Ghidini Claudia, Zanotti Cinzia, Boccacci Sara, Lanfranchi Arnalda, Caimi Luigi, Imberti Luisa
Diagnostic Department, Biotechnology Laboratory, Spedali Civili, Piazzale Spedali Civili, Brescia, Italy.
Diagn Mol Pathol. 2011 Jun;20(2):111-6. doi: 10.1097/PDM.0b013e3181fc02de.
The presence of myxovirus resistance protein A (MxA) RNA was studied in 55 febrile children with primary immunodeficiency, 27 of whom underwent hematopoietic cell transplantation, and in 28 age-matched controls. The level of MxA RNA was above the cutoff, established as the 95th percentile found in controls, with primary immunodeficiency either undergoing transplantation or not in febrile patients, and with a documented diagnosis of infection by adenovirus, cytomegalovirus, Epstein-Barr virus, respiratory syncytial virus, and rotavirus. The presence of rare viral infections, unrecognized among those that more frequently occur in patients with primary immunodeficiency and in patients undergoing transplantation, may explain the high MxA RNA levels observed in some patients with fever but undetectable genomes or antibodies for the more common viruses. The level of MxA in febrile patients with acute graft versus host disease was below the cutoff, with a median level comparable with that observed in patients with primary immunodeficiency, who did not undergo transplantation and were without fever and infections, but significantly lower compared with controls. The level of MxA was well correlated with viral infections in follow-up samples. These data indicate that the measurement of MxA RNA is simple and useful to detect viral infections and in distinguishing them from acute graft versus host disease after allogeneic cell transplantation.
对55名患有原发性免疫缺陷的发热儿童（其中27名接受了造血细胞移植）以及28名年龄匹配的对照者，研究了黏液病毒抗性蛋白A（MxA）RNA的存在情况。MxA RNA水平高于对照者中第95百分位数所确定的临界值，这些对照者包括原发性免疫缺陷发热患者中接受或未接受移植的患者，以及确诊感染腺病毒、巨细胞病毒、爱泼斯坦-巴尔病毒、呼吸道合胞病毒和轮状病毒的患者。在原发性免疫缺陷患者和接受移植的患者中更常见的病毒感染之外，存在罕见病毒感染，这可能解释了一些发热但未检测到更常见病毒基因组或抗体的患者中观察到的高MxA RNA水平。患有急性移植物抗宿主病的发热患者的MxA水平低于临界值，中位数水平与未接受移植、无发热和感染的原发性免疫缺陷患者中观察到的水平相当，但与对照者相比显著更低。随访样本中MxA水平与病毒感染密切相关。这些数据表明，MxA RNA的检测简单且有助于检测病毒感染，并将其与异基因细胞移植后的急性移植物抗宿主病区分开来。
