Abstract
Capturing the host response by using genomic technologies such as transcriptional profiling provides a new paradigm for classifying and diagnosing infectious disease and for potentially distinguishing infection from other causes of serious respiratory illness. This strategy has been used to define a blood-based RNA signature as a classifier for pandemic H1N1 influenza infection that is distinct from bacterial pneumonia and other inflammatory causes of respiratory disease. To realize the full potential of this approach as a diagnostic test will require additional independent validation of the results and studies to examine the specificity of this signature for viral versus bacterial infection or co-infection.
Highlights
Capturing the host response by using genomic technologies such as transcriptional profiling provides a new paradigm for classifying and diagnosing infectious disease and for potentially distinguishing infection from other causes of serious respiratory illness
Infectious disease lends itself well to these analyses since the host response to pathogens entails a cascade of cellular events and expressed molecules that can be readily measured on a genome scale
Strategies have been developed by several groups to use host gene expression to classify viral [6,7], bacterial [8], and fungal [9] bloodstream infections – a strategy termed a ‘paradigm shift’ by some investigators in the field [10]. The rationale for this approach is clear – immune effector cells respond to pathogens with characteristic gene expression patterns reflecting the interaction of the pathogen with pattern recognition receptor signaling
Summary
Capturing the host response by using genomic technologies such as transcriptional profiling provides a new paradigm for classifying and diagnosing infectious disease and for potentially distinguishing infection from other causes of serious respiratory illness. Infectious disease diagnostics focus on one or more pathogens of interest (for example, the urinary pneumococcal antigen test or multiplex PCR for respiratory viruses) or one-analyte-at-a-time biomarkers (for example, C-reactive protein or procalcitonin elevation as a marker for severe bacterial infections [2,3]). Infectious disease lends itself well to these analyses since the host response to pathogens entails a cascade of cellular events and expressed molecules that can be readily measured on a genome scale.
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