TY - JOUR T1 - A novel immune biomarker <em>IFI27</em> discriminates between influenza and bacteria in patients with suspected respiratory infection JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02098-2016 VL - 49 IS - 6 SP - 1602098 AU - Benjamin M. Tang AU - Maryam Shojaei AU - Grant P. Parnell AU - Stephen Huang AU - Marek Nalos AU - Sally Teoh AU - Kate O'Connor AU - Stephen Schibeci AU - Amy L. Phu AU - Anand Kumar AU - John Ho AU - Adrienne F. A. Meyers AU - Yoav Keynan AU - Terry Ball AU - Amarnath Pisipati AU - Aseem Kumar AU - Elizabeth Moore AU - Damon Eisen AU - Kevin Lai AU - Mark Gillett AU - Robert Geffers AU - Hao Luo AU - Fahad Gul AU - Jens Schreiber AU - Sandra Riedel AU - David Booth AU - Anthony McLean AU - Klaus Schughart Y1 - 2017/06/01 UR - http://erj.ersjournals.com/content/49/6/1602098.abstract N2 - 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 in vitro experiments using well-established infection models.We identified a single-gene biomarker, IFI27, which had a high prediction accuracy (91%) equivalent to that obtained by multi-gene biomarkers. In vitro studies showed that IFI27 was upregulated by TLR7 in plasmacytoid dendritic cells, antigen-presenting cells that responded to influenza virus rather than bacteria. In vivo studies confirmed that IFI27 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), IFI27 displayed 88% diagnostic accuracy (AUC) and 90% specificity in discriminating between influenza and bacterial infections.IFI27 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.IFI27 could discriminate between influenza and bacterial infection in suspected respiratory tract infection cases http://ow.ly/VEaY30bmlS3 ER -