Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA
Program on Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore.
J Clin Microbiol. 2018 Apr 25;56(5). doi: 10.1128/JCM.00203-18. Print 2018 May.
The four serotypes of dengue virus (DENV) cause one of the most important and rapidly emerging mosquito-borne viral diseases in humans. Of the currently available diagnostic tests for dengue, the reverse transcription-PCR (RT-PCR) assay is the most sensitive and specific, and so it is commonly used as the gold standard. However, the requirement of a sophisticated and expensive thermal cycler makes it very difficult to use as a point-of-care diagnostic test in resource-limited regions where dengue is endemic. Tsai et al. (J Clin Microbiol 56:e01865-17, 2018, https://doi.org/10.1128/JCM.01865-17) report the analytical and clinical performances of a reverse transcription-insulated isothermal PCR (RT-iiPCR) assay with a portable nucleic acid analyzer for rapid detection of the four DENV serotypes; its reproducibility and complete agreement on clinical samples with the multiplex RT-PCR assay developed by the Centers for Disease Control and Prevention suggest that the dengue RT-iiPCR is a potential point-of-care test. Compared with other DENV RNA detection methods, the unique isothermal PCR design of RT-iiPCR, together with further improvements, would represent a promising new type of field-deployable diagnostic test for dengue.
登革病毒(DENV)有四个血清型,是人类中最重要且迅速出现的蚊媒病毒性疾病之一。在现有的登革热诊断检测方法中,逆转录-聚合酶链反应(RT-PCR)检测法的灵敏度和特异性最高,因此通常被作为金标准。然而,这种检测方法需要复杂且昂贵的热循环仪,因此在登革热流行的资源有限地区,很难将其用作即时检测的诊断测试。Tsai 等人(J Clin Microbiol 56:e01865-17, 2018, https://doi.org/10.1128/JCM.01865-17)报道了一种使用便携式核酸分析仪的逆转录恒温扩增(RT-iiPCR)检测法,用于快速检测四种 DENV 血清型,该方法具有分析和临床性能;与疾病控制和预防中心开发的多重 RT-PCR 检测法相比,该方法在临床样本上具有可重复性和完全一致性,表明登革热 RT-iiPCR 是一种有潜力的即时检测方法。与其他 DENV RNA 检测方法相比,RT-iiPCR 的独特等温 PCR 设计,加上进一步的改进,将代表一种有前途的新型现场可部署的登革热诊断检测方法。