A novel host-protein score (called MMBV) helps to distinguish bacterial from viral infection by combining the blood concentrations of three biomarkers: tumour necrosis factor related apoptosis inducing ligand (TRAIL), interferon gamma induced protein 10 (IP-10), and C-reactive protein (CRP). These host biomarkers are differentially expressed in response to bacterial versus viral acute infection. We conducted a prospective study, with a time series design, in healthy adult volunteers in the Netherlands. The aim was to determine the variability of TRAIL, IP-10, and CRP and the MMBV score in healthy adults across time. Up to six blood samples were taken from each healthy volunteer over a period of up to four weeks. In 77 healthy participants without recent or current symptoms, MMBV scores (maximal) were bacterial in 1.3 % and viral (or other non-infectious etiology) in 93.5 % of participants. There was little variation in the mean concentrations of TRAIL (74.5 pg/ml), IP-10 (113.6 pg/ml), and CRP (1.90 mg/L) as well as the MMBV score. The variability of biomarker measurement was comparable to the precision of the measurement platform for TRAIL, IP-10, and CRP. Our findings establish the mean values of these biomarkers and MMBV in healthy individuals and indicate little variability between and within individuals over time, supporting the potential utility of this novel diagnostic to detect infection-induced changes.

中文翻译：

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健康成人中 TRAIL、IP-10 和 CRP 的自然变异——“HERACLES”研究

一种新型宿主蛋白评分（称为 MMBV）通过结合三种生物标志物的血液浓度来帮助区分细菌和病毒感染：肿瘤坏死因子相关凋亡诱导配体 (TRAIL)、干扰素 γ 诱导蛋白 10 (IP-10) 和 C -反应蛋白（CRP）。这些宿主生物标志物在对细菌和病毒急性感染的反应中存在差异表达。我们对荷兰的健康成年志愿者进行了一项采用时间序列设计的前瞻性研究。目的是确定健康成人中 TRAIL、IP-10 和 CRP 以及 MMBV 评分随时间的变化。在长达四个星期的时间内，从每位健康志愿者身上采集了多达六个血液样本。在 77 名最近或当前没有症状的健康参与者中，MMBV 评分（最大）为细菌感染（1.3%），病毒（或其他非感染性病因）为 93.5%。TRAIL (74.5 pg/ml)、IP-10 (113.6 pg/ml) 和 CRP (1.90 mg/L) 的平均浓度以及 MMBV 评分几乎没有变化。生物标志物测量的变异性与 TRAIL、IP-10 和 CRP 测量平台的精度相当。我们的研究结果确定了健康个体中这些生物标志物和 MMBV 的平均值，并表明随着时间的推移，个体之间和个体内部的变异性很小，这支持了这种新型诊断方法在检测感染引起的变化方面的潜在效用。