# US 12,595,511 B2 · Methods using characteristics of urinary and other DNA > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,595,511 B2 - Document ID: US12595511B2 - Status: Granted - Kind: B2 - Application number: 17/544,354 - Filed: 2021-12-07 - Published: 2022-06-09 - Granted: 2026-04-07 - Earliest claimed: 2020-12-08 - Assignees: The Chinese University of Hong Kong; Grail, LLC - Applicants: The Chinese University of Hong Kong; GRAIL, Inc. - Inventors: Yuk-Ming Dennis Lo; Kwan Chee Chan; Peiyong Jiang; Suk Hang Cheng; Ze Zhou; Tingting Xie; Guangya Wang; Chen Ding - Web page: https://patentgrep.com/patent/US12595511B2 ## CPC - C12Q 1/6883: for diseases caused by alterations of genetic material - C12Q 1/6816: characterised by the detection means (C12Q1/6804 takes precedence) - C12Q 1/6869: Methods for sequencing - G16B 40/20: Supervised data analysis - C12Q 2600/154: Methylation markers - C12Q: MEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS (immunoassay G01N33/53); COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES - G16B: BIOINFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR GENETIC OR PROTEIN-RELATED DATA PROCESSING IN COMPUTATIONAL MOLECULAR BIOLOGY ## Abstract The ends of cell-free DNA fragments may be used for analysis of a biological sample. In some embodiments, DNA from a urine sample may be analyzed. Cell-free DNA fragments often include jagged ends, where one end of one strand of double-stranded DNA extends beyond the other end of the other strand. The length and amount of these jagged ends may be used to determine a level of a condition of an individual. The density of ends of fragments in certain regions may also be used in classifying the level of a condition. Additionally, DNA fragments may show a periodic pattern with the amount of DNA fragments corresponding to a length of the overhang. The periodicity may be analyzed to determine properties of a biological sample. Jagged ends may also be analyzed with a technique that avoids trimming overhanging 3′ ends of a double-stranded DNA. ## Claims ### Claim 1 A method of analyzing a urine sample, the method comprising: measuring a characteristic of each nucleic acid molecule of a cell-free plurality of nucleic acid molecules from the urine sample of an individual, the cell-free plurality of nucleic acid molecules comprising at least 10,000 cell-free nucleic acid molecules, wherein: each nucleic acid molecule of the cell-free plurality of nucleic acid molecules is double-stranded with a first strand having a first portion and a second strand, the first portion of the first strand of at least some of the cell-free plurality of nucleic acid molecules overhangs the second strand, an extent of overhang varies among the cell-free plurality of nucleic acid molecules; the characteristic correlates to a length of the first strand that overhangs the second strand, wherein: the characteristic is the length of the first strand that overhangs the second strand, or the characteristic is a methylation status at one or more sites at end portions of the first strands, the second strands, or the first strands and the second strands of each of the cell-free plurality of nucleic acid molecules; determining a jagged index value using the measured characteristics of the cell-free plurality of nucleic acid molecules, wherein the jagged index value provides a collective average measure that a strand overhangs another strand in the plurality of nucleic acid molecules, wherein the collective average measure is proportional to an average length that the first strands overhang the second strands in the plurality of nucleic acid molecules; comparing the jagged index value to a reference value, wherein the reference value is determined using at least one of one or more reference samples of subjects that have a condition and one or more reference samples of subjects that do not have the condition; and determining a level of the condition of the individual using the comparison, wherein the level of the condition is whether the condition exists or a severity of the condition, and wherein the condition is bladder cancer or kidney cancer. ### Claim 2 (depends on 1) The method of claim 1, wherein the measuring comprises measuring a characteristic of a first strand, a second strand, or the first strand and the second strand for each nucleic acid molecule. ### Claim 3 (depends on 1) The method of claim 1, wherein the first portion is at a first end of the first strand, and the first end is a 5′ end. ### Claim 4 (depends on 1) The method of claim 1, further comprising: measuring sizes of nucleic acid molecules present in the urine sample, and filtering the nucleic acid molecules for molecules having sizes within a size range to obtain the cell-free plurality of nucleic acid molecules. ### Claim 5 (depends on 4) The method of claim 4, wherein the size specified range is 140 to 160 bp. ### Claim 6 (depends on 4) The method of claim 4, wherein: the cell-free plurality of nucleic acid molecules is a first plurality of nucleic acid molecules, and the size range is a first size range, the method further comprising: filtering the nucleic acid molecules for molecules having sizes with a second range to obtain a second plurality of nucleic acid molecules, and measuring the characteristic of a strand of each nucleic acid molecule of the second plurality of nucleic acid molecules, wherein determining the jagged index value comprises calculating a ratio using the measured characteristics of the first plurality of nucleic acid molecules and the measured characteristics of the second plurality of nucleic acid molecules. ### Claim 7 (depends on 1) The method of claim 1, wherein the characteristic is the methylation status at the one or more sites at end portions of the first strands, the second strands, or the first strands and the second strands of each of the cell-free plurality of nucleic acid molecules, and wherein the jagged index value is determined using a methylation level over the cell-free plurality of nucleic acid molecules at one or more sites of end portions of the first strands, the second strands, or the first strands and the second strands. ### Claim 8 (depends on 1) The method of claim 1, wherein the characteristic is the length of the first strand that overhangs the second strand. ### Claim 9 (depends on 1) The method of claim 1, further comprising: analyzing nucleic acid molecules to produce reads, aligning the reads to a reference genome, and filtering the nucleic acid molecules for molecules having reads within a certain distance relative to a transcription start site to obtain the cell-free plurality of nucleic acid molecules. ### Claim 10 (depends on 1) The method of claim 1, further comprising: analyzing nucleic acid molecules to produce reads, aligning the reads to a reference genome, and filtering the nucleic acid molecules for molecules having reads within a distance range relative to CTCF site or a DNASE1 hypersensitive site to obtain the cell-free plurality of nucleic acid molecules. ### Claim 11 (depends on 1) The method of claim 1, wherein the reference value is determined using one or more reference samples of subjects that have the condition. ### Claim 12 (depends on 1) The method of claim 1, wherein a machine learning model is used to perform the comparing of the jagged index value to the reference value and the determining of the level of the condition of the individual. ### Claim 13 A method of analyzing a urine sample, the method comprising: sequencing a cell-free plurality of nucleic acid molecules from the urine sample of an individual to produce sequence reads, wherein each nucleic acid molecule of the cell-free plurality of nucleic acid molecules is double-stranded with a first strand having a first portion and a second strand, and wherein the first portion of the first strand of at least some of the cell-free plurality of nucleic acid molecules overhangs the second strand; aligning the sequence reads to a reference genome to determine genomic locations of the cell-free plurality of nucleic acid molecules; filtering the cell-free plurality of nucleic acid molecules for nucleic acid molecules having a genomic location at a specified distance from a predetermined type of genomic site to obtain a set of nucleic acid molecules of the cell-free plurality of nucleic acid molecules, the set of cell-free nucleic acid molecules comprising at least 10,000 cell-free nucleic acid molecules, and wherein the type of genomic site is determined prior to aligning the sequence reads and wherein the predetermined type of genomic site is associated with a modification of a protein in chromatin at the genomic site or a protein interaction at the genomic site; measuring a characteristic of each nucleic acid molecule of the set of nucleic acid molecules, wherein: the characteristic correlates to a length of the first strand that overhangs the second strand, wherein: the characteristic is the length of the first strand that overhangs the second strand, or the characteristic is a methylation status at one or more sites at end portions of the first strands, the second strands, or the first strands and the second strands of each of the cell-free plurality of nucleic acid molecules; determining a jagged index value using the measured characteristics of the set of nucleic acid molecules, wherein the jagged index value provides a collective average measure that a strand overhangs another strand in the set of nucleic acid molecules, wherein the collective average measure is proportional to an average length that the first strands overhang the second strands in the set of nucleic acid molecules; comparing the jagged index value to a reference value, wherein the reference value is determined using at least one of one or more reference samples of subjects that have a condition and one or more reference samples of subjects that do not have the condition; and determining a level of the condition of the individual using the jagged index value, wherein the level of the condition is whether the condition exists or a severity of the condition, and wherein the condition is bladder cancer or kidney cancer. ### Claim 14 (depends on 13) The method of claim 13, wherein the distance is a range. ### Claim 15 (depends on 13) The method of claim 13, wherein the distance is 0 nt. ### Claim 16 (depends on 13) The method of claim 13, wherein the genomic site is a CTCF binding site, a DNASE1 hypersensitive site (DHS), or a region with a histone modification. ### Claim 17 (depends on 16) The method of claim 16, wherein the genomic site is the region with the histone modification. ### Claim 18 (depends on 17) The method of claim 17, wherein the histone modification comprises H3K4me1, H3K4me3, H3K36me3, H3K27me2, H3K9Ac, H3K27Ac, H4K16Ac, H3K27me3, or H3K9me3. ### Claim 19 (depends on 7) The method of claim 7, wherein the jagged index value is further determined using a methylation level over one or more sites of a complementary portion hybridized to the first strand, the method further comprising hybridizing the complementary portion to the first strand. ### Claim 20 (depends on 1) The method of claim 1, wherein determining the level of the condition comprises determining the condition is present in the individual, the method further comprising treating the condition in the individual, wherein the treating includes one or more of chemotherapy, immunotherapy, radiation therapy, and/or surgery.