Second generation gene sequencing "second sputum" intracranial infection source
Release date: 2017-08-31
If it weren't for the sudden encephalitis, Vicoy, a 22-year-old Philippine crew member of Tangshan Wanhang International Shipping Agency, might never think of a relationship with second-generation gene sequencing.
At the time, Vicoy was working on the ship. On June 2, he found that his left arm and leg had no strength and had a headache.
On the 3rd, he was sent to Caofeidian District Hospital. After several days of treatment, the symptoms of limb paralysis on the left side of Vicoy increased and fever began again. On the 8th, he was transferred to the top three hospitals in Tangshan City, the Affiliated Hospital of North China University of Technology. Dr. Mao Wenjing, a tube specialist at the Department of Neurology, is the attending doctor of Vicoy. She remembers that when he first came to the hospital, his left limb was almost completely paralyzed, and the pupils on both sides were not large.
After the waist was worn, the doctor saw a yellowish cerebrospinal fluid. "This is definitely a problem." Vicoy has high levels of white blood cells in the cerebrospinal fluid but low in sugar. "We initially judged that this is meningitis caused by brain tissue necrosis, but the nature of encephalitis is not very certain." On the 9th, with clinical experience, doctors used Vicoy for anti-Tuberculosis drugs.
However, it is still not diagnosed.
Doctors used routine methods to detect tuberculosis, which was never found. "Smear dyeing, bacterial culture, are useless." The initiator has always been unknown. The patient's condition has stabilized, but he is still feverish. Professor Liu Bin, director of the hospital's neurology department, knows that severe intracranial infections are dangerous. If the symptoms are delayed, the patient will be in danger.
Have to rescue the soldiers. On June 12, Liu Bin contacted Guan Hongzhi, a professor of neurology at Peking Union Medical College Hospital. He has another important identity. The Neurology Department of the Union Hospital has cooperated with the Huada Gene Research Institute since 2014, and firstly carried out the second generation sequencing of cerebrospinal fluid in China for the screening of pathogens of central nervous system infectious diseases. Guan Hongzhi is the person in charge of this project.
"Cerebrospinal fluid second-generation sequencing technology, we are leading in the international arena." On August 27, Guan Hongzhi said in an interview with the Science and Technology Daily reporter.
Second-generation sequencing is a novel nucleic acid sequencing method for high-throughput sequencing that can simultaneously measure millions or even hundreds of millions of DNA or RNA sequences, greatly speeding up the sequencing of whole genomes, and making a wide range of untargeted pathogens. Screening is possible. The traditional inspection technology is to suspect what to look for, one kind of test; the second generation sequencing technology is "one pot end", which is both "wide" and "fast".
Guan Hongzhi suggested using the second generation gene sequencing technology to try. On the afternoon of June 22, Li Yuan, the coordinator of Tianjin Huada Gene Delivery Pathogen Group, received a sample of Vicoy's cerebrospinal fluid. The second-generation sequencing technology detects all nucleic acid sequences in the cerebrospinal fluid sample and then compares and analyzes it with the pathogen genome database to determine the infectious pathogen. In general, it takes 48 hours. In this case, Huada Gene has been expedited. On the evening of the 23rd, the test report was released.
Mycobacterium tuberculosis was detected in the cerebrospinal fluid, and the patient was indeed suffering from tuberculous meningitis.
At this point, the "culprit" that made Vicoy's fever a headache finally appeared. The hospital urgently strengthened anti-tuberculosis treatment. After two or three days of intensive treatment, Vicoy's fever symptoms were alleviated.
In fact, more than half of the cases of central nervous system infection can not clearly identify the cause, the general method is to carry out empirical treatment. "As a molecular diagnostic tool, genetic testing provides accurate results for determining the central nervous system infection pathogens," said Guan Hongzhi.
However, the pathogen genome database needs to be continuously improved and localized. Guan Hongzhi, for example, is a more common type of parasite infection in the central nervous system in China, but there is no genome-wide data on these two parasites. Prior to obtaining its genome-wide data, only known partial gene sequences can be added to the database for alignment, which may reduce the sensitivity of the assay.
"And, the light measurement is useless, but it will be 'analysis'. Otherwise the data is only data, it lies there, useless." Guan Hongzhi said that improving the level of analysis and interpretation of test data is also the key to boosting the clinical transformation of technology.
In mid-July, Vicoy was discharged. This journey of Chinese medical treatment was finally shocked and ended smoothly.
Source: China Science and Technology Network - Technology Daily
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