Editorial Developments in immunological technologies leading to improvements in point-of-care diagnostic testing Volker Gurtler a , Charles Pavia b, ⁎ a School of Applied Sciences, Building 223, Level 1, Bundoora Campus, RMIT University, PO Box 71, Bundoora, 3083 Australia b Department of Biomedical Sciences, New York College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY 11568, United States abstract article info Available online 30 May 2011 Rapid and accurate point of care testing is of great concern, especially in terms of detecting infectious disease outbreaks in developing countries having high population burdens. While numerous detection systems are currently available, care must be taken in choosing those that are reliable and have proven acceptable levels of sensitivity and specificity, based on adequate laboratory and pre-clinical trial testing. Two papers in the current issue show significant advances in technology that could bring Point-of-Care Diagnostic Testing closer to reality for cholera and environmental mycobacteria. © 2011 Elsevier B.V. All rights reserved. Effective strategies designed to control the spread of many infectious diseases, that could lead to a massive outbreak, have relied wholly or partly on reactive measures implemented in response to the detection of the first few recognizable clinical cases. Such measures, however, may depend heavily on the most readily available detection system that would be typically based on culture, serology or molecular techniques. In this regard, a vital niche would be filled if assays for microorganisms fulfilled regulatory requirements for point- of-care testing in developing countries because this would overcome some of the problems associated with the lack of facilities and funding in these countries. In the aftermath of natural disasters such as the earthquake in Haiti, that occurred in October 2010, and the floods in India (July, 2010) these problems are exacerbated and further highlight the advantages point-of-care testing could make to issues such as cholera outbreaks, as well as other water- or food-borne outbreaks. In most developed countries and possibly in some developing countries, rapid testing for certain infectious diseases is currently available and has been for several years. Examples of these include the rapid group A streptococcus antigen test for pharyngitis, urine antigen tests for pneumococcal pneumonia (Murdoch et al., 2001) and Legionnaires disease, and testing of saliva fluid for HIV type 1 and 2 antibodies (Holguín et al., 2009). Results from such tests have shown good specificity and sensitivity, can usually be obtained within 30 min and are easy to use and do not require sophisticated laboratory facilities or highly trained staff. Accordingly, they fulfil the re- quirements for rapid and effective point-of-care testing. Currently, there are scores of commercial serology tests being sold in high-burden countries without international guidelines recom- mending their use or efficacy. Some are laboratory-based tests, whereas others are rapid dipstick tests, which could fill a vital niche for a point-of-care test. WHO has responded by issuing a negative policy recommendation – the first of its kind for the organization – on the usefulness of current commercially available tuberculosis detec- tion systems (Morris, 2011). Two papers in this issue of J Microbiol Methods have developed technologies leading to improvements in point-of-care diagnostic testing including immunological data from patient specimens (Stavri et al., in press) or from cultured isolates (Yu et al., in press). One paper (Yu et al., in press) describes a ready to use point-of-care test that improves on the readily available dipstick technology by attaching V. cholerae O1 and O139 serogroup specific monoclonal antibodies raised against lipopolysaccharides to functionalize colloidal gold nanoparticles for dual detection in gold nanoparticle biosensors. The other one uses superparamagnetic amine and carboxyl terminated particles to purify antibodies to specific antigens from environmental mycobacteria as the basis of an ELISA for environmental mycobacteria. Both these assays have applications in developing countries. The assay for V. cholerae would have been of great benefit during the cholera outbreaks after the Haitian earthquake. There are no immunological tests for environmental mycobacteria, so this paper is timely when put in to the context of the proposed WHO guidelines—it may be that such new technology is required for TB immunological testing also, especially in light of the fact that, apart from the United States and remote areas of the world (where routine BCG vaccination is not done or available), BCG vaccination done elsewhere precludes the use of PPD skin testing for the initial screening for possible exposure or infection with the tubercle bacillus. In conclusion these two papers show significant advances in technology that will bring Point-of-Care Diagnostic Testing closer to reality. In addition, with the success of reactive disease control strategies being shown already to depend on the timing of early testing of a Journal of Microbiological Methods 86 (2011) 275–276 ⁎ Corresponding author. Tel.: + 1 516 686 3778; fax: + 1 516 686 3832. E-mail address: cpavia@nyit.edu (C. Pavia). 0167-7012/$ – see front matter © 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.mimet.2011.05.015 Contents lists available at ScienceDirect Journal of Microbiological Methods journal homepage: www.elsevier.com/locate/jmicmeth