Molecular diagnosis

分子诊断
  • 文章类型: Journal Article
    来自105只山羊的肠系膜淋巴结(MSLNs)和回盲瓣(ICV)的样本,包括61个未接种疫苗和44个接种疫苗的鸟分枝杆菌副结核亚种(MAP),在屠宰时从确认有副结核病(PTB)病史的农场收集。这些山羊有亚临床感染。MSLN的PTB相容性病变,ICV固有层(LP),和Peyer的补丁(PPs)分别进行分级。此外,使用Ziehl-Neelsen染色(ZN)定量抗酸杆菌的负荷,通过免疫组织化学(IHC)的MAP抗原,和MAPDNA通过PCR靶向IS900序列。在39%的山羊中发现了与PTB相容的总体病变,31.72%接种疫苗(V)和68.29%未接种疫苗(nV)。在58%的动物中观察到组织病理学损伤诱导的MAP,36.07%接种疫苗,63.93%未接种疫苗。纳入组织病理学作为诊断工具导致MSLN的诊断病例增加28%,ICV的诊断病例增加86.05%。伴有中央矿化和坏死的IV级肉芽肿是MSLNs中最常见的病变。在ICV中,轻度肉芽肿性肠炎以多灶性上皮样巨噬细胞灶为主,在PP中比在LP中更频繁地发生。此外,在MSLN中注意到接种和未接种的山羊之间存在组织病理学病变的统计学差异,ICVLP,和ICVPPs。未接种疫苗的动物在ZN中显示出更高的阳性率,IHC,和PCR测试,强调抗MAP疫苗在减少靶器官PTB病变和细菌负荷方面的益处。我们的发现强调了将总体和组织病理学评估与各种实验室技术相结合的必要性,以对接种和未接种亚临床疾病的山羊进行PTB的准确形态学和病因诊断。然而,需要进一步的研究来完善山羊亚临床PTB的采样方案,以提高诊断工具的一致性.
    Samples from the mesenteric lymph nodes (MS LNs) and ileocecal valves (ICV) of 105 goats, comprising 61 non-vaccinated and 44 vaccinated against Mycobacterium avium subspecies paratuberculosis (MAP), were collected at slaughter from a farm with a confirmed history of paratuberculosis (PTB). These goats had subclinical infections. PTB-compatible lesions in the MS LNs, ICV lamina propria (LP), and Peyer\'s patches (PPs) were graded separately. Furthermore, the load of acid-fast bacilli was quantified using Ziehl-Neelsen staining (ZN), MAP antigens by immunohistochemistry (IHC), and MAP DNA by PCR targeting the IS900 sequence. Gross PTB-compatible lesions were found in 39% of the goats, with 31.72% vaccinated (V) and 68.29% non-vaccinated (nV). Histopathological lesions induced MAP were observed in 58% of the animals, with 36.07% vaccinated and 63.93% non-vaccinated. The inclusion of histopathology as a diagnostic tool led to a 28% increase in diagnosed cases in MS LNs and 86.05% in ICV. Grade IV granulomas with central mineralization and necrosis were the most common lesions in MS LNs. In the ICV, mild granulomatous enteritis with multifocal foci of epithelioid macrophages was predominant, occurring more frequently in the PPs than in the LP. Furthermore, statistical differences in the presence of histopathological lesions between vaccinated and non-vaccinated goats were noted in MS LNs, ICV LPs, and ICV PPs. Non-vaccinated animals showed higher positivity rates in ZN, IHC, and PCR tests, underscoring the benefits of anti-MAP vaccination in reducing PTB lesions and bacterial load in target organs. Our findings emphasize the necessity of integrating gross and histopathological assessments with various laboratory techniques for accurate morphological and etiological diagnosis of PTB in both vaccinated and non-vaccinated goats with subclinical disease. However, further studies are required to refine sampling protocols for subclinical PTB in goats to enhance the consistency of diagnostic tools.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    分支肾(BOR)和分支耳(BO)综合征的特征是影响耳朵的异常,常伴有听力损失,以及支气管弓和肾脏系统的异常。这些综合征表现出广泛的表型和复杂的基因组景观,EYA1基因和SIX基因家族的重要贡献,包括SIX1和SIX5。由于它们不同的表型表现,可以与其他遗传综合征重叠,分子遗传学确认至关重要。随着测序技术的进步,全基因组测序(WGS)越来越多地用于罕见疾病诊断.我们使用逐步方法探索了23个不相关的韩国家庭的基因组景观,这些家庭具有典型或非典型的BOR/BO综合征:靶向组测序和外显子组测序(步骤1),多重连接依赖性探针扩增(MLPA)与拷贝数变异筛选(步骤2),和WGS(步骤3)。将WGS集成到我们的诊断管道中检测到的结构变化,包括隐秘倒位和复杂的基因组重排,最终将诊断率提高到91%。我们的发现扩展了BOR/BO综合征的基因组结构,并强调了WGS解决临床异质性罕见疾病的遗传诊断的必要性。
    Branchio-oto-renal (BOR) and branchio-otic (BO) syndromes are characterized by anomalies affecting the ears, often accompanied by hearing loss, as well as abnormalities in the branchial arches and renal system. These syndromes exhibit a broad spectrum of phenotypes and a complex genomic landscape, with significant contributions from the EYA1 gene and the SIX gene family, including SIX1 and SIX5. Due to their diverse phenotypic presentations, which can overlap with other genetic syndromes, molecular genetic confirmation is essential. As sequencing technologies advance, whole-genome sequencing (WGS) is increasingly used in rare disease diagnostics. We explored the genomic landscape of 23 unrelated Korean families with typical or atypical BOR/BO syndrome using a stepwise approach: targeted panel sequencing and exome sequencing (Step 1), multiplex ligation-dependent probe amplification (MLPA) with copy number variation screening (Step 2), and WGS (Step 3). Integrating WGS into our diagnostic pipeline detected structure variations, including cryptic inversion and complex genomic rearrangement, eventually enhancing the diagnostic yield to 91%. Our findings expand the genomic architecture of BOR/BO syndrome and highlight the need for WGS to address the genetic diagnosis of clinically heterogeneous rare diseases.
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  • 文章类型: Journal Article
    美国热带地区的季节性热带干旱森林(SDTFs)是一个高度多样化但鲜为人知的濒危生态系统,从墨西哥北部到阿根廷南部。STDFs的一个植物区系元素是Magoniella属(Polygonaceae),其中包括两种藤本植物,laurifolia和M.obidensis,这些水果有翼,从哥斯达黎加分发到巴西南部。在2015年对哥伦比亚加勒比海SDTF的实地考察中,发现了形态上独特的Magoniella个体。在这项研究中,我们调查了Magoniella内部的物种边界,并确定了这些形态上独特的个体在Triplaridae部落中的系统发育位置。我们汇总了这两个物种的19个标本的形态特征数据,并产生了新测序的obidensis核质体DNA数据。形态计量学分析显示,与obidensis相比,哥伦比亚加勒比海地区的个体在果实长度和花被大小上存在显着差异。非冲突核和质体数据集的最大似然分析将哥伦比亚加勒比海个体作为M.obidensis的姐妹,并提供了最大的统计支持。此外,核核糖体ITS和lfy2i基因座的成对序列比较始终显示15点突变(10个转换,5个颠换)和6个2bp长的替换,在M.obidensis和哥伦比亚加勒比海个体之间存在差异。因此,我们的形态学和分子证据表明,Magoniella的哥伦比亚加勒比海个体代表了与laurifolia和obidensis不同的种群,我们将其描述和说明为一个新物种,M.Chersina.此外,我们提供了蓝藻和奥比纳氏菌的最新命名。这项研究强调了在记录和命名植物多样性方面结合形态和分子证据的力量。
    Seasonally tropical dry forests (SDTFs) in the American tropics are a highly diverse yet poorly understood and endangered ecosystem scattered from Northern Mexico to Southern Argentina. One floristic element of the STDFs is the genus Magoniella (Polygonaceae), which includes two liana species, M. laurifolia and M. obidensis, which have winged fruits and are distributed from Costa Rica to Southern Brazil. In a field expedition to the SDTFs of the Colombian Caribbean in 2015, morphologically distinctive individuals of Magoniella were found. In this study, we investigated the species boundaries within Magoniella and determined the phylogenetic position of these morphologically distinctive individuals in the tribe Triplaridae. We compiled morphological trait data across 19 specimens of both species and produced newly sequenced nuclear-plastid DNA data for M. obidensis. Morphometric analyses revealed significant differences in fruit length and perianth size among individuals from the Colombian Caribbean compared to M. obidensis and bract length when compared to M. laurifolia. Maximum likelihood analysis of non-conflicting nuclear and plastid datasets placed the Colombian Caribbean individuals as sister to M. obidensis with maximum statistical support. Additionally, pairwise sequence comparisons of the nuclear ribosomal ITS and the lfy2i loci consistently showed 15-point mutations (10 transitions, five transversions) and six 2 bp-long substitutions that differ between M. obidensis and the Colombian Caribbean individuals. Our morphological and molecular evidence thus suggests that the Colombian Caribbean individuals of Magoniella represent a divergent population from M. laurifolia and M. obidensis, which we describe and illustrate as a new species, M. chersina. Additionally, we provide nomenclatural updates for M. laurifolia and M. obidensis. This study highlights the power of combining morphological and molecular evidence in documenting and naming plant diversity.
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  • 文章类型: Journal Article
    环介导等温扩增(LAMP)是一种新型的核酸检测方法,以其等温特性而闻名。效率高,灵敏度,和特异性。LAMP使用4至6个引物靶向所需序列的6至8个区域,允许在60和65°C之间的温度下扩增,并且在一小时内产生多达109个拷贝。该产品可以通过各种方法监测,如比浊法,荧光法,和比色法。然而,它面临着一些限制,例如非特异性扩增的风险,底漆设计中的挑战,不适合短基因序列,和多路复用的困难。聚合酶和引物设计的最新进展提高了LAMP反应的速度和便利性。此外,将LAMP与滚环放大(RCA)等技术相结合,重组酶聚合酶扩增(RPA),CRISPR-Cas系统提高了效率。LAMP与各种生物传感器的结合实现了实时分析,扩大其在即时测试(POCT)中的应用。微流体技术进一步促进了LAMP分析的自动化和小型化,允许同时检测多个目标并防止污染。这篇评论强调了LAMP的进步,专注于底漆设计,聚合酶工程,以及它与其他技术的集成。LAMP与互补技术的持续改进和集成显著增强了其诊断能力,使其成为快速的强大工具,敏感,和特定的核酸检测,对医疗保健有前途的影响,农业,和环境监测。
    Loop-mediated isothermal amplification (LAMP) is a novel method for nucleic acid detection known for its isothermal properties, high efficiency, sensitivity, and specificity. LAMP employs 4 to 6 primers targeting 6 to 8 regions of the desired sequence, allowing for amplification at temperatures between 60 and 65°C and the production of up to 109 copies within a single hour. The product can be monitored by various methods such as turbidimetry, fluorometry, and colorimetry. However, it faces limitations such as the risk of non-specific amplification, challenges in primer design, unsuitability for short gene sequences, and difficulty in multiplexing. Recent advancements in polymerase and primer design have enhanced the speed and convenience of the LAMP reaction. Additionally, integrating LAMP with technologies like rolling circle amplification (RCA), recombinase polymerase amplification (RPA), and CRISPR-Cas systems has enhanced its efficiency. The combination of LAMP with various biosensors has enabled real-time analysis, broadening its application in point-of-care testing (POCT). Microfluidic technology has further facilitated the automation and miniaturization of LAMP assays, allowing for the simultaneous detection of multiple targets and preventing contamination. This review highlights advancements in LAMP, focusing on primer design, polymerase engineering, and its integration with other technologies. Continuous improvements and integration of LAMP with complementary technologies have significantly enhanced its diagnostic capabilities, making it a robust tool for rapid, sensitive, and specific nucleic acid detection with promising implications for healthcare, agriculture, and environmental monitoring.
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  • 文章类型: Journal Article
    背景:印记障碍是由印记基因表达改变引起的罕见疾病,表现出通过差异DNA甲基化调节的亲本起源特异性表达模式。印迹障碍患者的一个亚组在多个印迹基因座处具有DNA甲基化变化,一种被称为多基因座印记干扰(MLID)的条件。MLID在大多数但不是所有的印记障碍中被识别,并且在具有非典型临床特征的个体中也被发现;MLID的存在经常改变受影响的人的管理或预后。一些MLID病例是由反式作用遗传变异引起的,通常不是在病人身上,而是在他们的母亲身上,具有咨询意义。目前对MLID的定义没有共识,临床适应症提示测试,表观遗传和遗传诊断的分子程序和方法,实验室报告的建议,咨询的考虑,以及对预后和管理的影响。因此,这项研究的目的是涵盖这一尚未满足的需求。
    方法:进行了全面的文献检索,鉴定了100多篇文章,这些文章构成了两个工作组的讨论基础,重点是临床诊断(n=12名成员)和分子检测(n=19名成员)。经过八个月的准备和定期的在线讨论,来自11个国家的专家汇编了初步文件,并确定了在面对面会议上需要解决的问题,专家们和四名患者倡导组织的代表出席了会议。
    结果:根据现有证据和专家共识,我们制定了16项建议和8项建议,作为MLID临床和分子诊断的中期指导.
    结论:MLID是一种分子名称,对于MLID和非典型表型的患者,我们提出了替代术语多位点印记综合征。由于MLID的内在可变性,该指南强调了让各个领域的专家参与以确保自信的诊断方法的重要性,咨询,和关心。作者倡导全球,在基础研究和转化研究方面的合作努力,以解决目前缺乏答案的许多关键问题,并建议在未来3-5年内重新召开会议,以评估研究进展,并根据需要更新本指南。
    BACKGROUND: Imprinting disorders are rare diseases resulting from altered expression of imprinted genes, which exhibit parent-of-origin-specific expression patterns regulated through differential DNA methylation. A subgroup of patients with imprinting disorders have DNA methylation changes at multiple imprinted loci, a condition referred to as multi-locus imprinting disturbance (MLID). MLID is recognised in most but not all imprinting disorders and is also found in individuals with atypical clinical features; the presence of MLID often alters the management or prognosis of the affected person. Some cases of MLID are caused by trans-acting genetic variants, frequently not in the patients but their mothers, which have counselling implications. There is currently no consensus on the definition of MLID, clinical indications prompting testing, molecular procedures and methods for epigenetic and genetic diagnosis, recommendations for laboratory reporting, considerations for counselling, and implications for prognosis and management. The purpose of this study is thus to cover this unmet need.
    METHODS: A comprehensive literature search was conducted resulting in identification of more than 100 articles which formed the basis of discussions by two working groups focusing on clinical diagnosis (n = 12 members) and molecular testing (n = 19 members). Following eight months of preparations and regular online discussions, the experts from 11 countries compiled the preliminary documentation and determined the questions to be addressed during a face-to-face meeting which was held with the attendance of the experts together with four representatives of patient advocacy organisations.
    RESULTS: In light of available evidence and expert consensus, we formulated 16 propositions and 8 recommendations as interim guidance for the clinical and molecular diagnosis of MLID.
    CONCLUSIONS: MLID is a molecular designation, and for patients with MLID and atypical phenotypes, we propose the alternative term multi-locus imprinting syndrome. Due to the intrinsic variability of MLID, the guidelines underscore the importance of involving experts from various fields to ensure a confident approach to diagnosis, counselling, and care. The authors advocate for global, collaborative efforts in both basic and translational research to tackle numerous crucial questions that currently lack answers, and suggest reconvening within the next 3-5 years to evaluate the research advancements and update this guidance as needed.
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  • 文章类型: Journal Article
    核桃和榛子共过敏是临床实践中的常见表现,其分子基础尚不清楚。为此,在对一种或两种树坚果过敏并对其2S白蛋白敏感的20名患者中评估了核桃-榛子的交叉反应性。免疫印迹分析表明,85%的患者识别Jugr1,核桃2S白蛋白,这与严重症状的发展有关;其中50%共同识别榛子2S白蛋白,或14。使用色谱技术分离两种过敏原。抑制ELISA显示Jugr1强烈抑制Cor14特异性IgE的结合,但Cora14仅部分抑制Jugr1特异性IgE结合。我们的结果表明,对核桃/榛子2S白蛋白敏感的患者不是同质人群。有患者对核桃2S白蛋白的特异性表位敏感,有患者对核桃和榛子之间的交叉反应表位敏感,水罐r1是主要的敏化剂。
    Walnut and hazelnut coallergy is a frequent manifestation in clinical practice whose molecular basis remains unclear. For this purpose, walnut-hazelnut cross-reactivity was evaluated in 20 patients allergic to one or both tree nuts and sensitized to their 2S albumins. Immunoblotting assays showed that 85% of patients recognized Jug r 1, walnut 2S albumin, which was associated with the development of severe symptoms; 50% of them corecognized hazelnut 2S albumin, Cor a 14. Both allergens were isolated using chromatographic techniques. Inhibition ELISAs revealed that Jug r 1 strongly inhibited the binding of Cor a 14-specific IgE, but Cor a 14 only partially inhibited Jug r 1-specific IgE binding. Our results showed that patients sensitized to walnut/hazelnut 2S albumins were not a homogeneous population. There were patients sensitized to specific epitopes of walnut 2S albumins and patients sensitized to cross-reactive epitopes between walnut and hazelnut, with Jug r 1 being the primary sensitizer.
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  • 文章类型: Journal Article
    我们于2019年至2021年在NegrardiValpolicella的IRCCSSacroCuoreDonCalabria医院进行了一项前瞻性队列研究,以调查T.whipplei定植的持续时间。此外,持续殖民与起源大陆之间的相关性,目前的治疗方案,临床表现,和寄生虫共感染进行了评估。该队列包括在先前研究(2014-2016年)中进行测试并发现粪便样本中的T.whippleiDNA呈阳性的受试者。在2019年至2021年之间,有33名受试者参加了一项前瞻性研究。粪便,唾液,尿液,在基线和12个月后收集血液。病史,目前的治疗,并记录症状。其中,25%显示持续的肠道或口腔定植,50%的人在两次访问中都没有殖民,25%有间歇性定殖。在持续的T.whipplei定殖和受试者起源大陆之间没有发现关联,目前的治疗方案,最初的临床表现,和寄生虫共感染。持续的T.whipplei肠定植的最长持续时间超过6年,有11名受试者表现出持续三年以上的积极性,包括1个未成年人。我们的研究受到缺乏菌株特异性鉴定的限制。从家庭暴露中再感染,或者被新菌株感染。需要更大的前瞻性研究来进一步探索这种持久性的影响,并确定影响定殖持续时间及其潜在健康影响的关键因素。
    We conducted a prospective cohort study at the IRCCS Sacro Cuore Don Calabria Hospital in Negrar di Valpolicella from 2019 to 2021 to investigate the duration of T. whipplei colonization. In addition, the correlation between persistent colonization and the continent of origin, current treatment regimen, clinical manifestations, and parasite coinfection was evaluated. The cohort included subjects who were tested in a previous study (years 2014-2016) and found to be positive for T. whipplei DNA in fecal samples. Thirty-three subjects were enrolled in a prospective study between 2019 and 2021. Feces, saliva, urine, and blood were collected at baseline and after 12 months. Medical history, current treatment, and symptoms were recorded. Among them, 25% showed persistent intestinal or oral colonization, 50% had no colonization at both visits, and 25% had intermittent colonization. No association was found between persistent T. whipplei colonization and subjects\' continent of origin, current treatment regimen, initial clinical manifestations, and parasite coinfection. The longest duration of persistent T. whipplei intestinal colonization exceeded six years, with 11 subjects presenting persistent positivity for more than three years, including 1 minor. Our research was limited by the lack of a strain-specific identification of T. whipplei that made it impossible to distinguish between persistence of the same T. whipplei strain, reinfection from household exposure, or infection by a new strain. Larger prospective studies are needed to further explore the implications of this persistence and determine the key factors influencing the duration of colonization and its potential health impacts.
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  • 文章类型: Journal Article
    利什曼病是一组被忽视的疾病,具有重大的公共卫生问题,巴西是这种疾病在美洲的主要焦点。Sobral市,在塞阿拉州,是人类和狗内脏利什曼病的历史焦点,而是利什曼原虫的数据.猫的感染是有限的。在2021年4月至2022年2月之间,对转诊医院人群中的205只猫进行了采样和检测,以检测利什曼原虫。通过实时PCR。八只猫(3.9%;95%CI:1.7-7.5%)检测呈阳性。其中,三个(37.5%)显示与猫利什曼病相符的临床体征。与定居的猫相比,非定居的猫显示出明显更高的阳性(Fisher精确检验,P=0.0124)。考虑到它们作为婴儿乳杆菌的潜在作用,进行进一步的研究以了解利什曼原虫属至关重要。在Sobral的猫中循环,并在利什曼尼酶的这一重要重点中实施减少其暴露于phlebotomine沙蝇媒介的措施。
    Leishmaniases are a group of neglected diseases of significant public health concern, with Brazil being the primary focus of this disease in the Americas. The municipality of Sobral, in the state of Ceará, is a historical focus of visceral leishmaniasis in both humans and dogs, but data on Leishmania spp. infections in cats are limited. Between April 2021 and February 2022, 205 cats from a referral hospital population were sampled and tested for Leishmania spp. by real-time PCR. Eight cats (3.9%; 95% CI: 1.7-7.5%) tested positive. Among these, three (37.5%) displayed clinical signs compatible with feline leishmaniosis. Non-domiciled cats showed significantly higher positivity compared to domiciled ones (Fisher\'s exact test, P = 0.0124). Considering their potential role as reservoirs of L. infantum, it is crucial to conduct further studies to understand the Leishmania spp. circulating among cats in Sobral and to implement measures for reducing their exposure to phlebotomine sand fly vectors in this important focus of leishmaniases.
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