Schmidt N J
Med Clin North Am. 1983 Sep;67(5):953-72. doi: 10.1016/s0025-7125(16)31161-0.
There has been much interest and activity in the development of techniques for rapid viral diagnosis which would allow successful intervention in the treatment of patients or their contacts or in the control of viral diseases in the community. The greatest emphasis has been on techniques that permit viral detection directly in the clinical specimen, since these avoid the need to cultivate the agent, are feasible for detection of viruses that cannot be cultivated, and can detect virus in specimens in which the agent is no longer infectious. Direct methods used for viral detection include electron microscopy and various immunoassays which are based on demonstrating reactivity of viral antigen in the specimen with known viral antisera. The use of immunoassays for more rapid identification of viruses isolated in laboratory host systems and for selective detection of viral antigen in inoculated cell cultures even before the agents produce an observable effect has been an important advance in viral diagnosis by the approach of isolation and identification. The reliability of all specific viral identification procedures depends on the use of high quality viral antisera. Some of the problems previously encountered in preparing satisfactory viral immune reagents are being overcome through the availability of highly specific monoclonal antibodies produced by cell hybridization techniques. Virus-specific IgM antibody assays for rapid diagnosis have been improved greatly through the use of a "capture" technique in which antibody to the human mu chain is used in the solid phase to separate IgM from other serum components which might compete with IgM antibody or give nonspecific reactivity, and also through the availability of highly specific monoclonal antibodies to the human mu chain. A variety of simple assays for determination of viral antibody status have been developed, and many are commercially available. The reliability of some of these antibody assays has been improved through the incorporation of more suitable controls and through better definition of interpretations which should be made from test results.
在快速病毒诊断技术的开发方面，人们投入了大量的关注并开展了诸多活动，这些技术将有助于成功干预患者及其接触者的治疗，或控制社区中的病毒性疾病。目前最为关注的是能够直接在临床标本中检测病毒的技术，因为这些技术无需培养病原体，对于无法培养的病毒检测可行，并且能够在病原体不再具有传染性的标本中检测到病毒。用于病毒检测的直接方法包括电子显微镜检查和各种免疫测定法，这些方法基于证明标本中的病毒抗原与已知病毒抗血清的反应性。通过分离和鉴定的方法，使用免疫测定法在实验室宿主系统中更快速地鉴定分离出的病毒，以及在接种的细胞培养物中甚至在病原体产生可观察到的效应之前选择性地检测病毒抗原，这是病毒诊断方面的一项重要进展。所有特定病毒鉴定程序的可靠性都取决于使用高质量的病毒抗血清。通过细胞杂交技术生产的高度特异性单克隆抗体的可得性，先前在制备令人满意的病毒免疫试剂时遇到的一些问题正在得到克服。通过使用“捕获”技术，快速诊断的病毒特异性IgM抗体检测有了很大改进，在该技术中，固相使用针对人μ链的抗体将IgM与其他可能与IgM抗体竞争或产生非特异性反应的血清成分分离，并且还通过获得针对人μ链的高度特异性单克隆抗体。已经开发了多种用于确定病毒抗体状态的简单检测方法，其中许多可在市场上买到。通过纳入更合适的对照以及更明确地定义应从测试结果中做出的解释，这些抗体检测中的一些可靠性得到了提高。
