Yolken R H, Coutlee F, Viscidi R P
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Yale J Biol Med. 1989 Mar-Apr;62(2):131-9.
The diagnosis of viral infections is important for the accurate management of patients with infectious diseases and for the monitoring of the course of epidemics in susceptible populations. The utility of traditional viral diagnostic assays is limited by the time, expense, and expertise required for the performance of tissue culture techniques. Similarly, the application of immunoassay techniques has been inhibited by the limited degrees of sensitivity and specificity which can be attained by most immunoassay methods. Recently, techniques for the identification of DNA and RNA have been applied to the detection of viral nucleic acids in clinical samples. Such assays have a number of potential advantages over corresponding immunoassays directed at the detection of viral antigens. In order to be generally applicable to clinical diagnosis, however, formats for the detection of viral nucleic acids have to be devised which allow for the reproducible quantitation of target DNA or RNA in human body fluids. Furthermore, formats need to be devised which allow enhanced assay sensitivity while maintaining high degrees of specificity and reproducibility. The use of non-isotopic labeling, liquid-phase hybridization, and target amplification techniques offers partial solutions to these problems. The development of practical assays for the detection of viral nucleic acids under a broad range of clinical and laboratory conditions would represent a major advance in the ability of physicians to care for patients with suspected infections.
病毒感染的诊断对于准确管理传染病患者以及监测易感人群中的疫情进程至关重要。传统病毒诊断检测方法的实用性受到组织培养技术实施所需时间、费用和专业知识的限制。同样，免疫检测技术的应用也受到大多数免疫检测方法所能达到的有限灵敏度和特异性的制约。最近，DNA和RNA鉴定技术已应用于临床样本中病毒核酸的检测。此类检测相对于针对病毒抗原检测的相应免疫检测具有许多潜在优势。然而，为了普遍应用于临床诊断，必须设计出用于检测病毒核酸的方法，以便能够对人体体液中的目标DNA或RNA进行可重复定量。此外，还需要设计出能够在保持高特异性和可重复性的同时提高检测灵敏度的方法。使用非同位素标记、液相杂交和目标扩增技术为这些问题提供了部分解决方案。开发在广泛临床和实验室条件下检测病毒核酸的实用检测方法将代表医生护理疑似感染患者能力的重大进步。
