A novel immune biomarker IFI27 discriminates between influenza and bacteria in patients with suspected respiratory infection

Abstract

Host response biomarkers can accurately distinguish between influenza and bacterial infection. However, published biomarkers require the measurement of many genes, thereby making it difficult to implement them in clinical practice. This study aims to identify a single-gene biomarker with a high diagnostic accuracy equivalent to multi-gene biomarkers.In this study, we combined an integrated genomic analysis of 1071 individuals with experiments using well-established infection models.We identified a single-gene biomarker,, which had a high prediction accuracy (91%) equivalent to that obtained by multi-gene biomarkers. studies showed that was upregulated by TLR7 in plasmacytoid dendritic cells, antigen-presenting cells that responded to influenza virus rather than bacteria. studies confirmed that was expressed in influenza patients but not in bacterial infection, as demonstrated in multiple patient cohorts (n=521). In a large prospective study (n=439) of patients presented with undifferentiated respiratory illness (aetiologies included viral, bacterial and non-infectious conditions), displayed 88% diagnostic accuracy (AUC) and 90% specificity in discriminating between influenza and bacterial infections. represents a significant step forward in overcoming a translational barrier in applying genomic assay in clinical setting; its implementation may improve the diagnosis and management of respiratory infection.

Global Transcriptome Analysis Identifies a Diagnostic Signature for Early Disseminated Lyme Disease and Its Resolution

“…IFI27 (interferon alpha inducible protein 27) is the classifier gene for influenza A that has the highest random forest importance value. IFI27 has been described in a separate study as a novel single-gene biomarker in patient blood that was able to discriminate, with 88% diagnostic accuracy and 90% specificity, between influenza virus-and bacterium-associated respiratory infections (31). We have previously demonstrated that B. burgdorferi induces numerous IFN-regulated genes in skin at the site…”

Genomic Circuitry Underlying Immunological Response to Pediatric Acute Respiratory Infection

“…Among the ISGs, IFI27 had a robust ability to detect IFV infection as well as IFV-HRV co-infection, but not HRV alone. IFI27 as a single gene biomarker can distinguish IFV from bacterial infection (Tang et al, 2017). Mechanistically, IFI27 may be of considerable interest since this gene product is a mitochondrial protein thought to be involved in apoptosis (Gytz et al, 2017; Rosebeck and Leaman, 2008).…”

Molecular Diagnostics in Pulmonary Infections

“…While the foregoing studies require the use of multi-gene assays, Tang and colleagues recently used genomic analysis of 1071 patients to find a single gene capable of identifying viral infection, interferon alpha inducible protein 27 (IFI27) [97]. They demonstrated a considerable upregulation at the transcript level in patients with influenza as opposed to bacterial pneumonia, likely due to the specific activation of interferon signaling pathways downstream of pathogen recognition receptors selective for virus.…”