One of the newest branches of biology is the field of proteomics, thestudy of the proteins produced inside cells. New understanding aboutcell proteins is being used to create new tests for disease, and onenew test being developed could help doctors diagnose appendicitis.
Appendicitisis one of the world's most common medical problems. Over the course ofa lifetime, people have about a one in 10 chance of needing surgery toremove an inflamed or even a ruptured appendix. But Hanno Steen, director of The Proteomics Center at Children's Hospital Boston, says many people who arrive at a doctor's officedon't get the correct diagnosis - anywhere between 5 and 30 percent ofpatients.
"That means that for every 20 surgeries orappendectomies being done, at least one of them is wrong? meaning theycut somebody open, then figure out the appendices were alright," Steensays. "Even worse? when they miss the diagnosis, and that also happensactually quite commonly."
Steen and his colleague Alex Kentsiswondered if there might be a protein that the body produces only whenthe appendix is inflamed. They collected urine from dozens of childrenwith abdominal pain - some of the children ended up havingappendicitis, some did not. Steen and Kentsis used sophisticatedmolecular screening techniques to see if there were any proteinspresent only in the urine from children with appendicitis. And theyfound one.
"If one has the biomarker in urine, then you canenvision some dipstick test where either you pee in a cup and you holdthis dipstick in there and then you see color change," Steen says.
"Oryou have a little stick like the test like the pregnancy test, whereyou pee directly on a stick and then you see a color change. You see aplus or minus popping up and then based on that you can already saywith good probability whether this patient has appendicitis or not."
Steensays the advantages to such a test would be enormous? first of all, itwould save time. That means many people who do have infectedappendices would be at less risk of delayed surgical care.
WhatSteen really likes is that this method would be far cheaper and moreaccessible than the X-rays and other tests used in Western countries toconfirm a diagnosis of appendicitis.
"We also have to thinkabout what happens in other regions of this country or in other regionsof the world, where they don't have imaging technology like CT andultrasound at hand," he says.
Steen says his next step is torepeat the trial to ensure that, indeed, this biomarker does indicateappendicitis. But he and Kentsis are confident it does, and they thinkit should take only a few years before this technology is confirmed andis in the hands of doctors worldwide.
Steen and Kentsis' research is published in the .