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振动光谱学:产科疾病的一种有价值的筛查和诊断工具?

Vibrational Spectroscopy: A Valuable Screening and Diagnostic Tool for Obstetric Disorders?

作者信息

Richards Oliver, Jenkins Cerys, Griffiths Helena, Paczkowska Edyta, Dunstan Peter R, Jones Sharon, Morgan Margery, Thomas Tanya, Bowden Jayne, Nakimuli Annettee, Nair Manju, Thornton Catherine A

机构信息

Institute of Life Science, Swansea University Medical School, Swansea University, Swansea, United Kingdom.

Department of Physics, College of Science, Swansea University, Swansea, United Kingdom.

出版信息

Front Glob Womens Health. 2021 Jan 28;1:610582. doi: 10.3389/fgwh.2020.610582. eCollection 2020.

Abstract

Preeclampsia (PE) is a common obstetric disorder typically affecting 2-8% of all pregnancies and can lead to several adverse obstetric outcomes for both mother and fetus with the greatest burden of severe outcomes in low middle-income countries (LMICs), therefore, screening for PE is vital. Globally, screening is based on maternal characteristics and medical history which are nonspecific for the disorder. In 2004, the World Health Organization acknowledged that no clinically useful test was able to predict the onset of PE, which prompted a universal search for alternative means of screening. Over the past decade or so, emphasis has been placed on the use of maternal characteristics in conjunction with biomarkers of disease combined into predictive algorithms, however these are yet to transition into the clinic and are cost prohibitive in LMICs. As a result, the screening paradigm for PE remains unchanged. It is evident that novel approaches are needed. Vibrational spectroscopy, specifically Raman spectroscopy and Fourier-transform infrared spectroscopy (FTIR), could provide better alternatives suited for implementation in low resource settings as no specialized reagents are required for conventional approaches and there is a drive to portable platforms usable in both urban and rual community settings. These techniques are based on light scattering and absorption, respectively, allowing detailed molecular analysis of samples to produce a unique molecular fingerprint of diseased states. The specificity of vibrational spectroscopy might well make it suited for application in other obstetric disorders such as gestational diabetes mellitus and obstetric cholestasis. In this review, we summarize current approaches sought as alternatives to current screening methodologies and introduce how vibrational spectroscopy could offer superior screening and diagnostic paradigms in obstetric care. Additionally, we propose a real benefit of such tools in LMICs where limited resources battle the higher prevalence of obstetric disorders.

摘要

子痫前期(PE)是一种常见的产科疾病,通常影响2%至8%的妊娠,会给母亲和胎儿带来多种不良产科结局,在低收入和中等收入国家(LMICs),严重结局的负担最重,因此,子痫前期的筛查至关重要。在全球范围内,筛查基于母亲的特征和病史,而这些对该疾病并无特异性。2004年,世界卫生组织承认,没有临床可用的检测方法能够预测子痫前期的发病,这促使人们普遍寻求替代筛查方法。在过去十年左右的时间里,重点一直放在将母亲特征与疾病生物标志物结合到预测算法中使用,然而这些方法尚未进入临床,而且在低收入和中等收入国家成本过高。因此,子痫前期的筛查模式仍然没有改变。显然,需要新的方法。振动光谱学,特别是拉曼光谱学和傅里叶变换红外光谱学(FTIR),可以提供更适合在资源匮乏环境中实施的替代方法,因为传统方法不需要专门的试剂,并且有一种推动便携式平台在城市和农村社区环境中都能使用的趋势。这些技术分别基于光散射和吸收,允许对样品进行详细的分子分析,以产生疾病状态的独特分子指纹。振动光谱学的特异性很可能使其适用于其他产科疾病,如妊娠期糖尿病和产科胆汁淤积症。在这篇综述中,我们总结了目前作为当前筛查方法替代方案所寻求的方法,并介绍了振动光谱学如何能在产科护理中提供卓越的筛查和诊断模式。此外,我们提出了这些工具在低收入和中等收入国家的实际益处,在这些国家,有限的资源与产科疾病的较高患病率作斗争。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d6c/8593960/a4eb1eda4d98/fgwh-01-610582-g0001.jpg

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