A comparative study of serological diagnostic tests of leptospirosis.
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Whether the presence of antibodies in patients sera to large glycopeptides (LGP) isolated from a murine teratocarcinoma cell line (F9) can be useful in diagnosing malignant ovarian tumors of germ cell origin was examined by Farr's assay. We measured the binding ability to LGP by Farr's assay of human sera from 188 patients with various ovarian tumors and 110 normal volunteers. All of the 9 patients with dysgerminoma showed negative results (less than 200 cpm). Except the cases with dysgerminoma, 9 (64%) of the 14 patients with malignant ovarian tumors of germ cell origin were found positive (more than 200 cpm). Of these 9 positive cases, 4 cases with endodermal sinus tumor (EST), 2 cases with immature teratoma, one each with immature teratoma plus EST, choriocarcinoma, and mature solid teratoma were included. In contrast, all of the sera from benign ovarian tumors (111 cases), other malignant ovarian tumors (54 cases) and normal nonpregnant women (110 cases) were found negative. These result indicated that Farr's assay of anti-LGP antibodies in sera is useful in diagnosing ovarian germ cell tumors.
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Certain adverse reactions to aspirin (ASA), nonsteroidal anti-inflammatory drugs (NSAIDs) and pyrazolone derivatives resemble IgE-mediated hypersensitivity. However, convincing evidence of antigen-antibody interactions or inhibition of the cyclooxygenase pathway of arachidonic acid metabolism, stimulating the production of leukotrienes (LTs) and decreasing the production of prostaglandins (PGs), has not been presented. In this study, two types of specific IgE antibodies have been found in six serum samples from eight ASA-sensitive patients with salicyloyl and O-methylsalicyloyl disks using the Radio Allergo Sorbent Test (RAST), whereas no positive result could be found with acetylsalicyloyl disks. Further investigation on the specificity of these IgE antibodies and the chemical structure of their epitopes were performed by cross-inhibition studies. The results are in favor of an IgE-dependent mechanism involved in ASA sensitivity, and suggest that determination of specific IgE antibodies would be a safe diagnostic method for ASA sensitivity in vitro.
A solid-phase radioimmunoassay (RIA) test for rubella virus IgG and IgM class antibodies was used for completing the hemagglutination inhibition (HI) test in routine diagnostic serology. During a six-month period 80 serum specimens from 47 patients were tested by RIA because the HI test result was either unreliable or gave insufficient information. This was approximately 5% of the total number of serum specimens tested for rubella antibodies in our laboratory during the study period. The main indications for using the RIA test were improper timing in the taking of serum specimens, which accounted for IgM determination, and nonspecific agglutinins or nonspecific serum hemaglutination inhibitors, which disturbed the HI test. In all cases an unambiguous result was obtained by the RIA test, and five recent rubella infections, not diagnosably by the HI test, were detected. Based on these findings we consider the RIA test to be a good alternative among the methods proposed for diagnostic rubella serology.
BACKGROUND: Dengue viruses are a serious cause of illness in tropical and subtropical areas of the world. Laboratory diagnosis is essential for confirmation of dengue virus infections. Detection of specific IgM by IgM-capture enzymed-linked immunoassay (ELISA) has been widely used as a main serological diagnostic technique. OBJECTIVES: The levels of specific IgM in secondary dengue virus infections were compared with those in primary infections. STUDY DESIGN: A total of 1780 samples collected from 924 confirmed dengue cases were tested for anti-dengue IgM by IgM-capture ELISA. RESULTS AND CONCLUSIONS: Specific IgM was detected in all the cases with primary dengue virus infection on disease day 9 or later. However, specific IgM cannot be detected in 28% (204/716) of the cases in secondary infections. The average titers of IgM were higher in primary infections than in secondary infections. The results confirmed that IgM detection is a reliable serological diagnostic test in primary dengue virus infections. Although IgM detection is also a useful test, other serological diagnostic tests or tests for dengue virus detection are necessary for confirmation of all the secondary dengue virus infections.
The cost of serological diagnostic products amounts to more than a quarter of total laboratory material expenses. The major problem in serological diagnostics is correct interpretation of the presence of specific antibodies. Aspects influencing diagnostic conclusions drawn from serological finding include: 1. Features of infectious agents and pathogenesis of infection. 2. Principle of serological assay. 3. Condition of antigen used in the assay. 4. Individual reactivity of the patient. 5. Temporal data and data on the course of the disease. Modern serological methods such as ELISA and indirect immunofluorescence have, compared to classical techniques (i.e. complement fixation test, agglutination, immunoprecipitation and neutralization), a number of advantages. Nevertheless, they also have drawbacks of and classical methods should be used at least in selected cases for a number of years in future. Novel approaches such as immunoblotting, body fluid antibody detection, IgA and IgE determination and low avidity antibody detection are gaining importance and promise new insights.
Recently a few new herpes simplex virus (HSV) type-specific serological diagnostic tests have been introduced to the commercial market, but these tests have some limitations. Moreover, it is not yet clear which commercial test can be regarded as a "gold standard" for the serodiagnosis of HSV infections. In order to improve the clinical diagnostic value of serological tests for the detection of HSV infections, we developed novel, competition-based enzyme-linked immunosorbent assays for the specific determination of HSV type 2 antibodies (SeroHSV2) and HSV type 1 antibodies (SeroHSV1) and two complementary tests for the detection of HSV immunoglobulin M (IgM) and IgG antibodies (SeroHSV IgM and SeroHSV IgG). These four new kits were evaluated in comparison with some commercial kits for the detection of HSV antibodies that are commonly used at present in Israeli clinical laboratories. The results indicate that SeroHSV2 is highly sensitive (>92%) and highly specific (>94%). SeroHSV2 does not cross-react with other alphaherpesvirus antibodies. SeroHSV1 is highly sensitive (>94%) and specific (>91%) compared to four commercial available kits. SeroHSV IgM is highly specific (>92%) in comparison with other commercial HSV IgM tests. The sensitivity of SeroHSV IgM ranges between 50 and 70% compared to these tests. Further investigation of the discrepant results obtained by using in-house competition tests indicated that SeroHSV IgM is more sensitive. SeroHSV IgG was also found to be highly sensitive (>94%) and highly specific (>92%) compared to the other commercial HSV IgG tests.
OBJECTIVES: The objective of this study was to evaluate the epidemiology of Mycoplasma pneumoniae (Mpn) infections in Basse-Normandie by a retrospective analysis of serological and PCR data, and to confirm the diagnostic utility of PCR and serology. METHODS: From 1997 to August 2005, 6156 serum samples and 6123 respiratory tract samples were collected from hospitalised patients and evaluated for the diagnosis of Mpn infection by PCR, serological assays, or by the two tests. During the epidemic period (2004-2005), the results of 1489 patients were analysed. RESULTS: Over the 9-y period, the seroprevalence was 40,4% and we reported on 525 cases with serologically or/and PCR proven Mpn infection, according a cyclic pattern spaced out 7 years. During the epidemic period, the seroprevalence increased to 50,2% and the rate of infections was 8.3%. The analysis of the 124 cases of Mpn infection showed typical epidemiological characteristics: a peak of incidence among the children and young adults, a summer-winter pattern and some coinfections with viral strains. For diagnosis of Mpn infection, the comparison of PCR and serological assays among 36 patients showed a concordance of only 41.7%. CONCLUSION: Mpn infections were endemic and outbreaks were observed according cyclic pattern with a high incidence specially in the children. Sensitive and specific tests were now available for early and reliable diagnosis. In children, the combination of the PCR on nasopharyngeal samples and the IgM EIA serology test were recommended. In adults, the PCR was privilegiated.
The laboratory routine used and the criteria applied for serological case confirmation in vaccine efficacy trials have a direct influence on the identification of cases, which consequently may also affect the estimation of vaccine efficacy (VE). Some differences in the application of serological confirmation criteria among the recent clinical studies of pertussis vaccines include the level of increase in titre and use of single specimen diagnostics. Additionally, the use of pre-exposure serum specimen collections increases the sensitivity of serological confirmation. In the 1992-95 Stockholm trial, a regimen to collect serum samples systematically was introduced; using acute- and convalescent-phase sera from the cough episodes, the proportion of all cases which were serologically confirmed was 25%. When pre-exposure sera were also available, the proportion was 35%; the increased sensitivity was differential by vaccine group and affected the estimated VE to some extent. Therefore, with the different application of serological methods among the various efficacy studies, direct comparisons between studies should be made with great caution.
The two major inflammatory bowel diseases, Crohn's disease (CD) and ulcerative colitis (UC), represent clinicopathologic entities that traditionally have been diagnosed on the basis of a combination of clinical, radiologic, endoscopic, and histologic features. Serum perinuclear antineutrophil cytoplasmic antibodies (pANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) have recently been added to our diagnostic armamentarium. Several studies have demonstrated that UC-associated pANCAs recognize nuclear antigens. Additional studies have demonstrated that the pANCA human monoclonal antibody (mAb) Fab 5-3 reacts with histone H1 and with bacterial and mycobacterial antigens. Several reports have suggested that, in CD, pANCA and ASCA are correlated with colonic and small bowel disease respectively. One study found that higher ASCA levels were correlated with more aggressive CD. Serology may prove to be useful in predicting the evolution of indeterminate colitis. Magnetic resonance imaging (MRI) and leukocyte scintigraphy hold promise in identifying inflammatory CD. MRI enteroclysis is useful in identifying both luminal small bowel disease and extraluminal complications. A recent study of surveillance colonoscopy in extensive Crohn's colitis showed a high risk of dysplasia and cancer.
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Report about the results of serologic diagnostics of rubella. In the years 1975 til 1984 we took care for 17,731 pregnant women. 455 of them had rubella contact. In 16.7 per cent (76 women) there was a titer of 1:16 or below. In 18 cases of them we had to guess the patients on artificial abortion, because there were hints at a rubella disease. Nevertheless out of 379 pregnant women with serologic immunity decided on abortion. Reasons have been discussed. We propose a serologic diagnostics in each case of rubella contact of a pregnant women for prevention of rubella embryopathy.
While the antigen structure of yeast cell walls is well known, the immunological cross reactivity of these is often difficult to interpret. The cross reactions of eight yeasts were tested in rabbit hyperimmune sera by the indirect immunofluorescence test. Among the eight species examined were the medically important yeasts C. albicans, C. pseudotropicalis, C. krusei, C. parapsilosis, C. tropicalis, T. glabrata, and C. guilliermondii and the apathogenic yeast S. cerevisiae. It has been shown, that there is no correlation between the number of common antigens and the degree of cross reactivity which give identical titers. Therefore it appears, that the quantitative contributions of the single antigens have an important rule, i.e., some antigens are immunogenic in one species while having only hapten characteristics in another. Further the results show that in infections with C. krusei, C. pseudotropicalis, and C. guilliermondii homologous antigens have to be used for the serological diagnosis. The testing of human sera with the yeast antigens by the same methods showed that the strikingly distributions of the Candida titer and the Saccharomyces titer were similar. A larger number of sera of healthy people and patients were compared in the hemagglutination test. These results showed that pathological C. albicans titers cannot be caused by S, cerevisiae antibodies.