A highly standardized, robust, and cost-effective method for genome-wide transcriptome analysis of peripheral blood applicable to large-scale clinical trials.

The use of peripheral blood mononuclear cells (PBMC) for transcriptome analysis has already been proven valuable for assessing disease-associated and drug-response-related gene signatures. While these proof-of-principle studies have been critically important, the instability of RNA within PBMC prohibits their use in large-scale multicenter trials for which samples have to be transported for a prolonged time prior to RNA isolation. Therefore, a prerequisite for transcriptome analysis of peripheral blood in clinical trials will be a standardized and valid method to stabilize the RNA profile immediately after blood withdrawal. Moreover, to be able to perform such large-scale clinical studies routinely in several hundred patients more cost-effective array technologies are required. To address these critical issues, we have combined a whole-blood RNA stabilization technology with a method to reduce globin mRNA, followed by genome-wide transcriptome analysis using a newly introduced BeadChip oligonucleotide technology. We demonstrate that the globin mRNA reduction method results in significantly improved data quality of stabilized RNA samples with low intragroup variance and a detection rate of expressed genes similar to that in PBMC. More important, even small differences in gene expression such as are observed between females and males were detected and sufficient to predict gender in whole-blood samples. We therefore propose the combination of globin mRNA reduction after whole-blood RNA stabilization with a newly introduced cost-effective BeadChip array as the preferred approach for large-scale multicenter trials, especially when establishing predictive markers for disease and treatment outcome in peripheral blood.