Metody oparte na amplifikacji kwasów nukleinowych w diagnostyce wybranych chorób przenoszonych drogą płciową


Nucleic acid amplification methods in laboratory diagnostics of selected sexually transmitted diseases
B. Młynarczyk-Bonikowska, E. Skulska, M. Malejczyk, S. Majewski

1. Wstęp. 2. Metoda PCR i jej modyfikacje, które znalazły zastosowanie w diagnostyce STI. 3. Opryszczka narządów płciowych. 4. Zakażenia genitalnymi HPV. 5. Rzeżączka. 6. Zakażenia Chlamydia trachomatis. 7. Kiła. 8. Równoczesne wykrywanie kilku patogenów. 9. Podsumowanie

Abstract: Sexually transmitted diseases (STDs) are common in the world’s human population and are often asymptomatic. On the other hand, STDs are highly infective and connected with considerable morbidity and mortality. Therefore, using fast, sensitive and specific diagnostic methods is especially important. Polymerase chain reaction – PCR, invented thirty years ago by the Nobel prize winner Carry Mullis, revolutionized many fields of biological sciences, including laboratory diagnostics of infectious diseases. In this review, we discuss the application of nucleic acid amplification techniques (NAATs), including PCR, multiplex PCR, real time PCR and HDA-helicase dependent amplification, in the laboratory diagnostics of sexually transmitted diseases. Nucleic acids amplification tests are widely used in diagnostics of some STD-like genital herpes, Chlamydia trachomatis infection and gonorrhoea. In other diseases, like genital HPV infections, NAATs are used only in some indications. In the case of syphilis, there are no commercial tests and it was proven that NAATs are not sensitive and specific enough to be used routinely as a substitute to serologic methods. We compare NAATs with some other methods used in laboratory diagnostics of individual diseases, like serology, culture or direct immunofluorescence. In addition, we discuss limitations of the NAATs i.e. problems with their specificity in diagnostics of pharyngeal gonorrhoea. We also present the recommendations of the Centers for Disease Control and Prevention (CDC) and International Union Against Sexually Transmitted Diseases (IUSTI).

1. Introduction. 2. PCR method and its modifications which can be applied in diagnostics of STIs. 3. Genital herpes. 4. Infections with genital HPVs. 5. Gonorrhoea. 6. Chlamydia trachomatis infections. 7. Syphilis. 8. Simultaneous detection of several pathogens. 9. Summary