Eizuru Y
Division of Persistent & Oncogenic Viruses, Faculty of Medicine, Kagoshima University.
Rinsho Byori. 1994 Dec;42(12):1234-9.
Cytomegalovirus (CMV) is a ubiquitous pathogen and causes a variety of clinical manifestations from unapparent to fatal infections. Of these variable CMV infections, intrauterine infection and infections in immunocompromised hosts are severe and often fatal. CMV infection has been diagnosed by isolation of virus and detection of more than 4-fold increase in anti-CMV antibody titer and/or CMV-specific IgM. These retrospective diagnoses, however, are not compatible to the requirement of clinical side after the appearance of anti-CMV drug, ganciclovir. The appearance of ganciclovir requires the rapid diagnosis of CMV infection which is useful for the treatment of patient. The application of monoclonal antibody and polymerase chain reaction (PCR) to CMV diagnosis made it possible to satisfy the requirement of clinical side. We developed direct immunoperoxidase method using the Fab of a monoclonal antibody against an immediate-early antigen of CMV-infected cells. Using this method, CMV infection is diagnosed within 24 hours after the collection of clinical specimens. PCR is also useful for rapid diagnosis of CMV infection. In addition, PCR can detect virus DNA sequences in cerebrospinal fluid where CMV is seldom isolated even in AIDS patients with CMV encephalitis.
巨细胞病毒（CMV）是一种普遍存在的病原体，可导致从隐匿性感染到致命性感染的多种临床表现。在这些不同的CMV感染中，宫内感染和免疫功能低下宿主的感染较为严重，且往往是致命的。CMV感染的诊断过去是通过病毒分离以及抗CMV抗体滴度和/或CMV特异性IgM升高4倍以上来进行的。然而，这些回顾性诊断不符合抗CMV药物更昔洛韦出现后临床方面的要求。更昔洛韦的出现需要对CMV感染进行快速诊断，这对患者的治疗很有用。单克隆抗体和聚合酶链反应（PCR）应用于CMV诊断，使得满足临床方面的要求成为可能。我们开发了一种直接免疫过氧化物酶方法，使用针对CMV感染细胞早期抗原的单克隆抗体的Fab片段。使用这种方法，在采集临床标本后24小时内即可诊断CMV感染。PCR对CMV感染的快速诊断也很有用。此外，PCR可以检测脑脊液中的病毒DNA序列，即使在患有CMV脑炎的艾滋病患者中，CMV也很少能从脑脊液中分离出来。
