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Host RNA biosignatures distinguish bacterial from viral fever

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Awaiting clinical applications

The work by Herberg et al. and Mahajan et al. represents an important advance: the potential of genetics to help in the evaluation of febrile children.

Dr. Howard Bauchner

Clearly RNA sequencing and other methods for RNA quantification are in the early days, and clinical applications must await further replication and refinement of these results in rigorous studies. But the day may soon arise when a parent of a febrile child may do a laboratory test at home, call a physician, and mutually decide whether the child should be seen for further evaluation.

Howard Bauchner, MD, is JAMA Editor in Chief. He reported having no relevant financial disclosures. Dr. Bauchner made these remarks in an editorial accompanying the two reports on RNA biosignatures (JAMA 2016;316:824-5).


 

FROM JAMA

References

“Despite the young age of the febrile infants evaluated, they carried robust RNA biosignatures and demonstrated that regardless of the etiology of the infections, their immune systems are programed to respond not only with shared elements induced by common microbes but also with specific patterns that allow discrimination by class of pathogen,” they noted.

Further research is needed to confirm and refine these preliminary results. “As technology advances, RNA biosignatures may prove to be an alternative and accurate method to identify infants with bacterial infections. This would help clinicians target evaluation and therapy when they are needed and avoid invasive procedures, antibiotics, and hospitalizations when they are not,” Dr. Mahajan and his associates said.

Dr. Herberg’s study was supported by the Imperial College Comprehensive Biomedical Research Center, the National Institutes of Health, the European Union’s Seventh Framework Program, and numerous other groups. Dr. Herberg reported having no relevant financial disclosures. Dr. Mahajan’s study was supported by the Health Resources and Services Administration, Emergency Services for Children, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institutes of Health. Dr. Mahajan reported having no relevant financial disclosures.

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