RAPP-ID

Doctors treating infectious diseases still don’t have rapid diagnostic tests which could help them identify the exact strains of pathogens ailing their patients.### The development of such tests is complex and expensive, but that may improve thanks to IMI’s RAPP-ID project, which developed some of the technologies and innovations needed to speed up the development of such tests in the future. For example, the project developed a prototype of a breath sampler for influenza – the first test which uses something as simple as breathing out to detect the presence of pathogens in patients. ‘So far in clinical practice, there are no rapid point-of-care tests for detection of infections that are based on something as non-invasive as breathing out,’ said project coordinator Jorge Villacian, in an interview with the IMI Programme Office. ‘Of course, we are aware of the fact that we’re not there yet – this is still in an early stage of the development process. But the technology itself may be useful for other fields (outside of infectious diseases) as well.’ Some of the technologies created under RAPP-ID are undergoing further development in new EU-funded projects.

Flu is a highly infectious disease, yet during an epidemic, it can be hard to identify which patients have the virus. A device under development by IMI’s RAPP-ID project could deliver a flu diagnosis faster and without the hassle of an invasive nasal swab.### Patients would simply have to breathe into a bottle-like container for a few minutes to get a near-instant result at the point of care, which could be their doctor’s surgery or even their own home. Inside the device, the first step involves using highly-charged needles to direct the micro-droplets of water in the exhaled breath that carry the virus to a droplet of liquid in the bottom of the chamber. There, the walls of the virus are broken down and the viral proteins bind to specially designed magnetic beads coated with antibodies. The beads are then flushed into an array of tens of thousands of minute wells, each smaller than a red blood cell. Finally, additional reagents are brought to the array, causing the flu proteins to glow so that they can be counted with a camera. The different components have been demonstrated to work independently, as described in three papers in PLoS ONE, Applied Materials and Interfaces, and Analytical Chemistry. Now the team is keen to continue its work on the device. Meanwhile, lead researcher Professor Wouter van der Wijgaart from the KTH Royal Institute of Technology in Sweden, explains: "This kind of test will enable doctors to treat severely threatened patients the right way, and it will be valuable for use in clinical research. It’s harder than finding a needle in a haystack, but it can be done."

​IMI’s RAPP-ID project along with four other European research projects (BioMaX, DiaTools, CareMore and NextDx) will organise the first European Conference on Novel Technologies for In Vitro Diagnostics in Leuven, Belgium from 6 to 8 October 2014.### The conference will offer discussion and networking opportunities with major European players and experts in the field of in vitro diagnostics.

The goal of the meeting is to provide a forum for discussions on factors driving the development of new diagnostic tools, with particular emphasis on innovative devices and molecular technologies of medical or industrial relevance. Experts in the field will discuss exciting innovations in the sector, while keynote speakers will take an interdisciplinary approach by focusing on the technological, biological, clinical and regulatory aspects of in vitro diagnostics.

   -   More information on the programme and how to participate here.

The ideal point of care test (POCT) is cheap, easy to use, and delivers highly accurate results in less than half an hour, according to the results of a survey run by IMI project RAPP-ID.### POCTs are tests carried out where the patient is being cared for (e.g. at a doctor’s surgery), as opposed to in a central laboratory. Currently, doctors often have to wait days to find out what infections, if any, their patient has. RAPP-ID aims to develop POCTs that deliver more accurate and faster results. The survey also highlighted the pathogens and antibiotic resistance problems that are most relevant for clinicians. The survey results will therefore help the project team to develop a test that meets clinicians’ needs. Elsewhere in the project, the consortium has reviewed the state of the art in diagnostic tools. This, along with the results of the survey, will ensure that the results of the RAPP-ID project will be truly game-changing.

The IMI project RAPP-ID has launched a web-based survey to find out how clinicians currently manage certain infections and what they need for a diagnostic Point Of Care Test (POCT) to be useful in the clinic.### POCTs refer to tests that are carried out where the patient is being cared for, such as a doctor’s office, as opposed to in a central laboratory. Today, doctors and patients often have to wait for days for the results of tests to identify what infection, if any, a patient has. RAPP-ID is working to develop POCTs that will provide information in less than two hours on the cause of infection and, in the case of bacterial infections, whether the bacteria are resistant to certain drugs. This will allow doctors to administer the right medicines sooner. The survey will help the project partners focus the development of POCT platforms and ensure that they are clinically relevant and meet clinicians’ needs. All clinicians are welcome to complete the survey; the deadline for submitting responses is the end of this year. The results will be released early next year.

ND4BB – the story so far, in Nature Reviews Microbiology
IMI’s antimicrobial resistance (AMR) programme New Drugs for Bad Bugs (ND4BB) is the focus of a recent comment piece in Nature Reviews Microbiology by John Rex of AstraZeneca, who is involved in ND4BB. The article explains how ###IMI and other projects around the world are tackling the biggest challenges in antibiotic research and development. For example, TRANSLOCATION is investigating how to transport antibiotics into bacteria, while COMBACTE focuses on the design and implementation of more efficient clinical trials. ENABLE, IMI’s newest AMR project, is creating a drug discovery platform to fast-track the development of promising molecules. The article also highlights IMI project RAPP-ID, which is working on point-of-care tests, as well as a number of US-based initiatives. Looking to the future, the article notes that IMI has a project in development which will investigate new business models and economic strategies to incentivise the development of new antibiotics.
The article concludes: ‘Although the [AMR] crisis is far from resolved, the leadership of the European Commission are to be commended for their far-sighted approach to creating ND4BB and its projects, all of which provide hope that the global community will have access to an adequate pipeline of novel antimicrobial agents with which to address the challenge of AMR.’
(April 2014)