{"id":10246,"date":"2020-04-23T05:00:47","date_gmt":"2020-04-23T02:00:47","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/virus-herpes-simplex-hsv-1-si-2-igg-in-lcr-ser\/"},"modified":"2025-02-06T11:13:48","modified_gmt":"2025-02-06T09:13:48","slug":"virus-herpes-simplex-hsv-1-si-2-igg-in-lcr-ser","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/virus-herpes-simplex-hsv-1-si-2-igg-in-lcr-ser\/","title":{"rendered":"\u0412\u0438\u0440\u0443\u0441 \u043f\u0440\u043e\u0441\u0442\u043e\u0433\u043e \u0433\u0435\u0440\u043f\u0435\u0441\u0430 (HSV) 1 \u0438 2 IgG \u0432 \u0441\u043f\u0438\u043d\u043d\u043e\u043c\u043e\u0437\u0433\u043e\u0432\u043e\u0439 \u0436\u0438\u0434\u043a\u043e\u0441\u0442\u0438\/\u043a\u0440\u043e\u0432\u0438"},"content":{"rendered":"

\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f <\/em><\/strong><\/p>\n

Tipurile 1 si 2 de virus herpes simplex (HSV-1, HSV-2) sunt responsabile de o varietate larga de afectiuni, de la infectii cutaneo-mucoase pana la infectii SNC si infectii ocazionale ale organelor viscerale, unele dintre acestea cu potential letal. HSV-1 este asociat in principal cu infectii oculare si orale, in timp ce HSV-2 determina leziuni genitale.<\/p>\n

Familia herpesvirusurilor (HSV-1, HSV-2, VZV, EBV, CMV si HHV-6) provoaca colectiv aproximativ 4% din cazurile de meningita virala,\u00a0 HSV-2 fiind autorul cel mai frecvent.<\/p>\n

In ceea ce priveste sindroamele SNC, infectia primara sau recurenta cu HSV-1 este asociata predominant cu encefalita herpetica<\/em>; sindroamele SNC asociate in principal cu infectia HSV-2 includ meningita<\/em>, meningita aseptica recurenta (Mollaret\u2019s)<\/em> si meningoencefalita neonatala<\/em>.<\/p>\n

Encefalita herpetica<\/em> determinata de HSV-1apare rar, are evolutie letala si se manifesta in general la persoanele imunodeprimate sau la nou-nascuti. Encefalita virala se caracterizeaza prin debut brusc cu febra, cefalee, somnolenta, obnubilare si instalarea rapida a comei.<\/p>\n

Meninigita virala<\/em> este adesea o boala autolimitata, la persoanele imunocompetente, rata mortalitatii fiind usor ridicata atunci cand se asociaza cu encefalita. La persoanele imunosupresate meningita ia forme severe cu evolutie prelungita, urmata adesea de complicatii.<\/p>\n

EBV, HSV-1, si mai ales HSV-2 au fost asociate cu meningita Mollaret<\/em>, o forma rara de meningita benigna, recurenta, care se remite spontan. Celulele Mollaret (monocite activate cu aspect atipic cu nuclei bilobati si citoplasma amorfa) sunt gasite in LCR, de obicei, in prima zi a simptomelor.<\/p>\n

Meninigoencefalita neonatala<\/em> este determinata de HSV-2; virusul se transmite vertical de la mama la fat prin contactul direct dintre nou-nascut si secretiile genitale ale mamei. Herpesul neonatal se caracterizeaza prin manifestari cutanate, oculare si prin leziuni ale sistemul nervos central. Afectarea nervoasa se manifesta prin convulsii, tremor<\/a>, letargie<\/a> \u0438\u043b\u0438 iritabilitate<\/a>. Prognosticul este rezervat, rata mortalitatii fiind de aproximativ 25%. De asemenea, supravietuitorii pot prezenta retard psihomotor, microcefalie, spasticitate sau cecitate1;4;6;7<\/sup>.<\/p>\n

Sinteza intratecala de anticorpi specifici IgG, IgA, IgM\u00a0 (cu o predominanta marcata a anticorpilor IgG) poate fi observata incepand cu saptamana a 2-a de la debutul infectiei. Scaderea concentratiei intratecale de anticorpi specifici se face lent si dureaza luni sau chiar ani1;6<\/sup>.<\/p>\n

Detectarea prin PCR a HSV-ADN in LCR constituie metoda \u201cgold standard\u201d pentru diagnosticul rapid al infectiilor SNC (in prima saptamana de la debutul bolii), in timp ce demonstrarea productiei intratecale de anticorpi specifici constituie un element adjuvant pentru diagnosticul retrospectiv al infectiilor in 80% din cazuri2;6<\/sup>. Prezenta intratecala a anticorpilor specifici trebuie evaluata luand in considerare variabilele esentiale ale lichidului cefalo-rahidian, cum ar fi: celularitatea, concentratia totala a anticorpilor IgG, concentratia albuminei. Pentru o cuantificare mai veridica a sintezei intratecale de imunoglobuline, trebuie aplicata o functie hiperbolica pentru a distinge intre fractiunile proteice derivate din sange si respectiv SNC, prezente in LCR (diagrama lui Reiber)5<\/sup>.<\/p>\n

Recomandari pentru determinarea HSV <\/em><\/strong>IgG in LCR\/ser<\/strong> \u2013 diagnosticul sindroamelor SNC asociate cu HSV (meningita, meningita aseptica recurenta Mollaret\u2019s, meningoencefalita neonatala, boala diseminata)<\/em>5<\/sup>.<\/p>\n

Specimen recoltat<\/em><\/strong> \u2013 se recolteaza obligatoriu 2 probe: a) lichid cefalorahidian recoltat prin punctie lombara si b) sange venos5<\/sup>.<\/p>\n

Recipient de recoltare<\/em><\/strong>\u00a0\u2013 a) recipient steril; b) vacutainer fara anticoagulant cu\/fara gel separator5<\/sup>.<\/p>\n

Prelucrare\u00a0 necesara dupa recoltare <\/em><\/strong>\u2013 se separa serul prin centrifugare5<\/sup>.<\/p>\n

Volum minim proba<\/em><\/strong> \u2013 1) 2 mL; 2) 1mL5<\/sup>.<\/p>\n

Cauze de respingere a probei <\/em><\/strong>\u2013 ser hemolizat; plasma in loc de ser5<\/sup>.<\/p>\n

Stabilitate proba <\/em><\/strong>- 7 zile<\/em> la\u00a0 2-80<\/sup>C atat pentru ser cat si pentru LCR5<\/sup>.<\/p>\n

Metoda <\/em><\/strong>- nefelometrica<\/span> (pentru determinarea albuminei, anticorpilor totali IgG in ser si LCR); ELISA <\/span>(pentru determinarea anticorpilor specifici anti-HSV 1\/2 in ser si LCR)5<\/sup>.<\/p>\n

Valori de referinta, comunicarea si interpretarea rezultatelor<\/em><\/strong><\/p>\n

Pe buletinul final de rezultate sunt comunicati urmatorii parametri:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
\n

Denumire parametru<\/strong><\/p>\n<\/td>\n

\n

Valori de referinta<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Albumina in LCR<\/p>\n<\/td>\n

\n

100-350 mg\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Albumina in ser<\/p>\n<\/td>\n

\n

36.6-51 g\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Indice albuminic QAlb<\/p>\n<\/td>\n

\n

< 9<\/p>\n<\/td>\n<\/tr>\n

\n

IgG in LCR<\/p>\n<\/td>\n

\n

<40 mg\/L<\/p>\n<\/td>\n<\/tr>\n

\n

IgG in ser<\/p>\n<\/td>\n

\n

7-16 g\/L<\/p>\n<\/td>\n<\/tr>\n

\n

IgG in LCR\/IgG in ser (QIgG)<\/p>\n<\/td>\n

\n

< 3<\/p>\n<\/td>\n<\/tr>\n

\n

Index IgG (QIgG\/ Qalb)<\/p>\n<\/td>\n

\n

< 0.7<\/p>\n<\/td>\n<\/tr>\n

\n

HSV IgG \u00bd ASI<\/strong><\/p>\n<\/td>\n

\n

<1.3<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/strong>Buletinul va contine si interpretarea rezultatelor conform diagramei Reiber, cu urmatoarele situatii posibile:<\/p>\n

-bariera hematoencefalica integra; sinteza intratecala de imunoglobuline IgG absenta;<\/p>\n

-bariera hematoencefalica alterata; prezenta sinteza intratecala de imunoglobuline IgG;\u00a0<\/strong><\/p>\n

-bariera hematoencefalica alterata; sinteza intratecala de imunoglobuline IgG;\u00a0<\/strong><\/p>\n

-bariera hematoencefalica integra; prezenta sinteza intratecala de imunoglobuline IgG5<\/sup>.\u00a0<\/strong><\/p>\n

Pentru anticorpii IgG, indicele anticorpilor specifici (index specific antibodies = ASI) ASI este calculat conform formulei:<\/p>\n

ASI = Qspec.\/ QIgG.<\/p>\n

Qspec = coeficientul anticorpilor IgG specifici = anticorpi IgG specifici in LCR\/anticorpi IgG specifici in ser.<\/p>\n

QIgG = coeficientul anticorpilor IgG totali = anticorpi IgG in LCR\/anticorpi IgG in ser.<\/p>\n

Daca este necesar (QIgG > Qlim) se va efectua corectia pentru sinteza locala de IgG policlonale:<\/p>\n

ASI = Qspec.\/ Qlim.<\/p>\n

Qlim. reprezinta fractia anticorpilor\u00a0 IgG din LCR care provin numai din sange si se calculeaza cu ajutorul unei formule din indicele albuminic individual (Qalb).<\/p>\n

In mod normal ASI <1.3. Valorile ASI 1.3-1.5 constituie un rezultat echivoc.. O valoare a ASI mai mare de 1.5 indica o productie locala crescuta de anticorpi specifici3;5<\/sup>.<\/p>\n

\u00a0<\/span><\/p>\n

\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/p>\n

1. Doina Stanescu, Ileana Rebedea. Meningite acute. In Boli infectioase, Editura Medicala, 2000, 298-322.<\/span><\/p>\n

2. Guy Boivin. Diagnosis of Herpesvirus Infections of the Central Nervous System. In HERPES 11, Supplement, 2004.<\/span><\/p>\n

3. Hansotto Reiber, Peter Lange. Quantification of Virus-Specific Antibodies in Cerebrospinal Fluid and Serum: Sensitive and Specific Detection of Antibody Synthesis in Brain. In Clinical Chemistry, 37\/7, 1153-1160, 1991.<\/span><\/p>\n

4. Joshua T. Schiffer. Herpes Simplex Virus. In Mandell, Douglas,and Bennett\u2019s Principles and Practice of Infectious Diseases, 7th edition, Churchill Livingstone, Elsevier, 2010, 1943-1955.<\/span><\/p>\n

5. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate 2010. Ref Type: Catalog.<\/span><\/p>\n

6. Lothar Thomas. Laboratory diagnosis of neurological diseases. In Clinical Laboratory Diagnostics-Use and Assessment of Clinical Laboratory Results. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany, 1 Ed., 1998, 1308 \u2013 1325.<\/span><\/p>\n

7. Michael Costello, Margaret Yungbluth. Viral Infections. In Henry\u2019s Clinical Diagnosis and Management by Laboratory Methods, Saunders-Elsevier, 21st Edition, 980-989.<\/span><\/p>","protected":false},"excerpt":{"rendered":"

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\u041d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e\u0441\u0442\u044c \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u0441\u043f\u0438\u043d\u043d\u043e\u043c\u043e\u0437\u0433\u043e\u0432\u043e\u0439 \u0436\u0438\u0434\u043a\u043e\u0441\u0442\u0438 \u0438 \u0434\u0440\u0443\u0433\u0438\u0445 \u043e\u0442\u0434\u0435\u043b\u044f\u0435\u043c\u044b\u0445 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u044f\u0435\u0442\u0441\u044f \u043b\u0435\u0447\u0430\u0449\u0438\u043c \u0432\u0440\u0430\u0447\u043e\u043c \u0438 \u043e\u0441\u0443\u0449\u0435\u0441\u0442\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0432 \u0443\u0441\u043b\u043e\u0432\u0438\u044f\u0445 \u0441\u0442\u0430\u0446\u0438\u043e\u043d\u0430\u0440\u0430 \u043a\u0432\u0430\u043b\u0438\u0444\u0438\u0446\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u043c \u043c\u0435\u0434\u0438\u0446\u0438\u043d\u0441\u043a\u0438\u043c \u043f\u0435\u0440\u0441\u043e\u043d\u0430\u043b\u043e\u043c.<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[961],"product_tag":[],"class_list":{"0":"post-10246","1":"product","2":"type-product","3":"status-publish","5":"product_cat-serologie-boli-infectioase","7":"first","8":"instock","9":"sold-individually","10":"shipping-taxable","11":"purchasable","12":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/10246","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=10246"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10246"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10246"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10246"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10246"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}