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粪类圆线虫的分子检测:新出现的因素及诊断应用

Molecular detection of Strongyloides stercoralis: Emerging factors and diagnostic utility.

作者信息

Zainol Dinie Adila, Rahumatullah Anizah, Anuar Nor Suhada, Raaj Susin

机构信息

Institute for Research in Molecular Medicine (INFORMM), University Sains Malaysia (USM), 11800 Penang, Malaysia.

Institute for Research in Molecular Medicine (INFORMM), University Sains Malaysia (USM), 11800 Penang, Malaysia.

出版信息

Clin Chim Acta. 2025 Mar 1;569:120184. doi: 10.1016/j.cca.2025.120184. Epub 2025 Feb 7.

DOI:10.1016/j.cca.2025.120184
PMID:39923908
Abstract

Strongyloides stercoralis infection, a neglected tropical disease, poses a significant public health threat, especially in immunocompromised individuals. This parasitic nematode can establish chronic infections, potentially progressing to life-threatening conditions such as hyperinfection syndrome and disseminated disease. Timely and accurate diagnosis is critical for effective treatment and the prevention of severe complications. Traditional diagnostic methods, such as stool microscopy, are limited by low sensitivity, particularly for detecting low-intensity infections. Advances in molecular diagnostics, particularly Polymerase Chain Reaction (PCR), have significantly improved sensitivity and specificity, marking a pivotal shift in detection capabilities. However, critical barriers persist, including inconsistencies in sample collection and handling, geographic variations in parasite strains, and the impact of genetic diversity on assay performance. Emerging molecular technologies, such as real-time PCR, loop-mediated isothermal amplification (LAMP), and droplet digital PCR (ddPCR) hold significant promise for further enhancing diagnostic precision. These advanced methods provide opportunities for more robust and accessible diagnostics, particularly in resource-limited settings. To maximize their potential, it is imperative to address existing challenges through the standardization of protocols, optimization of sample handling procedures, and the development of high-quality, reliable reagents. By overcoming these obstacles, molecular diagnostics can be more effectively integrated into clinical and public health frameworks, facilitating improved management and control of S. stercoralis infection, ultimately reducing the morbidity and mitigating the global burden of this neglected tropical disease.

摘要

粪类圆线虫感染是一种被忽视的热带疾病,对公共卫生构成重大威胁,尤其是在免疫功能低下的个体中。这种寄生线虫可引发慢性感染,有可能发展为危及生命的病症,如超感染综合征和播散性疾病。及时、准确的诊断对于有效治疗和预防严重并发症至关重要。传统的诊断方法,如粪便显微镜检查,存在灵敏度低的局限性,特别是在检测低强度感染时。分子诊断技术的进步,尤其是聚合酶链反应(PCR),显著提高了灵敏度和特异性,标志着检测能力的关键转变。然而,关键障碍依然存在,包括样本采集和处理的不一致性、寄生虫菌株的地理差异以及基因多样性对检测性能的影响。新兴的分子技术,如实时PCR、环介导等温扩增(LAMP)和数字液滴PCR(ddPCR),有望进一步提高诊断精度。这些先进方法为更强大、更易获得的诊断提供了机会,特别是在资源有限的环境中。为了最大限度地发挥其潜力,必须通过标准化方案、优化样本处理程序以及开发高质量、可靠的试剂来应对现有挑战。通过克服这些障碍,分子诊断可以更有效地融入临床和公共卫生框架,促进对粪类圆线虫感染的更好管理和控制,最终降低发病率,减轻这种被忽视热带疾病的全球负担。

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