细环病毒从实验室到临床

细环病毒：从实验室到临床Torquetenovirus:￿the￿human￿virome￿from￿bench￿to￿bedsideTorquetenovirus:￿the￿human￿virome￿from￿bench￿to￿bedside D. Focosi et al. Clinical Microbiology and Infection 22 (2016) 589-593TTV: Transfusion transmitted virus or TorquetenovirusFrom torques and tenuis, Latin for ‘necklace’ and ‘thin,’ respectively输血后肝炎（肝中病毒载量是血中的输血后肝炎（肝中病毒载量是血中的10-100倍，并且与血清倍，并且与血清ALT升高相关）升高相关）【【现已否定现已否定该结论该结论】】Human viromeat least 29 major species细环病毒：首个被发现的单链环状细环病毒：首个被发现的单链环状DNA病毒病毒TTV prevalence >95% in most cases independent of age, socioeconomic standing and health conditions来源：来源：胎盘、呼吸道、输血胎盘、呼吸道、输血分布：分布：T淋巴细胞淋巴细胞现有临床应用：现有临床应用：•TTV as a Marker of Anthropic Pollution•TTV as a Marker of Immune StatusOrphan virus~孤儿病毒（非病原性病毒）孤儿病毒（非病原性病毒）检测水源是否被污染：检测水源是否被污染：•现有方法为检测细菌，但是很容易出现假阳性现有方法为检测细菌，但是很容易出现假阳性•某些情况下即使细菌检测为阴性也不能排除被污染某些情况下即使细菌检测为阴性也不能排除被污染•检测病毒更准确检测病毒更准确TTV分布广泛：医院空气、物件表面均可存在分布广泛：医院空气、物件表面均可存在TTV as a Marker of Anthropic PollutionTTV as a Marker of Immune Status免疫功能完整性：免疫功能完整性： the ability to mount a protective immune response against an antigenic stimulation.现有检测：抗原特异性，抗原非特异性；检测繁琐，检测方法缺乏标准化现有检测：抗原特异性，抗原非特异性；检测繁琐，检测方法缺乏标准化TTV与与CD8+57+T淋巴细胞比例成负相关淋巴细胞比例成负相关对抗病毒药不敏感对抗病毒药不敏感TTV as a Marker of Immune Statusexcessive (too many opportunistic infections and cancers) inadequate (too many episodes of cellular acute rejection) Maintenance immunosuppressionWhy Is TTV Not Yet Part of a Diagnostic Tool Kit?1.现有研究不足•无法培养•无抗体检测试剂•无动物模型2.PCR方法缺乏标准化（引物设计）•特异性引物•非特异性引物Take home messages1.TTV is a type of Orphan virus, prevalence>95% in most cases2.TTV replicates mainly in T lymphocytes3.Insensitive to current antiviral drugs4. TTV as a Marker of Immune Status•Predicting opportunistic infections•Predicting graft rejection。