The Significance of Protein Biomarkers in Preventive Health
Thomas Edison once said, "The doctor of the future will give no medicine but will instruct his patient in the care of the human frame, in diet, and the cause and prevention of disease." Modern medicine offers many guidelines and tools designed to help detect diseases early and prevent their complications, from pap smears to mammograms to CT scans. Researchers are frequently developing new technologies to catch diseases early. Protein biomarkers are among the technologies being examined for their potential role in general health. In this article, we’ll explore the significance of protein biomarkers in preventive health, as well as how to identify protein biomarkers.
What Are Protein Biomarkers?
Protein biomarkers are proteins in the body that can be measured to provide insight into your health. These biomarkers can be used for many purposes in medicine, and many biomarkers are available in medicine. Some, such as prostate-specific antigen (PSA) and beta-natriuretic peptide (BNP), have been available for many years, while others are still in development and being studied for their potential role in healthcare.
What Is a Screening Test?
A screening test has a common use in preventive health. Screening tests help detect a condition in its early stages when it is generally more treatable. Screening tests help identify diseases like cancer, diabetes, and high cholesterol before symptoms appear.
The goal of an effective screening test is to detect a condition early, at a stage when it is still treatable, in order to improve health outcomes. The features of a good screening test include:
- The disease can be detected before symptoms develop.
- The disease can be detected when it is early and is easy to treat.
- Treating the disease early in the course will decrease the chances of death and disability.
- The test has a low incidence of false positives and false negatives.
Ideally, screening tests are relatively non-invasive, making them more accessible and likely to be done. Screening tests range from labs to imaging studies. Questionnaires can also be used for screening for some conditions, such as depression and memory loss.
How Are Protein Biomarkers Used in Medicine?
Protein biomarkers play several roles in medicine. Some of these roles include:
- Early detection of disease
- Monitoring the progression or regression of a disease
- Monitoring how someone is responding to treatment
- Providing more personalized care
- Predicting the likelihood that a disease will develop
- Development of drugs
- Predicting the prognosis of a disease
A healthcare provider may order biomarkers for various other reasons in the medical setting, and more are under development.
What Types of Conditions Can Protein Biomarkers Detect?
Protein biomarkers can help detect conditions such as cancer, cardiovascular disease, inflammation, kidney disease, liver disease, and gastrointestinal disease. In some cases, these biomarkers can guide treatment through their presence or absence.
Protein biomarker research is completed through a field called proteomics, which is essentially the study of proteins. This field is continuously evolving and evaluating new potential biomarkers, which allow healthcare providers to make healthcare more personalized.
Biomarkers for Early Disease Detection
Many biomarkers can help detect diseases. Some of these biomarkers you may recognize as labs that are commonly drawn in preventive care or during a routine physical exam.
Cancer Detection Biomarkers
Several cancer biomarkers are available to test for health conditions. Some of these are done routinely for the detection of cancer, while others are used after the cancer treatment. Cancer detection biomarkers are an emerging area of research.
Prostate-specific antigen (PSA) is a common biomarker used in preventive care. While the United States Preventive Services Task Force (USPSTF) no longer routinely recommends universal screening for prostate cancer, the American Cancer Society recommends that healthcare providers give men the chance to discuss regular screening. PSA is a protein biomarker that is produced by both normal and cancerous prostate cells. PSA can be elevated due to:
- infection
- benign prostatic hypertrophy (BPH)
- inflammation of the prostate
- prostate cancer
Prostate cancer usually causes the levels of PSA in the blood to be significantly higher than they would be for other conditions.
Newer technology available for early cancer detection include multi-cancer detection tests like the Galleri® Multi-Cancer Early Detection Test. This test can detect more than 50 types of cancer in early stages and allows for earlier treatment. This testing is not currently included in the routine screening recommendations. Guidelines are being reviewed and updated frequently, so the recommendations for this type of testing may change over time.
Metabolic Disease Biomarkers
Healthcare providers routinely use several biomarkers of metabolic disease in preventive care. These biomarkers can provide information that can help with the diagnosis and monitoring of metabolic conditions, as well as potentially guide treatment options.
Newborn screening tests are a common example of protein biomarkers used in preventive care. Newborn screening testing is often referred to as a PKU test after one of the metabolic diseases that it can screen for, phenylketonuria. Newborn biomarker testing includes evaluating for several inherited metabolic disorders that can have devastating effects on newborn development. This testing allows the diseases to be detected before the abnormal metabolism affects development. Newborn screening generally consists of at least 38 core disorders.
Other protein biomarkers that may be used in preventive care include:
- C-reactive protein (CRP)
- uric acid
CRP is a non-specific marker of inflammation that is often higher in people with metabolic conditions such as obesity, high cholesterol, diabetes, and metabolic syndrome.
Healthcare providers may also use other biomarkers, such as liver function testing, to screen for metabolic disease, including metabolic-associated fatty liver disease (MAFLD). Detecting these conditions early can improve your ability to take control of your health and prevent the complications of some metabolic conditions. Triglycerides and cholesterol levels may also be useful in the diagnosis and evaluation of MAFLD. Biomarkers are also important in the staging of fibrosis and the degree of MAFLD, as factors such as platelet count and liver enzymes are frequently included in the formulas used to stage the disease.
Several protein biomarkers may be useful in cardiovascular disease, though many of them are not used regularly in preventive care. One example of a protein biomarker that is becoming increasingly utilized in predicting (and thus making it easier to prevent) cardiovascular disease is lipoprotein (a). Lipoprotein (a) is a genetic biomarker made in the liver that helps predict risk for heart disease.
Researchers are studying many biomarkers for the early detection of Alzheimer's disease. Biomarkers allowing the early detection of Alzheimer's disease may potentially improve healthcare providers' ability to treat the disease even before clinical symptoms start to appear. Many of the medications used to treat Alzheimer's disease are more effective at slowing the progression of the disease when they are started early in the course of the disease.
Biomarkers and Nutrition
Nutrition is well known to play a significant role in preventive health. Diet impacts many chronic diseases, and an improved diet is one of the cornerstones of lifestyle changes recommended to treat chronic disease. Healthcare providers may also use diet as a preventive measure for individuals at an increased risk of chronic disease. Patients may take a proactive approach to diet and exercise to help prevent or delay conditions such as:
- heart disease
- diabetes
- obesity
- cancer
Providers can use several biomarkers to assess nutritional status. They may use these biomarkers to validate intake information for research purposes and to analyze responses to food components. They may also use these nutrition biomarkers in combination with other biomarkers, such as those used for detecting and analyzing metabolic disease, to form a more complete health picture.
Biomarkers for Disease Susceptibility
In addition to protein biomarkers that can help detect diseases early in the course, some biomarkers, such as epigenetic biomarkers, may reveal an increased risk of disease before it develops. Epigenetic biomarkers are influenced by lifestyle and environmental factors. Studying these biomarkers may change the landscape of preventive care in the future. If you know you have an increased risk of developing a condition, you can potentially take proactive steps to prevent the disease rather than waiting to intervene when the disease develops.
Factor V Leiden is a biomarker that may indicate an increased risk of blood clots. While not everyone with Factor V Leiden will go on to develop blood clots, knowing you are at increased risk may change how your healthcare provider manages your health during times of elevated risk, such as pregnancy or surrounding surgery. Factor V Leiden is not often a routine test for preventive care, but if there is a family history of blood clots or you've had a blood clot in the past, your provider may order the test.
Biomarkers for Personalized Prevention
Biomarkers may also help personalize medical recommendations for the prevention and treatment of diseases. Genetic differences can influence the way your body responds to medications and the environment. Those differences can also affect your risk of getting a disease.
One example of this kind of biomarker is BRCA. A provider sometimes uses this genetic biomarker to determine if someone is at increased risk for developing breast or ovarian cancer. It is commonly obtained when people are diagnosed with cancer to help determine whether their family members may be at increased risk. If someone is known to have an abnormality in the BRCA gene, healthcare providers may recommend taking steps to prevent cancer, such as surgery or changes in screening.
Biomarkers for Disease Diagnosis
Many biomarkers are used to make the diagnosis of a disease. Hemoglobin A1c is a biomarker used to diagnose and treat diabetes. Hemoglobin A1c is a surrogate measure for blood sugar, estimating the average sugar over 3 months by calculating the percentage of red blood cells that have sugar molecules attached. The higher the blood sugar, the more red blood cells have sugar molecules attached.
Another protein biomarker that is frequently used in medicine is brain-type natriuretic peptide (BNP). This biomarker helps evaluate congestive heart failure. This biomarker is used in conjunction with other tests to evaluate patients who are having an exacerbation of their heart disease. This biomarker may also predict how likely someone is to be readmitted to the hospital after discharge.
Biomarkers for Monitoring Disease Progression and Treatment Response
Providers frequently use biomarkers to monitor disease progression and treatment response.
They may use several biomarkers to identify the type of asthma as well as the response to treatment. Eosinophils, serum IgE, and FeNO levels are all examples of biomarkers that may help monitor asthma. Several medications target different proteins, which can treat severe asthma and allergies. The provider may select these medications to treat patients who have certain biomarkers. One example of this is the use of omalizumab, which is a monoclonal antibody that targets IgE and may be beneficial in patients with elevated eosinophil levels.
Several forms of cancer have biomarkers that can follow the response to treatment and determine what types of medication may be beneficial. Estrogen, progesterone, and HER2 receptor status can help determine what type of treatment may benefit patients with breast cancer.
Carcinoembryonic antigen (CEA) is a colon cancer marker that is often used to determine whether someone is responding to treatment for colon cancer. Ca125 can help monitor treatment response in ovarian cancer patients. Neither biomarker is currently recommended for screening for these cancers, but healthcare providers frequently use them to evaluate whether a cancer is responding to therapy or possibly if metastatic disease is present.
PSA is an example of a biomarker that can help screen for cancer and determine the response to treatment. In prostate cancer, PSA is generally elevated. After treatment, the PSA often decreases to near undetectable levels. Rising PSA levels may indicate recurrent or metastatic disease.
Researchers have also investigated biomarkers to determine whether someone who becomes infected with COVID-19 may go on to develop severe disease. Several biomarkers can indicate inflammation and an increased risk of lung damage. Investigators have studied these biomarkers to help healthcare providers determine who is at risk for severe disease and death, as well as what treatments may be beneficial.
These are just examples of the many biomarkers that can help determine how you are responding to treatment for chronic conditions. If you have a chronic condition, your healthcare provider will help you determine what biomarkers may be indicated and how often the tests should be performed.
Future Directions for Biomarkers in Preventive Health
Biomarkers show great promise for preventive health and personalized healthcare. Multiple biomarkers are being evaluated, and panels are being developed that may shift and shape the future of healthcare.
Advancements in the fields of epigenetics and proteomics are occurring rapidly, with new technologies in detection equipment such as mass spectrometry. Artificial intelligence (AI) is another technology tool that is proving useful to identify potential new biomarkers. AI and machine learning are being used to identify patterns that would be otherwise difficult to track.
Why Are Biomarkers Important for Preventive Health
Biomarkers play a significant role in healthcare, including in preventive health. These important indicators can provide insight into your health and may inform you as to whether you are at an increased risk of certain diseases. Some biomarkers may help identify diseases in extremely early stages before you start to develop symptoms.
Biomarkers may help your healthcare provider work with you to develop a personalized plan for preventing and treating potential health conditions. Whether indicating an increased risk for cancer or identifying an increased risk for cardiovascular disease, biomarkers can provide significant insight into your unique healthcare needs and steps you can take. This may mean being proactive about lifestyle changes or considering starting medication at an earlier stage. In some cases, surgery may even be considered as a preventive measure.
Biomarkers provide a powerful tool to empower individuals in their healthcare journey.
Take Control of Your Preventive Healthcare with EverlyWell
Preventive health is the key to reducing your risk of developing disease, disability, and even death. In addition to monitoring any chronic health conditions you may have, preventive health allows you to screen for and detect diseases early when they can be more easily treated. Your healthcare provider can recommend screening tests, including any protein biomarkers that may be useful for your unique health needs.
At Everlywell, your health is important to us. We're proud to offer increased access to healthcare on your terms. We offer routine health exams for men and women, including at-home lab tests. You can schedule a visit with one of our licensed healthcare providers to discuss your healthcare needs and recommended preventive screenings.
If you're ready to explore preventive health options, schedule a virtual care visit today.