EDIM-TKTL1/Apo10 Blood Test: An Innate Immune System Based Liquid Biopsy for the Early Detection, Characterization and Targeted Treatment of Cancer

Int J Mol Sci. 2017 Apr 20;18(4):878. doi: 10.3390/ijms18040878.


Epitope detection in monocytes (EDIM) represents a liquid biopsy exploiting the innate immune system. Activated monocytes (macrophages) phagocytose unwanted cells/cell fragments from the whole body including solid tissues. As they return to the blood, macrophages can be used for a non-invasive detection of biomarkers, thereby providing high sensitivity and specificity, because the intracellular presence of biomarkers is due to an innate immune response. Flow cytometry analysis of blood enables the detection of macrophages and phagocytosed intracellular biomarkers. In order to establish a pan-cancer test, biomarkers for two fundamental biophysical mechanisms have been exploited. The DNaseX/Apo10 protein epitope is a characteristic of tumor cells with abnormal apoptosis and proliferation. Transketolase-like 1 (TKTL1) is a marker for an anaerobic glucose metabolism (Warburg effect), which is concomitant with invasive growth/metastasis and resistant to radical and apoptosis inducing therapies. The detection of Apo10 and TKTL1 in blood macrophages allowed a sensitive (95.8%) and specific (97.3%) detection of prostate, breast and oral squamous cell carcinomas. Since TKTL1 represents a drugable target, the EDIM based detection of TKTL1 enables a targeted cancer therapy using the vitamin derivatives oxythiamine or benfo-oxythiamine.

Keywords: DNase; DNaseX; EDIM; Szent-Györgyi; TKTL1; Warburg; liquid biopsy; macrophage; phagocytosis; transketolase.

Publication types

  • Review

MeSH terms

  • Animals
  • Apoptosis / genetics
  • Apoptosis / immunology*
  • Biological Evolution
  • Biomarkers, Tumor*
  • Biopsy
  • Blood Chemical Analysis / methods*
  • Early Detection of Cancer
  • Epitopes / genetics
  • Epitopes / immunology*
  • Fluorodeoxyglucose F18
  • Humans
  • Immunity, Innate
  • Lactic Acid / metabolism
  • Macrophages / immunology
  • Macrophages / metabolism
  • Molecular Targeted Therapy
  • Monocytes / immunology*
  • Monocytes / metabolism*
  • Neoplasms / blood
  • Neoplasms / diagnosis
  • Neoplasms / genetics
  • Neoplasms / immunology
  • Oxythiamine / pharmacology
  • Positron-Emission Tomography / methods
  • Recurrence
  • Transcriptional Activation
  • Transketolase / genetics
  • Transketolase / metabolism


  • Biomarkers, Tumor
  • Epitopes
  • Fluorodeoxyglucose F18
  • Oxythiamine
  • Lactic Acid
  • TKTL1 protein, human
  • Transketolase