Uemura Natsu, Makimura Koichi
Teikyo University Institute of Medical Mycology.
Nihon Rinsho. 2008 Dec;66(12):2334-9.
In the deep-seated mycosis that happens often to compromised hosts, an early diagnosis and treatment influence the life prognosis. Because there are a lot of cases with a difficult identification of the etiologic agent by the microscopy and culture, a molecular biological diagnosis that is rapid, highly sensitive and specific is expected. However, a genetic testing of pathogenic fungi has not been a healthcare service provided by health insurance in Japan yet. In this paper, the loop-mediated isothermal amplification (LAMP) method that is a new genetic test method is showed in addition to the polymerase chain reaction (PCR) method that is a current mainstream test. The mycosis gene diagnosis enables rapid identification of a pathogenic fungus, and so it is expected that the diagnostic method is utilized for a rapid and best therapeutic choice and an epidemiologic analysis. The achievement of an early clinical application will be hoped for in the future.
在免疫功能低下宿主中经常发生的深部真菌病,早期诊断和治疗会影响患者的生命预后。由于许多病例通过显微镜检查和培养难以鉴定病原体,因此人们期待一种快速、高度灵敏且特异的分子生物学诊断方法。然而,在日本,致病真菌的基因检测尚未作为一项医疗保险服务项目。本文除了介绍当前主流检测方法——聚合酶链反应(PCR)法之外,还展示了一种新型基因检测方法——环介导等温扩增(LAMP)法。真菌病基因诊断能够快速鉴定致病真菌,因此有望将该诊断方法用于快速且最佳的治疗选择以及流行病学分析。期待未来能够早日实现临床应用。