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肆虐的 SARS-CoV-2:初步诊断和令人费解的免疫反应。

Ravaging SARS-CoV-2: rudimentary diagnosis and puzzling immunological responses.

机构信息

Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, UT, USA.

Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.

出版信息

Curr Med Res Opin. 2021 Feb;37(2):207-217. doi: 10.1080/03007995.2020.1862532. Epub 2020 Dec 26.

Abstract

INTRODUCTION

In December 2019, the first COVID-19 case, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was reported in Wuhan, China. The SARS-CoV-2 rapidly disseminated throughout the world community spread, acquiring pandemic status with significant fatality.

OBSERVATIONS

Rapid SARS-CoV-2 diagnosis was soon perceived critical for arresting community spread and effective therapy development. Human SARS-CoV-2 infection can be diagnosed either by nucleic acid identification or specific antibody detection. Contrary to nucleic acid identification confirmed active SARS-CoV-2 infection; antibody detection confirms a past infection, even in asymptomatic subjects. SARS-CoV-2 specific antibodies augment the ability to effectively counter the virus. A crucial hurdle limiting the steadfast implementation of antibody detection is the time required for threshold B lymphocyte population generation. This process is dependent on precise antigen recognition and MHC class I molecules presentation.

CONCLUSIONS

Thus, nucleic acid and antibody dependent tests complement each other in identifying human SARS-CoV-2 infection and shaping up subsequent immunological responses. This article discusses the complimentary association of nucleic acid identification (corresponding to an active infection) and antibody testing (the yester CoV-2 infection vulnerability) as the diagnostic and screening measures of SARS-CoV-2 infection. Highlights Nucleic acid (RNA) identification and specific antibody detection against SARS-CoV-2 are the noted diagnostic mechanisms for screening human SARS-CoV-2 infection. While nucleic acid identification screens prevailing SARS-CoV-2 infection, detection of SARS-CoV-2 specific antibodies signifies a past infection, even in asymptomatic subjects. Antibodies against SARS-CoV-2 provide a potential therapeutic option transfer from antibody rich plasma of a recovered subject to an infected individual. Nucleic acid identification may not absolutely confirm the infection because of frequent SARS-CoV-2 genome mutations and possible technical errors, while specific antibody detection also needs at least (8-14) days for detectable screening of B-cell generated antibodies. Nucleic acid and antibody tests are complementary to each other as an early stage diagnostic assay for SARS-CoV-2 infection and possible therapy (antibodies). Sufferers with a high clinical suspicion but negative RT-PCR screening could be examined combined imaging and repeated swab test.

摘要

简介

2019 年 12 月,中国武汉首次报告了由严重急性呼吸系统综合症冠状病毒 2(SARS-CoV-2)引起的 COVID-19 病例。SARS-CoV-2 迅速在全球范围内传播,成为大流行,死亡率很高。

观察结果

快速诊断 SARS-CoV-2 很快被认为是阻止社区传播和有效开发治疗方法的关键。人类 SARS-CoV-2 感染可以通过核酸鉴定或特异性抗体检测来诊断。与核酸鉴定确认的活跃 SARS-CoV-2 感染不同;抗体检测确认过去的感染,即使在无症状患者中也是如此。SARS-CoV-2 特异性抗体增强了有效对抗病毒的能力。限制抗体检测坚定实施的一个关键障碍是产生阈值 B 淋巴细胞群体所需的时间。这个过程取决于精确的抗原识别和 MHC Ⅰ类分子的呈递。

结论

因此,核酸和抗体依赖性测试在识别人类 SARS-CoV-2 感染和塑造随后的免疫反应方面相辅相成。本文讨论了核酸鉴定(对应于活跃感染)和抗体检测(对过去的 CoV-2 感染脆弱性)作为 SARS-CoV-2 感染的诊断和筛选措施的互补关联。

核酸(RNA)鉴定和针对 SARS-CoV-2 的特异性抗体检测是筛选人类 SARS-CoV-2 感染的重要诊断机制。虽然核酸鉴定筛查当前的 SARS-CoV-2 感染,但 SARS-CoV-2 特异性抗体的检测表明过去的感染,即使在无症状患者中也是如此。针对 SARS-CoV-2 的抗体提供了一种潜在的治疗选择,即将恢复期患者的富含抗体的血浆转移给感染个体。由于 SARS-CoV-2 基因组频繁突变和可能的技术错误,核酸鉴定可能无法绝对确认感染,而特异性抗体检测也需要至少(8-14)天才能进行可检测的 B 细胞产生抗体筛查。核酸和抗体检测相互补充,作为 SARS-CoV-2 感染的早期诊断检测和可能的治疗方法(抗体)。对于临床高度怀疑但 RT-PCR 筛查阴性的患者,可以进行联合影像学和重复拭子检测。

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