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马传染病的诊断与预防:现状、潜力及未来挑战

Diagnosis and prevention of equine infectious diseases: present status, potential, and challenges for the future.

作者信息

Desmettre P

机构信息

Merial, Lyon, France.

出版信息

Adv Vet Med. 1999;41:359-77. doi: 10.1016/s0065-3519(99)80027-5.

Abstract

The frequent transfers of horses, whether on a permanent or temporary basis, make strict control of infectious diseases essential. Such control needs a reliable and rapid means to accurately diagnose the relevant diseases. Indirect diagnosis based on antibody detection remains certainly the best method to secure the epidemiologic surveillance of the diseases at regional, national, or even world level, while direct diagnosis is the only way to diagnose a new outbreak. New diagnostic methods resulting from advances in biochemistry, molecular biology, and immunology are now available. As far as antibody detection is concerned, the new methods are mainly based on immunoassays, especially ELISAs. Regarding the identification of the pathogens, while isolation is still of importance, much progress has been made with immunocapture tests including capture ELISA based on monoclonal antibodies. DNA probes and amplification tests such as PCR or RT-PCR are representing a real breakthrough. Factors common to all of these tests are specificity, sensitivity, rapid implementation, and quick results. Such tests are, however, often still at the development stage. They absolutely need to be validated under multicentric evaluations prior to being used on a larger scale. At the same time there is an obvious need for the standardization of the reagents used. The technical and economic impact of a false (either positive or negative) diagnosis justifies such an harmonization which could effectively be achieved worldwide under the aegis of the Office International des Epizooties (OIE), which is itself the primary source of disease information. Vaccines are also essential for the control of equine infectious diseases. Most vaccines used in the prevention of viral or bacterial diseases are inactivated adjuvanted vaccines, which may cause unacceptable side effects. Also, their efficacy can sometimes be questioned. Subunit vaccines, when available, represent significant advances especially with regards to safety. Greater progress is expected from the use of new technologies taking advantage of recent developments in molecular biology (recombinant DNA technology) and in immunology (immunomodulators). Significant results have been obtained with subunit vaccines or with live vectored vaccines using recombinant DNA technology. Good results are on the way to be achieved with genetic (or naked-DNA) vaccines. It is therefore possible to expect the availability of a new generation of vaccines in the rather short term. Such vaccines will not only be safer and more efficacious, but they will also make it possible to differentiate vaccinated from infected animals, which will contribute to better control of the infection. Whatever the quality of the vaccines of the future may be, vaccination alone will never be sufficient to control infectious diseases. It is therefore essential to keep on making the animal owners and their veterinarians aware of the importance of the management and the hygiene in the diseases control and to organize them under "Common Codes of Practice."

摘要

马匹的频繁转移,无论其为永久性还是临时性,都使得严格控制传染病至关重要。这种控制需要一种可靠且快速的手段来准确诊断相关疾病。基于抗体检测的间接诊断无疑仍是在区域、国家乃至世界层面确保对这些疾病进行流行病学监测的最佳方法,而直接诊断则是诊断新疫情爆发的唯一途径。如今,基于生物化学、分子生物学和免疫学进展的新诊断方法已可供使用。就抗体检测而言,新方法主要基于免疫测定,尤其是酶联免疫吸附测定(ELISA)。关于病原体的鉴定,虽然分离仍然很重要,但在免疫捕获试验方面已取得了很大进展,包括基于单克隆抗体的捕获ELISA。DNA探针以及诸如聚合酶链反应(PCR)或逆转录PCR(RT-PCR)等扩增试验代表了真正的突破。所有这些检测共有的因素是特异性、敏感性、实施快速以及结果迅速。然而,这些检测往往仍处于开发阶段。在大规模使用之前,它们绝对需要在多中心评估下进行验证。与此同时,显然需要对所使用的试剂进行标准化。错误(无论是阳性还是阴性)诊断所产生的技术和经济影响证明了这种协调的合理性,在国际兽疫局(OIE)的支持下,这种协调可以在全球范围内有效实现,而国际兽疫局本身就是疾病信息的主要来源。疫苗对于控制马传染病也至关重要。大多数用于预防病毒或细菌疾病的疫苗是灭活佐剂疫苗,这可能会引起不可接受的副作用。此外,它们的效力有时也会受到质疑。亚单位疫苗在有可用的情况下代表了重大进展,尤其是在安全性方面。利用分子生物学(重组DNA技术)和免疫学(免疫调节剂)的最新发展所采用的新技术有望取得更大进展。使用重组DNA技术的亚单位疫苗或活载体疫苗已取得了显著成果。基因(或裸DNA)疫苗也即将取得良好效果。因此,有望在相当短的时间内获得新一代疫苗。此类疫苗不仅将更安全、更有效,而且还将使区分接种疫苗的动物和感染动物成为可能,这将有助于更好地控制感染。无论未来疫苗的质量如何,仅靠疫苗接种永远不足以控制传染病。因此,必须不断让动物主人及其兽医认识到管理和卫生在疾病控制中的重要性,并根据“通用操作规范”对他们进行组织。

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