THE AGENT OF BACILLARY ANGIOMATOSIS - AN APPROACH TO THE IDENTIFICATION OF UNCULTURED PATHOGENS
THE AGENT OF BACILLARY ANGIOMATOSIS - AN APPROACH TO THE IDENTIFICATION OF UNCULTURED PATHOGENS
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DOI：
10.1056/nejm199012063232301
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发表时间：
1990-12-06
影响因子：
158.5
通讯作者：
TOMPKINS, LS
中科院分区：
文献类型：
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作者：
RELMAN, DA;LOUTIT, JS;TOMPKINS, LS
工作背景：杆菌性血管瘤病是一种引起人类免疫缺陷病毒感染患者和其他免疫功能低下宿主皮肤和内脏器官小血管增生的感染性疾病。该试剂通常在Warthin-Starry染色的病变组织切片中可见，但芽孢杆菌尚未成功培养或鉴定。这种杆菌也可能导致猫抓伤病。方法：采用聚合酶链反应（PCR）技术对该菌进行鉴定.我们使用与真细菌16 S核糖体RNA基因互补的寡核苷酸引物直接从杆菌性血管瘤病的组织样本中扩增16 S核糖体基因片段。确定这些片段的DNA序列，并分析与其他已知生物的系统发育相关性。平行研究正常组织。结果：从三个不相关的杆菌性血管瘤病患者的组织产生了一个独特的16 S基因序列。从第四例杆菌性血管瘤病患者中获得的序列与其他三例患者中发现的序列仅在241个碱基位置中的4个处不同。正常组织中未检测到相关的16 S基因片段。这些与杆菌性血管瘤病相关的16 S序列属于以前未表征的微生物，与Rochalimaea quintana关系最密切。结论：杆菌性血管瘤病的病因是一种以前未发现的立克次体样微生物，与立克次体密切相关。quintana。这种鉴定未培养病原体的方法可能适用于其他原因不明的传染病。
Background: Bacillary angiomatosis is an infectious disease causing proliferation of small blood vessels in the skin and visceral organs of patients with human immunodeficiency virus infection and other immunocompromised hosts. The agent is often visualized in tissue sections of lesions with Warthin-Starry staining, but the bacillus has not been successfully cultured or identified. This bacillus may also cause cat scratch disease. Methods: In attempting to identify this organism, we used the polymerase chain reaction. We used oligonucleotide primers complementary to the 16S ribosomal RNA genes of eubacteria to amplify 16S ribosomal gene fragments directly from tissue samples of bacillary angiomatosis. The DNA sequence of these fragments was determined and analyzed for phylogenetic relatedness to other known organisms. Normal tissues were studied in parallel. Results: Tissue from three unrelated patients with bacillary angiomatosis yielded a unique 16S gene sequence. A sequence obtained from a fourth patient with bacillary angiomatosis differed from the sequence found in the other three patients at only 4 of 241 base positions. No related 16S gene fragment was detected in the normal tissues. These 16S sequences associated with bacillary angiomatosis belong to a previously uncharacterized microorganism, most closely related to Rochalimaea quintana. Conclusions: The cause of bacillary angiomatosis is a previously uncharacterized rickettsia-like organism, closely related to R. quintana. This method for the identification of an uncultured pathogen may be applicable to other infectious diseases of unknown cause.