text_1: Is it Brain Infection or Cancer? A New Rapid Test Could Hold the Answer
text_2: This news release promotes a study in the journal PLoS ONE by researchers at Philadelphia University and Thomas Jefferson University in Philadelphia. The crux: Even basic problems with the brain and other parts of the central nervous system, or CNS, are not only serious but also tough to diagnose — and especially so in rapid fashion. According to the release, a test that uses a little cerebrospinal fluid, or CNF, gathered from a patient’s spine might help doctors quickly narrow down whether they are dealing with an infection (by a virus, bacteria, or fungus) or some other issue, such as a demyelinating disease or cancer. The key to making this possible are cytokines — tiny proteins that cells release to sound the alarm to one another — and a device that can quickly test a small sample of CNF for dozens of different cytokines and their abundances. The release’s title does a decent job of not selling the moon, since it does not promise the “holy grail” of identifying a specific problem with one test — just the presence of an infection or something else. However, the teasing of a rapid doctor’s office-style test when one does not yet exist, and when the sample size is so small (43 people with a wide variety of issues participated) seems dubious — especially when one of its own authors says additional research is needed to confirm the core findings. It’s also important to highlight that this early data is a “retrospective analysis,” which means that even if the sample size of patients were bigger, it would only suggest that further prospective work needed to be done to validate the testing in patients. Problems with brains and spinal cords are often tough to diagnose. This is because infections by bacteria, fungi, and viruses can manifest similarly to other issues, like cancer or autoimmune diseases. The blood-brain barrier makes sampling the fluid that can hint at what’s going on tricky and painful — so making the most use of a sample is best. It’s especially key with the youngest patients, whose still-developing bodies and immature immune systems may not be prepared to handle major problems like encephalitis (inflammation of the brain)and also can’t describe their symptoms. If a one-stop test existed that could help doctors rapidly narrow down a long list of suspects for a CNS problem, it could save valuable time and financial resources, and potentially patients’ lives. If this test can be validated it could conceivably improve speed of diagnosis in order to get the most appropriate treatment.