PDF(Pubmed)
Abstract：
Diphtheria toxin (DT) is the main virulence factor of Corynebacterium diphtheriae, C. ulcerans and C. pseudotuberculosis. Moreover, new Corynebacterium species with the potential to produce diphtheria toxin have also been described. Therefore, the detection of the toxin is the most important test in the microbiological diagnosis of diphtheria and other corynebacteria infections. Since the first demonstration in 1888 that DT is a major virulence factor of C. diphtheriae, responsible for the systemic manifestation of the disease, various methods for DT detection have been developed, but the diagnostic usefulness of most of them has not been confirmed on a sufficiently large group of samples. Despite substantial progress in the science and diagnostics of infectious diseases, the Elek test is still the basic recommended diagnostic test for DT detection. The challenge here is the poor availability of an antitoxin and declining experience even in reference laboratories due to the low prevalence of diphtheria in developed countries. However, recent and very promising assays have been developed with the potential for use as rapid point-of-care testing (POCT), such as ICS and LFIA for toxin detection, LAMP for tox gene detection, and biosensors for both.
摘要：
白喉毒素(DT)是白喉棒杆菌的主要毒力因子,溃疡和假结核。此外，还描述了具有产生白喉毒素潜力的新棒状杆菌物种。因此,毒素的检测是白喉和其他棒状杆菌感染的微生物学诊断中最重要的测试。自从1888年首次证明DT是白喉梭菌的主要毒力因子以来，负责疾病的全身表现，已经开发了各种DT检测方法，但是它们中的大多数的诊断有用性尚未在足够大的样本组上得到证实。尽管在传染病的科学和诊断方面取得了重大进展，Elek测试仍然是DT检测的基本推荐诊断测试。这里的挑战是，由于发达国家白喉的患病率较低，即使在参考实验室中，抗毒素的可用性也很差，并且经验也在下降。然而,最近和非常有前途的测定已经开发出来，有可能用作快速即时检测（POCT），如用于毒素检测的ICS和LFIA，用于毒性基因检测的LAMP，和生物传感器。
