The application of cell-free DNA methylation patterns in critical illnesses: A protocol paper

Biomarkers in clinical medicine are typically employed to gauge severity of disease, prognosis and to monitor response to treatment. While various biomarkers have been employed in clinical medicine with variable performance characteristics, the use of cell-free DNA (cfDNA) have gained increased traction as a novel biomarker in a wide range of disease states such as cancer and trauma. While the quantification of cfDNA have been correlated with disease severity, the use of methylation pattens of cfDNA can be used to localize the site of injury that may have implications regarding prognosis and therapeutics. We propose a procedure using samples in a swine model of cardiac arrest where carbon monoxide is being used as a therapeutic to demonstrate our method and feasibility to obtain plasma cfDNA methylation patterns to help identify tissue origin with potential application in critical care medicine.