San Diego State University Dr. Katrine Whiteson is calling for the development of a “small device attached to an iPhone” to enable specific diagnosis of infection in the lungs of cystic fibrosis patients.
At the same time, the postdoctoral researcher is further developing her own research, as reported in March by BioNews Texas, related to the “buttery” molecule known as 2,3-butanedione (dactyl) that damages the lungs of cystic fibrosis patients and causes flare-ups. In a recent article on Pharmaphorum, the publication conducted an interview with Dr. Katrine Whiteson, who led the new research that was recently published in The ISME Journal in January.
During the interview, Dr. Whiteson detailed the scientific process that led to her discovery of the molecule. She explained how diacetyl is produced by microbes in the mouths of the majority of people, but people with cystic fibrosis have higher concentrations in their breath. Streptococcus species are a main contributor, so it comes as no surprise that treatment with antibiotics decreases diacetyl. Yet not all cystic fibrosis patients are affected by the same bacteria, so “doctors treating cystic fibrosis patients would love to have specific biomarkers to look for so that they can identify which microbes in complex infections are the ones that they need to target, so that they can diagnose and treat infections earlier and more specifically,” stated Dr. Whiteson.
This is where diacetyl comes into play: “In the long term, this molecule or others may be important biomarkers indicating infections, so that doctors can diagnose microbes that are triggering worsened symptoms in cystic fibrosis.” Dr. Whiteson and her colleagues have applied for funding to allow research on diacetyl to identify the feasibility of using it as an indicator for periods of worsening symptoms for cystic fibrosis patients. She explained how diacetyl is accompanied by low pH and low oxygen conditions specific to the microbes producing the molecule, and these can be used as indicators of what is happening in the lungs of patients with flare-ups. For example, diacetyl may reveal inter-microbe communications, similar to how cells in humans use hormones to communicate.
The ultimate goal is to enable specific diagnosis of infection in the lungs so that doctors do not have to guess which antibiotics to use to combat the microbes. As it is now, doctors diagnose worsening symptoms by questioning patients when they come into the office. Dr. Whiteson dreams of “a small device attached to an iPhone to determine if [a patient’s] infection was getting worse.” The patient would then know whether or not a trip to the doctor is required to prevent inflammatory destruction in the lungs.
Dr. Whiteson also believes diacetyl can be used for more than cystic fibrosis “because the molecule is produced by a microbe that is widespread in human oral microbiomes… [and] could also indicate greater concentrations of Streptococcus spp. in other respiratory conditions such as pneumonia or COPD.”
At the end of the interview, Dr. Whiteson expressed excitement about the progress of companies such as Vertex Pharmaceuticals that are developing small molecules to address the root cause of cystic fibrosis. “These pharmaceuticals are a game changer for cystic fibrosis patients–dramatically restoring health and eliminating respiratory infection. I would love to see all cystic fibrosis patients have access to these treatments.”
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