Proteomics as a complementary approach to measure norovirus infection in clinical samples

Norovirus (NoV) is a leading cause of global acute gastroenteritis, particularly in young children, with no current licensed vaccine. Epidemiological studies have shown that asymptomatic cases are common, and infected patients may test positive for prolonged periods; however, the impact of these phenomena on transmission and public health measures remains unclear. A major limiting factor is our ability to measure infection, which is constrained to real-time reverse transcription polymerase chain reaction or antibody-based assays, both of which are susceptible to loss of detection by rapid NoV evolution. This review highlights the potential for proteomics to overcome current technical limitations and advance basic science discovery and clinical research. Importantly, proteomics-based protein detection can span NoV, host, and microbiome proteins and could help identify host or microbiome factors that correlate with disease outcome. Further developing proteomics tools to complement existing diagnostic technologies will improve our ability to assess NoV pathogenesis and transmission, as well as therapeutic efficacy.