INFLAMMATORY DISEASES AND INFECTION: Edited by Kenneth TylerA tale of two approaches how metagenomics and proteomics are shaping the future of encephalitis diagnosticsSchubert, Ryan D.; Wilson, Michael R. Author Information Department of Neurology, University of California San Francisco, San Francisco, California, USA Correspondence to Michael R. Wilson, MD, UCSF Multiple Sclerosis and Neuroinflammation Center, 1500 Owens Street, Suite 320, San Francisco, CA 94158, USA. Tel: +415 353 2069; e-mail: [email protected] Current Opinion in Neurology: June 2015 - Volume 28 - Issue 3 - p 283-287 doi: 10.1097/WCO.0000000000000198 Buy Metrics Abstract Purpose of review We highlight how metagenomics and proteomics-based approaches are being applied to the problem of diagnosis in idiopathic encephalitis. Recent findings Low cost, high-throughput next-generation sequencing platforms have enabled unbiased sequencing of biological samples. Rapid sequence-based computational algorithms then determine the source of all the nonhost (e.g., pathogen-derived) nucleic acids in a sample. This approach recently identified a case of neuroleptospirosis, resulting in a patient's dramatic clinical improvement with intravenous penicillin. Metagenomics also enabled the discovery of a neuroinvasive astrovirus in several patients. With regard to autoimmune encephalitis, advances in high throughput and efficient phage display of human peptides resulted in the discovery of autoantibodies against tripartite motif family members in a patient with paraneoplastic encephalitis. A complementary assay using ribosomes to display full-length human proteins identified additional autoantibody targets. Summary Metagenomics and proteomics represent promising avenues of research to improve upon the diagnostic yield of current assays for infectious and autoimmune encephalitis, respectively. Copyright © 2015 Wolters Kluwer Health, Inc. All rights resereved.