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Improving patient care via development of a protein-based diagnostic test for microbe-specific detection of chronic rhinosinusitis

Authors

  • Subinoy Das MD, FACS,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus, Ohio, U.S.A
    2. Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
    • Send correspondence to Subinoy Das, MD, FACS, 915 Olentangy River Road, Suite 4000 Columbus, OH 43212. E-mail: Subinoy.Das@osumc.edu

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  • Lucia E. Rosas DVM,

    1. Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
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  • Joseph A. Jurcisek BS,

    1. Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
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  • Laura A. Novotny MS,

    1. Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
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  • Kari B. Green PhD,

    1. Campus Chemical Instrument Center Mass Spectrometry and Proteomics Facility, The Ohio State University, Columbus, Ohio, U.S.A
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  • Lauren O. Bakaletz PhD

    1. Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus, Ohio, U.S.A
    2. Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
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  • Presented at the 116th Annual Meeting of the Triological Society, Orlando, Florida, U.S.A., April 12, 2013.

  • This research was supported by the National Center for Research Resources, Office of the Director, National Institutes of Health, OD /NIH KL2RR025754 (Das), National Institute on Deafness and Other Communication Disorders, NIDCD /NIH 3R01DC005847-06S109 (Bakaletz, Das), and by the Technology Development Fund, Nationwide Children's Hospital. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. This research described herein claims priority benefit from Patent Cooperation Treaty applications US /2012 /40910 and US /2012 /55401. The United States government has certain rights in the invention described herein. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

The hypothesis is that signature bacterial proteins can be identified in sinus secretions via high-throughput, proteomic based techniques. Nontypeable Haemophilus influenzae (NTHI) is the most common bacterial pathogen associated with sinusitis and serves as proof of principle pathogen for identifying biomarkers.

Study Design

In vitro and in vivo studies using proteomic-based analysis of cultures of NTHI and a novel, experimental chinchilla polymicrobial sinusitis model.

Methods

Nano-liquid chromatography /tandem mass spectrometry (nano-LC-MS/MS) was performed to annotate the secretome from an NTHI biofilm. A model of NTHI-induced sinusitis was developed in a chinchilla, and NTHI proteins were detected in chinchilla secretions. A reference standard RT–PCR-based assay was adapted to allow for sensitivity and specificity testing of the identified signature biomarkers in human patients.

Results

Outer membrane proteins P2 (OMP-P2) and P5 (OMP-P5) were identified as promising candidates for the detection of NTHI biofilms and positively detected in nasopharyngeal secretions of chinchillas experimentally infected with NTHI. An RT-PCR based test for the presence of NTHI biofilms demonstrated 100% sensitivity and 100% specificity when tested against eight unique strains commonly found in human bacterial rhinosinusitis.

Conclusions

Proteomic analysis was successful in identifying signature proteins for possible use as a biomarker for chronic rhinosinusitis (CRS). OMP-P2 and OMP-P5 were validated as promising candidates and were positively detected from nasopharyngeal secretions from chinchillas experimentally infected with NTHI. Collectively, these data support the use of OMP-P2 and OMP-P5 as biomarkers for a human clinical trial to develop a point-of-care medical diagnostic test to assist in the diagnosis and treatment of CRS.

Level of Evidence

NA. Laryngoscope, 124:608–615, 2014

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