title: Protein chip array profiling analysis in patients with severe acute respiratory syndrome identified serum amyloid a protein as a biomarker potentially useful in monitoring the extent of pneumonia.
abstract: BACKGROUND
  A new strain of coronavirus (CoV) has caused an outbreak of severe acute respiratory syndrome (SARS), with 8098 individuals being infected and 774 deaths worldwide. We carried out protein chip array profiling analysis in an attempt to identify biomarkers that might be useful in monitoring the clinical course of SARS patients.
  
  
  METHODS
  We performed surface-enhanced laser desorption ionization time-of-flight mass spectrometry on 89 sera collected from 28 SARS patients, 72 sera from 51 control patients with various viral or bacterial infections, and 10 sera from apparently healthy individuals.
  
  
  RESULTS
  Nine significantly increased and three significantly decreased serum biomarkers were discovered in the SARS patients compared with the controls. Among these biomarkers, one (11,695 Da) was identified to be serum amyloid A (SAA) protein by peptide mapping and tandem mass spectrometric analysis. When we monitored the SAA concentrations longitudinally in 45 sera from four SARS patients, we found a good correlation of SAA concentration with the extent of pneumonia as assessed by a serial chest x-ray opacity score. Increased SAA occurred in three of four patients at the time of extensive pneumonia as indicated by high x-ray scores. Over the course of gradual recovery in two patients, as assessed clinically and radiologically, SAA concentrations gradually decreased. In the third patient, the concentrations were initially increased, but were further increased with superimposed multiple bacterial infections. SAA was not markedly increased in the fourth patient, who had low x-ray scores and whose clinical course was relatively mild.
  
  
  CONCLUSIONS
  Protein chip array profiling analysis could be potentially useful in monitoring the severity of disease in SARS patients.
authors.affiliation: Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, The People's Republic of China.
authors.forename: Timothy T C
authors.initials: TT
authors.lastname: Yip
authors.forename: Johnny W M
authors.initials: JW
authors.lastname: Chan
authors.forename: William C S
authors.initials: WC
authors.lastname: Cho
authors.forename: Tai-Tung
authors.initials: TT
authors.lastname: Yip
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Ting-Lok
authors.initials: TL
authors.lastname: Kwan
authors.forename: Stephen C K
authors.initials: SC
authors.lastname: Law
authors.forename: Dominic N C
authors.initials: DN
authors.lastname: Tsang
authors.forename: John K C
authors.initials: JK
authors.lastname: Chan
authors.forename: King-Chung
authors.initials: KC
authors.lastname: Lee
authors.forename: Wai-Wai
authors.initials: WW
authors.lastname: Cheng
authors.forename: Victor W S
authors.initials: VW
authors.lastname: Ma
authors.forename: Christine
authors.initials: C
authors.lastname: Yip
authors.forename: Cadmon K P
authors.initials: CK
authors.lastname: Lim
authors.forename: Roger K C
authors.initials: RK
authors.lastname: Ngan
authors.forename: Joseph S K
authors.initials: JS
authors.lastname: Au
authors.forename: Angel
authors.initials: A
authors.lastname: Chan
authors.forename: Wilina W L
authors.initials: WW
authors.lastname: Lim
mesh_terms: D015415:Biomarkers / Q000097:blood; D001800:Blood Specimen Collection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010449:Peptide Mapping; D011024:Pneumonia, Viral / Q000175:diagnosis* / Q000209:etiology; D040081:Protein Array Analysis; D040901:Proteomics / Q000379:methods; D015203:Reproducibility of Results; D000685:Serum Amyloid A Protein / Q000032:analysis*; D045169:Severe Acute Respiratory Syndrome / Q000150:complications / Q000378:metabolism*; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods; D013997:Time Factors
chemical_list: D015415:Biomarkers; D000685:Serum Amyloid A Protein