结核病是一种严重危害人类健康的传染病，快速准确地诊断结核病对于控制疫情和治疗患者至关重要。传统的结核病诊断方法往往耗时较长，且需要专业的实验室设备和技术人员，这在一些医疗资源有限的地区是一个很大的挑战。近期，科学家们带来了好消息。Youngquist等人开发了一种名为“管中实验室”的检测方法，并搭配了便携式设备，能够在1小时内从血液或呼吸道样本中特异性地检测出导致结核病的结核分枝杆菌（Mtb）。这个神奇的“管中实验室”其实就是一个可消耗的样本管，里面装有经过优化的用于样本处理和分析的试剂。而与之配套的便携式设备则集成了样本孵育、数据采集和结果分析等模块。这种检测方法具有广泛的应用场景。它既可以支持基于血清的儿童肺结核和肺外结核的诊断和治疗监测，也能用于成人呼吸道样本的分析。此外，它还能检测出对利福平耐药的结核分枝杆菌变异菌株。与现有的诊断技术相比，“管中实验室”检测系统具有更高的灵敏度和良好的特异性。这意味着它能够更准确地检测出结核病患者，大大提高了在现场即时诊断结核病的能力，有望为全球结核病的防控带来新的突破。

期刊

Science Translational Medicine

标题

Rapid tuberculosis diagnosis from respiratory or blood samples by a low cost, portable lab-in-tube assay

作者

BRADY M. YOUNGQUIST, JULIAN SALIBA, YELIM KIM, THOMAS J. CUTRO, CHRISTOPHER J. LYON, JUAN OLIVO, NGAN HA, JANELLE FINE, REBECCA COLMAN, CARLOS VERGARA, JAMES ROBINSON, SYLVIA LACOURSE, RICHARD S. GARFEIN, DONALD G. CATANZARO, CHRISTOPH LANGE, EDDY PEREZ-THEN, EDWARD A. GRAVISS, CHARLES D. MITCHELL, TIMOTHY RODWELL, BO NING, TONY Y. HU

摘要

Point-of-care diagnosis of Mycobacterium tuberculosis (Mtb), the pathogen that causes tuberculosis (TB), is a critical public health need. Here, Youngquist et al. developed a lab-in-tube assay paired with a portable device to specifically detect Mtb in blood or respiratory samples within 1 hour. The consumable sample tube contains the reagents optimized for sample processing and analysis, and the device has integrated modules for sample incubation, data acquisition, and analysis of results. The assay supported serum-based TB diagnosis and treatment monitoring in children with pulmonary and extrapulmonary TB and in respiratory sample analysis from adults. The assay was also adapted to detect a rifampin-resistant variant Mtb strain. The lab-in-tube assay system achieved superior sensitivity compared with existing diagnostic techniques with good specificity, demonstrating its potential to improve TB diagnosis in point-of-care settings. —Molly Ogle

原文链接

https://www.science.org/doi/10.1126/scitranslmed.adp6411

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