Revitalizing at-home-health with first-void urine sampling

Major shifts in health care procedures have begun as health facilities adapt at-home telehealth-visits to supplement in-person clinic visits. At-home health care improves by utilizing technology to better facilitate patient care and coverage. Networks of telehealth and at-home sampling infrastructure are required during social distancing to continue caring for non-critical patients. The First Affiliate Hospital of Zhengzhou University, for example, created a full mobile system to allow case discussion amongst health care professionals.^[1] Benefiting from the advancements in telehealth, established self-sampling methods are becoming vital to maintaining routine diagnostics and tests previously obtained from in-clinic visits. 

Self collection allows clinicians innovative ways to test patients from their homes. With traditional blood tests impossible to collect without clinician, using new sample types is vital to ensure full patient care at-home. First-void urine (FVU), the first 5-50 mL of urine flow, is full of biomarkers and is a proven option for screening of sexually transmitted infections and has shown potential for screening and monitoring of cancers.^[2]

First-void urine diagnostic capabilities

First-void urine (FVU) is a reliable diagnostic for infectious diseases, prostate cancer and cervical cancer; while ongoing research continues to demonstrate the effectiveness of FVU for detection of other cancer types.

• Prostate cancer: Early prostate cancers can be detected by several biomarkers found within urine^[3][4] reducing the need for invasive biopsies. Advancements in biomarker discovery have shown prostate cancer can be identified with FVU at 91% sensitivity and 69% specificity, while midstream urine was inconclusive.^[5]
• Cervical cancer: Traditional methods for cervical cancer screening include physician taken pap smears or invasive self sampling; comparisons of FVU versus these methods show FVU is equally sensitive in detecting cervical cancer.^[6][7] Cervical cancer screening via urine can also improve participation in cervical cancer screening in comparison to the current invasive methods.^[8]
• Sexually transmitted diseases (STIs): Human papillomavirus (HPV) is the most common STI and high-risk types of the virus can cause cervical cancer. FVU samples collected contain a large amount of DNA from HPV allowing easy screening via PCR-based assays. ^[9]Furthermore, FVU have been shown to detect Chlamydia with high sensitivity and specificity.^[10] Ongoing research from the Tropical Institute of Medicine have shown that home-based FVU collection positively influences the quality and adherence to STI testing.^[11]
• Bladder, kidney, and other cancers: Biomarkers assayed from serum samples commonly testing for bladder, kidney, breast, ovarian, and other cancers are now being discovered in FVU.^[12][13] These findings demonstrate the future of FVU as a sample type, and with much ongoing research  the future of FVU is hopeful to discover more biomarkers within FVU.  

First-void urine sampling with Colli-Pee®

Collecting high quality FVU samples is crucial to assays that utilize the concentration of biomarkers found within the start of the urine stream. Novosanis has created the Colli-Pee for self-sampling to capture the first mL of urine flow (up to 20 mL), in its CE-marked sampling device that allows efficient and volumetric collection, to best utilize the advancements in urine assays.

Colli-Pee collector tubes can be prefilled with urine stabilization solutions for different urinary analytes, improving transport and storage of urine at ambient temperatures.

Benefits of Colli-Pee and at-home sampling

• Volumetric self sampling captures first-void urine, the first ml of urine flow
• User-friendly non-invasive sampling allows independent collection
• Sample preservation with Novosanis proprietary Urine Conservation Medium (UCM) which allows better storage and transport
• Sample tube design allows high throughput processing for clinic efficiency

Interested in learning more about at-home urine sampling? Go to novosanis.com, or contact us at info@dnagenotek.com to request trial kits or connect with a Novosanis representative.

References:

[1] https://www.liebertpub.com/doi/10.1089/tmj.2020.0084

[2] https://pubmed.ncbi.nlm.nih.gov/21928247/

[3] https://www.ncbi.nlm.nih.gov/pubmed/23524531

[4] https://link.springer.com/article/10.1007/s12094-020-02349-z

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744126/

[6] https://www.ncbi.nlm.nih.gov/pubmed/25964233

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744126/

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973997/

[9] https://www.sciencedirect.com/science/article/pii/S016609341830329X?via%3Dihub

[10] https://jcm.asm.org/content/46/4/1466

[11] https://novosanis.com/sites/default/files/poster/pdf/De%20Baetselier%20et%20al_STI%20Rio%202017_COLLI-PEE%20A%20new%20device%20to%20collect%20first-void%20urine%20at%20home%20for%20molecular%20detection%20of%20STIs.pdf

[12] https://www.ncbi.nlm.nih.gov/pubmed/29392540

[13] https://www.ncbi.nlm.nih.gov/pubmed/21928247