Method and device for purification of blood from circulating cell free DNA

1. A method of reducing the level of cell free DNA (cfDNA) in the blood of a subject, the method comprising: (a) performing an apheresis procedure comprising diverting blood or plasma from the subject into an apheresis device to produce the blood or plasma with reduced levels of the cfDNA, wherein the apheresis device is configured to perform apheresis and comprises one or more affinity matrices, wherein said one or more affinity matrices are capable of capturing nucleosome-bound cfDNA, exosome-bound cfDNA, and unbound cfDNA from the blood or plasma of the subject, and wherein at least one of said one or more affinity matrices comprises a histone protein; 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.

2. The method of claim 1 , wherein the subject has a disease characterized by elevated level of cfDNA in the blood.

3. The method of claim 1 , wherein the subject has a disease selected from the group consisting of 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.

4. A method of treating a disease characterized by elevated level of cfDNA in the blood of a subject in need thereof, the method comprising: (a) performing an apheresis procedure comprising diverting blood or plasma from the subject into an apheresis device to produce the blood or plasma with reduced levels of the cfDNA, wherein the apheresis device is configured to perform apheresis and comprises 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 the blood or plasma of the subject, wherein at least one of the one or more affinity matrices comprises a histone protein; 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.

5. The method of claim 4 , wherein the disease is characterized by elevated level of cfDNA in the blood.

6. The method of claim 4 , wherein the disease is selected from the group consisting of 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.

7. The method of claim 1 , further comprising monitoring the level of cfDNA in the blood of the subject.

8. The method of claim 1 , comprising continuing or repeating the apheresis procedure until the level of cfDNA in the blood of the subject is reduced by at least 25%.

9. The method of claim 8 , comprising continuing or repeating the apheresis procedure until the level of cfDNA is reduced by at least 50%.

10. The method of claim 9 , comprising continuing or repeating the apheresis procedure until the level of cfDNA is reduced by at least 75%.

11. The method of claim 1 , comprising continuing or repeating the apheresis procedure until at least 30 mg of cfDNA is removed from the blood of the subject.

12. The method of claim 1 , wherein the apheresis procedure is repeated two or more times.

13. The method of claim 1 , wherein the blood for the apheresis procedure is sourced from the portal vein.

14. The method of claim 1 , wherein the unbound cfDNA comprises dsDNA, ssDNA and oligonucleotides.

15. The method of claim 1 , wherein the subject is human.

16. The method of claim 1 , wherein the unbound cfDNA comprises dsDNA, ssDNA and oligonucleotides.

17. The method of claim 1 , wherein the device comprises two or more affinity matrices.

18. The method of claim 17 , 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.

19. The method of claim 1 , wherein the device comprises a single affinity matrix.

20. The method of claim 1 , wherein the histone protein is H1 histone.

21. The method of claim 20 , wherein the histone protein is H1.3 histone.

22. The method of claim 4 , further comprising monitoring the level of cfDNA in the blood of the subject.

23. The method of claim 4 , comprising continuing or repeating the apheresis procedure until the level of cfDNA in the blood of the subject is reduced by at least 25%.

24. The method of claim 23 , comprising continuing or repeating the apheresis procedure until the level of cfDNA is reduced by at least 50%.

25. The method of claim 24 , comprising continuing or repeating the apheresis procedure until the level of cfDNA is reduced by at least 75%.

26. The method of claim 4 , wherein the apheresis procedure is continued or repeated until at least 30 mg of cfDNA is removed from the blood of the subject.

27. The method of claim 4 , wherein the apheresis procedure is repeated two or more times.

28. The method of claim 4 , wherein the blood for the apheresis procedure is sourced from the portal vein.

29. The method of claim 4 , wherein the subject is human.

30. The method of claim 4 , wherein the unbound cfDNA comprises dsDNA, ssDNA and oligonucleotides.

31. The method of claim 4 , wherein the device comprises two or more affinity matrices.

32. The method of claim 31 , 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.

33. The method of claim 4 , wherein the device comprises a single affinity matrix.

34. The method of claim 4 , wherein the histone protein is HI histone.

35. The method of claim 34 , wherein the histone protein is H1.3 histone.