Method and device for purification of blood from circulating cell free DNA
The invention provides apheresis devices and their use for removal of substantially all types of cell free DNA (cfDNA) in patients' blood, including nucleosome-bound cfDNA, exosome-bound cfDNA and unbound cfDNA (including double stranded DNA (dsDNA), single stranded DNA (ssDNA) and oligonucleotides), to limit the negative effects of the circulating cfDNA and to treat various diseases.
1. A device configured to perform apheresis comprising one or more affinity matrices, wherein said one or more affinity matrices are capable of capturing nucleosome-bound cell free DNA (cfDNA), exosome-bound cfDNA, and unbound cfDNA from blood or plasma of a subject, wherein at least one of the one or more affinity matrices comprises an H1 histone protein.
2. The device of claim 1 , wherein the unbound cfDNA comprises dsDNA, ssDNA and oligonucleotides.
3. The device of claim 1 , wherein the device comprises two or more affinity matrices.
4. The device of claim 3 , wherein (i) the first one or more affinity matrices is capable of capturing nucleosome-bound cell free DNA (cfDNA) and/or exosome-bound cfDNA and (ii) the second one or more affinity matrices is capable of capturing unbound cfDNA, and wherein the first and second affinity matrices are arranged within the device in any order.
5. The device of claim 1 , wherein the device comprises a single affinity matrix.
6. The device of claim 1 , wherein the H1 histone protein is H1.3 histone.
7. A method of reducing the level of cell free DNA (cfDNA) in blood or plasma of a subject, the method comprising:
(a) performing an apheresis procedure comprising diverting the blood or plasma from the subject into the apheresis device of claim 1 to produce the blood or plasma with reduced levels of the cfDNA; and
(b) returning the blood or plasma with reduced levels of the cfDNA to the subject, wherein the apheresis procedure reduces the level of nucleosome-bound cfDNA, exosome-bound cfDNA, and unbound cfDNA in the blood of the subject.
8. The method of claim 7 , wherein the subject has a disease characterized by elevated level of cfDNA in the blood.
9. The method of claim 7 , wherein the disease is selected from a neurodegenerative disease, a cancer, a chemotherapy-related toxicity, an irradiation induced toxicity, an organ failure, an organ injury, an organ infarct, ischemia, an acute vascular event, a stroke, graft-versus-host-disease (GVHD), graft rejection, sepsis, systemic inflammatory response syndrome (SIRS), multiple organ dysfunction syndrome (MODS), a traumatic injury, aging, diabetes, atherosclerosis, an autoimmune disorder, eclampsia, infertility, a pregnancy-associated complication, a coagulation disorder, and an infection.
10. A system for extracorporeal treatment of blood by reduction of the level of circulating cfDNA, wherein the system comprises an extracorporeal circuit, comprising the device according to claim 1 .
11. The method of claim 7 , further comprising monitoring the level of cfDNA in the blood of the subject.
12. The method of claim 7 , comprising continuing or repeating the apheresis procedure until the level of cfDNA in the blood of the subject is reduced by at least 25%.
13. The method of claim 12 , comprising continuing or repeating the apheresis procedure until the level of cfDNA is reduced by at least 50%.
14. The method of claim 13 , comprising continuing or repeating the apheresis procedure until the level of cfDNA is reduced by at least 75%.
15. The method of claim 7 , wherein the apheresis procedure is continued or repeated until at least 30 mg of cfDNA is removed from the blood of the subject.
16. The method of claim 7 , wherein the apheresis procedure is repeated two or more times.
17. The method of claim 7 , wherein the blood for the apheresis procedure is sourced from the portal vein.
18. The method of claim 7 , wherein the subject is human.