Department of Pediatrics, University Federico II, Naples, Italy.
Curr Opin Gastroenterol. 2011 Jan;27(1):24-9. doi: 10.1097/MOG.0b013e3283413750.
To provide an update of the advantages of new-generation molecular diagnostics as regards acute diarrhea, and to evaluate how they can help clinicians and researchers diagnose this condition.
Thanks to real-time polymerase chain reaction techniques, many enteropathogens can now be identified simultaneously within hours. Most techniques are based on amplification of specific nucleotide sequences. With high-resolution melting analyses, microarrays, and metagenomic analyses, multiple genomic sequences can be evaluated in a single sample; thus, a wide range of enteropathogens can be evaluated in one run. Molecular techniques have elucidated the role of major enteropathogens such as norovirus and bocavirus and their evolving epidemiology. They have revealed novel transmission routes, also in food-borne diarrhea outbreaks, and have opened the way to new therapies and preventive measures, as well as to surveillance of emerging rotavirus strains after vaccine introduction.
Molecular approaches are best suited for epidemiologic purposes and for selected clinical conditions such as early identification of treatable agents in at-risk patients, rather than for cases requiring only oral rehydration. In the field of acute diarrhea, the major application of molecular techniques is the identification of novel agents of gastroenteritis and their epidemiology.
介绍新一代分子诊断技术在急性腹泻方面的优势，并评估其如何帮助临床医生和研究人员诊断这种疾病。
由于实时聚合酶链反应技术，现在可以在数小时内同时识别许多肠道病原体。大多数技术基于特定核苷酸序列的扩增。通过高分辨率熔解分析、微阵列和宏基因组分析，可以在单个样本中评估多个基因组序列；因此，可以在一次运行中评估多种肠道病原体。分子技术阐明了诺如病毒和博卡病毒等主要肠道病原体的作用及其不断变化的流行病学。它们揭示了新的传播途径，包括食源性腹泻暴发中的传播途径，并为新疗法和预防措施开辟了道路，也为疫苗引入后新兴轮状病毒株的监测开辟了道路。
分子方法最适合用于流行病学目的和某些临床情况，例如在高危患者中及早识别可治疗的病原体，而不是仅需要口服补液的情况。在急性腹泻领域，分子技术的主要应用是鉴定新型胃肠炎病原体及其流行病学。
