Lighting up the Lungs to Detect Disease

A novel imaging tool that rapidly diagnoses bacterial lung infections could help physicians customize antibiotic treatment for patients in intensive care units. Currently, diagnosing bacterial infections relies on a slow process of detection followed by biopsy and lab-based culture growth — procedures that are prone to contamination and can result in late treatment.

This image shows a prototype of one of the components that the Proteus team is developing. The light sources are LEDs, which will shine light down an optical fiber that has been passed into the deep (distal) areas of patients’ lungs. In this way, Proteus will be “lighting up the lung” using fluorescence microscopy. Courtesy of Paul McCool/Engineering and Physical Sciences Research Council/Proteus.

The bedside technology, known as Proteus, uses LEDs and miniaturized optical fibers to enable the clinician to enter, image and sense the distal regions of patients’ lungs. Custom molecules called proteus smartprobes allow the detection of pathologies across a spectrum of wavelengths and fluorescence lifetimes, and are used to detect specific pathogens within the distal lung region, enabling real-time identification of disease. Sensors enable the clinician to detect, timestamp and process photons quickly. Use of multicolor wide-field fluorescence endoscopy allows labelled bacteria and lung tissue in vivo to be viewed in real time.

Proteus can detect whether harmful bacteria are present within 60 seconds, enabling quick and appropriate treatment. Fast, accurate diagnosis means that unnecessary use of antibiotics can be avoided.

Images produced by the current wide-field fluorescence endoscopy system, in which the bacteria can be observed among lung tissue. Courtesy of Engineering and Physical Sciences Research Council/Proteus.

According to the team, Proteus easily reaches parts of the lungs that existing tools cannot access. The technology could significantly change the way critically ill patients and patients with long-term lung conditions are assessed and treated. It could also aid understanding of bacterial diseases.

Kev Dhaliwal, who is leading the project and is a consultant in Respiratory Medicine at the University of Edinburgh, said, “We need to understand disease in patients better so that we can make better decisions at the bedside. The Proteus project and clinical partners brings together scientists and clinicians from many disciplines from all corners of the United Kingdom to develop technology that can help us spot disease in real time at the bedside and help us to give the right treatments at the right time. The rise of antimicrobial resistance is the biggest challenge in modern medicine and the support and mentorship from CARB-X will accelerate development of Proteus technology to be ready for clinical use faster and more widely than previously possible.”

The interdisciplinary collaboration is led by researchers at the Universities of Edinburgh and Bath and Heriot-Watt University. It has been supported by the U.K.'s Engineering and Physical Sciences Research Council with additional support from the Wellcome Trust and Medical Research Council and from CARB-X, a major international initiative to tackle antibiotic resistance co-funded by the U.S. Government and Wellcome.

For more information about Proteus, visit the Proteus web site.