臨床病毒學的近年發展

RECENT ADVANCES IN CLINICAL VIROLOGY

為解決病毒疾病，從種牛痘開始，一直就是利用免疫學的方法來研究病毒學的問題。近十年來，用融合瘤技術（Hybridoma technology）產生的單株抗體（Monoclonal antibodies）也就成為臨床病毒學的一個研究方向。單株抗體的使用把原來用傳統免疫方法如中和試驗（Neutralization test）和補體結合反應（Complement-fixationtest）分型或分類的病就原要加以分析，有的因而可以重新分型或分類。這裏目前似乎有做不完的工作。另一方面由於遺傳工程技術（Genetic engineering）的應用也使原來使用一般生物化學及分子生物學的方面來分類的病毒有了革命性的改變。因為基因選植（gene cloning）的普遍化，使原來不易培熱病毒，可以完全用選植的病毒基因來做而打開了新的病毒分類，這方面由最近研究人類疣瘤病毒（Haman Papilloma Virus）就可以看得出來。選一個小小的病毒基因片段而大行其核酸互交法，可以想將來稿基本研究將大行改觀，其中影響臨床病毒學的診斷也是極為深遠的。 In parallel with the development of hybridoma technology and genetic engineering, several progressive steps have improved our understanding of virus diseases recently. At the same time, enzyme-linked immunosorbant assay has widely been used in clinical virology laboratories. Some types of human papillomaviruses have been discovered in a number of human carcinoma. The typing of the virus was made by analysis of cloned viral DNA with restriction endonucleases. The virus DNA probes have been used for diagnosis of virus disease. Human parvovirus was detected in symptom-free blood donors and this virus has been associated with arthritis, with acute exanthem of childhood and with aplastic crisis of hemolytic anemia. The nucleic acid homology was also used to compare new isolates of RNA viruses in an epidemic or outbreak of the virus disease. Antiviral drugs have been developed and used in prevention of herpes simplex virus and influenza in recent years. Human retrovirus was reported in adult T-cell leukemia as human T-lymphotropic virus type I (HTLV-I). The virus associated with acquired immunodeficiency syndrome (AIDS) was recognized as HTLV-III or lymphadenopathy virus (LAV). This virus was isolated and identified in our laboratory from the first case of AIDS in Taiwan. As to food-borne viruses to human disease, the development was slow. The rotavirus that caused human gastroenteritis and hepatitis A virus could be transmitted via foods.