Proteomics in the Clinic Rapid Diagnostics

Rapid detection of proteins for the purposes of diagnosis or monitoring is certainly nothing new: the Enzyme-linked immunosorbent assay (ELISA) test is a long-established feature of clinical laboratories, and portable kits based on this assay are regularly used in medical general practice and the home. Technologies for the development of protein detection kits are highly advanced and can precisely assay the level of diagnostic protein markers in minute samples of body fluids. Supporting matrices and miniaturized sensors are produced by a number of suppliers and the development of specific antibodies for protein capture has been fully industrialized. However, there are as yet relatively few point-of-care tests based on specific protein detection, and proteomics is therefore well placed to provide novel and multiple diagnostic proteins for validation in these formats. Biosite Inc has been successful in exploiting microdetection technology in the management of chronic heart failure. Excessive cardiac load causing distension of the ventricular walls induces release of B-type natriuretic peptide (BNP) from plasma membrane granules of the cells lining the ventricles (54). This hormone plays a role in fluid balance and blood pressure regulation and is a specific hormonal marker of chronic heart failure, which can be used diagnostically in preference to invasive or less accurate methods, such as echocardiogram or symptom assessment. The Biosite product assays BNP from a capillary of blood within 15 minutes using an antibody-based detection system, exemplifying the use of a protein to rapidly diagnose the disease. The advantage of this can be readily appreciated in terms of both appropriate patient triage and reduced costs through the avoidance of unnecessary tests and therapies. Biosite has utilized the same system to simultaneously measure myoglobin, troponin I, and creatinine kinase (CK-MB), to be used in ruling out myocardial infarction.

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