xken health for practice
Use of xken health in practice
xken health is based on clinical proteomic analysis and provides you, as a treating physician, with molecular proteomic diagnostics for everyday practice. Most of your patients will not have had any contact with this method to date.
The special features of clinical proteomic analysis
Every cellular process is controlled by proteins. Clinical proteome analysis defines all proteins and their fragments (peptides) in their complexity, the clinical proteome. These measured molecules are fragments of proteins that are the building blocks of all cells and part of the machinery that keeps the cell alive. Every body has an individual proteome status that indicates its state of health. xken health determines the body's proteome status and thus enables early detection of diseases. Proteins control and regulate the entire molecular process and, with their specific mechanisms, also determine emerging diseases. The body's defense mechanisms correct even disease-specific developments via specific proteins. If the body's own defenses are no longer sufficient or evade the control mechanisms, degeneration or disease mechanisms in organic tissue or damage to the body itself can occur. If these disease processes are detected early, a wide range of therapeutic measures are still effective. Medications only work at the molecular level and even then only effectively if administered in the early stages. Until now, chronic diseases, in particular, were only discovered with their organic effects, based on significant loss of function in individual organs, such as the kidneys. A concrete definition only comes from pathology based on histological findings.
Checklist
A urinary tract infection or symptomatic nephrolithiasis can be ruled out.
An active infectious disease (e.g. influenza or COVID-19) can be ruled out.
xken health is an individual health service (IGeL). They have taken all legal aspects into account.
The effect of drugs and metabolites on test results has been extensively studied. However, in individual cases, an influence cannot be ruled out.
Return shipment can be ensured within 48 hours, including parcel delivery time, after sampling.
xken health is a registered in vitro diagnostic (IVD) device.
Note on stockpiling
To ensure a quick and smooth process for your patients, we recommend that you stock up on our test kits for distribution to your patients. If you regularly send large numbers of samples from your clinic, we will provide you with a sufficient number of urine collection tubes with stabilizer and shipping materials. Please contact us (med@xken-health.com).
Price model
Regular, and above all, independent, monitoring of your health status brings the greatest benefit. We recommend repeating xken health every two years at the latest, depending on your physical condition and age. Regular monitoring allows us to detect changes in your patients' bodies and determine the influence of other factors—such as lifestyle changes.
Delivers xken health Indications of the presence of a specific disease, we offer a more in-depth analysis with all the proteomic tests already proven by studies from our sister company, protexam GmbH Furthermore, an individual database will be set up for each patient upon request, in which their results will be made available.
4.950,00 €
xken health is used by the patient for the first time.
3.850,00 €
xken health is repeated as part of a check-up within 14 months.
850,00 €
Annual therapy check-up.
350,00 €
Initial in-depth diagnostics if there is suspicion.
250,00 €
Any further in-depth diagnostics if there is suspicion.
Using clinical proteomic analysis, a test was developed as part of a study (CRIT-CoV-U) that predicts a severe course of COVID-19. We incorporate the results of this work into xken health and offer users an evaluation that includes predisposition to COVID-19 infection.
The participating physician-scientists and biochemists hypothesize that the foundations for a severe COVID-19 course are already present in every patient. This individual overall predisposition makes it possible to provide an accurate prognosis for the course of a COVID-19 infection even at the onset. xken health uses this proteome test from the CRIT-CoV-U study to determine the predisposition for a potentially severe COVID-19 course even before infection. This hypothesis is based on fundamental scientific knowledge.
In the case of a COVID-19 infection, the predisposition test can be repeated to confirm the diagnosis. This enables the patient to behave according to their personal risk and take precautions for their health.
From the perspective of xken health – the health test – the scope of testing is being expanded to include the prognosis of a severe course of Covid-19. Patient health is xken health's top priority, and vital insights are provided for the benefit of patients. This analysis is therefore provided free of charge with every xken health test ordered as an 'off-label use' at the mutual request of the patient and their physician.
Medical background
Tissue weakness, cardiovascular, and kidney diseases are all associated with biological age. This biological age is reflected by a distinct molecular proteome pattern—the aging proteome.
The aging proteome is a molecular melting point of many diseases. It can provide clues to chronic diseases and the dynamic aging processes they trigger.
Molecular diagnostics enables you to offer your patients a broader range of diagnostic options. Early detection of body imbalances can be diagnosed at an early stage, and the initiation of therapeutic measures can prevent further harmful progression.
Mmolecular mechanisms
Most protein fragments of the aging proteome are collagens. Collagens are largely responsible for the structural integrity of the human body as a whole, for example, as a major component of bone and connective tissue.
Collagen is produced and then broken down again during all of the body's repair processes. These repair processes must be precisely controlled by the body. Between all cells lies the extracellular matrix, which, at the molecular level, is not statically integrated into the cell exchange process but exists in a dynamic equilibrium. If an imbalance arises, this can lead to impaired wound healing and even fibrosis. Fibrosis can occur anywhere and in any part of the body. If undetected in organs, it leads to impaired organ function and accelerates aging. Fibrosis creates scarred structures that prevent the orderly life of cells. Early detection of such fibrotic structures, which are predominantly due to endogenous or exogenous factors, can support you in your patient assessment. Even behavioral changes towards a healthier lifestyle for your patient can slow down negative tendencies.
Another disease phenomenon that affects the entire body and every organ is damage to the endothelium. The endothelium is a thin layer of endothelial cells that lines the interior (lumen) of blood vessels. It serves as a barrier to tissue but is also involved in the regulation of the cardiovascular system. Endothelial damage can occur as a result of chronic diseases or as part of fibrosis. Both fibrosis and endothelial damage have a massive impact on the patient's health status and accelerated aging.
Clinical studies have demonstrated disease-specific proteome patterns or the clinical significance of the individual components of xken health. As a rule, all disease-specific proteome patterns are associated with pathophysiology. Due to their high statistical significance and high study quality, the findings are highly relevant and, together with the overall medical history, provide a qualified basis for therapy.
xken health is highly sensitive and can detect even slight changes in the proteome. This means that previously recovered infections (e.g., influenza or COVID-19) are also mapped and can influence test results in individual cases. A comprehensive medical history is therefore essential so your patients can derive the maximum benefit from an xken health diagnosis.
All components required for an xken health diagnosis have been validated in clinical studies. This includes the entire process, from the selection of the sample medium (urine) to the technology used (CE-MS coupling) and the proteomic tests currently in use.
Relevant Study
BioAge and LifeSpeed
Martens DS, et al. Urinary peptidomic profiles to address age-relateddisabilities: a prospective population study. Lancet Healthy Longev.2021, 2(11):e690-e703.
HeartRisk
Campbell RT, et al. The novel urinary proteomic classifier HF1 hassimilar diagnostic and prognostic utility to BNP in heart failure. ESCHeart Fail. 2020, 7(4):1595-1604.
HeartRisk
Zhang ZY, et al. Epidemiologic observations guiding clinicalapplication of a urinary peptidomic marker of diastolic left ventriculardysfunction. J Am Soc Hypertens. 2018, 12(6):438-447.
HeartRisk
Zhang ZY, et al. Urinary Proteome and Systolic Blood Pressure asPredictors of 5-Year Cardiovascular and Cardiac Outcomes in aGeneral Population. Hypertension 2015, 66(1):52-60.
HeartRisk
Kuznetsova T, et al. Urinary proteome analysis in hypertensivepatients with left ventricular diastolic dysfunction. Europeanheart journal 2012, 33(18):2342-2350.
HeartRisk
Delles C, et al. Urinary proteomic diagnosis of coronary arterydisease: identification and clinical validation in 623individuals. J. Hypertens. 2010, 28(11):2316–2322.
KidneyRisk
Tofte N, et al. Early detection of diabetic kidney disease by urinaryproteomics and subsequent intervention with spironolactone to delayprogression (PRIORITY): a prospective observational study andembedded randomised placebo-controlled trial. Lancet DiabetesEndocrinol. 2020, 8(4):301-312.
KidneyRisk
Siwy J, et al. Proteomics and personalized medicine: a focus on kidneydisease. Expert Rev Proteomics 2019, 16(9):773-782.
KidneyRisk
Siwy J, et al. Noninvasive diagnosis of chronic kidney diseases usingurinary proteome analysis. Nephrol Dial Transplant. 2017,32(12):2079-2089.
KidneyRisk
Good DM, et al. Urinary proteomic diagnosis of coronary artery disease: identification and clinical validation in 623 individuals. J. Hypertens. 2010, 28(11):2316–2322.
OncoRisk
Siwy J, et al. Noninvasive diagnosis of chronic kidney diseases usingurinary proteome analysis. Nephrol Dial Transplant. 2017,32(12):2079-2089.
Before a disease manifests itself through the appearance of specific symptoms and can be detected using routine medical diagnostic procedures, it is preceded by changes at the molecular level. These changes are reflected in the composition of the protein pattern, which can be determined in urine using a state-of-the-art diagnostic procedure.
By determining the proteome in urine using capillary electrophoresis coupled with mass spectrometry (CE-MS) and subsequently comparing it with proteome data from studies, it is possible to obtain individual information as a snapshot of the current state of health in general and with regard to specific diseases. Through changes in lifestyle and dietary habits, the reduction of risk factors, and further targeted medical clarification of the findings, improvements for future individual health development can be achieved.
The patient is given the opportunity to positively influence their health and future well-being before lasting damage occurs. All conclusions from clinical proteomic analysis are based exclusively on the individual proteomic status and are compared with study results in each individual case. By repeating xken health, the therapeutic success and the influence of other external influences or behaviors are also scientifically verifiable.
One of the most important indications for determining aging, or the speed of life and its subsequent course, is LifeSpeed. The LifeSpeed test is based on a proteomic pattern, the so-called "death prediction score," which maps the patient's probability of survival over the next five years. For the underlying study, data from over 10,000 patients were evaluated, and the survival data for each age group was determined based on internal causes. The results very precisely indicate the chance of survival or the risk of premature death.
On this basis, you can propose a targeted intervention and attitude of the patient to reduce the risk of (premature) death, compared to the cohort of the same age, taking into account a personalized diagnosis.
Key data of the practical case:
Based on the data collected, the theoretical patient, with a chronological age of 65, has a survival rate of approximately 53% for the next 5 years. This below-average survival rate can be modified through targeted interventions based on selected parameters, such as BMI, glomerular filtration rate (eGFR), and the results of the xken BioHealth tests.
The modifiable parameters are all directly or indirectly associated with chronic diseases or preceding negative symptoms. A therapy and its success can be professionally verified by repeating xken health.
If the causes of this test result are not obvious from the overall medical history, xken health can support you in finding a suitable treatment. This involves optimized interventions that initiate targeted changes. These changes result in a reduction in the risk of death from approximately 47% to 23%.
LifeSpeed
The score is a dimensionless, aggregated value derived directly from the extensive study results. Its result and the patient's expected life expectancy are statistically significantly correlated.
Time – before therapy
The theoretical patient has a BMI of 28 and an eGFR of 65. Further diagnostics with xken health show a chronic kidney disease score of 1.2 and cardiovascular risk score of -2.2, which is in the risky range.
This means a manifest chronic disease of the cardiovascular system, including the kidneys. As a result, xken health's LifeSpeed (score = 6.38) measures a below-average survival expectancy in the next five years (approximately 53%).
Measures
The patient receives targeted therapy for the diagnosed problem areas. At the same time, the patient adjusts their body weight (BMI = 27), and the treating physician can therapeutically increase the eGFR rate (70).
Depending on the state of health and the overall medical history, it must be determined which therapeutic measures can still be exhausted.
Time – after therapy
At the end of therapy, the score for chronic kidney disease improved to 0.4 and cardiovascular risks to -0.2, so that the interim result was no longer in the risky range.
As a result of the therapy and measures, xken health measures with LifeSpeed (score = 5.02) an improved survival expectancy in the next five years (approximately 77%).
xken health for practice
Individual therapy control
Clinical proteomic analysis can demonstrate therapeutic success at all stages of patient treatment with respect to the defined disease-specific proteomic pattern. Depending on the type of therapy, an appropriate time interval should be chosen so that an improved dosage or alternative treatment can be implemented quickly.
Hardly any patient responds immediately to a given therapy or dosage; often, other therapies are already in place, which can cause intolerance. A thorough medical history is essential for leveraging the broad reservoir of knowledge provided by clinical proteomic analysis. The patient benefits from the correct choice of therapy and dosage.
Therapy adjustment is linked to compliance. If life expectancy with "LifeSpeed" is shorter than predicted, rapid and precise therapy adjustment is required. Patient adherence to therapy is crucial for success. In these cases, we recommend an annual review.
Positive test results:
Next Steps
The xken health results are provided to you in a detailed laboratory report. This laboratory report compiles and categorizes the results of the individual test components. To derive an overall picture of your patient's health status, pre-existing conditions must be appropriately taken into account. This is important because xken health is so sensitive that, for example, acute and recent infections can be detected and influence the overall result.
The detection of alterations in the protein profile does not constitute a classic medical diagnosis, but rather indicates highly significant molecular alterations associated with the corresponding diseases, which are not detectable in the early stages by routine medical diagnostics and may still be reversible with appropriate interventions. The further diagnostic and therapeutic consequences of this finding should be decided on an individual basis.
Do you have any questions or would you like to schedule a consultation on a specific case? Contact us, and we'll put you in touch with the physicians involved in the studies. Once you've submitted your questions in writing, they'll be available to answer your questions by phone. Our team will organize all further steps – for the health of your patients!
Biological age
Biological age represents the current state of cellular aging compared to the chronological age of a study group. This data can only be evaluated in combination with a medical history, so that the cause can be precisely investigated and the patient receives an indication for their lifestyle.
LifeSpeed
Based on the cell age determined by the proteome, a comparison is made with the statistical life expectancy of the study group. This determines the chance of remaining alive over the next 10 years. This refers to life expectancy due to disease. Targeted therapeutic measures can improve the outlook in individual cases.
Put it through its paces
A test for coronary heart disease, heart failure, and chronic kidney disease will be performed. Positive results indicate evidence of changes in the associated diseases examined in the study group. As part of xken health's diagnostic services, we recommend conducting further diagnostic testing with the affected patient.
OncoRisk
The statement should not be interpreted as a rigid prognosis, but as a consequence of the current health status, which can fundamentally be influenced prognostically.
It may be an indication of systemic inflammation if there is no change in the protein profile that can be attributed to a specific tumor (prostate, bladder, renal cell, pancreatic and bile duct carcinoma).
