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[The indirect immunofluorescence reaction in the laboratory diagnosis of ixodid tick-borne borreliosis].

Serological verification of ixodid tick-borne borrelioses (TBB) is carried out in Russia by using IFA with the standard antigen prepared from the strain Ip-21 B. afzelii by the Laboratory of Infection Vectors, Gamaleya Research Institute of Epidemiology and Microbiology, Russian Academy of Medical Sciences. This study is under way at approximately 50 research and practical institutions that are situated in 30 large administrative territories of the country. The nIFA data on 371 sera from 214 patients with TBB and 229 sera from controls who had other infections have been analyzed. Changes in the proportion antibody sera, mean geometrical and cut-off antibody titers in patients with TBB were compared with those in the controls. The values of seroconversion were analyzed in relation to the time lasted after the onset, the first serum collection, and an interval of reexamination. The specific results of tested of the coded sera were obtained during the international interlaboratory blind experiment. It is concluded that nIFA yields results that are suitable for TBB verification.

Acute Disease↗

Methylamine accumulation in cultured cells as a measure of the aqueous storage compartment in the laboratory diagnosis of genetic lysosomal diseases.

Intracellular accumulation of the lysosomotropic compound [14C]methylamine was used to estimate the size of the lysosomal compartment in fibroblasts cultured from patients with a variety of lysosomal storage diseases. In previous work from our laboratory, it was shown that methylamine accumulation was significantly increased in diseases with infantile or juvenile onset and storage of predominantly water-soluble material such as in the mucopolysaccharidoses, mucolipidoses, and oligosaccharidoses. In the present study, methylamine incorporation was abnormally increased in cells from patients with glycogenosis type II and with Niemann-Pick type C disease, whereas it was normal in other sphingolipidoses and in the late-infantile and juvenile forms of neuronal ceroid lipofuscinoses. The methylamine test was also checked regarding its potential use for prenatal diagnostic testing. In model systems with cultured amniotic or chorionic villus cells, lysosomal storage was experimentally induced by the cathepsin inhibitor leupeptin and was readily detected when compared to untreated controls. Cultured amniotic cells from a fetus with mucopolysaccharidosis II were found to incorporate significantly higher amounts of [14C]methylamine than the normal controls. The results indicate that the methylamine accumulation method is an additional tool in the diagnosis and prenatal diagnosis of lysosomal diseases with abnormal storage of water-soluble material.

Amnion↗

Laboratory diagnosis of venous thromboembolism.

Venous thromboembolism is a common medical condition in both out-patients and in-patients. Despite the development of non-invasive tests, the diagnosis of deep vein thrombosis and pulmonary embolism remains a clinical challenge. In an effort to improve diagnostic accuracy and to reduce the necessity of serial testing, laboratory markers of thrombin generation and fibrinolysis have been investigated as first-line screening tests. Although the majority of markers are elevated in acute thrombosis, D-dimer, a specific derivative of cross-linked fibrin, appears to have the most potential clinical utility. Accuracy studies and preliminary management trials suggest that rapid D-dimer enzyme-linked immunosorbent assays and the whole blood agglutination assay, SimpliRED D-dimer (Agen Biomedical, Brisbane, Australia), have strong potential as exclusionary tests in patients with suspected venous thrombosis.

Blood Coagulation Tests↗

The laboratory diagnosis of mycobacterial disease.

The diagnosis of mycobacterial disease still relies heavily on conventional microscopy and culture techniques. More modern methods, such as the Bactec 460 radiometric system and the Roche biphasic system, are becoming available but are not yet widely used. Non-culture methods eg, using molecular biology techniques or gas liquid chromatography, are being developed but are currently the province of research and reference laboratories. Disease caused by species other than Mycobacterium tuberculosis poses problems of diagnosis and treatment. These other species can be identified by comparatively simple techniques but, as they are widely distributed in the environment, deciding between casual contamination and true infection can be difficult. Although such infections are not a major problem in numerical terms, the variable response of patients to treatment means that conventional sensitivity testing is of little assistance, and it is necessary to seek evidence of synergy in drug combinations for the effective treatment of these infections.

Adult↗