Division of Laboratory Medicine, Chiba University Hospital, Chiba, Japan.
Adv Clin Chem. 2024;118:35-85. doi: 10.1016/bs.acc.2023.11.003. Epub 2023 Dec 14.
The World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19), a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a global pandemic in March 2020. Reverse transcription-polymerase chain reaction (RT-PCR) is the reference technique for molecular diagnosis of SARS-CoV-2 infection. The SARS-CoV-2 virus is constantly mutating, and more transmissible variants have emerged, making genomic surveillance a crucial tool for investigating virus transmission dynamics, detecting novel genetic variants, and assessing mutation impact. The S gene, which encodes the spike protein, is frequently mutated, and it plays an important role in transmissibility. Spike protein mutations affect infectivity and vaccine effectiveness. SARS-CoV-2 variants are tracked using whole genome sequencing (WGS) and S-gene analysis. WGS, Sanger sequencing, and many S-gene-targeted RT-PCR methods have been developed. WGS and Sanger sequencing are standard methods for detecting mutations and can be used to identify known and unknown mutations. Melting curve analysis, endpoint genotyping assay, and S-gene target failure are used in the RT-PCR-based method for the rapid detection of specific mutations in SARS-CoV-2 variants. Therefore, these assays are suitable for high-throughput screening. The combinatorial use of RT-PCR-based assays, Sanger sequencing, and WGS enables rapid and accurate tracking of SARS-CoV-2 variants. In this review, we described RT-PCR-based detection and surveillance techniques for SARS-CoV-2.
世界卫生组织(WHO)于 2020 年 3 月宣布,由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的 2019 年冠状病毒病(COVID-19)为全球大流行病。逆转录-聚合酶链反应(RT-PCR)是 SARS-CoV-2 感染分子诊断的参考技术。SARS-CoV-2 病毒不断发生变异,出现了更具传染性的变异株,因此基因组监测成为调查病毒传播动态、检测新的遗传变异株和评估突变影响的重要工具。编码刺突蛋白的 S 基因经常发生突变,在传染性方面起着重要作用。刺突蛋白突变影响感染力和疫苗效果。SARS-CoV-2 变异株通过全基因组测序(WGS)和 S 基因分析进行追踪。已开发出 WGS、Sanger 测序和许多 S 基因靶向 RT-PCR 方法。WGS 和 Sanger 测序是检测突变的标准方法,可用于识别已知和未知的突变。熔解曲线分析、终点基因分型测定和 S 基因靶标失败用于基于 RT-PCR 的方法中 SARS-CoV-2 变异株的特定突变的快速检测。因此,这些测定方法适用于高通量筛选。基于 RT-PCR 的测定方法、Sanger 测序和 WGS 的组合使用可实现 SARS-CoV-2 变异株的快速、准确追踪。在本综述中,我们描述了用于 SARS-CoV-2 的基于 RT-PCR 的检测和监测技术。