a Division of Infectious Disease , City of Hope National Medical Center , Duarte , CA , USA.
b Department of Infectious Diseases, Infection Control and Employee Health , The University of Texas MD Anderson Cancer Center , Houston , TX , USA.
Expert Rev Mol Diagn. 2018 Oct;18(10):845-854. doi: 10.1080/14737159.2018.1522250. Epub 2018 Sep 19.
Fungal infection burden related to Mucorales has been on the rise with significant associated morbidity and mortality. The major obstacle in the management has been lack of a non-invasive rapid and a reliable diagnostic test. Developing a culture-independent biomarker for the early diagnosis of mucormycosis is a major unmet need in modern mycology. Several approaches have been developed, such as immunohistochemistry (IHC) that can confirm the histopathologic diagnosis of the invasive mold infection, polymerase chain reaction (PCR) on formalin-fixed paraffin-embedded (FFPE) or fresh tissue, body fluids such as bronchoalveolar fluid (BAL), and detection directly from serum/blood. Serologic tests, matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS), metabolomics and metagenomic shotgun sequencing are other evolving technologies. Area covered: In this review paper, we report the current status of the molecular diagnostics in the diagnosis of mucormycosis: serologic tests, IHC, PCR, protein-based with MALDI-TOF, metabolomics and metagenomic sequencing. Expert commentary: This review will conclude with an expert commentary on the potential uses/challenges of the currently available tests and the future of molecular diagnostics for mucormycosis.
真菌感染与毛霉病的负担一直在增加，与之相关的发病率和死亡率也很高。管理方面的主要障碍一直是缺乏非侵入性、快速和可靠的诊断测试。开发一种用于早期诊断毛霉病的非培养依赖性生物标志物是现代真菌学中的一个主要未满足的需求。已经开发了几种方法，例如免疫组织化学（IHC），它可以确认侵袭性霉菌感染的组织病理学诊断，福尔马林固定石蜡包埋（FFPE）或新鲜组织上的聚合酶链反应（PCR），如支气管肺泡液（BAL）等体液，以及直接从血清/血液中检测。血清学检测、基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF/MS）、代谢组学和宏基因组鸟枪法测序是其他正在发展的技术。涵盖领域：在这篇综述论文中，我们报告了分子诊断在毛霉病诊断中的现状：血清学检测、IHC、PCR、基于 MALDI-TOF 的蛋白质、代谢组学和宏基因组测序。专家评论：这篇综述将以对现有测试的潜在用途/挑战以及毛霉病分子诊断的未来的专家评论结束。
