National Health Mission Area, Johns Hopkins University Applied Physics Laboratory, Laurel, MD;
Welch Medical Library, Johns Hopkins University, Baltimore, MD.
Clin Chem. 2018 Apr;64(4):656-679. doi: 10.1373/clinchem.2017.275966. Epub 2017 Nov 29.
Advancements in the quality and availability of highly sensitive analytical instrumentation and methodologies have led to increased interest in the use of microsamples. Among microsamples, dried blood spots (DBS) are the most well-known. Although there have been a variety of review papers published on DBS, there has been no attempt at describing the full range of analytes measurable in DBS, or any systematic approach published for characterizing the strengths and weaknesses associated with adoption of DBS analyses.
A scoping review of reviews methodology was used for characterizing the state of the science in DBS. We identified 2018 analytes measured in DBS and found every common analytic method applied to traditional liquid samples had been applied to DBS samples. Analytes covered a broad range of biomarkers that included genes, transcripts, proteins, and metabolites. Strengths of DBS enable its application in most clinical and laboratory settings, and the removal of phlebotomy and the need for refrigeration have expanded biosampling to hard-to-reach and vulnerable populations. Weaknesses may limit adoption in the near term because DBS is a nontraditional sample often requiring conversion of measurements to plasma or serum values. Opportunities presented by novel methodologies may obviate many of the current limitations, but threats around the ethical use of residual samples must be considered by potential adopters.
DBS provide a wide range of potential applications that extend beyond the reach of traditional samples. Current limitations are serious but not intractable. Technological advancements will likely continue to minimize constraints around DBS adoption.
高度敏感的分析仪器和方法的质量和可用性的提高，使得人们对使用微样本越来越感兴趣。在微样本中，干血斑（DBS）最为人所知。尽管已经有各种关于 DBS 的评论文章发表，但还没有人试图描述 DBS 中可测量的全部分析物，也没有发表任何系统的方法来描述采用 DBS 分析的优缺点。
我们使用范围综述评论方法来描述 DBS 中的科学状态。我们确定了 2018 年在 DBS 中测量的分析物，并发现传统液体样本中应用的每一种常见分析方法都已应用于 DBS 样本。分析物涵盖了广泛的生物标志物，包括基因、转录本、蛋白质和代谢物。DBS 的优势使其能够在大多数临床和实验室环境中应用，并且采血和冷藏的去除使生物样本采集扩展到难以到达和脆弱的人群。弱点可能会限制其在短期内的应用，因为 DBS 是一种非传统的样本，通常需要将测量值转换为血浆或血清值。新方法带来的机会可能会消除当前许多限制，但潜在使用者必须考虑到剩余样本的伦理使用带来的威胁。
DBS 提供了广泛的潜在应用，超出了传统样本的范围。目前的局限性是严重的，但并非不可克服的。技术进步很可能会继续最大限度地减少 DBS 采用的限制。
