Author Interviews, Cancer Research, NEJM, NIH, OBGYNE / 05.12.2024
NEJM: Prenatal cell-free DNA Can Detect Occult Maternal Cancer
MedicalResearch.com Interview with:
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Dr. Bianchi[/caption]
Diana W. Bianchi, M.D.
Senior Investigator
Center for Precision Health Research
Director,
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institutes of Health
MedicalResearch.com: What is the background for this study?
Response: The ability of prenatal cell-free DNA (cfDNA) sequencing to incidentally detect maternal cancers has been demonstrated by several retrospective studies from commercial or national laboratories. However, there are no standardized approaches to the identification and medical management of prenatal screening results that might indicate a maternal cancer. We sought to prospectively identify DNA sequencing patterns and other biomarkers that could distinguish which women with nonreportable or unusual cfDNA sequencing results had cancer and to determine the best approach for diagnostic work-up of pregnant people who receive these results.
Dr. Bianchi[/caption]
Diana W. Bianchi, M.D.
Senior Investigator
Center for Precision Health Research
Director,
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institutes of Health
MedicalResearch.com: What is the background for this study?
Response: The ability of prenatal cell-free DNA (cfDNA) sequencing to incidentally detect maternal cancers has been demonstrated by several retrospective studies from commercial or national laboratories. However, there are no standardized approaches to the identification and medical management of prenatal screening results that might indicate a maternal cancer. We sought to prospectively identify DNA sequencing patterns and other biomarkers that could distinguish which women with nonreportable or unusual cfDNA sequencing results had cancer and to determine the best approach for diagnostic work-up of pregnant people who receive these results.
Dr. Khullar[/caption]
Dhruv Khullar, M.D., M.P.P.
Director of Policy Dissemination
Physicians Foundation Center for Physician Practice and Leadership
Assistant Professor of Health Policy and Economics
Weill Cornell Medicine, NYC
MedicalResearch.com: What is the background for this study?
Response: From prior research, we know that there are racial/ethnic differences in the acute impact of COVID-19, including higher rates of hospitalization and death among Black and Hispanic individuals compared to white individuals. Less is known about whether there are differences in the rates or types of long COVID by race and ethnicity.
Dr. Altan-Bonnet[/caption]
Nihal Altan-Bonnet, Ph.D.
Chief of the Laboratory of Host-Pathogen Dynamics
NHLBI
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Enteric viruses such as norovirus, rotavirus and astrovirus are responsible for nearly 1.5 billion global infections per year resulting in gastrointestinal illnesses and sometimes leading to death in the very young, in the elderly and in the immunocompromised. These viruses have been thought to traditionally infect and replicate only in the intestines, then shed into feces and transmit to others via the oral-fecal route (e.g. through ingestion of fecal contaminated food items).
Our findings reported in Nature, using animal models of norovirus, rotavirus and astrovirus infection, challenge this traditional view and reveal that these viruses can also replicate robustly in salivary glands, be shed into saliva in large quantities and transmit through saliva to other animals.
In particular we also show infected infants can transmit these viruses to their mothers mammary glands via suckling and this leads to both an infection in their mothers mammary glands but also a rapid immune response by the mother resulting in a surge in her milk antibodies. These milk antibodies may play a role in fighting the infection in their infants .









