심상성 루프스에서 Nested-Primer Gene Amplification Assay에 의한 결핵균 DNA의 검출

Abstract

Lupus vulgaris, which is a progressive form of postprimary tuberculosis in patients with a moderate to high degree of immunity and tuberculin sensitivity, is the most common, most serious, and most variable type of cutaneous and mucous membrane tuberculosis. Domonstration of M.tuberculosis directly or in culture in some of these eruptions can be difficult. It is essential to demonstrate the presence of M.tuberculosis in a clinical sample for a definitive diagnosis of tuberculosis. With the discovery of the polymerase chain reaction (PCR), the DNA diagnostic approach for infection has developed in a short period. With the dual purpose of definitive and rapid diagnosis of tuberculosis, this study examined the usefulness of a nested PCR for detection of M. turberculosis. Compared with a single-step PCR, the two-step PCR was able to enhance sensitivity approximately 1,000-fold on the basis of bacterial counts and DNA quantity. We concluded that two-step nested PCR appeared to be the most useful PCR protocol for early and sensitive diagnostic method detecting M.tuberculosis in acid-fast stain negative specimens.