Antibody Response Detected From Swabs Predicts Respiratory Viral Infection

Doctor holding a cotton swab
Doctor holding a cotton swab
A simple diagnostic test aids in the early and accurate detection of respiratory viral infection.

Host antiviral mRNAs and single-host proteins acquired from nasopharyngeal swabs accurately predicted viral infection, according to research in the Journal of Infectious Diseases.

Acute respiratory disease, commonly caused by viral infection, affects millions of patients annually. However, diagnosis of viral causes of disease is difficult and requires a broad test that would include several known causative agents. Recent advances show the potential for gene expression patterns and host mRNAs, detected from swabs, to accurately diagnose infections.

In the first of two prospective studies, RNASeq experiments were performed on nasal swabs that had been stimulated by the small molecule ligand of RIG-I, effectively mimicking viral infection. 

Results indicated that a signature from 3 antiviral mRNAs (CXCL10, IFIT2, and OASL) predicted virus detection with an accuracy of 97% (95% CI, 0.9-1.0). The discovery of these further identified 2 proteins that strongly correlated with virus detection (CXCL11 and CXCL10).

In the second study, elevated levels of CXCL11 (area under the curve [AUC]=0.901, 95% CI, 0.86-0.94) and CXCL10 (AUC=0.83, 95% CI, 0.80-0.91) were found to successfully identify viral infection using the Yale-New Haven hospital panel of 9 viruses (adenovirus; human metapneumovirus; influenza A and B; parainfluenza 1, 2, and 3; respiratory syncytial virus A and B; and rhinovirus) plus several viruses not included in this panel.

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The success of these biomarkers at identifying viral infections could represent a new, cost-effective method to rule in/rule out viral infection in respiratory disease. Investigators noted that this study included mainly older adults and young children who were currently undergoing respiratory virus testing; therefore, the biomarkers need to be further tested in different patient groups and clinical settings.


Landry ML, Foxman EF. Antiviral response in the nasopharynx identifies patients with respiratory virus infection [published online December 21, 2017]. J Infect Dis. doi: 10.1093/infdis/jix648