Abebaw Desalegn, Akelew Yibeltal, Adugna Adane, Teffera Zigale Hibstu, Belew Habtamu, Selabat Bantegzie, Getie Molla, Mulu Anemut Tilahun, Atnaf Aytenew
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Markos University, 269, Debre Markos, Ethiopia.
Department of Medicine, Centre for Inflammatory Diseases, Monash University, Clayton, VIC, 3168, Australia.
Eur J Med Res. 2024 Dec 23;29(1):612. doi: 10.1186/s40001-024-02221-8.
Antibiotic resistance (AMR) remains a global public health threat with a high burden in sub-Saharan countries. The overuse of antimicrobials in the clinical setting is the main factor for the spread of antibiotic resistance. Diagnostic uncertainty in differentiating between bacterial and viral infections is the major contributor to antimicrobial overuse. The available biomarkers lack specificity in guiding clinicians to make antibiotic decisions and only estimate bacterial infection.
Myxovirus resistance (Mx) proteins are a type of interferon (IFN)-inducible protein that belongs to the dynamin superfamily of large guanine triphosphates (GTPases) involved in broad antiviral responses. Myxovirus resistance protein A (MxA) is a host-derived biomarker with antiviral properties against various viruses. It is induced by IFN I and IFN III as part of the innate immune response. Its basal level is < 15 ng/ml and elevated levels are detectable 1-2 h after IFN induction and remain detectable in serum up to 10 days after viral infection. Increased levels in the blood are associated with viral infection and remain low during bacterial infections. This biomarker showed promising performance in diagnosing undifferentiated febrile patients with respiratory tract infections. In this review, we discuss the role of Mx proteins, specifically MxA, in diagnosing acute viral infections, including how they are induced and their potential as diagnostic tools.
A comprehensive electronic search was conducted in Scopus and Medline (using the PubMed interface) regarding myxovirus resistance protein A as a biomarker for acute viral infection. In the search strategy, English language was used without date restriction. Manual search was also performed when appropriate.
Elevated MxA combined with other biomarkers, such as CRP and PCT, is a promising tool for identifying patients with viral infections. Therefore, incorporating MxA in the existing point of care formats help to improve the antibiotic stewardship programs and future randomized controlled trials are recommended to evaluate its utility in medical practice.
抗生素耐药性（AMR）仍然是全球公共卫生威胁，在撒哈拉以南国家负担沉重。临床环境中抗菌药物的过度使用是抗生素耐药性传播的主要因素。区分细菌和病毒感染时的诊断不确定性是抗菌药物过度使用的主要原因。现有的生物标志物在指导临床医生做出抗生素决策方面缺乏特异性，仅能估计细菌感染情况。
黏液病毒抗性（Mx）蛋白是一种干扰素（IFN）诱导蛋白，属于参与广泛抗病毒反应的大GTP酶（鸟苷三磷酸酶）动力蛋白超家族。黏液病毒抗性蛋白A（MxA）是一种具有抗病毒特性的宿主来源生物标志物，可抵抗多种病毒。它作为先天免疫反应的一部分，由I型干扰素和III型干扰素诱导产生。其基础水平低于15纳克/毫升，IFN诱导后1 - 2小时可检测到水平升高，病毒感染后10天内血清中仍可检测到。血液中水平升高与病毒感染有关，在细菌感染期间保持较低水平。这种生物标志物在诊断未分化的呼吸道感染发热患者方面表现出良好的性能。在本综述中，我们讨论了Mx蛋白，特别是MxA在诊断急性病毒感染中的作用，包括它们如何被诱导以及作为诊断工具的潜力。
在Scopus和Medline（使用PubMed界面）中进行了全面的电子搜索，以查找黏液病毒抗性蛋白A作为急性病毒感染生物标志物的相关内容。在搜索策略中，使用英语且无日期限制。必要时也进行了手动搜索。
升高的MxA与其他生物标志物，如CRP和PCT相结合，是识别病毒感染患者的有前景的工具。因此，将MxA纳入现有的即时检测形式有助于改善抗生素管理计划，建议未来进行随机对照试验以评估其在医疗实践中的效用。
