Use of DNA amplification methods for clinical diagnosis in autoimmune diseases.
Use of DNA amplification methods for clinical diagnosis in autoimmune diseases.
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使用 DNA 扩增方法进行自身免疫性疾病的临床诊断。
DOI：
10.1002/jcla.1860030611
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发表时间：
1989
影响因子：
2.7
通讯作者：
Saito,I
中科院分区：
文献类型：
--
作者：
Fox,RI;Dotan,I;Compton,T;Fei,HM;Hamer,M;Saito,I
自身免疫性疾病通常被认为是遗传和环境因素相互作用的结果。近年来，在利用重组DNA方法分析特定遗传因子和感染因子方面取得了重大进展。然而，需要新的技术，更快速，更便宜，适合于在疾病过程中早期获得的小组织活检。最近报道了基于聚合酶链反应（PCR）和Qβ-复制酶（QβR）的DNA扩增新方法。这些方法进行了简要的审查，并提出他们的潜在应用与自身免疫性疾病的患者。可以考虑几种类型的应用，包括检测：a）特异性HLA-D等位基因，以预测预后并更好地利用现有药物; B）关节抽吸物或滑膜活检中的细菌、真菌和螺旋体感染; c）人类免疫缺陷病毒（HIV）和其他病毒（例如，d）通过确定单克隆基因重排、核型改变或癌基因激活，血液或组织中的肿瘤转化。常规临床实验室可能很快将开始实施DNA扩增方法，以筛查血液制品中的传染性病原体（特别是HIV和B肝炎病毒）。由于这些技术将是现成的，风湿病学家/临床免疫学家应该开始制定策略，使他们能够以具有成本效益的方式使用这些方法进行诊断和监测治疗。
Autoimmune disease is generally felt to result from the interaction of genetic and environmental factors. In recent years, significant advances have been made in using recombinant DNA methods to analyze specific genetic factors and infectious agents. However, new techniques are needed that are more rapid, inexpensive, and suitable for small tissue biopsies obtained early in the course of disease. New methods of DNA amplificaiton based on polymerase chain reaction (PCR) and Qβ‐replicase (QβR) have recently been reported. These methods are briefly reviewed, and their potntial applications to patients with autoimmune disease are presented. Several types of applications can be considered, including detection of: a) specific HLA‐D alleles in order to predict prognosis and better utilize existing medications; b) bacterial, fungal, and spirochete infections in joint aspirates or synovial biopsies; c) human immunodeficiency virus (HIV) and other viruses (e.g., EBV, CMV) that may be associated with immune dysregulation in certain patients; and d) neoplastic transformation in blood or tissues by determining monoclonal gene rearrangements, karyotypic alterations or oncogene activation.It is likely that routine clinical laboratories will soon begin implementing DNA amplification methods in order to screen blood products for infectious agents (especially HIV and hepatitis B virus). Because these techniques will be readily available, rheumatologists/clinical immunologists should begin developing strategies that will allow them to use these methods in a cost‐effective manner for diagnosis and monitoring treatment.