dr. Miller, what is your opinion about vaccinations?” comes the reply.

The big can of worms has been opened, but I expect this midway through each semester as we complete our study of the body’s immune system in my Anatomy and Physiology undergraduate course. Many of my students are parents and with all of the media (both positive and negative) regarding vaccines the last several years, they are questioning this pediatric rite-of-passage. As they should, I say. Just the question shows me that they are beginning to think critically regarding the function of the human body and its relationship to the environment. I do not think giving my opinion is a good idea. I do, however, want them to have the opportunity to make informed decisions regarding the health of their families with properly vetted resources.

A very good tool that can be printed and distributed for free to any interested student can be found right here at the LifeSciTRC. A number of years ago the U.S. Department of Health and Human Services published this excellent booklet and made it free to the general public: Understanding Vaccines. This booklet is also a useful tool for follow-up and review when teaching the immune system. Most of it is presented in easy to understand language for the lay person. It covers microbes, what vaccines are, the public health aspect of vaccination, the immune system, and more. There’s also a great glossary in the back. The only problem with the booklet is that it was published over 10 years ago, and there have been many scientific discoveries and changes regarding this subject since its publication. As an alternative or together with the booklet, students can be directed to the online version which is updated regularly here: NIH Understanding Vaccines Website.

In addition to giving students these resources, I do discuss the purpose of vaccines. I find it is especially important that they hear and understand that vaccines do carry some risks, but their benefits far outweigh the risks in general. I want them to also understand that vaccinating people is a public health issue. Vaccinated people not only receive protection themselves, but help to protect those that cannot be vaccinated for various reasons, thus protecting their entire community from the return of devastating diseases. The booklet does a great job describing how community immunity or the lack thereof affects diseases in the “You and Your Community” section.

Another important point I like to make is regarding continuing to receive vaccines for diseases we haven’t seen in quite a while here in the U. S. This does not mean the diseases no longer exist, as many, such as measles, still strike in other areas of the world.  Our world is becoming smaller and smaller, and by this I mean it is very easy for people to travel to nearly any place and become infected with a disease for which we have a vaccine. When the person comes home, they can begin to spread the disease throughout their families and communities, if the vaccine rate has dropped below optimal in that area. We can now also discuss the past scare of Ebola, which has no vaccine, coming to the United States and bring home the point of the need for vaccines. We cannot always know where the person standing next to us and our children at the grocery line, in church, or at school has been lately or if they’re up to date on their vaccines.

When you are asked the question, “What about vaccines?” do not shy away from it in your classrooms. Instead, try these well-vetted resources that you can study yourself and share with your students. It will be well worth the time and effort.

Resources:

  1. Understanding Vaccines (Booklet) – http://www.lifescitrc.org/resource.cfm?submissionID=5774
  2. Understanding Vaccines (Website) http://www.niaid.nih.gov/topics/vaccines/understanding/Pages/Default.aspx
  3. Easy to Read Immunization Schedules for Children – http://www.cdc.gov/vaccines/schedules/easy-to-read/child.html
  4. A Universal Vaccine (Article) – http://www.lifescitrc.org/resource.cfm?submissionID=7414

 

Miller

 

 

 

 

Deborah Miller, D.C., is a LifeSciTRC Scholar and Fellow who teaches undergraduate Anatomy & Physiology at Chattahoochee Technical College.  She is also a member of the Physiology Educator Community of Practice (PECOP) and serves on the 2015 LifeSciTRC Advisory Board.