Improving Development of the Molecular Signature for Diagnosis of Acute Respiratory Viral Infections

Abstract

Acute respiratory viral infections cause significant morbidity and mortality in the United States and worldwide. Unfortunately, clinicians do not currently have practical means to make a timely and accurate diagnosis of acute viral respiratory infections and they often resort to unnecessary antibiotic treatment that increases healthcare costs and facilitates development of antibiotic resistance. In a recent breakthrough paper in Cell Host & Microbe, Zaas et al. provided a novel approach for diagnosis of acute respiratory infections based on microarray gene expression profiles of the blood (Zaas et al., 2009). They developed an “acute respiratory viral response” 30-gene panviral signature that can accurately diagnose symptomatic subjects (with influenza A, HRV, and RSV) from uninfected individuals and validated this signature in data from an independent study that contained influenza A patients and healthy controls (Ramilo et al., 2007). Overall, the study of Zaas et al. made a significant contribution toward improved diagnosis of infectious diseases from peripheral blood. In the present brief communication, we first propose several ways to improve the analysis that led to development of the 30-gene panviral signature and then provide an example of how the new analysis protocol can lead to an improved molecular signature.