Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.
Int J Mol Sci. 2019 Jul 25;20(15):3631. doi: 10.3390/ijms20153631.
Fungal keratitis (FK) is one of the most severe corneal infectious diseases. FK often leads to poor visual prognosis and thus requires accurate diagnosis. Conventional approaches, including clinical diagnoses, smears, and cultures, often fail to provide reliable diagnostic value. Omics approaches, such as those using genomic, metagenomic, and tear proteomic data sources, provide promising features for improving the diagnosis and monitoring the progression of FK. Genomic approaches are based mainly on detecting amplicons of ribosomal RNA genes, and internal transcribed spacers are gradually gaining popularity in clinical practices. A metagenomic approach based on 16S rRNA genes may help monitor the dynamic change of conjunctival microbiota associated with an FK event, whereas that based on shot-gun and 18S rRNA target enrichment sequencing could have the potential to diagnose FK using clinical samples. A tear proteomic approach may provide comprehensive information about ocular surface defense and injury during FK. Representative up- and down-regulated proteins during FK could also be used as biomarkers to determine the clinical course and develop a treatment strategy in different stages of FK. Consequently, a personalized tear proteomic approach will soon play a key role in FK management.
真菌性角膜炎（FK）是最严重的角膜感染性疾病之一。FK 常导致不良的视觉预后，因此需要准确的诊断。传统方法，包括临床诊断、涂片和培养，往往无法提供可靠的诊断价值。组学方法，如利用基因组、宏基因组和泪液蛋白质组学数据来源的方法，为改善 FK 的诊断和监测进展提供了有前景的特征。基因组方法主要基于检测核糖体 RNA 基因的扩增子，内部转录间隔区在临床实践中逐渐流行。基于 16S rRNA 基因的宏基因组方法可能有助于监测与 FK 事件相关的结膜微生物群的动态变化，而基于散弹枪和 18S rRNA 靶向富集测序的方法可能具有使用临床样本诊断 FK 的潜力。泪液蛋白质组学方法可能提供 FK 期间眼表防御和损伤的全面信息。FK 期间代表性的上调和下调蛋白也可用作生物标志物，以确定 FK 的临床病程并在不同阶段制定治疗策略。因此，个性化的泪液蛋白质组学方法将很快在 FK 管理中发挥关键作用。
