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中国生物工程杂志

CHINA BIOTECHNOLOGY
中国生物工程杂志
中国生物工程杂志  2022, Vol. 42 Issue (9): 50-57    DOI: 10.13523/j.cb.2204057
综述     
分子即时检测(POCT)技术及其在新发传染病中的应用*
郭彦彤1,2,刘仲明1,张海燕1,**(),张宝2,**()
1.中国人民解放军南部战区总医院 广州 510010
2.南方医科大学公共卫生学院 广东省热带病研究重点实验室BSL-3实验室(广东) 广州 510515
Molecular Diagnostic POCT Technology and Its Application in Emerging Infectious Diseases
GUO Yan-tong1,2,LIU Zhong-ming1,ZHANG Hai-yan1,**(),ZHANG Bao2,**()
1. PLA Southern Theater Command General Hospital, Guangzhou 510010, China
2. BSL-3 Laboratory(Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research,School of Public Health, Southern Medical University, Guangzhou 510515, China
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摘要：

分子即时检测(point-of-care testing,POCT)技术具有灵敏度高、分析速度快、体积小、检测成本低廉等特点,在分子诊断领域受到广泛关注。近年来,分子POCT技术的发展与应用在应对新发、突发传染病,保护人类生命健康方面具有重大意义。介绍近五年来新兴的分子POCT技术,总结新兴分子POCT技术的最新研究进展及应用前景,分析POCT技术的优势与面临的挑战,探讨提高其检测灵敏度和选择性的技术策略。
关键词： POCT;  分子诊断;  新发传染病;  生物安全    
Abstract:

The development and application of molecular point-of-care (POCT) technology has been noticed in recent years because of its high sensitivity, fast analysis speed, small size, and low detection cost. The development and application of molecular POCT technology is of great significance for protecting human life and health and coping with the threat of emerging and sudden infectious diseases. In this paper, several emerging molecular POCT technologies in the past five years, focusing on describing the latest research progress, and their application prospects were introduced. The advantages and challenges of molecular POCT were discussed, as well as the technical strategies to improve its detection sensitivity and selectivity.
Key words: Point-of-care testing (POCT)    Molecular diagnostics    Emerging infectious diseases    Biosafety
收稿日期: 2022-04-22 出版日期: 2022-10-10
ZTFLH:  R446  
基金资助: * 军队生物安全研究专项(19SWAQ24);军队实验动物专项(SYDW[2020]18)
通讯作者: 张海燕,张宝     E-mail: zhanghaiyan1998@126.com;zhang20051005@126.com
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引用本文:

郭彦彤,刘仲明,张海燕,张宝. 分子即时检测(POCT)技术及其在新发传染病中的应用*[J]. 中国生物工程杂志, 2022, 42(9): 50-57.

GUO Yan-tong,LIU Zhong-ming,ZHANG Hai-yan,ZHANG Bao. Molecular Diagnostic POCT Technology and Its Application in Emerging Infectious Diseases. China Biotechnology, 2022, 42(9): 50-57.

链接本文:

https://manu60.magtech.com.cn/biotech/CN/10.13523/j.cb.2204057    或    https://manu60.magtech.com.cn/biotech/CN/Y2022/V42/I9/50

图1  i-Genbox的原理[9]
图2  基于纸质BPE的ECL miRNA-155检测生物传感器的制备[16]
图3  可穿戴设备的分层组装[21]
图4  用于埃博拉病毒检测的自动化CRISPR微流体芯片[24]
图5  过滤辅助磁流体血液-PCR反应[25]
设备 种类 制造商 病原体 评价 来源
GeneXpert 微型PCR仪 Cepheid SARS-CoV-2 敏感度与特异度均为100%,检出限为250 copies/mL,反应耗时120 min [31]
FilmArray® RP2.1 微型PCR仪 BioFire SARS-CoV-2 与RT-qPCR的检测结果一致性很高,检出限为50 copies/mL,反应耗时60 min [32]
AGS8830 微型PCR仪 杭州安誉 SARS-CoV-2 无需核酸提取,检出限为500 copies/mL,反应耗时40 min [33]
Cobas Liat 气压式微流体设备 Roche SARS-CoV-2 与RT-qPCR的检测结果一致性为98.6%,反应耗时20 min [34]
GenePOC Carba 微流体设备 Meridian Bioscience 产碳青霉烯酶
的肠杆菌		 无需核酸提取,总敏感度为100%,高于XpertCarba-R的96.4%, 反应耗时70 min [35]
ID NOW INAA设备 Abbott SARS-CoV-2 与RT-qPCR相比敏感度为85.1%,特异度为99.7%,阳性预测值和阴性预测值分别为88.5%和99.6%,反应耗时5~13 min [36]
Alere i INAA设备 Alere 甲流/乙流病毒 与多重RT-PCR相比,甲/乙流敏感度为97.7% 和96.3%,特异度均为100%,耗时15 min [37]
表1  用于病原体检测的商业分子POCT设备
技术名称 检测对象 样品用量
/μL		 评价 来源
基于智能手机的RT-LAMP反应POCT SARS-CoV-2 RNA 20 免核酸提取,反应耗时30 min,测试结果与传统RT-PCR仪结果一致 [38]
基于智能手机的超级三明治电化学生物传感器(纳米金颗粒标记的捕获探针+Au@SCX8-RGO-TB纳米材料) SARS-CoV-2 RNA 10 需要核酸提取,实现了对各种临床咽拭子样本中SARS-CoV-2样本的灵敏、准确、快速检测,阳性检出率为88.2%,而RT-qPCR法为70.59% [39]
基于3D打印的便携POCT仪器 ZIKV RNA 100 RNA自动提取由3D打印机完成,整个ZIKV检测在27~30 min内完成 [40]
基于LAMP的手驱动微流体芯片 沙门氏菌DNA 2 一种手指驱动DNA提取,荧光成像肉眼可视,快速便捷的POCT检测平台 [41]
基于LAMP的微流体芯片 疱疹病毒DNA 200 需要DNA提取,反应耗时30 min左右 [42]
转化纳米粒子的侧向流动检测(upconversion nanoparticle-based lateral flowassays, UCNP-LFAs) 乙肝病毒DNA 200 需要核酸提取,智能手机作为阅读器,检测核酸的荧光强度低于金标准 [43]
柔性纳米株电化学传感器 沙门氏菌DNA 200 针对食源性疾病病原体,需核酸提取,提供便携、低成本、可靠的POCT检测平台 [44]
基于智能手机平台LFA检测 SARS-CoV-2 RNA 140 免RNA提取,智能手机进行控制、数据处理与分析 [45]
基于LAMP的纳米放大比色法 SARS-CoV-2 RNA 4 免RNA提取,检测的准确性、敏感度和特异度分别大于98.4%、96.6%和100% [46]
螺旋环介导等温扩增(helical loop mediated isothermal amplification,HAMP) MERS RNA 2 需RNA提取,反应耗时75 min,采用羟基纳普特霍尔蓝(hydroxy naphthol blue,HNB)作为染色指标进行视觉分析 [47]
逆转录绝热等温PCR 登革热病毒 RNA 5 需核酸提取,一种快速、特异、灵敏的POCT检测系统,可用于登革热病毒感染的常规诊断 [48]
重组酶聚合酶扩增反应 EBOV RNA 10 检测耗时20 min,以PT-PCR为金标准,检测EBOV的敏感度为97%,特异度为97% [49]
表2  分子POCT诊断在新发传染病中的应用实例
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