Quick Diagnosis for Early Treatment

Dec. 12, 2014

By Medical Discovery News

Quick Diagnosis for Early Treatment

The time it takes to test for the cause of an infection ranges from minutes to weeks. A new generation of biosensors may change that, as they are being developed to identify the viral, bacterial, or fungal origin of an illness within a few hours, allowing physicians to begin the correct treatment sooner.

Many infections have symptoms that resemble the flu, such as HIV, the fungal infection coccidioidomycosis, Ebola, and even anthrax. This makes it very difficult to make a diagnosis. The emergence of new microbial pathogens such as SARS and MERS and bacterial resistance to antibiotics only adds to the fight against infectious agents. Scientists like Louis Pasteur and Robert Koch developed the traditional method for diagnosing infectious disease about 150 years ago, and modern methods have improved their discoveries.

Viruses, bacteria, and fungi have genetic information contained in DNA, RNA, or both. Each strand of DNA or RNA is made of four kinds of building blocks called nucleotides: adenine (A), cytosine (C), guanine (G), and thymine (T) in DNA or uracil (U) in RNA. Every species has a unique genetic code as seen in its arrangement of nucleotides, and by unlocking that code scientists can determine their identity. Each of the nucleotides has a different molecular weight, so the number of each nucleotide in a strand of DNA or RNA can be determined by measuring it on a device called a mass spectrometer. This can identify a microbial pathogen faster than the traditional culturing method, and can also identify those that can’t be grown in a lab.

However, the massive amount of DNA and RNA in a patient’s own cells complicates things. To tackle this problem, inventors of the new biosensor have coupled a mass spectrometer with polymerase chain reaction (PCR) to amplify any piece of genetic information that matches a known sequence from a pathogen. The sensor can then detect a very broad array of potential pathogens simultaneously.

Scientists have been very careful in selecting the unique genetic regions of various pathogens for this test. Once the PCR is used to amplify pieces of potential pathogens in the sample, the mass spectrometer spits out a series of numbers that can be cross-referenced to a database of over 1,000 pathogens that cause human disease in just a few hours.

For example, two children were hospitalized with flu-like symptoms in Southern California in 2009. They tested positive for the flu virus, but doctors did not know which strain of the flu they had. The new sensor analyzed their samples and revealed that both children were infected with H1N1, otherwise known as swine flu, which was not circulating at that time. H1N1 became a pandemic strain with cases all around the world.

This new technology represents a universal pathogen detector, capable of identifying the organism responsible for a person’s illness in just a few hours. Networking the detectors between hospitals and health departments would quickly identify outbreaks and possibly save lives.

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Semi-Precious Pathogens

Oct. 17, 2014

By Medical Discovery News

Bug in amber

Some diseases are older than others. AIDS, for instance, is a recent phenomenon, while malaria has plagued humans for millennia. Recently, scientists examining ticks fossilized in amber found they were infected with bacteria similar to those that cause Lyme disease, a spirochete named Borrelia burgdorferi. Lyme disease is a bacterial infection caused by the bite of an infected tick. The discovery of an ancient Borrelia-like bacterium, now named Palaeoborrelia dominicana, shows that tick-borne diseases have been around for millions of years.

Lyme disease was identified in the early 1970s when mysterious cases of rheumatoid arthritis struck children in Lyme, Conn., and two other nearby towns. The first symptom is a rash called erythema migrans, which begins with a small red spot where the tick bite occurred. Over the next few days or weeks, the rash gets larger, forming a circular or oval red rash much like a bull’s eye. This rash can stay small or can cover the entire back. But not everyone with Lyme disease gets this rash, and the other symptoms, including fever, headaches, stiff neck, body aches, and fatigue, are common to many other ailments. Some people develop symptoms of arthritis, nervous system problems, or even cardiac issues.

Lyme disease can be difficult to diagnose. Sometimes, people write off their initial symptoms as the flu or another common illness, and experience symptoms for months or even years before finding the true cause. To diagnose Lyme disease, doctors measure the levels of antibodies the body produces in response to Borrelia infection. Lyme patients are treated with antibiotics, but if the bacteria have been in the body for a long period of time, it can take a long time to cure. The sooner diagnosis and treatment begin, the more quickly and completely patients will recover. Even after treatment for Lyme disease, people can still experience muscle or joint aches and nervous system symptoms.

Scientists from Oregon State University have studied 15- to 20-million-year-old amber found in the Dominican Republic. Despite existing for millions of years, bacteria are rarely found in fossils. However, free-flowing tree resin traps and preserves material such as seeds, leaves, feathers, and insects in great detail. Amber is then formed from the fossilization of the resin over millions of years as it turns into a semi-precious stone. This is the oldest fossil evidence of ticks containing such bacteria.

Four ticks from the Dominican amber were examined and found to have large populations of spirochetes that resemble the Borrelia bacteria, such as those that cause Lyme disease today. The oldest reported case of Lyme disease was Oetzi, a well-preserved natural mummy who lived 5,000 years ago and was discovered by hikers in the Alps. In other studies, fossils have revealed bacteria such as Rickettsia, which cause modern diseases like Spotted Fevers and Typhus, found in ticks from about 100 million years ago. Evidence suggests that even dinosaurs may have been infected with Rickettsia, showing these microbes likely infected other creatures before humans were added to the mix. Millions of years of co-evolution resulted in highly adapted pathogens that scientists and physicians still struggle to understand and treat.

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