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目前不明病因病毒感染的诊断趋势。

Current Trends in Diagnostics of Viral Infections of Unknown Etiology.

机构信息

FSBI "Center of Strategic Planning" of the Ministry of Health, 119435 Moscow, Russia.

I.M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia.

出版信息

Viruses. 2020 Feb 14;12(2):211. doi: 10.3390/v12020211.

Abstract

Viruses are evolving at an alarming rate, spreading and inconspicuously adapting to cutting-edge therapies. Therefore, the search for rapid, informative and reliable diagnostic methods is becoming urgent as ever. Conventional clinical tests (PCR, serology, etc.) are being continually optimized, yet provide very limited data. Could high throughput sequencing (HTS) become the future gold standard in molecular diagnostics of viral infections? Compared to conventional clinical tests, HTS is universal and more precise at profiling pathogens. Nevertheless, it has not yet been widely accepted as a diagnostic tool, owing primarily to its high cost and the complexity of sample preparation and data analysis. Those obstacles must be tackled to integrate HTS into daily clinical practice. For this, three objectives are to be achieved: (1) designing and assessing universal protocols for library preparation, (2) assembling purpose-specific pipelines, and (3) building computational infrastructure to suit the needs and financial abilities of modern healthcare centers. Data harvested with HTS could not only augment diagnostics and help to choose the correct therapy, but also facilitate research in epidemiology, genetics and virology. This information, in turn, could significantly aid clinicians in battling viral infections.

摘要

病毒的进化速度令人震惊,它们不断传播并悄然适应最新的治疗方法。因此,寻找快速、信息丰富且可靠的诊断方法变得前所未有地紧迫。传统的临床检测(PCR、血清学等)正在不断优化,但提供的信息非常有限。高通量测序(HTS)是否会成为病毒感染分子诊断的未来金标准?与传统的临床检测相比,HTS 在分析病原体方面更加通用和精确。然而,它尚未被广泛接受为诊断工具,主要是因为其成本高,且样本制备和数据分析复杂。为了将 HTS 整合到日常临床实践中,必须解决这些障碍。为此,需要实现三个目标:(1)设计和评估通用的文库制备方案,(2)组装特定用途的流水线,(3)构建适合现代医疗机构需求和财务能力的计算基础设施。HTS 采集的数据不仅可以增强诊断并有助于选择正确的治疗方法,还可以促进流行病学、遗传学和病毒学的研究。这些信息反过来也可以极大地帮助临床医生对抗病毒感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8480/7077230/0af40a39c4a4/viruses-12-00211-g001.jpg

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