Proteomic Assay Pinpoints Cause of Upper Respiratory Disease

A novel proteomics assay performed on nasal wash fluid rapidly determines if runny nose and other respiratory symptoms are due to cold or flu virus infection.

Improved approaches to diagnose acute respiratory virus infections could decrease inappropriate antibacterial use and provide care-providers with critical information needed to guide treatment.

Towards this end, investigators at Duke University sought to characterize immune responses in the inflamed nasal passage through proteomic analysis of nasopharyngeal lavage in human subjects experimentally challenged with influenza A/H3N2 or human rhinovirus, and to develop targeted assays measuring peptides involved in this host response allowing classification of acute respiratory virus infection.

They reported in the February 20, 2017, online edition of the journal EBioMedicine that unbiased proteomic discovery analysis of nasal wash fluid identified 3285 peptides corresponding to 438 unique proteins, and revealed that infection with H3N2 induced significant alterations in protein expression. These included proteins involved in acute inflammatory response, innate immune response, and the complement cascade. Verification of this signature using targeted mass spectrometry in independent cohorts of subjects challenged with influenza or rhinovirus demonstrated that it performed with high accuracy.

"Every day, people are taking time off from work, going to emergency rooms, urgent care or their primary care doctors with symptoms of an upper respiratory infection," said senior author Dr. Geoffrey S. Ginsburg, director of the center for applied genomics & precision medicine at Duke University. "Looking for these proteins could be a relatively easy and inexpensive way of learning if a person has a viral infection, and if not, whether the use of antibiotics is appropriate."