Characterization and classification of lupus patients based on plasma thermograms

Plasma thermograms (thermal stability profiles of blood plasma) are being utilized as a new diagnostic approach for clinical assessment. In this study, we investigated the ability of plasma thermograms to classify systemic lupus erythematosus (SLE) patients versus non SLE controls using a sample of...

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Published inPloS one Vol. 12; no. 11; p. e0186398
Main Authors Garbett, Nichola C., Brock, Guy N., Chaires, Jonathan B., Mekmaysy, Chongkham S., DeLeeuw, Lynn, Sivils, Kathy L., Harley, John B., Rovin, Brad H., Kulasekera, K. B., Jarjour, Wael N.
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 17.11.2017
Public Library of Science (PLoS)
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ISSN1932-6203
1932-6203
DOI10.1371/journal.pone.0186398

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Summary:Plasma thermograms (thermal stability profiles of blood plasma) are being utilized as a new diagnostic approach for clinical assessment. In this study, we investigated the ability of plasma thermograms to classify systemic lupus erythematosus (SLE) patients versus non SLE controls using a sample of 300 SLE and 300 control subjects from the Lupus Family Registry and Repository. Additionally, we evaluated the heterogeneity of thermograms along age, sex, ethnicity, concurrent health conditions and SLE diagnostic criteria. Thermograms were visualized graphically for important differences between covariates and summarized using various measures. A modified linear discriminant analysis was used to segregate SLE versus control subjects on the basis of the thermograms. Classification accuracy was measured based on multiple training/test splits of the data and compared to classification based on SLE serological markers. Median sensitivity, specificity, and overall accuracy based on classification using plasma thermograms was 86%, 83%, and 84% compared to 78%, 95%, and 86% based on a combination of five antibody tests. Combining thermogram and serology information together improved sensitivity from 78% to 86% and overall accuracy from 86% to 89% relative to serology alone. Predictive accuracy of thermograms for distinguishing SLE and osteoarthritis / rheumatoid arthritis patients was comparable. Both gender and anemia significantly interacted with disease status for plasma thermograms (p<0.001), with greater separation between SLE and control thermograms for females relative to males and for patients with anemia relative to patients without anemia. Plasma thermograms constitute an additional biomarker which may help improve diagnosis of SLE patients, particularly when coupled with standard diagnostic testing. Differences in thermograms according to patient sex, ethnicity, clinical and environmental factors are important considerations for application of thermograms in a clinical setting.
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Competing Interests: This work was supported by the Kentucky Science and Technology Corporation (www.kstc.com) under Award Number COMMFUND-1517-RFP-017 (NCG). NCG and GNB are co-inventors on a patent application describing approaches for the analysis of DSC plasma thermogram data and their use for diagnostic classification (Garbett, N.C., and Brock, G.N. “Methods of Characterizing and/or Predicting Risk Associated with a Biological Sample Using Thermal Stability Profiles,” U.S. PCT Application PCT/US16/57416, Oct. 2016). NCG is a consultant for TA Instruments, Inc., a supplier of calorimetry instrumentation but not the supplier of the DSC instrument used to collect data for this study. This does not alter the authors’ adherence to all PLOS ONE policies on sharing data and materials.
Current address: Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States of America
These authors are joint senior authors on this work.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0186398