The host response as a tool for infectious disease diagnosis and management

ABSTRACT

Introduction: A century of advances in infectious disease diagnosis and treatment changed the face of medicine. However, challenges continue to develop including multi-drug resistance, globalization that increases pandemic risks, and high mortality from severe infections. These challenges can be mitigated through improved diagnostics, and over the past decade, there has been a particular focus on the host response. Since this article was originally published in 2015, there have been significant developments in the field of host response diagnostics, warranting this updated review.

Areas Covered: This review begins by discussing developments in single biomarkers and pauci-analyte biomarker panels. It then delves into ‘omics, an area where there has been truly exciting progress. Specifically, progress has been made in sepsis diagnosis and prognosis; differentiating viral, bacterial, and fungal pathogen classes; pre-symptomatic diagnosis; and understanding disease-specific diagnostic challenges in tuberculosis, Lyme disease, and Ebola.

Expert Commentary: As ‘omics have become faster, more precise, and less expensive, the door has been opened for academic, industry, and government efforts to develop host-based infectious disease classifiers. While there are still obstacles to overcome, the chasm separating these scientific advances from the patient’s bedside is shrinking.

KEYWORDS:

• Communicable diseases
• host-pathogen interactions
• metabolome
• molecular diagnostics
• proteome
• respiratory tract infection
• Sepsis
• transcriptome

Declaration of Interest

EL Tsalik reports sources of research funding: NIAID, DARPA, DTRA. Prior consultant for Immunexpress, CytoVale, Prenosis, and bioMerieux. Equity in Host Response, Inc. Patents issued or pending for Biomarkers for the molecular classification of bacterial infection; Methods to diagnose and treat acute respiratory infections; and Gene expression signature useful to predict sepsis mortality. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.