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Proteomics and Severe Acute Respiratory Syndrome (SARS): Emerging Technology Meets Emerging Pathogen

Department of Microbiology, Toronto Medical Laboratories and Mount Sinai Hospital, and University of Toronto, Ontario, Canada

^aAddress correspondence to this author at: Department of Microbiology, Rm 1487, Mount Sinai Hospital, 600 University Ave., Toronto, Ontario, Canada M5G 1X5. Fax 416-586-8746; e-mail dlow@mtsinai.on.ca.

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Early recognition and rapid initiation of infection control precautions were the most important strategies for controlling severe acute respiratory syndrome (SARS) during the global epidemic that occurred from March to June of 2003. This approach was hampered, however, by the fact that clinical and laboratory features did not distinguish patients with SARS from those with other respiratory illnesses and that there was no reliable rapid diagnostic test (1)(2)(3).

Currently, the "gold standard" for the laboratory diagnosis of SARS coronavirus (CoV) infection is antibody detection by indirect immunofluorescence assay or ELISA. The median time to seroconversion in SARS patients, however, is 17–20 days after the onset of symptoms (4); therefore, rapid diagnosis by antibody detection is not possible. ELISA-based antigen detection tests are well known to offer high specificity and reproducibility, but they lack sensitivity (5). As for the direct detection of viruses, culturing of the virus from clinical specimens is dangerous and insensitive; the detection of viral RNA by reverse transcription-PCR is expensive and labor-intensive and relies on the availability of expertise, and false-positive results may result from contamination. In addition, although SARS-CoV can be detected in nasopharyngeal specimens, sputum, and stool, peak viral shedding from these sites, and therefore the most optimal time for testing, occurs around 10 days after illness onset and then decreases (4)(6).

In this issue of Clinical Chemistry, reports by Kang et al. (7) and Yip et al.(8) present evidence that a new proteomics technology, . . . [Full Text of this Article]

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