Status: Funded - Open
Gene expression analyses for the differentiation between viral and bacterial meningitis in children
Benson Ogunjimi, MD
BACKGROUND: Recently, the value of gene expression analyses for infectious diseases has been illustrated in several clinical and experimental settings. Several studies were able to show a difference in gene expression signatures between different types of influenza, between different types of bacterial infections, between tuberculosis and other inflammatory or infectious diseases in African children and between some viral infections and some bacterial infections.
GAP: Until now, no one has addressed the value of gene expression data in differentiating between viral and bacterial meningitis.
HYPOTHESIS: We hypothesize that viral and bacterial meningitis activate different gene pathways.
METHODS: In a multicentre prospective study, we will use host gene expression data, by using RNA microarrays on RNA extracted from whole blood, to differentiate between viral (N=40) and bacterial (N=40) infections in children with meningitis. We will recruit 40 patients, aged between 3 months and 16 years, with viral meningitis (enterovirus) and 40 patients with bacterial meningitis (Streptococcus pneumoniae (SP) or Neisseria meningitides (NM)) presenting at the emergency room.
IMPACT: We believe that our research will majorly transform the assessment of patients presenting with signs of meningitis and will add to the development of new scoring systems in developed countries. Gene expression sequencing will add to the differentiation between viral and bacterial origins of meningitis in academic centers (i.e. where RNA micro-array analyses are possible) on the short term (< 3 years), and in other large hospitals on the longer term (<7 years). We believe that our proposed methodology will be of particular importance in situations were CSF sampling is not feasible or advisable. Furthermore, our study will allow us to develop a better understanding of the pathophysiology of and host immune response against meningitis.