title: Detecting specific infections in children through host responses: a paradigm shift.
abstract: OBJECTIVE
  There is a need for improved diagnosis and for optimal classification of patients with infectious diseases. An alternative approach to the pathogen-detection strategy is based on a comprehensive analysis of the host response to the infection. This review focuses on the value of transcriptome analyses of blood leukocytes for the diagnosis and management of patients with infectious diseases.
  
  
  RESULTS
  Initial studies showed that RNA from blood leukocytes of children with acute viral and bacterial infections carried pathogen-specific transcriptional signatures. Subsequently, transcriptional signatures for several other infections have been described and validated in humans with malaria, dengue, salmonella, melioidosis, respiratory syncytial virus, influenza, tuberculosis, and HIV. In addition, transcriptome analyses represent an invaluable tool to understand disease pathogenesis and to objectively classify patients according to the clinical severity.
  
  
  CONCLUSIONS
  Microarray studies have been shown to be highly reproducible using different platforms, and in different patient populations, confirming the value of blood transcriptome analyses to study pathogen-specific host immune responses in the clinical setting. Combining the detection of the pathogen with a comprehensive assessment of the host immune response will provide a new understanding of the correlations between specific causative agents, the host response, and the clinical manifestations of the disease.
authors.affiliation: Division of Pediatric Infectious Diseases, Center for Vaccines and Immunity, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Asuncion
authors.initials: A
authors.lastname: Mejias
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Suarez
authors.forename: Octavio
authors.initials: O
authors.lastname: Ramilo
mesh_terms: D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D005334:Fever / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation / Q000276:immunology; D054884:Host-Pathogen Interactions / Q000276:immunology*; D006801:Humans; D007223:Infant; D007962:Leukocytes / Q000276:immunology*; D046228:Microarray Analysis; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D015203:Reproducibility of Results
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