Dr. Jane Emily Hill, University of British Columbia, Canada
Dr. Jane Emily Hill and her team of researchers from the University of British Columbia and in collaboration with National Jewish Health, is leading the development of a novel approach to diagnose nontuberculous mycobacterial pulmonary infections based on molecules found in breath.
Congratulations on your paper getting published. Could you explain what nontuberculosis mycobacteria are and why it’s hard to diagnose a pulmonary disease caused by them?
Nontuberculosis mycobacteria (NTM) are ubiquitous environmental bacteria commonly found in water and soil. These pathogens are increasingly recognized as serious causes of human morbidity and mortality and pose a significant threat to individuals with an underlying lung disease, such as people with cystic fibrosis (CF).
Reaching a diagnosis of pulmonary NTM disease in patients with CF is very complex. In addition to monitoring clinical symptoms, NTM screening, diagnosis, and treatment relies on traditional culture techniques. However, NTM cultures grow slowly, taking up to 8 weeks, and the majority of patients have only transient positive cultures or indolent infections. In simple terms, the isolation of NTM from a respiratory sample is not enough to confirm a pulmonary NTM disease diagnosis and initiate antibiotic treatment. The decision to treat is consequential, requiring daily antibiotics for several months.
It sounds like culture-based methods might be too slow and inconclusive on their own to diagnose pulmonary NTM disease. Did you and your team come up with a solution to this?
In our pilot study, we investigated whether biomarkers found in exhaled breath can be leveraged to differentiate between people with CF with active-NTM lung disease, those with an indolent NTM infection, and those without any history of a positive NTM culture.
After collecting and analyzing breath samples from 11 patients with CF, we putatively identified 17 breath molecules that could be used for the diagnosis of pulmonary NTM disease. We are following this work up in a much larger clinical study, screening a few hundred patients throughout North America.
What motivated you to delve into this alternative diagnostic approach based on breath samples?
Breath holds great potential as a source of information on an individual’s health status. If we could diagnose a lung infection non-invasively and quickly using exhaled breath, it would improve the quality of lives of many people around the world. Elevating the human condition through the development of next-generation diagnostics was a fundamental motivator of this work.
Your paper was published in the context of a transformative agreement with IOP Publishing. What was this process like?
It was simple and easy, as the process required to utilize the agreement was automated. I actually learned about the transformative agreement by accident; after enquiring about the cost of publishing, I found it was free for me.
What do you think are the advantages of publishing through a transformative agreement?
While I am not sure of the costs to my institution, there are substantial advantages to researchers publishing through this agreement. The cost of publishing, especially that of making a publication open access, can be prohibitive. Yet, for many of us, open access is a key goal so that our findings can be shared as widely as possible. This was easy to do with a transformative agreement, which ensured that this study is published open access.
Do you have any word of advice for other authors interested in publishing open access through a transformative agreement?
It could be worthwhile for authors to learn about these agreements in advance, as this might affect their decision on where to publish. In my case, IOPP’s Journal of Breath Research was my target journal, and I hoped it would accept our article. Finding out that not only could we publish in this journal, but also have our article be open access without incurring any fee, was terrific.