CytoAstra, LLC, Bioventures/UAMS, Little Rock, AR, USA.
Yale School of Public Health, New Haven, CT, USA.
Nat Commun. 2024 Oct 25;15(1):9228. doi: 10.1038/s41467-024-53243-z.
Current malaria diagnostics are invasive, lack sensitivity, and rapid tests are plagued by deletions in target antigens. Here we introduce the Cytophone, an innovative photoacoustic flow cytometer platform with high-pulse-rate lasers and a focused ultrasound transducer array to noninvasively detect and identify malaria-infected red blood cells (iRBCs) using specific wave shapes, widths, and time delays generated from the absorbance of laser energy by hemozoin, a universal biomarker of malaria infection. In a population of Cameroonian adults with uncomplicated malaria, we assess our device for safety in a cross-sectional cohort (n = 10) and conduct a performance assessment in a longitudinal cohort (n = 20) followed for 30 ± 7 days after clearance of parasitemia. Longitudinal cytophone measurements are compared to point-of-care and molecular assays (n = 94). Cytophone is safe with 90% sensitivity, 69% specificity, and a receiver-operator-curve-area-under-the-curve (ROC-AUC) of 0.84, as compared to microscopy. ROC-AUCs of Cytophone, microscopy, and RDT compared to quantitative PCR are not statistically different from one another. The ability to noninvasively detect iRBCs in the bloodstream is a major advancement which offers the potential to rapidly identify both the large asymptomatic reservoir of infection, as well as diagnose symptomatic cases without the need for a blood sample.
目前的疟疾诊断方法具有侵入性，灵敏度不足，而快速检测则受到目标抗原缺失的困扰。在这里，我们介绍了 Cytophone，这是一种创新的光声流动细胞仪平台，它使用高脉冲率激光器和聚焦超声换能器阵列，通过血红蛋白（疟疾感染的通用生物标志物）对激光能量的吸收产生的特定波形、宽度和时间延迟，实现对疟原虫感染的红细胞（iRBC）的非侵入性检测和识别。在喀麦隆成年人患有单纯性疟疾的人群中，我们评估了我们的设备在横断面队列（n=10）中的安全性，并在纵向队列（n=20）中进行了性能评估，该队列在寄生虫血症清除后随访 30±7 天。纵向 Cytophone 测量结果与即时护理和分子检测（n=94）进行了比较。Cytophone 的安全性为 90%，特异性为 69%，与显微镜相比，接收者操作特征曲线下面积（ROC-AUC）为 0.84。与显微镜和 RDT 相比，Cytophone、显微镜和 RDT 的 ROC-AUC 与定量 PCR 没有统计学差异。能够非侵入性地检测血液中的 iRBC 是一项重大进展，它有可能快速识别感染的大量无症状储库，以及在无需血液样本的情况下诊断有症状的病例。
