Thursday, July 9, 2015

In a Drop of Blood, A History of Infections


Using less than a drop of blood, a new test can reveal nearly every virus a person has ever been exposed to, scientists said.

The test, which is still experimental, can be performed for as little as $25 and could become an important research tool for tracking patterns of disease in various populations, helping scientists compare the old and the young, or people in different parts of the world.

It could also be used to try to find out whether viruses, or the body’s immune response to them, contribute to chronic diseases and cancer, the researchers said.

“I’m sure there’ll be lots of applications we haven’t even dreamed of,” said Stephen J. Elledge, the senior author of the report, published in the journal Science, and a professor of genetics at Harvard Medical School and Brigham and Women’s Hospital.

“That’s what happens when you invent technology- you can’t imagine what people will do with it,” Dr. Elledge said. “They’re so clever.”

The test can detect past exposure to more than 1,000 strains of viruses from 206 species-pretty much the entire human “virome,” meaning all the viruses known to infect people. The test works by detecting antibodies, highly specific proteins that the immune system has made in response to viruses.

Tried out in 569 people in the United States, South Africa, Thailand and Peru, the blood test found that most had been exposed to about 10 species of virus-mostly the usual suspects, like those causing colds, flu, gastrointestinal illness and other common ailments.

But a few subjects had evidence of exposure to as many as 25 species, something the researchers had yet to explain, Dr. Elledge said.

There were some differences in patterns of exposure from continent. In general, people outside the United States had higher rates of virus exposure. The reason is not known, but the researchers said it might be due to “differences in population density, cultural practices, sanitation or genetic susceptibility.”

Scientists not associated with the work said it had vast potential.

“This will be a treasure trove for communicable disease epidemiology,” said Dr.William Schaffner, an infectious disease expert at of Vanderbilt University in Tennessee. “It will be like the introduction of the electron microscope. It will allow us to have more resolution at a micro level.”

One possibility, Dr. Schaffner said, would be to deploy the test in large populations to find out the ages at which children are exposed to various illnesses in order to help with timing vaccinations.

Another idea, he said, would be to test collections of frozen blood samples to learn about patterns of disease.

By showing all the antibiotics a person has produced against viruses, the test may shed light on many illnesses, said Adolfo Garcia-Sastre of the Icahn School of Medicine at Mount Sinai in New York. “A lot of diseases could be affected by the type of antibodies a person has elicited by infectious agents,” he said.

The most obvious candidates are autoimmune diseases like multiple sclerosis and Type 1 diabetes. Researchers have long suspected that viruses may contribute to such ailments, by provoking the immune system to produce antibodies that mistakes a person’s own cells for viruses and attack them. To look for such viruses, scientists had to test for them one by one.

The new test, Dr. Garcia-Sastre said, “in an unbiased way, allows you look at the whole repertoire,”

The technology could help answer questions about cancer, he said, such as why the same disease progresses faster in some patients than in others.

There were some surprises, Dr. Elledge said. One was “that the immune response is so similar from person to person.” Different people made similar antibodies that targeted the same region on a virus.

Another surprise came from people infected their immune responses to other viruses to be diminished. “Instead, they have exaggerated responses to almost every virus, “he said.

The test can take up to two months, but it could be done in two or three days, Dr. Elledge said, if a company were to streamline the process. “That’s what can make it work for people, “he said.

Taken from TODAY Saturday Edition, The New York Times International Weekly, June 20, 2015