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Quantitative analysis of individual cell-free DNA concentration before and after penetrating trauma



Cell-free DNA (cfDNA) elevations were remarked in the blood of trauma patients. Published increases refer to comparative values of a healthy control group, ignoring thereby inter- and intra-individual differences under normal conditions. The aim of this study was to quantify cfDNA in patients in the time course of a planned orthopedic surgery, which constitutes the advantage of obtaining individual pre- and post-trauma values for each patient. By this approach, a basis should be established for the potential future application of cfDNA as biomarker for the detection of mild injuries related to volunteer experiments in forensic biomechanics.


Plasma samples of ten patients obtaining knee or hip arthroplasty were analyzed quantitatively for cfDNA by real-time qPCR the day prior operation (Prior), immediately afterwards (Day0), and the day after the surgery (Day1).


Prior values exhibited a broad range, indicating pronounced inter-individual differences in the basic level of cfDNA. After surgery, levels were significantly elevated on both days (Wilcoxon test p = 0.002). In nine patients, highest values were measured on Day0, whereby a fold change of 19 was remarked once. After Day0, values decreased, though they did not reach Prior values until Day1 in nine patients.


Endoprosthesis surgery represents a well-defined trauma scenario for the measurement of individual cfDNA elevations. The analysis of pre- to post-trauma alterations lay the groundwork for the application of cfDNA as biomarker for the detection of minor injuries in the field of forensic biomechanics.

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The authors would like to thank the whole medical personnel that helped with the sample collection as well as the staff at the institute of clinical chemistry at the Campus Grosshadern for their technical support.

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Correspondence to Katrin Brodbeck.

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The authors declare that they have no conflict of interest.

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All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.



Table 2 Detailed study population characteristics and values of cell-free DNA

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Brodbeck, K., Kern, S., Schick, S. et al. Quantitative analysis of individual cell-free DNA concentration before and after penetrating trauma. Int J Legal Med 133, 385–393 (2019).

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  • Cell-free DNA
  • Individual values
  • Trauma
  • Injury
  • Arthroplasty
  • Forensic biomechanics