PCR鉴别诊断间日疟及恶性疟的研究

目的 :在同一反应体系中建立能鉴别诊断间日疟与恶性疟的 PCR检测方法。方法 :根据红内期疟原虫 SSUr RNA编码基因序列 ,设计合成 3个引物 ,采用聚合酶链反应技术 ,在同一反应体系中 ,间日疟原虫和恶性疟原虫分别预期被扩增出 34 1bp和 4 31bp的 DNA条带。结果 :间日疟原虫和恶性疟原虫模板在同一反应体系中分别被扩增出预期大小的 DNA片段 ,并经限制性酶切证实 ;杜氏利什曼原虫、弓形虫、健康人血及空白对照均无特异性扩增条带 ;以该检测体系至少可检出原虫血症为 2 .56× 10 ^-7间日疟原虫感染和 1.0 8× 10 ^-5恶性疟原虫感染 ;69份镜检阳性的间日疟和 2份恶性疟患者血样 PCR检测均为阳性 ,1例发热待查患者PCR诊断为间日疟 ,与镜检复查结果一致 ,所有疟疾阳性标本中未检出混合感染 ,2 0份健康人血 PCR均为阴性。结论 :该检测体系灵敏、特异 ,对于诊断间日疟和恶性疟以及鉴别间日疟原虫和恶性疟原虫混合感染具有一定的应用价值。     

PCR检测疟疾混合感染的现场应用研究

目的 评价PCR检测技术在间日疟与恶性疟混合感染区诊断疟疾的现场应用价值。方法 采集海南省疟疾混合感染流行区304份滤纸干血滴样本，根据红内期疟原虫SSUrRNA基因序列，设计合成3条引物．采用PCR技术在同一反应体系中扩增出间日疟原虫和恶性疟原虫不同的DNA片段，检测现场所采样本中的间日疟原虫或恶性疟原虫DNA；同时与镜检法进行比较。结果 在304份样本中，PCR法阳性15份，其中间日疟7份．恶性疟8份；镜检法阳性11份，其中间日疟6份，恶性疟5份。镜检阳性的样本PCR均为阳性；镜检阴性而PCR阳性的4份样本，其扩增产物经限制性酶切鉴定，证实为间日疟原虫或恶性疟原虫DNA。结论 此PCR检测体系灵敏、特异．对诊断或鉴别诊断间日疟原虫和恶性疟原虫混合感染具有实用价值。     

PCR检测疟疾混合感染的现场应用研究

目的　评价PCR检测技术在间日疟与恶性疟混合感染区诊断疟疾的现场应用价值。　方法　采集海南省疟疾混合感染流行区 3 0 4份滤纸干血滴样本 ,根据红内期疟原虫SSUrRNA基因序列 ,设计合成 3条引物 ,采用PCR技术在同一反应体系中扩增出间日疟原虫和恶性疟原虫不同的DNA片段 ,检测现场所采样本中的间日疟原虫或恶性疟原虫DNA ;同时与镜检法进行比较。　结果　在 3 0 4份样本中 ,PCR法阳性 15份 ,其中间日疟 7份 ,恶性疟 8份 ;镜检法阳性11份 ,其中间日疟 6份 ,恶性疟 5份。镜检阳性的样本PCR均为阳性 ;镜检阴性而PCR阳性的 4份样本 ,其扩增产物经限制性酶切鉴定 ,证实为间日疟原虫或恶性疟原虫DNA。　结论　此PCR检测体系灵敏、特异 ,对诊断或鉴别诊断间日疟原虫和恶性疟原虫混合感染具有实用价值。     

疟疾复合PCR检测系统的建立

目的：建立简易、快速的复合ＰＣＲ系统,用于检测间日疟、恶性疟及混合感染。方法：以疟原虫小亚单位核糖体核糖核酸基因为靶片段,设计疟原虫属特异性上游引物Ｓ１和间日疟原虫、恶性疟原虫种特异性下游引物Ｓ２和Ｓ３,建立双温度点复合ＰＣＲ扩增系统并用于临床血样的检测。结果：从间日疟原虫和恶性疟原虫感染血样中分别扩增出７０５ｂｐ和５７５ｂｐ特定扩增带,而食蟹猴疟原虫、诺氏疟原虫及健康人血样均未见扩增带。检测原虫水平达２－１０虫／μｌ全血。限制性内切酶酶切分析证实扩增产物为目的片段。检测１０４份镜检确诊疟疾患者血样,其中８１份与镜检结果相符,并查出镜检未发现的１７份混合感染和２份虫种鉴别失误的恶性疟。结论：本系统敏感性高,特异性强,操作简便,可在一次扩增中同时检出间日疟和恶性疟两种原虫。     

复式PCR检测间日疟原虫和恶性疟原虫的现场应用

目的探讨复式PCR方法在疟疾诊断中的现场应用价值。方法根据疟原虫18 S rRNA基因序列,合成疟原虫属特异性上游引物和间日疟原虫、恶性疟原虫种特异性下游引物,优化PCR反应体系,建立在同一PCR反应体系中同时检测间日疟原虫、恶性疟原虫基因组特异性DNA片段的疟疾诊断方法,并评价其现场应用价值。结果间日疟原虫和恶性疟原虫基因组DNA经过复式PCR后,分别扩增出1 451 bp和833 bp的特异性条带,而伯氏疟原虫、食蟹猴疟原虫及健康人血样均无扩增带出现,用该反应体系可检出原虫血症为1.1×10-6和5.6×10-7的间日疟原虫和恶性疟原虫感染。与镜检法相比,复式PCR检测119份现场样本,112份与镜检结果相同,阳性率为54%,漏诊率为0.8%,误诊率为0,而镜检法依次分别为53%、1.7%和3.4%。结论复式PCR方法检测疟原虫具有简便、快速、特异、敏感等优点,在疑似病例的鉴别诊断和分子流行病学调查中具有良好的应用价值。     

间日疟原虫环子孢子蛋白基因片段的扩增应用于诊断间日疟感染的研究

根据间日疟原虫环子孢子蛋白（ＣＳＰ）基因序列，设计并合成间日疟原虫特异性引物一对，采用聚合酶链反应技术，进行间日疟原虫感染的检测。结果：（１）从间日疟原虫患者的全血ＤＮＡ中扩增出约７７２ｂｐ的基因片段，经限制性内切酶切，证实为间日疟原虫ＣＳＰ基因片段；（２）与间日疟原虫亲缘关系相近的三株恶性疟原虫、弓形虫、利什曼原虫和正常人全血核酸抽提物经扩增后均未见特异性的扩增条带；（３）该检测体系可检测出间日疟原虫感染血样中２．８虫／μｌ血的水平；（４）将该检测体系用于深圳地区及湖北随州地区间日疟感染患者血样的检测，１４７份患者的血样中１４４份检出阳性，可见一条特异性扩增带，与镜检的符合率达９８％，而２０正常人血样均为阴性。上述结果表明该法灵敏、特异且稳定性好，适用于间日疟感染的检测。     

聚合酶链反应技术与镜检法诊断间日疟的对比研究

目的　评价聚合酶链反应技术在间日疟诊断中的应用价值。　方法　根据红内期疟原虫 SSUr RNA编码基因序列 ,设计合成 1对引物 ,采用聚合酶链反应技术 ,扩增检测“四热”病人血样中间日疟原虫 DNA;同时作厚血膜镜检疟原虫。　结果　从间日疟患者血样中扩增出 341bp的 DNA片段 ,与预期的扩增片段大小相符 ,而正常人血样及空白对照无特异性条带 ;对于 2 34份“四热”病人血样 ,PCR法检出 16份阳性 ,阳性率为 6 .8% ;厚血膜镜检 13份阳性 ,阳性率为 5 .6 % ;两种方法相比差异无显著性 (P>0 .0 5 ) ;对于 3份 PCR阳性而镜检法阴性的血样 ,重新作 PCR,结果仍然为阳性。以镜检法为标准 ,PCR法的灵敏度为 10 0 % ,特异度为 98.6 %。　结论　PCR技术灵敏特异 ,可替代镜检法用于间日疟感染的临床及现场检测。     

套式PCR扩增特定SSU rRNA基因片段检测四川疟原虫感染的研究

目的用套式PCR系统诊断、鉴别人体疟原虫感染。方法以疟原虫小亚单位核糖体核糖核酸（SSUrRNA）基因为靶基因,选用1对疟原虫属特异性引物和4对种特异性引物,建立套式PCR扩增系统并用于四川省疟疾病人血样的检测。结果从间日疟原虫、恶性疟原虫和三日疟原虫感染血样中分别扩增出104bp、102bp和115bp预期大小的特定扩增带。61份血样检测结果与镜检的间日疟阳性符合率为100％。并查出镜检漏诊的2例P.v.和P.m.的混合感染及1例P.v.、P.f.和P.m.的混合感染病例。结论本系统特异、灵敏、稳定、简便,可在诊断疟疾的同时判定混合感染,故对疟疾的诊断、大规模流行病学研究及疫情监控有实际应用价值。     

套式PCR扩增特定SSUrDNA基因片段检测四川疟原虫感染的研究

目的：用套式PCR系统诊断、鉴别人体疟原虫感染。方法：以疟原虫小亚单位核糖体核糖核酸（SSUrDNA）基因为靶基因,选用1对疟原属特异性引物,建立套式PCR扩增系统并用于四川省疟疾病人血样的检测。结果：从间日疟原虫、恶性疟原虫和三日疟原虫感染血样中分别扩增出104bp,102bp和115bp预测大小的特定扩增带。61份血样检测结果与镜检的间日疟阳性符合率为100％,并查出镜检漏诊的2例P.v.和P.m.的混合感染及1例P.v.、P.F.和P.m.的混合感染病例,结论本系统特异、灵敏,稳定、简便,可在诊断疟疾的同时判定混合感染,故对疟疾的诊断,大规模流行病学研究及疫情监控有实际应用价值。     

标签引物-套式/多重PCR检测恶性疟原虫和间日疟原虫的研究

目的 建立简便、灵敏、低本底、可同时检测恶性疟原虫和间日疟原虫的套式/多重聚合酶链反应（PCR）系统。 方法 应用标签引物扩增技术、Primer Premier 5.0软件、美国生物信息中心(NCBI-BLAST)网络资源和矩阵试验法优化套式/多重PCR，检测疟疾患者滤纸血样并与镜检结果进行比较。 结果 新建立的标签引物套式/多重PCR，检测模拟现场滤纸血样的敏感性为恶性疟原虫1～2个虫/μl血，间日疟原虫5～10个虫/μl血。检测71份现场采集的镜检疟原虫阳性滤纸血样（恶性疟24份和间日疟47份）的结果与镜检结果的符合率分别为87.5%和100%。 结论 通过标签引物扩增技术优化的套式/多重PCR系统，适用于检测现场采集的滤纸血样，其检出低原虫血症的敏感性和鉴定虫种的准确性均优于镜检法，是很有潜力的疟疾诊断技术。     

巢式PCR法在疟疾检测及虫种鉴别中的应用

根据疟原虫小亚单位核糖体核糖核酸(SSU rRNA)基因序列设计疟原虫通用型和种特异性的引物,对60份血样进行巢式PCR检测及虫种鉴定,并与血样的吉氏染色镜检结果进行比较。巢式PCR检出40份疟原虫阳性血样,其中22份为恶性疟原虫(Plasmodium falciparum)阳性、13份为间日疟原虫(P.vivax)阳性、3份为恶性疟原虫和间日疟原虫混合感染、1份为卵形疟原虫阳性(P.ovale)、1份未能分型。与镜检结果一致的血样为46份,占76.7%(46/60),其中恶性疟原虫阳性18份、间日疟原虫阳性11份和阴性17份。将两种检测结果不一致的血样进行扩增片段序列测定和实时荧光PCR分析,检测结果均与巢式PCR结果一致。卵形疟原虫阳性血样扩增片段的序列分析结果显示,该序列与卵形疟原虫SSU rRNA基因序列(GenBank登录号DQ845247)的对应部分同源性为100%,证实该病例为输入性卵形疟原虫感染病例。     

Application of real-time polymerase chain reaction (PCR) analysis for detection and discrimination of malaria parasite species in Thai patients

A TaqMan real-time PCR system was used to detect and discriminate the 4 species of human malaria parasites in clinical blood samples. A 150-base pair (bp) region of the small subunit ribosomal RNA (SSU rRNA) gene of each malaria parasite, including species-specific sequences to be detected by TaqMan probe, was used as a target for PCR analysis. The PCR method used universal primers and species-specific TaqMan probes for Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. The detection threshold for the method, as determined with serial dilution of cultured P. falciparum-infected erythrocytes, was 5 parasite-infected erythrocytes per reaction. Fifty blood samples of falciparum malaria and a second set of 50 samples of vivax malaria, diagnosed by microscopic examination at the Hospital for Tropical Diseases, Mahidol University, Thailand, were analyzed by real-time PCR. In the 50 samples of microscopically-diagnosed falciparum malaria, 40 were regarded as P. falciparum single infection, 7 were P. falciparum and P. vivax mixed infections, and 3 were P. vivax single infection by real-time PCR. In the second set of 50 samples of microscopically diagnosed vivax malaria, all were considered P. vivax single infection by PCR. Neither P. ovale nor P. malariae infection was identified in the 100 blood samples. Real-time PCR analysis was shown to be more sensitive and accurate than routine diagnostic methods. Application and extension of the PCR method reported here will provide a powerful tool for further studies of malaria.     

1例国内罕见的输入性卵形疟的实验室检测

目的对1例输入性疑似疟疾患者的血样进行实验室检测。方法制备疑似疟疾患者血样的血涂片,吉姆萨染色后进行疟原虫的镜检观察。利用实验室自行研制的疟原虫属特异性（通用型）和4种疟原虫种特异性的巢式PCR和实时荧光PCR检测方法,对该血样进行疟疾检测及分型。将PCR扩增片段进行序列测定,并与已知的卵形疟序列进行blast比对分析。结合血样的分子生物学检测结果,重新对镜检结果进行复核。结果血样初次镜检为疟疾阴性。使用疟原虫巢式PCR通用引物对血样的DNA进行PCR检测,扩增出了预期大小约240bp的条带;巢式PCR分型检测表明,血样仅扩增出预期大小约450bp的卵形疟条带,无对应大小的恶性疟、间日疟和三日疟扩增条带产生。疟原虫通用型和卵形疟特异性的荧光PCR检测结果均为典型的S形阳性曲线,卵形疟扩增片段的熔解温度为72.5℃。序列分析表明,扩增片段长度为434bp,blast比对发现去除引物后的393个碱基与GenBank DQ845247等卵形疟的SSU rRNA对应部分的基因序列同源性为100%。重新对血涂片进行镜检复核,结果在薄血膜中发现了卵形疟的环状滋养体,被寄生的红细胞为椭圆形,边缘呈伞矢状。结论使用巢式PCR、实时荧光PCR、序列分析和镜检等方法,证实该例输入性的疑似疟疾患者为卵形疟原虫感染。     

Malaria epidemiology in low-endemicity areas of the Atlantic Forest in the Vale do Ribeira, São Paulo, Brazil

We describe a seroepidemiological survey of malaria prevalence in two areas of low endemicity: Intervales State Park and Alto Ribeira State Tourist Park (PETAR). Both are located in the Vale do Ribeira in the state of S?o Paulo, Brazil. In this study, 318 subjects from both areas had their blood analyzed for the presence of malaria parasites by thin and thick blood smears. One hundred and sixty-three (51.2%) of the subjects were from Intervales State Park and 155 (48.7%) were from PETAR. We analyzed all the samples by indirect immunofluorescent assay (IFA) to detect antibodies against asexual forms of Plasmodium vivax and Plasmodium malariae and enzyme immunosorbent assay (ELISA) to detect the presence of antibodies against circumsporozoite proteins (CSP) from P. vivax VK210, human P. vivax-like/Plasmodium simiovale, P. vivax VK247 and Plasmodium brasilianum/P. malariae. The presence of Plasmodium species was detected by polymerase chain reaction (PCR). Eighteen of the subjects analyzed had positive IFA results for IgM against P. malariae antigens, and three others were positive for P. vivax antigens. Positivity of IgG antibodies against P. vivax detected by IFA was high in samples from both Intervales State Park and PETAR (32.0% and 49.0%, respectively), while positivity for P. malariae was lower (16.0% and 19.3% in Intervales State Park and PETAR, respectively). ELISA tests showed a higher prevalence of antibodies against P. vivax VK210 (35.0%) in samples from Intervales State Park and against human P. vivax-like (29.7%) in samples from PETAR. PCR reactions revealed the presence of parasites in several of the samples analyzed. In Intervales State Park, one subject was infected by P. malariae and two by Plasmodium falciparum, while in PETAR, one subject was positive for P. falciparum and three for both P. falciparum and P. vivax parasites. The areas where these parks are located belong to the Atlantic Forest habitat, and inhabitants frequently, see monkeys. Our data suggest that monkeys may constitute a natural reservoir for malaria in both areas.     

套式PCR检测蚊体内疟原虫的敏感性与特异性

目的：分析套式聚合酶链反应技术检测蚊体内疟原虫的敏感性与特异性。方法：采用２对针对间日疟原虫小亚单位核糖体核糖核酸基因（ＳＳＵｒＤＮＡ）的特异引物，利用套式ＰＣＲ技术，从蚊体ＤＮＡ样本中，扩增间日疟原虫ＳＳＵｒＤＮＡ片段，进行间日疟原虫的检测。结果：扩增产物经琼脂糖凝胶电泳分析，可见扩增出特异的约１２１ｂｐ大小的ＤＮＡ片段，估测每份蚊虫ＤＮＡ样本中含有３个以上子孢子或１００只蚊中含有１只阳性蚊即可得此片段，而对恶性疟原虫、食蟹猴疟原虫、约氏疟原虫及正常蚊虫ＤＮＡ不能扩增出此片段。结论：此法具有高度的敏感性和特异性。     

聚合酶链反应（PCR）技术在恶性疟诊断中的应用

应用聚合酶链反应（ＰＣＲ）检测云南疟疾病人血样５３份，结果均为阳性，可出现一条４９２ｂｐ的特异条带，与镜检符合率达１００％；同时检测间日疟血样８份及上海正常人血样１２份，均为阴性，表明本法具有高敏感性及特异性。     

Amplification of LDH gene from indian strains of Plasmodium vivax

BACKGROUND & OBJECTIVES: Plasmodium vivax is geographically widespread and responsible for > 50% of malaria cases in India. Increased drug resistance of the parasite highlights the immediate requirement of early and accurate diagnosis as well as new therapeutics. In view of this, the present study was undertaken to amplify P. vivax (Indian strains) lactate dehydrogenase gene (PvLDH) which has been identified as a good target for antimalarials as well as diagnostics. METHODS: P. vivax infected clinical blood samples were collected from southern part of India and were tested with established diagnostic parameters (ICT, Giemsa staining). Total DNA was extracted from blood samples and subjected to PCR using two sets of primers, one for the amplification of full PvLDH gene (951 bp) and the other for a partial PvLDH gene fragment (422bp), covering a variable antigenic region (140aa) as compared to other plasmodial species. RESULTS & CONCLUSION: PCRs for both the full and partial gene targets were optimised and found to be consistent when tested on several P. vivax positive clinical samples. In addition, full gene PCR was found to specifically detect only P. vivax DNA and could be used as a specific molecular diagnostic tool. These amplified products can be cloned and expressed as a recombinant protein that might be useful for the development and screening of antimalarials as well as for diagnostic purposes.