Presence of Viral Nucleic Acids in the Middle Ear Acute Otitis Media Pathogen or Bystander?
Presence of Viral Nucleic Acids in the Middle Ear Acute Otitis Media Pathogen or Bystander?
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DOI：
10.1097/inf.0b013e318241afe4
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发表时间：
2012-04-01
影响因子：
3.6
通讯作者：
Hendley, J. Owen
中科院分区：
文献类型：
--
作者：
Chonmaitree, Tasnee;Ruohola, Aino;Hendley, J. Owen
病毒在急性中耳炎(AOM)的发病机制中起着重要作用，在没有病原菌的情况下，活病毒可引起AOM。AOM病原体的检测一般依赖于中耳液的细菌培养。当采用病毒培养并在AOM患儿的中耳液中检测到活病毒时，病毒被普遍认为是AOM的病原体。由于病毒培养不敏感，不能检测呼吸道病毒的全面谱，聚合酶链式反应分析通常用于检测中耳液中的病毒核酸。虽然聚合酶链式反应分析大大提高了病毒的检测率，但由于同时检测多种病毒的核酸，并且在高比例的无症状儿童中重复检测特定病毒的核酸，因此在中耳检测病毒核酸的意义出现了新的问题。本文首先回顾了活病毒在AOM中的作用，并提出了中耳病毒核酸代表AOM病原体或旁观者状态的点对点论点。虽然有证据支持这两个方向，但对数据的解释和未来的研究方向提出了有用的信息。
Viruses play an important role in acute otitis media (AOM) pathogenesis, and live viruses may cause AOM in the absence of pathogenic bacteria. Detection of AOM pathogens generally relies on bacterial culture of middle ear fluid. When viral culture is used and live viruses are detected in the middle ear fluid of children with AOM, the viruses are generally accepted as AOM pathogens. Because viral culture is not sensitive and does not detect the comprehensive spectrum of respiratory viruses, polymerase chain reaction assays are commonly used to detect viral nucleic acids in the middle ear fluid. Although polymerase chain reaction assays have greatly increased the viral detection rate, new questions arise on the significance of viral nucleic acids detected in the middle ear because nucleic acids of multiple viruses are detected simultaneously, and nucleic acids of specific viruses are detected repeatedly and in a high proportion of asymptomatic children. This article first reviews the role of live viruses in AOM and presents the point-counterpoint arguments on whether viral nucleic acids in the middle ear represent an AOM pathogen or a bystander status. Although there is evidence to support both directions, helpful information for interpretation of the data and future research direction is outlined.