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J Infect Dis. 2018 Mar 5;217(6):897-905. doi: 10.1093/infdis/jix648.

Antiviral Response in the Nasopharynx Identifies Patients With Respiratory Virus Infection.

Author information

1
Department of Laboratory Medicine Yale University School of Medicine, New Haven, Connecticut.
2
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.

Abstract

Background:

Despite the high burden of respiratory infection and the importance of early and accurate diagnosis, there is no simple diagnostic test to rule in viral infection as a cause of respiratory symptoms.

Methods:

We performed RNA sequencing on human nasal epithelial cells following stimulation of the intracellular viral recognition receptor RIG-I. Next, we evaluated whether measuring identified host mRNAs and proteins from patient nasopharyngeal swabs could predict the presence of a respiratory virus in the sample.

Results:

Our first study showed that a signature of 3 mRNAs, CXCL10, IFIT2, and OASL, predicted respiratory virus detection with an accuracy of 97% (95% confidence interval [CI], 0.9-1.0), and identified proteins correlating with virus detection. In a second study, elevated CXCL11 or CXCL10 protein levels identified samples containing respiratory viruses, including viruses not on the initial test panel. Overall area under the curve (AUC) values were: CXCL11 AUC = 0.901 (95% CI, 0.86-0.94); CXCL10 AUC = 0.85 (95% CI, 0.80-0.91).

Conclusions:

Host antiviral mRNAs and single host proteins detectable using nasopharyngeal swabs accurately predict the presence of viral infection. This approach holds promise for developing rapid, cost-effective tests to improve management of patients with respiratory illnesses.

PMID:
29281100
PMCID:
PMC5853594
DOI:
10.1093/infdis/jix648
[Indexed for MEDLINE]
Free PMC Article

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