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Using a Bacterial Pathogen to Probe for Cellular and Organismic-level Host Responses
Published on: February 22, 2019
A 29-mRNA host-response classifier identifies bacterial infections following liver transplantation - a pilot study
Amelie Halder1, Oliver Liesenfeld2, Natalie Whitfield2
1Heidelberg University, Medical Faculty Heidelberg, Department of Anesthesiology, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
Purpose:
Infections are common complications in patients following liver transplantation (LTX). The early diagnosis and prognosis of these infections is an unmet medical need even when using routine biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT). Therefore, new approaches are necessary.
Methods:
In a prospective, observational pilot study, we monitored 30 consecutive patients daily between days 0 and 13 following LTX using the 29-mRNA host classifier IMX-BVN-3b that determine the likelihood of bacterial infections and viral infections. True infection status was determined using clinical adjudication. Results were compared to the accuracy of CRP and PCT for patients with and without bacterial infection due to clinical adjudication.
Results:
Clinical adjudication confirmed bacterial infections in 10 and fungal infections in 2 patients. 20 patients stayed non-infected until day 13 post-LTX. IMX-BVN-3b bacterial scores were increased directly following LTX and decreased until day four in all patients. Bacterial IMX-BVN-3b scores detected bacterial infections in 9 out of 10 patients. PCT concentrations did not differ between patients with or without bacterial, whereas CRP was elevated in all patients with significantly higher levels in patients with bacterial infections.
Conclusion:
The 29-mRNA host classifier IMX-BVN-3b identified bacterial infections in post-LTX patients and did so earlier than routine biomarkers. While our pilot study holds promise future studies will determine whether these classifiers may help to identify post-LTX infections earlier and improve patient management.
Clinical Trial Notation:
German Clinical Trials Register: DRKS00023236, Registered 07 October 2020, https://drks.de/search/en/trial/DRKS00023236.
Insights
A new 29-mRNA host classifier, IMX-BVN-3b, shows promise for early detection of bacterial infections in liver transplant patients. This novel biomarker identified infections earlier than C-reactive protein (CRP) and procalcitonin (PCT).
Area of Science:
- Transplantation immunology
- Infectious disease diagnostics
- Molecular diagnostics
Background:
- Infections are frequent and serious complications after liver transplantation (LTX).
- Early diagnosis and prognosis of LTX infections remain challenging with current biomarkers like C-reactive protein (CRP) and procalcitonin (PCT).
- Novel diagnostic approaches are needed to improve patient outcomes.
Purpose of the Study:
- To evaluate the utility of a 29-mRNA host classifier (IMX-BVN-3b) for early detection of bacterial and viral infections in liver transplant recipients.
- To compare the diagnostic performance of IMX-BVN-3b against traditional biomarkers (CRP and PCT).
Main Methods:
- A prospective, observational pilot study involving 30 consecutive liver transplant patients.
- Daily monitoring using the IMX-BVN-3b classifier from day 0 to day 13 post-LTX.
- Clinical adjudication was used to determine true infection status, with results compared to CRP and PCT levels.
Main Results:
- Bacterial infections were confirmed in 10 patients and fungal infections in 2.
- The IMX-BVN-3b classifier detected bacterial infections in 9 out of 10 cases.
- IMX-BVN-3b bacterial scores increased post-LTX and decreased by day four; CRP was elevated in all patients, with higher levels in bacterial infections, while PCT showed no significant difference.
Conclusions:
- The 29-mRNA host classifier IMX-BVN-3b demonstrated capability in identifying bacterial infections in post-LTX patients.
- IMX-BVN-3b detected infections earlier than conventional biomarkers like CRP and PCT.
- Further research is warranted to confirm the clinical utility of IMX-BVN-3b for early post-LTX infection management.
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