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Existing biomarkers like CA19-9 show limited sensitivity (65–75%) and specificity (70–80%), driving the need for more precise, minimally invasive detection. CRISPR-Cas13a provides attomolar, single-nucleotide RNA targeting and supports rapid detection of circulating RNA, while microbial transcriptomic findings in PDAC plasma suggest distinct bacterial small RNAs as liquid-bio markers, enabling a fast (\u003C30 min), low-cost (\u003CUS$5/test) diagnostic pathway for early PDAC detection.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/crispr-cas13a-diagnostics-for-circulating-microbial-transcripts-in-pancreatic-cancer-letter-to-the-editor/435694/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/crispr-cas13a-diagnostics-for-circulating-microbial-transcripts-in-pancreatic-cancer-letter-to-the-editor/435694.png","ImageObject",300,407,{"name":92,"@type":93},"CatatanPagi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are current biomarkers like CA19-9 insufficient for PDAC diagnosis?","Question",{"text":112,"@type":113},"CA19-9 shows limited sensitivity (65–75%) and specificity (70–80%), especially in early-stage disease and in individuals lacking the Lewis antigen. This creates a need for more ultrasensitive diagnostic approaches before clinical presentation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What makes CRISPR-Cas13a suitable for detecting circulating microbial transcripts?",{"text":117,"@type":113},"CRISPR-Cas13a is an RNA-guided, RNA-targeting system with attomolar sensitivity and single-nucleotide specificity. It enables real-time detection of RNA signatures without amplification bias.",{"name":119,"@type":110,"acceptedAnswer":120},"How could microbial transcript biomarkers improve liquid biopsy for early PDAC detection?",{"text":121,"@type":113},"Microbial transcriptomic studies identify bacterial RNA fragments in plasma from PDAC patients, including Fusobacterium and Enterobacter-associated small RNAs. Integrating Cas13a assays with these microbial RNA signals could deliver fast (\u003C30 min), low-cost (\u003CUS$5/test), and highly specific testing for earlier detection.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},435694,1791163243,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},962090894170,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Letter to the Editor  \nCRISPR-Cas13a diagnostics for circulating microbial transcripts in pancreatic cancer  \nMuhammad Shahid Mehmood, MPhila , Inbsaat Iqbal, MDb , Fatima Hajj, MDc ,*  \nAbstract  \nPancreatic ductal adenocarcinoma (PDAC) is the seventh leading cause of global cancer deaths, with a 5-year survival rate below 11% and over 80% of cases diagnosed at advanced, unresectable stages. Current biomarkers such as CA19-9 show suboptimal diagnostic accuracy (sensitivity 65–75%; specificity 70–80%), necessitating more precise and minimally invasive diagnostic tools. Recent advances in CRISPR-Cas13a technology, an RNA-guided, RNA-targeting system with attomolar sensitivity and >95% diagnostic accuracy, enable rapid detection of circulating RNA molecules. Concurrently, microbial transcriptomic studies have revealed distinct bacterial RNA fragments in plasma of PDAC patients, including Fusobacterium and Enterobacter small RNAs, detected in up to 68% of advanced and 41% of early-stage cases. Integrating Cas13a platforms with microbial RNA biomarkers could revolutionize liquid biopsy diagnostics by providing a fast (\u003C30 min), low-cost (\u003CUS$5/test), and highly specific assay for early PDAC detection. This approach merges microbiome science, RNA diagnostics, and precision oncology to address one of the most urgent needs in pancreatic cancer care.  \nKeywords: circulating biomarkers, CRISPR-Cas13a, early detection, liquid biopsy, microbial transcripts, microbiome, novel diagnostics, pancreatic cancer, RNA diagnostics  \nTo the Editor,  \nPancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, ranking seventh globally in cancerrelated deaths, with a 5-year survival rate below 11%[1] . Delayed diagnosis contributes to this dismal outcome, as over 80% of cases are detected at an unresectable stage[2] . Traditional biomarkers such as CA19-9 exhibit limited sensitivity (65–75%) and specificity (70–80%), particularly in early-stage disease orin individuals lacking the Lewis antigen[3] . These gaps necessitate innovative, ultrasensitive diagnostic modalities capable of detecting disease before clinical presentation.  \nRecent advances in CRISPR-Cas13a technology, originally characterized as an RNA-guided RNA-targeting system, have redefined molecular diagnostics. Cas13a exhibits attomolar sensitivity and single-nucleotide specificity, enabling real-time detection of RNA signatures without amplification bias [4] .  \naInstitute of Microbiology, University of Agriculture Faisalabad, Faisalabad, Pakistan, bDepartment of Radiotherapy and Medical Oncology, King Edward Medical University, Lahore, Pakistan and cFaculty of Medical Sciences, Lebanese University, Beirut, Lebanon  \nSponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding author. Address: Faculty of Medical Sciences, Lebanese University, P.O. Box 6573/14, Beirut, Lebanon. Tel.: +961 81001507.  \nE-mail: [fatimalalala2001@gmail.com](fatimalalala2001@gmail.com) (F. Hajj).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nAnnals of Medicine & Surgery (2026) 88:1038–1039  \nReceived 8 October 2025; Accepted 11 November 2025  \nPublished online 2 December 2025  \n[http://dx.doi.org/10.1097/MS9.0000000000004392](http://dx.doi.org/10.1097/MS9.0000000000004392)  \nPlatforms such as SHERLOCK and CARMEN-Cas13a have demonstrated diagnostic accuracy exceeding 95% for RNA viruses and oncogenic transcripts in less than 60 min[5] . Such precision opens new avenues for identifying circulating microbial transcripts as non-invasive biomarkers in pancreatic canc","cbCaieYEIfebEUPn","https://ap.wps.com/l/cbCaieYEIfebEUPn","pdf",173687,"English","# Abstract\n# To the Editor\n## Limitations of current biomarkers in PDAC\n## CRISPR-Cas13a capabilities for RNA diagnostics\n## Tumor-associated microbiome and microbial RNA signals\n## Proposed Cas13a-based microbial transcript testing for liquid biopsy\n## Summary and concluding perspective","[{\"question\":\"Why are current biomarkers like CA19-9 insufficient for PDAC diagnosis?\",\"answer\":\"CA19-9 shows limited sensitivity (65–75%) and specificity (70–80%), especially in early-stage disease and in individuals lacking the Lewis antigen. This creates a need for more ultrasensitive diagnostic approaches before clinical presentation.\"},{\"question\":\"What makes CRISPR-Cas13a suitable for detecting circulating microbial transcripts?\",\"answer\":\"CRISPR-Cas13a is an RNA-guided, RNA-targeting system with attomolar sensitivity and single-nucleotide specificity. It enables real-time detection of RNA signatures without amplification bias.\"},{\"question\":\"How could microbial transcript biomarkers improve liquid biopsy for early PDAC detection?\",\"answer\":\"Microbial transcriptomic studies identify bacterial RNA fragments in plasma from PDAC patients, including Fusobacterium and Enterobacter-associated small RNAs. Integrating Cas13a assays with these microbial RNA signals could deliver fast (\\u003c30 min), low-cost (\\u003cUS$5/test), and highly specific testing for earlier detection.\"}]","CRISPR-Cas13a diagnostics for circulating microbial transcripts in pancreatic cancer - Letter to the Editor | PDF",1790674788]