NMR test for pneumonia

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  • Published: Jan 1, 2010
  • Author: David Bradley
  • Channels: NMR Knowledge Base
thumbnail image: NMR test for pneumonia

The first demonstration of how metabolic analysis using NMR spectroscopy to analyse a urine sample for diagnosis of community-acquired pneumonia has been undertaken. The simple diagnostic could be useful as the incidence of community-acquired pneumonia rises across the globe.

Biochemist Carolyn Slupsky of the University of California Davis working with colleagues at the University of Alberta, University of Toronto, Canada and Austin Health in Australia, has developed a fast and accurate urine test for pneumonia based on NMR.

Pneumonia is a lung infection that afflicts millions of people around the world each year. Various infectious agents, bacteria, viruses, fungi and parasites, reach the lower respiratory tract causing difficulty in breathing, fever, chest pains and a severe cough. It can be fatal, especially among elderly patients, smokers, and those with chronic lung diseases or compromised immune systems. However, because there are so many causes and the symptoms can resemble those of other conditions it is difficult to diagnose.

Neverthless, Streptococcal pneumonia is the major cause of community-acquired, rather than hospital-acquired, pneumonia. A rapid, accurate diagnostic test for pneumonia could save lives by enabling doctors to begin appropriate treatment earlier.

Currently, diagnosis of pneumonia relies on observation of clinical symptoms, chest X-rays and an analysis of a patient's blood or sputum by bacterial culture. This raft of tests can take up to two days and unfortunately yield a high rate of false-negatives. Previous studies showed that more than four out of every five patients admitted to hospital with pneumonia were misdiagnosed, which leads to inevitable delays in treating them with an appropriate antibiotic.

"The false negative (e.g. chest X-ray does not clearly show pneumonia, and no culture) is serious," Slupsky told SpectroscopyNOW, "This is often the case. The great thing about this test is that it has the capacity to be able to pick up pneumonia in its earliest stages. We showed distinct changes in mice very quickly after infection, which we also published this year in J Proteome Res."

Slupsky and colleagues have now used NMR spectroscopy to "fingerprint" pneumonia caused by the bacterium Streptococcus pneumoniae. They compared this with urine samples from patients with other types of pneumonia and non-infectious lung diseases. They discussed the research in detail in the December issue of the Journal of Proteome Research and have applied for a patent on the diagnostic procedure.

"This is the first study to demonstrate that NMR-based analysis of metabolites in urine has the potential to provide rapid diagnosis of the cause of pneumonia," explains Slupsky. "It also shows that we can use this technology to quickly and easily monitor patient recovery," she adds. "The goal is a tool for rapid, accurate diagnosis so that patients can quickly begin treatment with the appropriate medication."

Slupsky and colleagues' metabolomic NMR study profiled hundreds of urine samples collected from healthy individuals and patients with a variety of pulmonary diseases or infections. They characterised 61 metabolites in the urine samples and found that urine from patients infected with Streptococcal pneumonia had a characteristic chemical profile that clearly distinguished them from healthy individuals or patients with other ailments.

The team was surprised to discover that most of the changes in metabolites related to infection by S. pneumoniae were caused by the body's response to the infection rather than by the invading bacteria. "In future studies, we hope to explore how bacteria and other microbes interact with the body of the individual they infect, and how these interactions alter metabolism in the body, resulting in unique metabolite profiles in the urine," says Slupsky.
For the time being, however, the metabolomic NMR approach could save lives. "By analyzing urine samples collected at various intervals during the patient's hospitalization, we could actually observe sick patients recover; their recovery was reflected in the chemical composition of their urine," Slupsky adds.

The views represented in this article are solely those of the author and do not necessarily represent those of John Wiley and Sons, Ltd.



 S. pneumoniae (Credit: US Centers for Disease Control and Prevention)
NMR diagnostic for pneumonia

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