聚合酶链反应测试在南美锥虫病研究中的用途

Norma Bautista-Lopez, M. Ndao
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摘要

聚合酶链式反应(PCR)检验是一种高度灵敏、特异和快速的恰加斯病诊断工具。恰加斯病是由原生鞭毛虫恰加斯原虫(Trypanosoma cruzi)引起的,是美洲的地方病。虽然传统的血清学方法仍被用于恰加斯病的诊断,但已逐渐被 PCR 等分子方法所取代。PCR 可以检测人和动物血液或组织样本中的寄生虫 DNA,包括无症状感染和动物储库。在一项对新世界猴群进行的研究中,发现 PCR 分析在锥虫感染方面优于传统筛查工具,但仍可能出现假阴性结果。在临床研究中,PCR 被用于评估尼福霉素和苯并咪唑治疗急性和慢性恰加斯病患者的效果。然而,由于外周血中存在低度和间歇性寄生虫血症,即使在没有治疗的情况下也是如此,因此 PCR 并不可靠,无法用于评估治疗是否成功。基于这一限制因素以及其他因素,我们认为在临床和临床前研究中,PCR 并不适合作为南美锥虫病的金标准检测方法。其他诊断方法,如血清学和生物标志物检测,应与 PCR 技术结合使用,以更准确地诊断恰加斯病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Usefulness of polymerase chain reaction tests in Chagas disease studies
The Polymerase Chain Reaction (PCR) test is a highly sensitive, specific, and rapid diagnostic tool for Chagas disease. Chagas disease is caused by the protozoan flagellate Trypanosoma cruzi and is endemic to the Americas. While conventional serological methods are still used in the diagnosis of Chagas disease, they are being gradually replaced by molecular methods like PCR. PCR can detect the parasite’s DNA in blood or tissue samples from humans and animals, including asymptomatic infections and animal reservoirs. In a study conducted on a colony of New World monkeys, PCR analysis was found to be superior to conventional screening tools for trypanosome infection, although false negatives can still occur. In clinical studies, PCR has been used to assess the effectiveness of Nifurtimox and Benznidazole in treating acute and chronic Chagas patients. However, the presence of low-grade and intermittent parasitemia in peripheral blood, even in the absence of treatment, renders PCR an unreliable test for evaluating successful treatment. Based on this limiting factor, among others, we do not believe that PCR is an appropriate gold standard test for Chagas in clinical and preclinical studies. Other diagnostic methods, such as serological and biomarker tests, should be used in conjunction with PCR techniques for more accurate diagnosis of Chagas.
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