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현장검사를 위한 다항목 면역측정법 기술의 최근 동향

Discerning Trends in Multiplex Immunoassay Technology with Potential for Resource-Limited Settings

Julian Gordon|Gerd Michel
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2013.01|Laboratory Medicine Online|제3권 제1호|pp. 62-72

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배경: 재원이 제한된 상황에서 풍토병 진단을 위한 보다 강력한 도구를 찾기 위하여, 저자들은 현재 적용 가능한 기술들을 분석해보았다. 정확한 표준검사실에 의존함으로써 발생하는 손실 없이,확실한 진단을 위해 점점 더 강력해지고 있는 다항목 검사능력과더불어 이미 체액 분석에 사용될 수 있는 방법을 중점으로 분석하였다. 민감하고 특이적으로 질병을 발견하기 위해 이러한 기술적진보가 중요한 의미를 가질 수 있으나, 현재까지 특히 재원이 제한된 상황 하에서 이 기술들의 임상적 유용성은 입증되지 않았다. 게다가, 많은 새로운 기술 개발이 물리학이나 제조업 분야에서 이루어지고 있어 임상의사나 임상검사실의 연구자들이 사용하거나 쉽게 이해할 수 있는 실정은 아니다. 내용: 이 문헌고찰은 재원이 제한된 상황에서 고민감도 다항목 면역측정법으로 사용될 가능성이 있는 기술의 추세에 관한 견해를 제시하고 있다. 제한된 비용과 민감도 및 다항목 검사능력 측면에서의 활용 가능성에 따라 다양한 기술을 설명하고 평가하였다. 이러한 기술에 대한 연구들은 임상 연구자들이 흔히 구독하는 학술지가 아닌 기술적인 내용을 다루는 잡지에 빈번하게 보고되었고,보고자들은 가능한 단점들은 무시한 채, 그들이 개발한 기술의가능성을 위주로 기술의 유용성을 주장해왔다. 그러므로 연구자들이 공개하지 않았을지도 모르는 기술적인 단점에 관심을 갖는것이 중요하다. 요점: 면역발색측정법들, 도파관과 관련된 기술을 포함한 광학적방법들, 전기화학적 방법들, 자기력제한적 방법들, 미세관이나 미세선 또는 미세띠에 기반한 전계효과 트랜지스터 방법들이 차세대검사 기술로서 유용하게 사용될 가능성이 있다.

Abstract

Background: In the search for more powerful tools for diagnoses of endemic diseases in resource-limited settings, we have been analyzing technologies with potential applicability. Increasingly, the process focuses on readily accessible bodily fluids combined with increasingly powerful multiplex capabilities to unambiguously diagnose a condition without resorting to reliance on a sophisticated reference laboratory. Although these technological advances may well have important implications for the sensitive and specific detection of disease, to date their clinical utility has not been demonstrated, especially in resource-limited settings. Furthermore, many emerging technological developments are in fields of physics or engineering, which are not readily available to or intelligible to clinicians or clinical laboratory scientists. Content: This review provides a look at technology trends that could have applicability to high-sensitivity multiplexed immunoassays in resourcelimited settings. Various technologies are explained and assessed according to potential for reaching relevant limits of cost, sensitivity, and multiplex capability. Frequently, such work is reported in technical journals not normally read by clinical scientists, and the authors make enthusiastic claims for the potential of their technology while ignoring potential pitfalls. Thus it is important to draw attention to technical hurdles that authors may not be publicizing. Summary: Immunochromatographic assays, optical methods including those involving waveguides, electrochemical methods, magnetorestrictive methods, and field-effect transistor methods based on nanotubes, nanowires, and nanoribbons reveal possibilities as next-generation technologies.

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