Breathalyzer to detect lung cancer . . . Researchers at the University of Huddersfield (West Yorkshire, UK) are working on a breathalyzer device that will be able to detect very early signs of cancer, making a cure much more likely. LUNG cancer is one of the world's biggest killers. In the UK it accounts for 6% of all deaths, largely because treatment is often ineffective by the time symptoms are diagnosed. But researchers at the University of Huddersfield are working on a breathalyser device that will be able to detect very early signs of the disease, making a cure much more likely. And it will be pharmacists who administer a test that has the potential to save hundreds of thousands of lives. "The intention is that we will catch patients before they start getting the symptoms. Once lung cancer patients start experiencing symptoms it is often very advanced and has a very low cure rate," says Rachel Airley, the University of Huddersfield lecturer who developed the breath test project. It has received backing of £105,000 from Dr Philip Brown of the S.G. Court Group, a pharmacy chain based in the South East of England, where initial trials will be carried out. The University itself has provided matching funding. "We are looking to be able to distinguish between patients with early lung cancer and patients who have maybe got bronchitis, emphysema or non-malignant smoking related disease . . . or who have maybe just got a cough."

Researchers develop app to measure cholesterol . . . Engineers at Cornell University (Ithaca, New York) have invented a new lifesaving smartphone app that will help the user keep an eye on his or her cholesterol levels with just a 'selfie.' The Smartphone Cholesterol Application for Rapid Diagnostics, or 'smartCARD,' reads your cholesterol level in about a minute. David Erickson, Cornell associate professor of mechanical engineering and senior author on a new peer-reviewed study, said that smartphones have the potential to address health issues by eliminating the need for specialized equipment. Thanks to advanced, sophisticated camera technology, Erickson and his colleagues have created a smartphone accessory that optically detects biomarkers in a drop of blood, sweat or saliva. The new application then discerns the results using colour analysis. When a user puts a drop of blood on the cholesterol test strip, it processes the blood through separation steps and chemical reactions. The strip is then ready for colorimetric analysis by the smartphone application. The smartCARD accessory, which looks somewhat like a smartphone credit card reader, clamps over the phone's camera. Its built-in flash provides uniform, diffused light to illuminate the test strip that fits into the smartCARD reader. The application in the phone calibrates the hue saturation to the image's color values on the cholesterol test strip, and the results appear on your phone. Erickson added that although smartCARD is ready to be brought to market immediately, he is optimistic that it will have even more its advanced capabilities in less than a year. The study is published online in the journal Lab on a Chip.

HPV home tests could ID cancer risk . . . HPV self-testing is as effective as tests done by doctors, according to a Lund University (Lund, Sweden) study. Simple HPV home tests could therefore complement existing screening programs, and identify more women at risk for cervical cancer. Sweden has a system of regular gynaecological smear tests, which has halved the number of cases of cervical cancer. Most of the patients who die from the disease are therefore either above the screening age, or part of the 20% who fail to attend their screenings. The figures are similar in other countries with equivalent screening programs. "We are usually able to cure cases of cancer that are identified through smear tests. For those women who have not been for smear tests, the cancer has progressed considerably further by the time it is diagnosed. It is these women who are at risk of dying from the disease," says Lotten Darlin, MD, at Lund University in Sweden. The most common response when asked why they haven't attended cervical smear tests is that the tests are unpleasant, that the women felt healthy and/or that they haven't had time, according to one of Lotten Darlin's studies. She therefore investigated the possibility of home testing, but the testing kits that are currently available have been shown to be either complicated or expensive. Darlin and her colleagues have therefore developed their own test, which comprises a simple cotton bud and a test tube. The test is sent off to a lab, where it has been shown to produce just as clear results as HPV tests taken by a doctor. HPV tests measure levels of human papilloma virus, a virus that in the long run can cause cervical cancer. In one study, self-testing kits were sent to 1,000 women who had not had a smear test for over nine years. Fifteen per cent of them used the test and sent in samples for analysis. "That may not seem like many. But for this group, who have failed to go for a smear test for so many years, it is nonetheless a significant improvement," says Lotten Darlin. She believes that the simple self-testing kit could also be used in countries that do not have a program of regular cervical smear tests: "It doesn't require a lot of resources or a well-developed healthcare system to analyze the results. The women just need a basic knowledge of their bodies to take the test correctly." Other studies that Dr Darlin has conducted concern the end of the regular screening program. The tests are discontinued at different ages in different parts of Sweden, but usually end between the ages of 60 and 65. Lotten Darlin's studies show that many cases of cervical cancer are diagnosed in women in their sixties -- a quarter of cases after the age of 65. She thinks the health service therefore shouldn't let older women leave the screening program without a special exit test for HPV.

EGF receptor ecto-domain mutations: when to screen and when not to screen . . . The epidermal growth factor receptor (EGFR) is expressed in normal colonic cells and is activated by specific peptide growth factors that regulate cell proliferation, survival and differentiation. Increased expression and activation of the EGFR has been observed in the majority of colorectal carcinoma (CRC), suggesting that the EGFR pathway plays an important role in colon carcinogenesis. The monoclonal antibodies cetuximab and panitumumab are capable of blocking EGFR activity and have shown clinical activity in patients with metastatic CRC (mCRC). However, the efficacy of these agents is significantly limited by mechanisms of intrinsic and acquired resistance. In this respect, the S492R mutation of the extracellular domain of the EGFR is a peculiar mechanism of acquired resistance that limits the binding of cetuximab, but not panitumumab, to the EGFR. This study is the first to demonstrate that the S492R EGFR ectodomain mutation is never present in patients that have not been exposed to EGFR monoclonal antibodies. In particular, a large cohort (505 patients) of KRAS exon 2 wild type mCRC cases, potential candidates for treatment with cetuximab, were screened to test for the S492R EGFR mutation; a sensitive test that failed to identify any mutation. These findings suggest that the S492R EGFR mutation is not involved in primary resistance to cetuximab in CRC and have important consequences on the molecular assessment of mCRC patients. Based on these findings patients with mCRC should not be routinely screened for the S492R mutation prior therapy with cetuximab.

Changes in proteins may predict ALS progression . . . Measuring changes in certain proteins – called biomarkers – in people with amyotrophic lateral sclerosis may better predict the progression of the disease, according to scientists at Penn State College of Medicine (Hershey, Pennsylvania). ALS is often referred to as Lou Gehrig's disease, is a neurological disease in which the brain loses its ability to control movement as motor neurons degenerate. The course of the disease varies, with survival ranging from months to decades. "The cause of most cases of ALS remains unknown," said James Connor, Distinguished Professor of Neurosurgery, Neural and Behavioral Sciences and Pediatrics. "Although several genetic and environmental factors have been identified, each accounts for only a fraction of the total cases of ALS." This clinical variation in patients presents challenges in terms of managing the disease and developing new treatments. Finding relevant biomarkers, which are objective measures that reflect changes in biological processes or reactions to treatments, may help address these challenges. The project was led by Xiaowei Su, an MD/ PhD, a student in Connor's laboratory, in collaboration with Zachary Simmons, director of the Penn State Hershey ALS Clinic and Research Center. Su studied plasma and cerebrospinal fluid samples previously collected from patients undergoing diagnostic evaluation, who were later identified as having ALS. Analysis shows that looking at multiple biomarkers to predict progression is not only mathematically possible, it improves upon methods using single biomarkers. Statistical models analyzing plasma had reasonable ability to predict total disease duration and used seven relevant biomarkers. For example, higher levels of the protein IL-10 predict a longer disease duration. IL-10 is involved with anti-inflammation, suggesting that lower levels of inflammation are associated with a longer disease duration. The researchers identified six biomarkers for cerebrospinal fluid. For example, higher levels of G-CSF -- a growth factor known to have protective effects on motor neurons, the cells that die in ALS – predicts a longer disease duration. Perhaps most importantly, the results suggest that a combination of biomarkers from both plasma and cerebrospinal fluid better predict disease duration. While the size of this study is small, the ability of the specific biomarkers used to predict prognosis suggests that the approach holds promise. "The results argue for the usefulness of researching this approach for ALS both in terms of predicting disease progression and in terms of determining the impact of therapeutic strategies," Connor said. "The results present a compelling starting point for the use of this method in larger studies and provide insights for novel therapeutic targets."