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比较巴西临床疑似牛狂犬病诊断的五种不同实验室技术。

Comparison of five different laboratory techniques for the rabies diagnosis in clinically suspected cattle in Brazil.

机构信息

Department of Pathology, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, SP, Brazil.

Instituto Pasteur de Sao Paulo, Avenida Paulista 393, Sao Paulo, SP 01311‑000, Brazil.

出版信息

J Virol Methods. 2020 Sep;283:113918. doi: 10.1016/j.jviromet.2020.113918. Epub 2020 Jun 15.

Abstract

The direct-fluorescent antibody test (dFAT) is considered the "gold standard" assay to diagnose rabies. However, it is crucial to develop molecular techniques, such as RT-PCR and RT-qPCR, since many laboratories lack the needed supplies for performing complementary methods (viral isolation, for example). For this purpose, diagnostic techniques must be specific and sensitive to guarantee accuracy. This present investigation aimed to detect rabies virus (RABV) in 126 clinically suspected cattle in Brazil using different diagnostic tests [dFAT, mouse inoculation test (MIT), immunohistochemistry (IHC), RT-PCR and RT-qPCR] and to compare those results obtained under routine laboratory conditions. The results of the present investigation demonstrate that the molecular techniques are more sensitive and may detect low viral load, even though the non-homogeneous viral distribution caused a false-negative result in dFAT. We also observed a usual alteration in antigens distribution among regions of the central nervous system (CNS). By both dFAT and IHC assays, the most reliable CNS structures were thalamus and midbrain. Although this investigation demonstrated diagnostic sensitivity and specificity close to 100 % in all laboratory techniques employed, a dFAT auxiliary test is required for bovine specimens, such as molecular techniques, when there are poor sampling conditions (low viral load combined with unavailability of brainstem structures).

摘要

直接荧光抗体试验(dFAT)被认为是诊断狂犬病的“金标准”检测方法。然而,开发分子技术,如 RT-PCR 和 RT-qPCR,至关重要,因为许多实验室缺乏执行互补方法(例如病毒分离)所需的用品。为此,诊断技术必须具有特异性和敏感性,以保证准确性。本研究旨在使用不同的诊断检测方法(dFAT、小鼠接种试验(MIT)、免疫组织化学(IHC)、RT-PCR 和 RT-qPCR)检测巴西 126 例临床疑似牛中的狂犬病病毒(RABV),并比较在常规实验室条件下获得的结果。本研究结果表明,分子技术更敏感,即使在 dFAT 中检测到低病毒载量时也可能检测到低病毒载量,而且不均匀的病毒分布导致 dFAT 出现假阴性结果。我们还观察到中枢神经系统(CNS)区域之间抗原分布的常见改变。通过 dFAT 和 IHC 检测,丘脑和中脑是最可靠的 CNS 结构。尽管本研究表明所有使用的实验室技术的诊断敏感性和特异性均接近 100%,但在采样条件较差(低病毒载量与脑干结构不可用时)时,牛标本需要辅助 dFAT 检测,例如分子技术。

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