Extracellular vesicles for clinical diagnostics of nervous system diseases

In the last decade there has emerged a new dimension in molecular studies which can be applied to gliomas (brain tumors). Extracellular vesicles (EVs), small structures containing genetic materials, are now known to be produced by glioma cells. These EVs, often many hundreds in number, are released by glioma cells into the blood and fluids surrounding the brain. Originally, these EVs were described as "cell dust in human plasma". There is general consensus that EVs contain gene products including proteins, RNA and DNA. As these products originate from tumor they can be harvested to provide systems that mirror glioma development and progression. My objective has been to study the role of EVs in human blood and other fluids; to identify these EVs and to measure them in order to develop a non-invasive biomarker for detection of glioma. The studies that I have performed have explored the role of these EVs in cancer development and have reviewed the EV-gene products that might be measured to help patients. I then concentrated on developing techniques to find these EVs in small amounts of human fluids and then explored one gene product seen in gliomas. I have worked to improve the way in which we find these EV gene products with the eventual goal of providing diagnosis and care of brain tumor patients without resorting to surgery.There is increasing evidence that extracellular vesicles (EVs) isolated from biofluids will be an important contribution in medicine to develop a non-invasive ways to diagnose and monitor disease. This thesis describes some of the groundwork in development of this new biomarker resource that has so far primarily focused on brain cancer, but the knowledge gained here should have universal applications for all types of diseases.