Division of Pediatric Infectious Diseases and Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
Curr Opin Infect Dis. 2021 Oct 1;34(5):552-558. doi: 10.1097/QCO.0000000000000750.
Analyses of the host transcriptional response to infection has proved to be an alternative diagnostic strategy to standard direct pathogen detection. This review summarizes the value of applying blood and mucosal transcriptome analyses for the diagnosis and management of children with viral and bacterial infections.
Over the years, studies have validated the concept that RNA transcriptional profiles derived from children with infectious diseases carry a pathogen-specific biosignature that can be qualitatively and quantitively measured. These biosignatures can be translated into a biologically meaningful context to improve patient diagnosis, as seen in children with tuberculosis, rhinovirus infections, febrile infants and children with pneumonia; understand disease pathogenesis (i.e. congenital CMV) and objectively classify patients according to clinical severity (i.e. respiratory syncytial virus).
The global assessment of host RNA transcriptional immune responses has improved our understanding of the host-pathogen interactions in the clinical setting. It has shown the potential to be used in clinical situations wherein our current diagnostic tools are inadequate, guiding the diagnosis and classification of children with infectious diseases.
对宿主转录反应的分析已被证明是一种替代的诊断策略，可替代标准的直接病原体检测。本综述总结了应用血液和黏膜转录组分析诊断和管理儿童病毒和细菌感染的价值。
多年来，研究已经证实了这样一个概念，即来自传染病患儿的 RNA 转录谱携带有病原体特异性的生物标志物，可进行定性和定量测量。这些生物标志物可以转化为具有生物学意义的上下文，以改善患者的诊断，例如在结核病、鼻病毒感染、发热婴儿和肺炎儿童中；了解疾病发病机制（例如先天性 CMV），并根据临床严重程度客观分类患者（例如呼吸道合胞病毒）。
宿主 RNA 转录免疫反应的全面评估提高了我们对临床环境中宿主-病原体相互作用的理解。它显示了在我们目前的诊断工具不足的情况下用于临床的潜力，指导了传染病患儿的诊断和分类。
