結核分子疫学の成果と展望
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In the traditional study of tuberculosis epidemiology, information about social contact of persons and patients illness history used to be an only relevant basis for elucidating transmission of tuberculosis infection. Therefore, it was very difficult to give a clear conclusion of whether isolates from different patients derived from a common source of infection or not. Recently, the subspecies typing of <I>M. tuberculosis</I> strains has become possible, based on the visualization of multiple loci of an insertion sequence (IS<I>6110</I>) that is a relatively stable gene fragment existing in a specific region of the genome. The variability of the number of copies and locations of this IS<I>6110</I> in a genome is the basis that enables this technique to be used for the above purpose, which is a unique tool applicable to the analysis of <I>M. tuberculosis</I>. Generally, this technique, i.e., restriction fragment length polymorphism (RFLP) analysis, depends on the diversity of pattern of any polymorphic marker found in a genome of a strain. Among various markers so far developed and examined, IS<I>6110</I> has been proved most appropriate for the purpose of typing strains of <I>M. tuberculosis</I> complex, especially in such circumstances as in Japan where isolated strains RFLP patterns are similar each with others so that finer subtyping is needed.<BR>In this lecture, I would like to review the following topics based on the world literature of molecular epidemiology and the findings of our own that we have achieved during 1992 through 2001 in our Institute; 1) typing of the isolates for the identification of the infection source, 2) pathogenesis of tuberculosis under low incidence situation, 3) predominance of certain genotypes endemic in an area, 4) cross-contamination of isolates in the laboratory, 5) the stability of IS<I>6110</I> patterns, 6) phylogeny of <I>M. tuberculosis</I> complex, and 7) differentiation between <I>M. tuberculosis</I> and <I>M. bovis</I> BCG.
- 日本結核病学会の論文
- 2002-11-15
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