Department of Biochemistry, School of Life Science, University of Kwazulu-Natal, Pietermaritzburg, Private Bag X01 Scottsville 3209, South Africa.
J Med Microbiol. 2013 Oct;62(Pt 10):1491-1505. doi: 10.1099/jmm.0.052506-0.
In the last decade, there has been an upsurge of interest in developing malaria rapid diagnostic test (RDT) kits for the detection of Plasmodium species. Three antigens - Plasmodium falciparum histidine-rich protein 2 (PfHRP2), plasmodial aldolase and plasmodial lactate dehydrogenase (pLDH) - are currently used for RDTs. Tests targeting HRP2 contribute to more than 90% of the malaria RDTs in current use. However, the specificities, sensitivities, numbers of false positives, numbers of false negatives and temperature tolerances of these tests vary considerably, illustrating the difficulties and challenges facing current RDTs. This paper describes recent developments in malaria RDTs, reviewing RDTs detecting PfHRP2, pLDH and plasmodial aldolase. The difficulties associated with RDTs, such as genetic variability in the Pfhrp2 gene and the persistence of antigens in the bloodstream following the elimination of parasites, are discussed. The prospect of overcoming the problems associated with current RDTs with a new generation of alternative malaria antigen targets is also described.
在过去的十年中，人们对开发疟疾快速诊断检测试剂盒（RDT）以检测疟原虫物种产生了浓厚的兴趣。目前，有三种抗原——恶性疟原虫高变区蛋白 2（PfHRP2）、疟原虫醛缩酶和疟原虫乳酸脱氢酶（pLDH）——用于 RDT。针对 HRP2 的检测方法占当前使用的疟疾 RDT 的 90%以上。然而，这些检测方法的特异性、敏感性、假阳性数量、假阴性数量和温度耐受性差异很大，这说明了当前 RDT 面临的困难和挑战。本文描述了疟疾 RDT 的最新进展，综述了检测 PfHRP2、pLDH 和疟原虫醛缩酶的 RDT。讨论了 RDT 面临的困难，例如 Pfhrp2 基因的遗传变异性以及在寄生虫消除后血液中抗原的持续存在。还描述了使用新一代替代疟疾抗原靶标克服当前 RDT 相关问题的前景。
