Proteomics in Proximity

Welcome to the Olink® Proteomics in Proximity podcast! 
 
Below are some useful resources from this episode: 
 
Published study of primary focus
Álvez MB, Edfors F, von Feilitzen K, Zwahlen M, Mardinoglu A, Edqvist PH, Sjöblom T, Lundin E, Rameika N, Enblad G, Lindman H, Höglund M, Hesselager G, Stålberg K, Enblad M, Simonson OE, Häggman M, Axelsson T, Åberg M, Nordlund J, Zhong W, Karlsson M, Gyllensten U, Ponten F, Fagerberg L, Uhlén M. Next generation pan-cancer blood proteome profiling using proximity extension assay. Nat Commun. 2023 Jul 18;14(1):4308. doi: 10.1038/s41467-023-39765-y. PMID: 37463882; PMCID: PMC10354027. https://pubmed.ncbi.nlm.nih.gov/37463882/ 
 
Laboratory, first author, and corresponding author of the study
·         SciLifeLab, a collaborative resource for life scientists located in Sweden: https://www.scilifelab.se/
·         María Bueno Álvez (first author), PhD student, Science for Life Laboratory (SciLifeLab): https://www.linkedin.com/in/mar%C3%ADa-bueno-%C3%A1lvez-33395b192/ 
·         Dr. Mathias Uhlén (corresponding author), Professor of Microbiology, Royal Institute of Technology (KTH), Leader of the Human Protein Atlas, Founding director of the Science for Life Laboratory (SciLifeLab): https://www.kth.se/pro/sysbio/uhlen-group/researchers/mathias-uhlen-1.67763 
 
Olink tools and software
·         Olink® Explore 1536, the platform that measured proteins in this study with a next-generation sequencing (NGS) readout: https://olink.com/products-services/explore/
·         Olink® Explore HT, Olink’s newest solution for high-throughput biomarker discovery that measures 5300+ proteins simultaneously with minimal sample consumption: https://olink.com/products-services/exploreht/ 
·         Olink® Insight, an open-access resource to accelerate protein biomarker discovery: https://insight.olink.com/
 
UK Biobank Pharma Proteomics Project (UKB-PPP), one of the world’s largest scientific studies of blood protein biomarkers conducted to date
·         Published article: Styrkarsdottir U, Lund SH, Thorleifsson G, Saevarsdottir S, Gudbjartsson DF, Thorsteinsdottir U, Stefansson K. Cartilage Acidic Protein 1 in Plasma Associates With Prevalent Osteoarthritis and Predicts Future Risk as Well as Progression to Joint Replacements: Results From the UK Biobank Resource. Arthritis Rheumatol. 2023 Apr;75(4):544-552. doi: 10.1002/art.42376. Epub 2022 Dec 28. PMID: 36239377. https://pubmed.ncbi.nlm.nih.gov/36239377/ 
·         UKB-PPP website: https://www.ukbiobank.ac.uk/learn-more-about-uk-biobank/news/uk-biobank-launches-one-of-the-largest-scientific-studies 
 
Analysis of UK Biobank proteomics data from cancer patients, with co-authors including Ruth C. Travis, Karl Smith-Byrne, and Joshua R. Atkins
Preprint article: Papier K, Atkins JR, Tong TYN, Gaitskell K, Desai T, Ogamba CF, Parsaeian M, Reeves GK, Mills IG, Key TJ, Smith-Byrne K, Travis RC. Identifying proteomic risk factors for cancer using prospective and exome analyses: 1,463 circulating proteins and risk of 19 cancers in the UK Biobank. medRxiv 2023.07.28.23293330; doi: https://doi.org/10.1101/2023.07.28.23293330. https://www.medrxiv.org/content/10.1101/2023.07.28.23293330v1 

U-CAN Biobank, a prospective biobank of cancer patient biomaterial in Sweden
Glimelius B, Melin B, Enblad G, Alafuzoff I, Beskow A, Ahlström H, Bill-Axelson A, Birgisson H, Björ O, Edqvist PH, Hansson T, Helleday T, Hellman P, Henriksson K, Hesselager G, Hultdin M, Häggman M, Höglund M, Jonsson H, Larsson C, Lindman H, Ljuslinder I, Mindus S, Nygren P, Pontén F, Riklund K, Rosenquist R, Sandin F, Schwenk JM, Stenling R, Stålberg K, Stålberg P, Sundström C, Thellenberg Karlsson C, Westermark B, Bergh A, Claesson-Welsh L, Palmqvist R, Sjöblom T. U-CAN: a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden. Acta Oncol. 2018 Feb;57(2):187-194. doi: 10.1080/0284186X.2017.1337926. Epub 2017 Jun 20. PMID: 28631533. https://pubmed.ncbi.nlm.nih.gov/28631533/ 
 
Galleri GRAIL test, a blood-based test that detects a biosignature shared by over 50 cancer types: https://grail.com/galleri-test/ 
 
Genotype-Tissue Expression (GTEx) project, a biobank and open-access database to study tissue-specific gene expression and regulation: https://www.gtexportal.org/home/
 
Human Protein Atlas (HPA), a Swedish-based program with the aim to map all human proteins using an integration of various omics technologies and provide these data freely available to the scientific community: https://www.proteinatlas.org/ 
 
 
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In case you were wondering, Proteomics in Proximity refers to the principle underlying Olink Proteomics assay technology called the Proximity Extension Assay (PEA), and more information about the assay and how it works can be found here: https://bit.ly/3Rt7YiY 
 
For any questions regarding information Olink Proteomics, please email us at info@olink.com or visit our website: https://www.olink.com/

WHAT IS PROTEOMICS IN PROXIMITY?
Proteomics in Proximity discusses the intersection of proteomics with genomics for drug target discovery, the application of proteomics to reveal disease biomarkers, and current trends in using proteomics to unlock biological mechanisms. Co-hosted by Olink's Dale Yuzuki, Cindy Lawley and Sarantis Chlamydas.

What is Proteomics in Proximity?

Proteomics in Proximity discusses the intersection of proteomics with genomics for drug target discovery, the application of proteomics to reveal disease biomarkers, and current trends in using proteomics to unlock biological mechanisms. Co-hosted by Olink's Dale Yuzuki, Cindy Lawley and Sarantis Chlamydas.

[Music]

Welcome to the Proteomics and Proximity Podcast

where co-hosts, Dale Yuzuki, Cindy Lawley and Sarantis Chlamydas from Olink Proteomics

talk about the intersection of proteomics with genomics for drug target discovery,

the application of proteomics to reveal disease biomarkers,

and current trends in using proteomics to unlock biological mechanisms.

Here we have your hosts, Dale, Cindy and Sarantis.

Welcome to Proteomics and Proximity.

I'm Dale Yuzuki, your host, along with Cindy Lawley and Sarantis Chlamydas.

And here we have a special treat today. Sarantis?

Yeah, thank you, thank you, Dale. I'm really happy to be back from holidays

and then having the first host, Maria.

And Maria is a student, she's a PhD student in Mathias Uhlén's lab,

and she had recently a great paper, she was the first author of a great paper that

we'll discuss a little bit later in more detail.

Maria started her studies in Barcelona in Autònoma University of Barcelona,

then she moved to Stockholm [Sweden], and she gained a Master's degree,

joined the Protein Atlas, the Human Protein Atlas project in 2020,

and, since 2022, she's been a part of Mathias Uhlén's lab

where she's working on an amazing project around proteomics in different diseases and cancer

to try to identify signatures, protein signatures.

Maria's background is around, of course, proteomics, transcriptomics,

and she's also a bioinformatician and wet lab scientist.

That means she has a complete package of a full experience and expertise in the field,

also in the field of multiomics - that's something I'm really interested also to hear.

And I will start my question, actually, Maria, I mean, we are really happy to have you,

and it is always a pleasure to discuss with you. I would like to know a little bit more

how you see your transition from transcriptomics to proteomics,

and how you see the match between these two omics approaches from your perspective?

Thank you, Sarantis, it's really great to be here today.

So, I think for me it was a very smooth transition,

basically because at the Human Protein Atlas, that's been kind of a very connected thing.

It's never been like, transcriptomics is one thing and then proteomics is something

completely independent. It's always been quite linked, and that's because, of course, the Human

Protein Atlas has been about understanding proteins, but we have not always been able to just

look at them right away in such a scale, right? I mean, but now with Olink, it seems like that has been

there forever, but in the very early days, transcriptomics was a really, really useful tool

to look at the proteins - indirectly, of course - but we learned a lot and it's

a resource that is still used to this day in many, many groups. So, I was really lucky to work

with transcriptomics first, I think, so that I could understand ... I sometimes say

that that's the simple part where everything is clean and you don't have so much

noise of post-translational modifications and so on. So, I think it's more of the straightforward

tissue transcriptomics analysis. But now, of course, it's really great to go to more toward plasma

proteomics, which is kind of the other extreme. To ask you a little bit about the transcriptomics piece,

there at Science for Life Laboratories, right? And was the interest there

in transcriptomics around a cancer indication, or was it across tissues?

Yes, so the very early transcriptomics, that was published around 2015 in Science, and that was

healthy tissue. So, that was kind of a really big study across different tissues, try to just

characterize which proteins are specific, and that was kind of the flagship of the Protein

Atlas, try to just see what's there. But then, of course, there's been other, more

integration with GTEx data and trying to understand, of course, a little bit more about disease.

And so, this transcriptomic data set was from the tissues from Science for Life Laboratories,

right? Like you mentioned, there are other projects that are characterizing tissues like GTEx.

What made the Science for Life effort unique or different?

So, nowadays, at the Human Protein Atlas (HPA), we have both data from HPA and GTEx integrated

into the database. When I say HPA, I mean Human Protein Atlas, it's just a little bit too long.

So, our own samples, for example, we have a really detailed brain collection of samples, so it's

not only brain, but we have tons of different regions in the brain. So,

for example, we have a ton of detail on that stage that you can't really have with GTEx data.

So, it was more trying to complement, and also, of course, if you have two different independent

sources of data that agree on the same transcriptome levels, that's, of course, very reassuring.

So, that's why we try to combine both in the same database.

Amazing. So, hey, Maria, this is my first chance to ask a question, and I'm actually going to

click back to ask about your interest in getting into science. So usually we say,

you don't have to start with elementary school, but if you want to, I mean, whatever,

you know, sparked this interest in you, I'd love to hear about that. And then

what nurtured that interest to end up in Mathias's lab? I mean, what a remarkable

place to be. Thank you for question. It's, of course, always difficult to know when it all

started, but I think you will probably click with this: that

biology is just fascinating. Like, you see people getting old, people getting sick.

I don't know why, I see the effect of epigenetics as well. I have a twin system myself,

so I was always surrounded by what I thought was biology. And then I thought,

studying genetics, which was my bachelor's [degree], that would allow me to see why this is happening,

why we're getting old, why we're getting different, why we're getting sick. So, I think that was for

me what raised my interest in science. But I think also, back then I didn't know how science really

looked like. So, I didn't know about scientific research and so on. It was more of a dream, right? Like,

let's work on something fun. Yeah, but then, of course, about Mathias's group, that was when I moved

here to Sweden. Of course, I had heard about the Protein Atlas before. We used it in our Bachelor's

and during the Master's [programs]. But then, I think, moving to Sweden was really putting me very close to

his group and to his research. So, you learn a lot during the Master's [graduate program] about the database. And I also

got to know people in the lab. So, that's really how I ended up there. It sounds

like you committed to doing a Master's [degree] first and then that evolved into doing the PhD. How did

they keep the carrot in front of you, that you kept moving through that?

Because I love the stories behind making these decisions. I think students

are hungry for other people's stories about this. Yeah, I think for me, it was moving here to

the SciLifeLab, or starting my Master's [degree] here. I had not connected so much with research and like

academic life at my previous university. Not because of the university, I think it was more of the

like, how bachelor's [programs] are structured in Spain and in many other countries. You don't really get

to feel how it is to be a researcher. But then I moved here to Sweden and I started this program

and they had a really nice mentorship initiative where you could get a PhD student as a mentor.

And for me, that was really what changed my perspective. I was paired with Max

Karlsson of PhD student here at Mathias Uhlén's [lab]. And that's really when I saw, okay, this is

what I want to do. This is what I want to be. That's amazing! I love that story, the mentorship,

and the fact that they structured that with the mentorship. That's amazing. So then this publication

that Sarantis hinted at and that Dale talked about in the intro: this is essentially a pretty

remarkable set of data looking at over 1400 patients that had 12 different cancers.

This was our Explore 1536 Olink tool. And so I think 1463 proteins were included in

this study. Tell us a little bit about this study because it's a remarkable paper.

For me, I was already working at this group when they started the planning and

and everything was being run. So of course hearing about the total number of samples for

for the first phase was 10,000. So this is only the the the cancers that we're talking about.

So I was hearing about this and I was like this is unbelievable. I had already worked with Olink data,

but it was only a few panels. So also moving to the Explore [platform], I was really, really interested.

And the data was delivered in very early 2022 or maybe even in

December 2021. And that was exactly when I started my PhD. So you can't imagine how it felt like.

This is, first of all, a Christmas present and then a welcoming present. So yeah,

that felt really, really exciting also because we didn't know anything back then. Like, is there

going to be any signal in these 10,000 samples? So that was really exciting times. And you already had

pretty strong experience in bioinformatics, right? So I imagine it really was.

Exactly yes. Otherwise, it would have been a bit scary maybe. Jump right into the deep

end of the pool. That's right. And so the 10,000 samples, is that

including the U-CAN Biobank? Are all those within the U-CAN Biobank? You also in this study

used the SCAPIS Wellness cohort that's also under the auspices of the SciLife Lab as I understand it,

is that right? Yes, so these 10,000 samples included U-CAN Biobank, which is this Swedish

initiative which collects samples from many different cancers. And that's the study that

is not published. So that's around 1,500 samples in total. And then we also had other cohorts. Like,

you mentioned the SCAPIS, you mentioned Wellness. So this is other Swedish and also non-Swedish cohorts

from other different diseases. We also have infectious data, infectious disease,

autoimmune disease, from Karolinska Institute. So it's really a lot. And of course, we had to

break it down. And that's kind of the first published study, but we have a lot of lines of research open

right now. Can I ask you some technical, I'm sorry if it's very naive question. If I understand

correctly, the controls were from wellness cohorts, from a different cohort in a way.

Do you think that: is it easy or how easy it is to just have a control for different cohorts in order to

to have a well-studied project from your perspective.

Yes, so ideally you would always run case-control, right? Like you would have for every single disease

and every single cohort, you would have matched controls. That's usually possible, but then of course,

if you run 10,000 samples, it's a real loss if you just need to spend 50% of that on control. So

we've been trying to include different sets of healthy cohorts, so not only wellness, but we also have,

for example, we talked about the SCAPIS, then we have also health individuals also from Turkey. So

just try to have many different ones so we can have a look at the preanalytical variation

and we can see that everything makes sense across cohorts. But of course, that's always a

limitation, right? In this big studies that you can't ... you have to live with maybe a

couple of healthy cohorts, but not much for a disease. No, and I think also the fact that you have different

type of counts is a kind of control in the way, right? Because you expect to see this classification

in a specific type of cancer than the other that's kind of, you know, there's specific effects

happening in one like the other, which is a kind of control. This is what makes the study really,

really amazing. Can you give a comment? Because when I start reading a little bit ... can you give a

comment about the lung and colorectal cancer? There's something common between these cancers. I

haven't heard about. What is your feeling? And what do you think is happening in these

types of cancer? There are so many commonalities rather than differences. And just for context,

I'll just say those were two of the 12 cancers for which the team characterized the ability

to differentiate among these cancers within this study. So that was the primary focus and the

exciting result, which allowed for leveraging machine learning and characterizing the signature.

So I think these particular cancers were a little challenging perhaps, but also an opportunity

for advancing our understanding. So yeah, Maria, please. You know, I'm happy just about that,

because, as a bioinformatician without a very strong medical background, that was

my first question: like, what is this? So that's a shoutout to our doctors that we are very

likely to have and call in anytime we have these kind of questions. So we had very strong discussions

about this because it's kind of the biggest overlap that we saw. So there is an overlap between

the immune cancers. So they have some shared signals, but also these lung and colorectum cancers. And I was

really wondering: why could this be? And after meeting with doctors, I mean, of course, we

would have to look farther into these, probably get more like samples with more detail,

like with histology and so on. But their guess is that we are looking at two cancers that are mostly

adenocarcinomas, and it's probably a common signature in the pathway in the development of this

type of cancer. So it was mostly apoptotic signal, and I think also like cellular stress, which is

quite a general thing, but it makes sense that we don't really see that in, for example, immune

cell cancers. For them, it was quite obvious, but I had exactly the same reaction

you had now like, why would that be? So yeah, that's a nice thing about collaborating with the doctors.

It's almost like I pictured as a Venn diagram of these. What

seem like quite disparate diseases, the pathways that are overlapping in these diseases, I think,

are giving us a sense of that mechanistic biology. So I think you're turning yourself into

someone who understands that as well as the bioinformatics like Sarantis said, quite a full package of

someone who can work with these data and their complexity. I mean on that note on

data complexity, if I understand correctly, it was in review for many, many months, right? I think

the pre-print to showed maybe December, January, and it wasn't published until late July.

Can you comment on that in terms of the review process in terms of what you can share? Was it because

the data with the machine learning in terms of those algorithms, was that where a lot of the

review work entailed? Yeah, so I think you understood a little bit of the complexity. So it's really a

huge amount of data and when you're dealing with this kind of data and machine learning,

it's a little bit dangerous sometimes. So it's kind of you need machine learning to understand it,

but then you also, you should be skeptical about it. So I understand 100% why it took maybe a

bit longer than expected because you need to make sure that the pipeline is three years and that

there's enough controls. That it's not noise that you're capturing. Of course,

that we will never know until we replicate or validate our findings in different cohorts

to be sure as much as possible that this is a really well-structured study. And I'm happy

that we went through these revisions so that everything is in place. When I saw

some of the first reactions on social media, namely over LinkedIn, it was interesting, right? One

of the - not criticisms, or may have been a slight criticism - was that these were post-diagnostic

samples. By that I mean these were taken from untreated individuals at the time of diagnosis, these 1400

samples. What can you say about that in terms of could you have gotten pre-diagnostic samples or

what have you for an early detection? I really understand. And I mean, I would call it also a

limitation, right? Of course, you need like many different kinds of studies. I think

this one is also very interesting, but then of course, knowing that these proteins are also up

before diagnostics, that's of course really, really interesting. But in our case, we had access to this

biobank, so we couldn't start now. We would have to wait 10 years, right? To get all these data. So

we still think it's valuable to know what happens at the time of diagnosis.

We also, for example, we had early-stage and late-stage [cancer] samples, so we also think it's relevant to

see that these proteins are also up in early stage. And I can comment maybe that now with all

these UK Biobank, new data that has been released. There was, for example, a pre-print, I think it was

last week, also on different kinds of cancers. And I was, for example, very happy to see that

a lot of our proteins that we found upregulated, they also see seven years prior to diagnostics. So I

think it's valuable and complementary, maybe. So we don't have to wait so many years to see

when we already have samples, but then of course, if we also have that data, that's definitely great.

I think that was one of the most fascinating aspects of your paper in that you found in your

signatures across the 12 cancer types, some well-known markers for well-known cancers have been

researched extensively, and then other new markers that imply new mechanisms. And what can

you comment on that? Yeah, for me, that was the most fascinating. Because if, I mean, it's great when

you find the top marker and that's already been found, because then you're sure that you're doing

things, right? Exactly, but if everything was known, then why am I even working with this, right? So it's

I think it's good to have a combination of really well-known markers, unknown, and maybe some of

my favorite are those that they have been described somewhere in 2015 in a random paper, but no one

has ever looked at those, and they have been forgotten. And then you find it, and you dig in the

literature and you realize, "Wow, this was, this was linked to melanoma many years ago, and I'm seeing

it again. These are my favorites." So here it is. You heard it here first from a bioinformaticist

that she has favorite markers. Big surprise. I do want to just mention that pre-print,

I'm so happy you talked about it. I think that was Ruth Travis and Karl Smith-Byrne and Joshua (Atkins), and

I just have a little tiny story when we were at ESHG, Joshua came up to our booth, and he told us how

excited he was about the UKB data being available that he's been sifting through it. And he was the one,

Dale and Sarantis, I think I told you this story before, who just kept telling me I can't tell you

anything about it, because we're coming out with a pre-print, but Holy crap, Holy crap, Holy crap,

he was so excited about mining those data. And so if he's a representative of the kind of excitement

that a resource like that can generate, I think we're going to have some really fun conversations

in the next few months about what people are seeing there. So it's, yeah, thank you for highlighting

that pre-print. Truly pioneering work, right? There is only one first, and like you mentioned,

you're looking at some random paper in 2015 that had some association with one of those 12

cancer types, and all of a sudden it pops up, right? As being an important, I thought that was very

interesting too, and the analysis where you actually look at the weightings and its influence on the

overall power in terms of that signature. Yeah, and I think something that is also,

for me, a take-home from this study, and we probably haven't talked about it yet, is that

not all cancers have the same amount of proteins that are important, right? So you can have,

maybe you need 20 proteins to characterize a cancer, or you might need 200. And I think that was not

so evident for all of us a few years ago, like we were hoping to find one protein.

Ah, the smoking gun, we want the smoking gun. The one single biomarker, right? It's so much easier

to get clinical utility past the FDA, and they love having one single test, one single HDL, LDL,

you know. But the body's so good at

repurposing all these proteins for all these different tissues. I think it's a

good lesson. I will say I'm just, I love this figure, and having Mathias talk through this figure,

which really characterizes some of the signatures that are showing up stronger in some cancers than

others. And then the connective diagram that you have, sorry, we don't use slides on this

podcast, but I will say that the images are gorgeous that allow us to just talk about what you've done,

and help folks understand the significance of the approach across multiple different diseases,

right? So, and then I think you capture it well around the importance of early cancer detection,

and these tools around genetic detection of cell-free DNA, for example, in blood, they'd suffer

from false positives, and that's a big concern that folks will be given a potential diagnosis

that isn't real because we want to make sure we capture some of these cancers

in early stages that are real. And so being able to add value to that approach, do you have any

thoughts about how this might complement that, how it might be leveraged in combination

with some of these innovative new approaches? Yeah, that's a very, very relevant

comment, and we talk about it a lot here because I mean, when we see the false

positive rates, and it does look so, so bad when you look at the numbers, but then if you think about

a population scale, then that would be a disaster, right? If you could call in so many patients.

And an individual patient experience, too? How that feels, how that would feel to an individual,

exactly what you say. Yeah, and I mean, what we've discussed before is that

it's, of course, really nice with cancers that you can have external means of

getting a validation that the person has the cancer, so instead of just running the blood test,

and saying, "Oh, yeah, you're diagnosed with the cervical cancer." If you could have a way to

verify that, like for example, the mammography or some other test. Then it's kind of

easy to convince the population that this is only a screening, that it's not that sensitive, and then

if you get the false alarm, then you of course get sent back home when you get the negative

second test. But when I think about, for example, cell-free DNA and all the other ways of

finding cancer that are very promising, I think that if we could maybe combine

cell-free DNA testing with proteomics in plasma, that would probably filter out some

of the false positives, some people that would have maybe DNA signal, but are not so strong on the proteomics

side or the other way around. So I think it would be at least two layers where it's more difficult to

be a false positive or, on the other hand, a false negative. Yeah, but so I think maybe, multi-omics,

multi-modal, both words. Yeah, what a lot of people found out at AACR in Orlando was the

readout for the Phase 3 clinical trial for the Galleri GRAIL test, and the fact is it just replicated

the Phase 2 and Phase 1, pivotal trial, or clinical trials, in that there is about a 50% false positive

rate, even with 99% specificity, just because of the prevalence of cancers, about 1% in the general

population of normal risk, and that is a problem, right? But then to think,

the harms that happen where people are saying, well, we have the

signal [that you're positive for cancer], but we're not sure, right? If you have cancer, you have to look for regular diagnosis,

and naturally for colorectal, for lung adenocarcinoma, it's all very straightforward in terms

of diagnosing those. But the Galleri test is looking at 48 other cancer types, and some of them really

do not have gold standard diagnostic methods. And so patients can be sent, right? You might say, well,

it must be terrible to be that person. Yeah, right? Where they're told, you might have cancer,

and we can't really find it using our best diagnostic tools. A real, genuine harm

to individuals, and yet the same time, the value of early detection, right? The incredible power

to prevent death? To catch it in stage one. Yeah. If you know about

this false positive rate and you can't validate that this is cancer, then you're

also not going to treat it, I guess. So, yeah, I mean, for me, I think that in the ideal case

scenario, you would just be able to sample everyone longitudinally through their lives, and I think

then it would be really easy. I'm saying easy, but it would be easier to find differences in your

proteome and like actual pathological states. But now, I mean, you're sampling a person comparing it

to some threshold, some other data that has been collected, there's going to be a lot of noise.

But of course, that's daydreaming, like, what would I like to have? Yeah, for sure. And next

steps, right? Sort of what's in the future? In this study, you were able to do sort of a 70-30 split

to be able to train your machine learning around a set of the samples and then validate with a

subset of those samples. And I think your areas under the curve for across all cancers were like

0.8 to 1, but really, really high in AML, CLL and myeloma, as I wrote down in my notes. I think that

next steps are for validation. Anything you can say about what you all are planning or what you hope

others will do to help validate this so that we understand its power? Yeah, so I mean, ideally, as I said,

it would be nice to just work with these cancers for many, many years and get additional

cohorts and buy data these findings. But our plan for now was to share these data, share

all the protein levels in the database. So for example, I love the preprint that we

just referred to, of course, they found exactly the same proteins in myeloma and that was really,

okay, we haven't validated ourselves, but these people have found it in Sweden, right? So it's not

only up to us to maybe validate these findings, but we also hope that other research groups will

refer to this and realize that they have the same thing in their own data, maybe even with other

methods. So just, it was more to share a list and to share our results and hope that also other people

will do the same. Yeah, and I think this ability to, because I can imagine, you know, sort of these

three to 12 to, however many proteins are needed for each cancer, those tests, but then you did

this beautiful thing, which is combine the proteins that were across all of these into an 83-protein

panel that was, I think - I'll let you describe that. I think it's a great part of the paper that I

appreciated and wanted to highlight. Yeah, so of course, I mean, the most important is to

learn about the proteins that are important for a disease or that was the, the aim, but what we wanted

to see also is if we can go down. So instead of looking at the 1400 proteins, what happens if we

just pick, would we think are the most representative? Do we still get good classifications?

Are we still able to separate all these samples into their specific cancer of origin?

And I think, I mean, of course, this is only the first study. We haven't validated,

but it looks quite nice that only using 80 proteins instead of 1,000, you can really guess what

that sample is. And I mean, in the future that I think would be a really nice way to

look at diseases, to just have a list of markers for not only cancers, but maybe other diseases that

could be related and then just try to see where your sample falls. So based on these markers,

you're most likely a cervix cancer patient. Yeah, I have a few questions. The first question is:

how do you see ... for sure, there are other bases of disease, right? How would you

see this protein signature of 83 correlates with other diseases? I mean, how unique? Because you haven't

done this correlation, how unique are you stuck between cancer, but how unique is compared to other

biological disorders, for example? Yeah, so for that, you will have to wait a little bit.

I mean, as I said, we have many, many different diseases now. I think we have around 88 in

phase one, and we are planning for a second phase. So you expect us to write about this.

I think it's also been highlighted in other pieces of work that there is a few proteins that are found

kind of everywhere. I think GDF-15 is one of them. It's some proteins that are just up, also

immune proteins. There is probably inflammation everywhere, but there's also quite many that are

very, very specific. So I'm always reading Olink papers because it's really fun to see, okay,

this protein that popped up for colorectal is also maybe related to HIV, I don't know. So it's

quite nice. That's so cool. And expanding the protein panels, right, we've just announced the

[Olink Explore] expansion to 5,300 proteins. Sorry, go ahead, Sarantis, you have another question.

No, no, it's perfectly fine. We think the same. I think

about what you just said in terms of proteins that are common

to disease that go beyond just cancer or just autoimmune or just infectious and to think, wow,

to have a certain set of markers that yeah, there's something going on here or yeah, you better

get this checked out. I guess, you could start monitoring these more general

markers since it is probably expected that more specific markers will pop up later on in the disease.

And then once you know something is wrong, you could go deeper and run another panel maybe.

And I just want to comment on this new release of the Explore HT, do you call it?

Yeah, absolutely. I think that's really exciting at least from my side because when, I don't know,

when you work in in biomarker discovery, I don't think a lot of people are used to this really high

number of targets. And for me already 1,500, I felt like that was amazing, right? Like eventually,

you start getting to know some proteins by heart, but it's still a lot of proteins to look at.

But now, I mean, from, of course, you had 3000 in between, but for me, going from 1,500 to

more than 5,000 proteins that we will have in the next phase, I'm really looking forward

for that. That's going to be a really nice, well, it's a really nice list. It's a good chance to

mention that just this week, we've integrated that entire list into our Insight app. So this is

a freely available software that has a web-based interface at insight.olink.com. And you can

browse pathways, see how many of the total proteins in those pathways we have on that HT [platform] and our

other panels. I am in there all the time. I was surprised that I'm a super user of it. So clearly,

it's underutilized because it's relatively a new set of tools that we've provided in the last

year. And the data stories in there include the Cancer Protein Atlas that we're talking

about here today. So folks can browse some of the results that you found in that exciting study,

which by the way, is in Nature Communications. You're a PhD student! Look at you, Maria. Amazing.

Amazing. I mean, on that note, Maria, there is an idea for a Disease Protein Atlas. Is that

correct? Not just cancer, but other diseases. What can you comment on that? So right now,

we have published this story. So that's the data that's available now on the Atlas. It's still called

Human Disease Blood Atlas, although now it's more like a cancer atlas. But the idea is we're going to

keep on releasing data. So I mentioned phase one that has infectious diseases. It has autoimmune

disease and many others that's going to be soon, relatively soon part of the database.

And then of course, we have plans to expand to a phase two and and and have more targets. So that's

also going to be part of the Atlas and hopefully on Olink Insight as well. So that it can reach

as many researchers as possible. That's an amazing resource. Does Mathias [Uhlen] talk about how many

millions of hits and how many thousands of pages of data are freely available? Yeah. I mean, it's

really a unique effort, I'd say. And also, I kind of really like the history of focusing on

proteins and now going a little bit more. We have this health study and now we have this disease study.

So I think it's quite a natural course of how you should look at biology. From the

healthy to the disease and look at those differences. Maria, talking about a little bit biomarkers

and I know that the scope of the proteins is around identifying biomarkers for prognosis.

But for sure, among these biomarkers, there will be targets, right? For drugs. I mean, are you

considering to take a look more to the drug development perspective? I'm sure that you are. But

have you found some really cool new targets for example, that pharma companis could take advantage

of? I mean, if you want to share or is it too early? It's very tough for you. Do you need

more cohorts to validate those drug targets? Yeah, both of those. Great question. So I think

you're both on the right path. We, of course, understand how how valuable this data is

and we are of course starting to see some proteins that look very interesting. But as you both

mentioned, it's early in the sense that you need lots of validation. So we want to be careful with that.

We are of course looking at different markers. We have an eye on them. But it

takes a while before you can say anything about the disease. But crowdsourcing the data

like this, making it publicly available, allowing different folks with different ideas about how to

analyze these data, have them debate over social media as Dale was alluding to, really move things

long quickly in my experience. I think the genetic history is a great testament to that. I think

we're seeing that now too. So I'm excited that you're making these data publicly available

and Mathias's commitment to that throughout his career. Yeah, for me, that's a really important

thing that of course it's great to move forward in your own science. But what you said, for example,

about drug drug development, maybe some people doing their own research, they will see this resource,

they will find okay, this is really a good target and that will inspire them. So I think Mathias's

spirit has always been to share and to inspire and I think that's a great way to do science

at least I'm very happy I'm here. think that's an important point, right? Because

wasn't there a decision made on the on the analysis to focus on the upregulated proteins in the

disease samples? Yes, and that's also been a long debate of course because typically

upregulated proteins are very interesting because it's kind of easy to detect

them when they are high compared to the healthy population, right? But also sometimes like

for example, we saw with AML, with leukemia, that you had this really good marker that was upregulated

and this really good marker that was downregulated and you could think maybe let's take both but

many times they are just correlated because one is the receptor of the other, right? So in a way

sometimes up- and down-regulated proteins, they are still in the same pathway. So maybe it's not

that interesting to focus on both at the same time since they are leading to the same story.

And then the other piece though is that if you can modulate the upregulated-ness

of the diseased protein. There are only a handful of drugs that upregulate proteins. Yeah, I guess when

we talk about it being more classical from the clinical perspective, it's related to exactly that.

It's kind of easier to suppress than it is maybe to just somehow make this protein be produced or

provide. Yeah, I've never thought about that. That's a really interesting point. Yeah, thanks.

So therefore, we have drug targets that you need to lower in order to lower whatever

incidence or whatever mechanism that's driving the cancers. And what I think is fascinating about

cancer biology, after all we've learned in the cancer genomics and transcriptomics,

here it is, you're looking at protein level now. Maybe we're circling back all the way back to the

beginning of the conversation, right? It started with transcriptomics. And wow, once you look at the

proteome, everything is illuminated in a new way. Yeah, that's the real thing, right? I mean,

it is, we are proteins. So it's really, really nice to be able now to look at proteins directly.

And see, also in blood, like you don't even have to go to your pancreas to study pancreatic cancer,

you can hopefully just look at your blood. I never thought of that before. I am protein. Yeah,

we are protein. I think that because you haven't talked to Mathias.

Hard to get on his schedule, but we've got a surrogate for Mathias ight here. So I think this will

be our new new mantra here. We are protein. I think you made an impact, Maria. Every one of us

is protein. That's right. Yeah, what a thought. Yeah, thank you for your generosity with

your time today. We really enjoyed this conversation. Yeah. Thank you for inviting me. It's been really

great to discuss with you. Yeah. And then not just not to forget to thank all of these patients

that consented to allow, you know, now and in the future, all the work that you and others do, I mean,

what a wonderful generous act and without it, we wouldn't be where we are today. For sure.

All right. Thank you. Thank you. Thanks so much.

Thank you for listening to the Proteomics in Proximity podcast brought to you by Olink Proteomics.

To contact the hosts or for further information, simply email info@olink.com.

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