proteins and analyze them for the discovery of biomarkers using matrix-assisted laser
desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS), and liquid
chromatography-electrospray ionization mass spectrometry (LC-ESI-MS) [9–11].
The common gynecological malignancy is endometrial cancer (ECa). It affects 6% of
women worldwide. The early-stage diagnosis of endometrial cancer is difficult. The non-
invasive and efficient diagnosis of ECa is through the detection of urinary proteins of ECa
patients. Urine is one of the important biofluids for screening protein biomarkers. The
kidney, prostate, and bladder cancers are also quantified by the urinary proteins. Urinary
proteins separated through 2DE can be analyzed by densitometry, mass spectrometry,
and database search. In a study conducted by Mu, Alan Kang-Wai, et al., urinary proteins
of ECa were analyzed by 2DE where Zn-α-2-glycoprotein, α-1-acid glycoprotein, and C59
were present in the urine of patients and the lower levels of nebulin proteins were
marked when compared with the control [12].
Huang, Hong‐Lei, et al. in their work analyzed the protein biomarkers of breast cancer
using 2DE. They identified a link between the proteins of breast cancer and tumor
igenesis. They distinguished the normal cells from non-invasive and invasive cancerous
cells. They quantified the extracellular secreted proteins and the total cellular proteins
from normal and cancerous breast cancer cells. They identified 133 differentially ex
pressed proteins and concluded that unreported proteins identified in their study have a
positive correlation with two-dimensional difference gel electrophoresis (2D-DIGE)
data. The novel proteins in their study can be used as diagnostic and therapeutic markers
for cancer [13].
8.3 Enzyme-Linked Immunosorbent Assay (ELISA)
ELISA is a diagnostic tool in clinical investigations. It provides selective, sensitive,
quantitative, and reproducible results in analyzing the analytes. It is a kind of gold
standard technique for detecting biomarkers. It detects antibodies, antigens, proteins,
glycoproteins, and hormones. It is used to test human immunodeficiency virus (HIV)
infections, pregnancy, and blood typing. ELISA is unable to detect the disease at an early
stage as biomarkers concentration is lower than the limit of detection of ELISA.
Oligonucleotide-based immunosorbent assay is being used nowadays for achieving more
sensitive results [14–16].
ELISA identifies one kind of biomarker at a time. In clinical diagnosis, a single bio
marker hardly meets the clinical demand. The identification of multiple biomarkers
may enhance the accuracy of the diagnosis of various diseases. Semiconductor quantum
dots-based fluorescent immunosorbent assay is more sensitive, simultaneous, and
multiplexed in identifying the multiple biomarkers. Inflammatory biomarkers are the
indicators of many diseases. Low levels of C-reactive protein (CRP) indicate the pa
thogenesis of cardiovascular disease while serum amyloid A (SAA) marks bacterial in
fections. A dual quantum dot-based fluorescence-linked immunosorbent assay (FLISA)
was performed for detecting CRP and SAA. The as-fabricated assay has a broad linear
range and lower limits of detection for both proteins. The assay results showed good
specificity and efficiency and can thus be utilized for the simultaneous identification and
quantification of other disease biomarkers in in-vitro diagnostics and are described in
Figure 8.1 [17].
Biomarker Detection
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