Respiratory tract infections are frequently treated based only on patient symptoms, although this practice can result in inaccurate prescribing and the over-use of antibiotics. The challenge is to precisely identify the pathogens (viruses or bacteria) causing the infection and target treatment accordingly. Until now this has necessitated lengthy and expensive laboratory analysis of samples. Dental caries and periodontitis alone are two of the most prevalent, chronic, non-communicable diseases worldwide, with high income countries spending 5-10 % of their total public health expenditure on oral health. The early diagnosis of these conditions is important for long-term disease monitoring and for the development of patient-specific treatments by detecting the relevant bacteria and host protein biomarkers. The DIAGORAS project developed a platform that allows clinicians, general practitioners and dentists to perform a diagnostic test at the point-of-care. The test consists of a panel of microbial targets and host biomarkers that enable complete patient analysis and accurate diagnosis, treatment and monitoring of diseases.
The diagnostic platform
“Our platform can take samples, identify the causative microorganisms and measure associated human infection-response biomarkers, resulting in more accurate patient management and monitoring,” explains Dr Konstantinos Mitsakakis, the project’s coordinator. “The platform will help reduce the ‘just-in-case’ prescribing of antibiotics and facilitate better management of dental healthcare costs.” At the heart of the system is a disk-shaped microfluidic platform, the LabDisk, which integrates all of the biochemical and microparticle components needed to perform microbiological and protein biomarker analyses. “In practice, the platform miniaturises a whole laboratory on a disk,” says Dr Mitsakakis, based at the coordinating institution Hahn-Schickard in Freiburg, Germany. For respiratory tract infections, the user only needs to take a swab from the patient, place it into a transport medium and insert a small portion of this transport medium into the DIAGORAS disk. All necessary molecular steps are then automatically performed and a result is finally made available via the LabDisk platform reader. Essentially, DNA and RNA of the pathogens are extracted, purified and mixed with amplification (PCR) reagents. This mix is then distributed in multiple reaction chambers where nucleic acid amplification is performed and a signal is generated. A positive signal from a specific chamber means that one or more specific pathogens are present. The procedure for oral infections is the same, except that the sample used is saliva and the panel of microorganisms to be detected is different. In both applications, micro/nanoparticles are also used to detect and quantify the levels of host-specific biomarkers.
More accurate treatment
The report generated gives valuable information about a range of microorganisms, as well as the level of protein biomarkers in the tested sample, enabling decions leading to more accurate treatments compared to the use of diagnostic symptoms alone. “We are delighted to develop a powerful diagnostic tool for healthcare providers that will enable the rapid and accurate treatment of conditions that impact on almost every person at some point in our lives. The system is now ready to move to product development and later to clinical validation stages,” says Dr Mitsakakis.
DIAGORAS, Point-of-Care, diagnostics, oral infections, respiratory tract infections, biomarkers, microfluidics, LabDisk