Rapid diagnosis of Naja atra snakebites
Rapid diagnosis of Naja atra snakebites
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DOI：
10.3109/15563650.2014.887725
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发表时间：
2014-03-01
影响因子：
3.3
通讯作者：
Liau, M. Y.
中科院分区：
文献类型：
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作者：
Hung, D. Z.;Lin, J. H.;Liau, M. Y.
背景。在世界许多地方，特别是在东南亚，毒蛇咬伤是公共卫生的负担，对蛇咬伤的临床诊断至关重要和必要。由于各种毒蛇的临床表现相互重叠，使毒蛇的种类难以界定或识别。需要一种快速可靠的方法来鉴定蛇的种类。本研究设计并测试了一种用于台湾眼镜蛇咬伤诊断的横向流条带系统。方法。我们研制了一种基于免疫层析法快速检测人血清中眼镜蛇毒液的试剂盒。分别以1 mg/ml鸭抗蛇毒血清和0.5 mg/ml山羊抗兔免疫球蛋白抗体溶液组成的检测系和对照系包被于硝化纤维素条上。胶体金与兔抗眼镜蛇毒液多克隆抗体结合。从2007年7月到2012年12月，我们使用该试剂盒检测蛇咬伤患者的血清，并检查我们的快速检测与目前使用的夹心酶联免疫吸附试验（ELISA）之间的一致性。结果。本试剂盒可在20分钟内检测出血清样品中的眼镜蛇毒液，检出限为5 ng/ml。与台湾其他非眼镜蛇毒液在体外无交叉反应。共有88名被蛇咬伤的患者（34名眼镜蛇和54名其他非眼镜蛇）接受了测试。ELISA检测结果的敏感性为83.3%，特异性为100%。ELISA检测结果与免疫层析条检测结果吻合较好（kappa = 0.868）。讨论和结论。提示免疫层析试纸条适用于眼镜蛇毒液的检测，可作为眼镜蛇咬伤的快速诊断工具。
Background. The clinical diagnosis of snakebites is critical and necessary in many parts of the world, especially in Southeastern Asia, where venomous snakebites are a burden on public health. It is difficult to define or recognize the species of venomous snake because of the overlapping clinical manifestations of envenomations. A quick and reliable method for identifying the snake species is necessary. We designed and tested a strip of lateral flow system for the diagnosis of cobra snake bites in Taiwan. Methods. We developed a kit based on an immunochromatographic method for rapid detection of cobra (Naja atra) venom in human serum. The test and control lines composed of 1 mg/ml polyclonal duck antivenom and 0.5 mg/ml goat anti-rabbit immunoglobulin antibody solutions, respectively, were coated on nitrocellulose strips. Colloidal gold was conjugated with rabbit polyclonal anti-cobra venom antibodies. From July 2007 to December 2012, we used the kit to test serum from snakebite patients and to examine the agreement between our rapid test and the currently used sandwich enzyme-linked immunosorbent assay (ELISA). Results. Our kit was able to detect cobra venom in serum samples in 20 minutes with a detection limit of 5 ng/ml. An absence of cross-reactivity with other non-cobra venoms from Taiwan was noted in vitro. A total of 88 snakebite patients (34 cobra and 54 other non-cobra) were tested. The sensitivity of the strips based on the ELISA results was 83.3% and the specificity was 100%. There was a strong agreement between the results of the ELISA and immunochromatographic strips (kappa = 0.868). Discussion and conclusions. This data indicates that an immunochromatographic strip might be suitable for cobra venom detection and could be used as a quick diagnostic tool in cases of N. atra snakebite.