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利用多重聚合酶链反应同时快速检测不同眼部结构的病毒感染。

Utilization of multiplex polymerase chain reaction for simultaneous and rapid detection of viral infections from different ocular structures.

机构信息

Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.

出版信息

Sci Rep. 2024 Aug 3;14(1):17997. doi: 10.1038/s41598-024-68171-7.

Abstract

The impact of viral keratitis (VK) on individuals and society is notable. Early diagnosis and treatment are crucial in managing viral keratitis effectively. Timely intervention with antiviral medications and supportive care can help mitigate the severity of the infection and improve visual outcomes. We examined the prevalence of varicella-zoster virus (VZV), herpes simplex virus type 1 (HSV-1), adenovirus (AdV) and herpes simplex virus type 2 (HSV-2) in patients suspected for ocular infections. Patients included in the study exhibited various clinical manifestations indicative of ocular pathology, such as infectious keratitis, corneal scar, endogenous endophthalmitis, panuveitis, endothelitis, stromal edema, and other relevant conditions. Four different types of tear fluid, corneal samples epithelium, aqueous humor and vitreous humor were taken. After genome extraction, multiplex real-time PCR was used for diagnosis of viruses. 48 (29.6%) out of the total of 162 (100%) eye specimen were positive. The dominant prevalence was VZV (12.3%) and HSV-1 (11.7%) followed by AdV (4.9%) and HSV-2 (0.6%). There were 4 (8.3%) coinfections within the samples (HSV-1 and VZV). Aqueous humor samples demonstrated superior virus detection ability and our only HSV-2 positive sample was from aqueous humor. The utilization of multiplex real-time PCR assays in differential diagnosis of VK holds promise for expeditious diagnoses while also preventing unwarranted antibiotic prescriptions. Moreover, the aqueous humor appears to be a more sensitive site for detecting viral keratitis.

摘要

病毒性角膜炎(VK)对个人和社会的影响是显著的。早期诊断和治疗对于有效管理病毒性角膜炎至关重要。及时使用抗病毒药物和支持性治疗可以帮助减轻感染的严重程度并改善视力结果。我们检查了疑似眼部感染患者中水痘带状疱疹病毒(VZV)、单纯疱疹病毒 1 型(HSV-1)、腺病毒(AdV)和单纯疱疹病毒 2 型(HSV-2)的流行情况。研究纳入的患者表现出各种提示眼部病变的临床表现,如感染性角膜炎、角膜瘢痕、内源性眼内炎、全葡萄膜炎、内皮炎、基质水肿和其他相关情况。采集了 4 种不同类型的泪液、角膜上皮样本、房水和玻璃体液。基因组提取后,采用多重实时 PCR 进行病毒诊断。在总共 162 份(100%)眼部标本中,有 48 份(29.6%)为阳性。优势流行的病毒是 VZV(12.3%)和 HSV-1(11.7%),其次是 AdV(4.9%)和 HSV-2(0.6%)。在样本中存在 4 种(8.3%)混合感染(HSV-1 和 VZV)。房水样本具有更高的病毒检测能力,我们唯一的 HSV-2 阳性样本来自房水。多重实时 PCR 检测在 VK 的鉴别诊断中具有快速诊断的潜力,同时还可以防止不必要的抗生素处方。此外,房水似乎是检测病毒性角膜炎的更敏感部位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b87/11297968/56e95763c1ab/41598_2024_68171_Fig1_HTML.jpg

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