苍白密螺旋体实验诊断研究新进展  

Advances in Laboratory Diagnosis of Treponema Pallidum

作　　者：闵彦 刘丹[2] MIN Yan;LIU Dan(Department of Laboratory Medicine,the 960th Hospital of PLA,Ji'nan 250031,China;Department of Immunology and Pathogenic Biology,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]解放军960医院检验科,山东济南250031 [2]上海中医药大学免疫学与病原生物学教研室,上海201203

出　　处：《药物生物技术》2021年第3期319-322,共4页Pharmaceutical Biotechnology

摘　　要：梅毒是由苍白密螺旋体(Treponema pallidum,TP)引起的性传播疾病。苍白密螺旋体的实验诊断对于梅毒的确诊具有重要意义。文章对苍白密螺旋体传统实验诊断技术以及苍白密螺旋体分子诊断技术的发展进行了概述。常规PCR(Polymerase chain reaction,PCR)技术、实时定量PCR技术对一期梅毒皮损分泌物检测具有较好的敏感性和特异性。巢式PCR技术(Nested polymerase chain reaction,nested PCR)对二期梅毒、隐性梅毒以及神经梅毒病人唾液标本检测发现,唾液可以作为梅毒诊断的体液标志物,并用于评估梅毒治疗效果。巢式PCR技术对一期、二期梅毒全血中TP-DNA的敏感性也较高。巢式实时PCR技术(Nested and real-time PCR,NR-PCR)对神经梅毒患者耳垂血标本的检测阳性率明显比全血标本的阳性率高。环状等温测序技术(Loop-mediated isothermal amplification,LAMP)适用于不发达地区梅毒分子诊断的发展。性传播疾病质谱技术(Sexually transmitted infection-mass spectrometry,STI-MS)在梅毒的筛查和流性病学调查中具有巨大潜力。以上技术的发展将对特殊人群,比如TP/HIV合并感染患者、神经梅毒患者以及梅毒母婴垂直传播的实验诊断和研究,提供一定的理论和实验依据。Syphilis is a sexually transmitted disease caused by Treponema pallidum(TP).Laboratory detection of Treponema pallidum plays an important role in syphilis diagnosis in the appropriate clinical context.Traditional laboratory diagnosis methods and the molecular diagnosis methods of TP were reviewed in this article.The sensitivity and specificity of routine polymerase chain reaction(PCR)and real-time PCR could be superior in the detection of chancre secretions for the early stage of syphilis.TP-Deoxyribonucleic acid(TP-DNA)detection rate in saliva by nested PCR indicated that saliva could not only be used as diagnostic fluid for syphilis,but also an indicator of therapeutic effectiveness in secondary syphilis,latent syphilis and symptomatic neurosyphilis.Nested PCR was also a sensitive method for detecting whole blood TP-DNA and was especially useful for detecting early syphilis including primary syphilis and secondary syphilis.For neurosyphilis patients,significantly more earlobe blood samples tested positive than did wholeblood samples by nested and real-time PCR(NR-PCR).A loop-mediated isothermal amplification(LAMP)assay was used for the development of TP molecular diagnosis in underdeveloped areas.Sexually transmitted infection-mass spectrometry(STI-MS)was a useful high-throughput screening tool for detecting mixed infections of STIs and had great potential for application in large-scale epidemiological programs for specific microorganisms of STI.This review provides a perspective to help researchers address the clinical diagnosis of TP/HIV coinfection,neurosyphilis and mother-to-child transmission of syphilis.

关 键 词：苍白密螺旋体 梅毒 分子诊断 实验诊断 PCR 环介导等温测序技术 传染病质谱技术 

分 类 号：R377.1[医药卫生—病原生物学]