Proteomic fingerprints for potential application to early diagnosis of severe acute respiratory syndrome.
BACKGROUND
Definitive early-stage diagnosis of severe acute respiratory syndrome (SARS) is important despite the number of laboratory tests that have been developed to complement clinical features and epidemiologic data in case definition. Pathologic changes in response to viral infection might be reflected in proteomic patterns in sera of SARS patients.


METHODS
We developed a mass spectrometric decision tree classification algorithm using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. Serum samples were grouped into acute SARS (n = 74; <7 days after onset of fever) and non-SARS [n = 1067; fever and influenza A (n = 203), pneumonia (n = 176); lung cancer (n = 29); and healthy controls (n = 659)] cohorts. Diluted samples were applied to WCX-2 ProteinChip arrays (Ciphergen), and the bound proteins were assessed on a ProteinChip Reader (Model PBS II). Bioinformatic calculations were performed with Biomarker Wizard software 3.1.1 (Ciphergen).


RESULTS
The discriminatory classifier with a panel of four biomarkers determined in the training set could precisely detect 36 of 37 (sensitivity, 97.3%) acute SARS and 987 of 993 (specificity, 99.4%) non-SARS samples. More importantly, this classifier accurately distinguished acute SARS from fever and influenza with 100% specificity (187 of 187).


CONCLUSIONS
This method is suitable for preliminary assessment of SARS and could potentially serve as a useful tool for early diagnosis.
Kang
Xixiong
X
Center for Laboratory Diagnosis, Beijing Tiantan Hospital and Capital University of Medical Sciences, Beijing, China.
Xu
Yang
Y
Wu
Xiaoyi
X
Liang
Yong
Y
Wang
Chen
C
Guo
Junhua
J
Wang
Yajie
Y
Chen
Maohua
M
Wu
Da
D
Wang
Youchun
Y
Bi
Shengli
S
Qiu
Yan
Y
Lu
Peng
P
Cheng
Jing
J
Xiao
Bai
B
Hu
Liangping
L
Gao
Xing
X
Liu
Jingzhong
J
Wang
Yiping
Y
Song
Yingzhao
Y
Zhang
Liqun
L
Suo
Fengshuang
F
Chen
Tongyan
T
Huang
Zeyu
Z
Zhao
Yunzhuan
Y
Lu
Hong
H
Pan
Chunqin
C
Tang
Hong
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D001800:Blood Specimen Collection; D002648:Child; D003663:Decision Trees; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D040081:Protein Array Analysis; D020543:Proteome / Q000032:analysis*; D012189:Retrospective Studies; D045473:Severe acute respiratory syndrome-related coronavirus; D012680:Sensitivity and Specificity; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods; D013997:Time Factors; D014764:Viral Proteins / Q000097:blood*
D015415:Biomarkers; D020543:Proteome; D014764:Viral Proteins