Human Neutrophil Lipocalin (HNL) in the Distinction between Bacterial and Viral Infections
The early and accurate discrimination between bacterial or viral causes of acute infections is key to the better use of antibiotics and will help slow down the fast-growing antibiotic resistance. This discrimination is possible to achieve by the assay of the biomarker human neutrophil lipocalin (HNL). By the measurements in serum sensitivities and specificities of >90% are achieved in both adults and children. In order to eliminate the need to produce serum a whole blood assay of an assay time of <10 minutes was developed in which blood neutrophils are activated to release its HNL. The diagnostic accuracy of this assay also showed sensitivities and specificities of>90% and was clearly superior to contemporary assays such as blood neutrophilcounts, CRP, procalcitonin and the expression of CD64 on blood neutrophils. This format lends itself to the development of a point-of-care HNL assay and will be a major step forward to accomplish the goal of accurately diagnosing patients with symptoms of acute infections within 10 minutes at the emergency room or at the doctor´s office.