3 virusologie lp AM.pptx

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    LP 9:Diagnostic de laborator in virozerespiratorii. Izolarea virusurilor gripale pe oul

    de gaina embrionat. Reactia dehemaglutinare. Identifcarea virusurilorgripale. Reactia de hemaglutinoinhibare. Cazclinic prezentat de studenti.

    LP 12: Diagnosticul in inectia cupapipomavirusuri umane - algoritm.Diagnostic serologic versus diagnosticulmolecular. Importanta tehnicilor degenotipare si corelarea cu diagnosticulcitologic. Posibilitati de vaccinare in cancerede etiologie virala. Caz clinic prezentat de

    studeni.

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    PapovaviusesPapilomavirusuri(>100 genotipuri)

    Poliomavirus (la rozatoare)

    Virusul simian vacuolizant SV40

    Papillomavirusurile determina:

    tumori benigne ale pielii negi sau veruci! care pot regresa spontan" inectie litic# $n celule permisive cu productia de virioni inectanti

    leziuni ale mucoasei genitale si anale care pot maligniza dacapersista mai multi ani " inectie persistent# $n celule nepermisive care

    duce la transormare malign#

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    Frecventa inectiilor asimptomatice! su"clinicesau atipice

    Persistenta virusurilor si capacitateatransormanta #$isplazie cervicala intraepiteliala

    si carcinom cervical scuamos % &PV 1'! 1! 1!! *)

    +a,oritatea cancerelor $e cervi-! vulvare sipeniene sunt asociate cu &PV tipurile 1'! 1!

    1! ! *! 9! 4*! *1! *2! *'! ''! '! .0 caretransorma /eratinocitele umane

    Principalul actor $e risc pentru cancer $e coluterin %a"senta screening

    F356 7 P6PL8+6V7S7L3 7+63(&PV)

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    Epiteliu Normal

    Suprafata cervicala

    Membrana bazala

    Celule bazale

    Celule

    Parabazale

    Strat scuamos

    %tratscuamosmatur

    . .

    . .

    .

    .

    .

    Epiteliu Infectat

    Adaptat dupa Frazer IH. Nature Rev Immunol. 2004;4:4654.

    Eliberarea virionilor

    cu cel descuamate (3 sapt)

    Infectia celulelor

    bazale (keratinocite)

    (gene E1 si E2)

    A! viral Episomal

    in nucleul celulei

    (E1 and E2" E# and E$)

    %eplicare de A! viral

    odata cu multiplicarea cel(E#

    and E$)

    Asamblare virala(gene &1 and &2)

    nectia cu &PV are anumiteparticularitati

    &

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    iagnostic &PV ; $iagnostic $irect

    1

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    ?enotipare &PVPCR urmat de hibridizareaacizilor nucleici!

    26 genotipuri

    Rezultatul poate fi:

    1' pozitiv(cu decelarea urmatoarelor

    genotipuri: 6, 11, 1#, 1, 31, 33, 4,

    *, *1, !", !4, *, *+, ##, #,$3, #$,

    2' negativ sau

    "% pozitiv pentru alt genotip -./ fara

    a se cunoaste genotipul -./

    responsabil de leziune" rezultat

    notat 0-./ ')* genotipuri

    +, , 1', 1, +, 1, , *, 9,/0, /, 4*, *1, *2, 1), 1/, 11, *',*, *9, +, +, +/, '', +*, ', +2,

    *0, *, *, .332!, 4, 233/!,4) 33*!, 4/ 334!, I%)2, and

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    Vaccinarea este utila in anumite situatii

    Vaccin

    6ntigen 6$,uvant

    SS53+ 6@7V65: 6S04-+onoosoril lipi$ 6 a"sor"it pe

    - &i$ro-i$ $e aluminiu

    Garcon N. evelopment and evaluat!on o" A#04$ a novel and !mproved ad%uvant &'&tem conta!n!n( )*+ andalum!num &alt. In: #c,!%n& -$ Ha(an $ ed&. Immunopotent!ator& !n modern vacc!ne&. +ondon: Academ!c*re&&$ 2005: /6/1.

    6S04

    irus Li/e Particles (VLP)articule asemanatoare virusului

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    Majoritatea Ac IgG de lanivelul epiteliului genital seconsidera a fi rezulatultransudarii la nivel epitelial aanticorpilor serici

    Un raspuns imunumoral puternic estenecesar pentru a realizaniveluri sustinutedetectabile de anticorpila nivelul mucoaseicervicale (infectiaprimara)

    HPV are mecanisme proprii

    prin care scapa mecanismelorsistemului imun natural deaparare

    Nu determina viremieHPV nu distruge keratinocitele

    Lamina Aazala

    Vas $e sange

    5piteliu

    Adaptat dupa :

    )unoz N et al. ,apter /: H*- !n t,e et!olo(' o" ,uman cancer.-acc!ne 24#3 2006 #3/#3/0

    G!ann!n! #. et al. 7n,anced ,umoral and memor' 8 cellular !mmun!t' u&!n( H*-/6/1 +/ -+* vacc!ne "ormulated 9!t, t,e)*+alum!n!um &alt com!nat!on A#04 compared to alum!n!um &alt onl'. -acc!ne$ -olume 24$ I&&ue& 3334$ /4 Au(u&t 2006$*a(e& 5

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    1'!1! 4*! 1Prevenirea cancerului $e col

    uterin6vem 2 vaccinuri pe piata:

    impotriva 9P6 +, , +, 4

    impotriva 9P6 + si 4

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    Diagnostic in inectia cu virusuri gripale

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    ORTHOMIXOVIRUSURI-V. GRIPALE A, B, C

    myxa-mucus

    tip A, B, C : NP, M

    subtipuri: HAsi NA16 tipuri de HA si 9 de NA

    +atrice

    ucleocapsi$a Belicoi$ala6ss

    &6 # Bemaglutinina

    transcriptaza

    anvelopa

    6 # neuramini$aza

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    iagnostic clinic $e gripa

    ebra )-1 zile!, mialgie, cealee, astenie saptamani!, tuse uscata, aringita,rinoree.

    ;ripa nu se diagnosticheaza clinic.Simptomatologie asemanatoare cu inectii $eterminate $e:

    )'copla&ma pneumon!ae, adenovirusuri,virusul respirator sincitial, rhinovirusuri,virusuri paragripale, si +e(!onellaspp.

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    EI4&45IE

    .4SI6I&A

    .rodus

    .atologic

    I74&A%E g' I%EC

    8detectiedirecta

    g' I!I%EC

    8serologie

    /' 5%I.A&E A" 6" CS!9

    A!9A6

    45E

    Culturicelulare

    A

    : .C% si I9

    A

    studii epidemoiologice

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    Pro$use patologice:

    a)spalatura nazo aringianase obtine cuan! nu sunt indicate

    $n diagnosticul virozelor respiratorii.

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    Spalatura nazo aringiana(SF)ecoltare

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    isc $e la"orator asociat manevrarii $epro$use patologice supuse $iagnosticului in

    ve$erea izolarii virusurilor gripale

    6irusurile gripale sunt prezente intractul respirator in concentratiiridicate si pot usor disemina din

    e?udate, spalaturi nazoaringiene siaspirate traheobronsice la personalulcare manipuleaza aceste probe

    clinice prin intermediul aerosolilor.Culturile de celule inectate sunt siele sursa de inectie si diseminare a

    virusurilor.

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    iagnostic $e la"orator in gripairectii $e $iagnostic

    IEF'R5GID5(BIIC'R5

    G7$ RHA= RHAI

    D5B5CBI5 DIR5CB' PCR si I

    DI';(E%BIC %5REFE;IC

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    .-pe culturi primare de rinichi demaimuta rhesus.

    -pe linia continua epiteliala derinichi de ciine " 3DCH - 3adin-Darb Canine Hidne.

    .pe ou de gaina embrionat,de 2-zile, inoculat intraamniotic sauintraalantoidian.

    Izolare virala ! e"amenul optim pentru diag gripei

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    &ema$sor"tie$emonstreaza izolarea v

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    Izolareape E;5

    Izolarea se dem prin proprietatea v. gripalede a aglutina hematii

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    Etape#

    ag viral dilutii binaresuspensie de $ematii

    %e incubeaza la temperatura camerei

    %e citesc rezultatele in &' minute

    Martorul reactiei contine suspensie $ematii

    ol &6:Demonstrarea prezentei virusului hemaglutinant

    Bitrarea antigenului hemaglutinant inaintea reactiei de hemagutino-inhibare

    HA

    3+8S5636 P3C353V7S7L73656 3 &3+6?L7563

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    ID5(BIIC'R5' 6. ;RIP'F5R. 953';FJBI(E-I(9IK'R5

    )e$nica reactiei#

    dilutii binare din serul testato cantitate constanta de ag viral $emaglutinant%e lasa la incubat *' min la *+,-%e adauga sistemul indicator . suspensia de $ematii%e incubeaza &' min la temperatura camerei

    /eactia de identificare a virusurilor gripale

    HAI

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    Reactia de953';FJBI('R5 si953';FJBI(E-I(9IK'R5

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    ('B nucleic acid tests!RB PCR

    Duic/ iagnosis o Flu Strains Possi"le EitB eE +icrocBip 5est(ational nstitute o 6llergG an$ nectiousiseases) # FluBip!

    ne-pensive 5est etects inHuenza nections Duic/lGan$ 6ccuratelG(ational nstitute o 6llergG an$ nectiousiseases) % +Bip

    SEine Hu real#time P /it (PrimeresignLt$ # 7I) ! 5Be real#time P /it # rapi$lGmultiplGing a sample ta/en rom a

    suspecte$ sEine Hu patient< 5Bis testJuic/lG $iKerentiates common strains o tBeHu virus rom otBer &11