Mejias Asuncion, Suarez Nicolas M, Ramilo Octavio
Division of Pediatric Infectious Diseases, Center for Vaccines and Immunity, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA.
Curr Opin Infect Dis. 2014 Jun;27(3):228-35. doi: 10.1097/QCO.0000000000000065.
There is a need for improved diagnosis and for optimal classification of patients with infectious diseases. An alternative approach to the pathogen-detection strategy is based on a comprehensive analysis of the host response to the infection. This review focuses on the value of transcriptome analyses of blood leukocytes for the diagnosis and management of patients with infectious diseases.
Initial studies showed that RNA from blood leukocytes of children with acute viral and bacterial infections carried pathogen-specific transcriptional signatures. Subsequently, transcriptional signatures for several other infections have been described and validated in humans with malaria, dengue, salmonella, melioidosis, respiratory syncytial virus, influenza, tuberculosis, and HIV. In addition, transcriptome analyses represent an invaluable tool to understand disease pathogenesis and to objectively classify patients according to the clinical severity.
Microarray studies have been shown to be highly reproducible using different platforms, and in different patient populations, confirming the value of blood transcriptome analyses to study pathogen-specific host immune responses in the clinical setting. Combining the detection of the pathogen with a comprehensive assessment of the host immune response will provide a new understanding of the correlations between specific causative agents, the host response, and the clinical manifestations of the disease.
对于传染病患者，需要改进诊断方法并进行优化分类。病原体检测策略的一种替代方法是基于对宿主感染反应的全面分析。本综述重点关注血液白细胞转录组分析在传染病患者诊断和管理中的价值。
初步研究表明，患有急性病毒和细菌感染的儿童血液白细胞中的RNA带有病原体特异性转录特征。随后，在疟疾、登革热、沙门氏菌、类鼻疽、呼吸道合胞病毒、流感、结核病和艾滋病毒感染者中，已经描述并验证了其他几种感染的转录特征。此外，转录组分析是理解疾病发病机制并根据临床严重程度对患者进行客观分类的宝贵工具。
微阵列研究已被证明在使用不同平台以及不同患者群体中具有高度可重复性，证实了血液转录组分析在临床环境中研究病原体特异性宿主免疫反应的价值。将病原体检测与对宿主免疫反应的全面评估相结合，将为特定病原体、宿主反应和疾病临床表现之间的相关性提供新的认识。
