间接FLISA法检测钩端螺旋体特异性IgM方法的探讨

为研制钩端螺旋体（钩体）特异性IgM检测试剂,并用于早期诊断钩体病,以钩体外膜蛋白为抗原,探索间接ELISA法检测钩体特异性IgM的各项实验条件,并对钩体病患者血清标本进行检测,结果,１０５份健康人血ＩgM阴性,钩体IgM阳性血清可被特异性阻断,２－巯基乙醇破坏试验阳性,试剂存放４℃和３７℃4天的检测结果基本一致,检测临床钩体病人112份血清,IgM阳性83份,阳性率74．11％,与常规TAT法基本一致,0－7病日的阳性率明显高于MAT法,说明该法检测钩体病IgM具有特异,敏感,快速,稳定,简便等优点,对钩体病早期诊断有一定的价值。     

嗜肺军团菌和弯曲杆菌在间接荧光抗体试验中的血清学交叉反应

50名培养证实弯曲杆菌胃肠炎的患者血清中作了嗜肺军团菌抗体检查。间接免疫荧光试验检测有10名患者(20％)出现阳性滴度(≥16)。36份急性期患者血清只有1份检测到抗体,而14份在症状出现10天以上获得的血清中却有10份(71％)有抗体。所有阳性血清均含有特异性IgM抗体而特异性IgG或IgA未能在任何标本中检测到。从42例类似沙门氏菌胃肠炎病人血清中未能检测到军团菌抗体。这些结果显示在嗜肺军团菌和弯曲杆菌之间有血清学交叉反应。     

内蒙地区发热患者血清中冠状病毒抗体的检测

目的分析内蒙地区发热患者中冠状病毒的感染情况。方法以SARS冠状病毒感染Vero细胞涂片为冠状病毒抗原片,用间接免疫荧光法分别检测55例发热患者和68例正常人血清中冠状病毒的IgG、IgM抗体。结果发热患者血清中冠状病毒IgG抗体和IgM抗体阳性率分别为29.1%(16/55)和10.9%(6/55),而正常人血清中只检测到2.9%(2/68)的IgG抗体,且未检测到IgM抗体,2组患者的IgG和IgM抗体阳性率比较差异均有显著性;随机选取7例患者的IgG阳性血清进行SRAS冠状病毒的特异性抗体封闭实验,结果有6例血清仍为阳性,有1例血清转为阴性,说明冠状病毒IgG抗体阳性血清中85.7%为普通冠状病毒特异性,14.3%为SARS冠状病毒特异性。结论普通冠状病毒是内蒙地区发热患者的主要病原体之一,部分患者还存在SARS冠状病毒的既往感染。     

肿瘤患者血清中SARS-CoV抗体阳性原因分析

探讨SARS冠状病毒(SARS—CoV)抗体在SARS病原学诊断中的特异性及其在肿瘤患血清中的假阳性问题。应用ELISA和荧光定量RT-PCR技术检测了111例正常对照和40例肿瘤患血清中SARS—CoV抗体的阳性率。在111例正常对照中,IgM抗体均阴性,IgG抗体的阳性率为3．6％(4／111);IgG抗体诊断SARS的特异性为96．4％,两种抗体同时阳性诊断SARS的特异性为100％。40例肿瘤患中,IgM抗体均阴性,IgG抗体阳性率17．5％(7／40)。经RT—PCR检测,上述肿瘤患阳性病例均为阴性。结果表明,同时测定SARS—CoV的两种抗体可降低诊断的假阳性率,提高诊断的特异性。用非纯化SARS—CoV抗原制备的ELISA试剂盒测定肿瘤患的SARS—CoV抗体,可能出现假阳性。在肿瘤患中出现假阳性的原因可能与包被的抗原有关。     

无偿献血者ALT异常与戊型肝炎病毒感染的关系

目的 了解无偿献血者ALT异常（按血站标准,以大于25赖氏单位为异常）与戊型肝炎病毒感染的关系。方法 对萧山地区2004年8～11月无偿献血者中,ALT异常的102例血清标本,进行抗-HEV IgM抗体检测;同时对照检测450份ALT正常的无偿献血者血清标本。结果 在102例ALT异常血清中,抗-HEV IgM抗体阳性为6例,阳性率为5.88%,在450份ALT正常血清中,抗-HEV IgM抗体阳性为5例,阳性率为1.11%。结论 在无偿献血者ALT异常血清中,抗-HEV IgM抗体检出比例较高。     

捕捉法ELISA检测脊髓灰质炎IgA抗体方法的建立与应用

建立了一种检测脊髓灰质炎(简称脊灰)IgA抗体的捕捉法ELISA(Aac-ELISA)。方法敏感,快速,特异,用于检测144份脊灰可疑病人的血清,IgA抗体检出率为77.8％(112/144).而这些血清的IgM抗体检出率为65.2％(94/144)。如同时检测IgM和IgA抗体,则阳性率可达91.7％(132/144)。麻痹后1～3天内IgA的检出率为76.5％(13/17),4～7天内为95％(19/20)。最长检出IgA的一例可疑病人,其血清收集于病后第59天。本方法在一部分16天后可疑病人IgM阴性血清中查出IgA阳性,故可以作为查IgM抗体诊断方法的补充,尤其适用于诊断感染后未能及时收到血清标本,IgM已经转阴而IgA抗体仍为阳性的病人。     

牛传染性鼻气管炎病毒重组gE蛋白间接ELISA诊断方法的建立

以重组牛传染性鼻气管炎病毒gE蛋白,经纯化后作为诊断抗原建立了检测牛血清特异性gE抗体的间接酶联免疫吸附试验,确定其最佳包被量为每孔1.075μg。样品稀释度为1:40,兔抗牛IgG辣根过氧化物酶标记抗体稀释度为1∶5000。判定标准为样品OD值大于0.582为阳性,小于0.472为阴性,在0.472与0.582之间为可疑。经抗特异性试验和重复性试验证明该方法特异性高、重复性好。在403份血清样品中,进口试剂盒检出234份阳性样品,该诊断方法检出248阳性样品,与进口试剂盒的符合率为94.3%,但该诊断方法检出率更高。在43份血清样品中,中和试验检出24份阳性样品,该诊断方法检出28份阳性样品,与中和试验的符合率为85.7%。应用该诊断方法调查了我国部分地区IBRV的感染率,发现这些地区的IBRV感染率为68.7%。     

ELISA检测流行性乙型脑炎病毒的研究——Ⅲ.联合应用微量细胞培养和ELISA法鉴定临床标本中流行性乙型脑炎病毒

临床疑似流行性乙型脑炎(简称乙脑)病人的血浆和脑脊液共41份,接种C6/36(白纹伊蚊纲胞系)培养后,用ELISA双夹心法检测培养液中乙脑病毒(JEV),其中16份(血浆和脑脊液各8份)为阳性,阳性率为39.5％。14份阳性标本按种小白鼠脑内后均出在典型症状而死亡,取脑组织作中和试验鉴定,表明14份病毒标本均为JEV。8例血浆病毒阳性者中7例血清IgM抗体阳性。说明本法检出的JEV是特异性的。可用于病毒的特异性快速鉴定。     

SLE患者血清中SARS—CoV抗体阳性原因分析

为了探讨严重急性呼吸综合征(SARS)冠状病毒(SARS—CoV)抗体测定在系统性红斑狼疮(SLE)患者中的假阳性问题,应用酶联免疫吸附试验(ELISA)和荧光定量RT—PCR技术检测了66例正常对照和31例SLE患者血清中SARS—CoV抗体的阳性率。结果,66例正常对照中,IgM抗体均阴性,IgG抗体的阳性率为3．0％(2／66);31例SLE患者中,IgM抗体和IgG抗体阳性率分别为29％(9／31)和58．1％(18／31),IgG抗体和IgM抗体同时阳性为22．6％(7／31)。经RT—PCR检测,上述阳性病例均为阴性。结论：用非纯化抗原制备的ELISA试剂盒测定SLE患者的SARS—COV抗体,可能出现假阳性,两种抗体同时测定可降低诊断的假阳性率,提高诊断的特异性。在SLE患者中出现假阳性的原因可能与包被的抗原有关。     

啮齿类动物中汉坦病毒感染血清学和病原学检测方法比较研究

致病性汉坦病毒的宿主主要为啮齿类动物,其病毒感染状况是人间疫情发生的关键影响因素,可通过检测宿主动物标本中病毒基因组RNA、蛋白抗原及特异性抗体而进行监测。本研究利用367份鼠肺及鼠血标本,对双抗原夹心ELISA(ELISA)、实时荧光RT-PCR(RT-PCR)和免疫荧光(IFA)等三种分别检测抗体、核酸和抗原的方法进行比较评估。ELISA法检出抗体阳性鼠血标本46份,阳性率为12.53%;RT-PCR法检出病毒RNA阳性鼠肺标本28份,阳性率为7.63%;IFA检出抗原阳性鼠肺标本24份,阳性率为6.54%。宿主动物组织标本中检出汉坦病毒RNA和(或)结构蛋白抗原的标本,对应的血液标本中可检出病毒特异性抗体,100%(24/24)IFA检测阳性标本和89.3%(25/28)RT-PCR检测阳性标本对应血标本ELISA抗体检测阳性,反之亦然,检出抗体的标本基本包含了可检出抗原和RNA的标本。RT-PCR与IFA检测结果差异无显著性(χa2=0.64,P0.05),一致性检验Kappa系数为0.71,一致性高(Z=13.66,P0.05),首先对血标本开展基于ELISA的特异性抗体检测,可显著缩小RT-PCR或IFA法检测病毒RNA或抗原的范围(χb2=12.04,χc2=20.05,P0.05)。本研究为宿主动物汉坦病毒感染实验室监测方案优化提供了有益的依据。     

Mumps Meningoencephalitis,Toronto, 1963

Between January and June 1963, 45 children were hospitalized with mumps meningoencephalitis. Of 39 patients with laboratory evidence of mumps infection, 24 had parotitis and 15 showed no salivary gland involvement. Cerebrospinal fluids from 18 of 40 patients yielded mumps virus by inoculation of rhesus monkey kidney cultures; 33 subjects, including 12 of the 18 virus excretors, showed rising or elevated levels of mumps antihemagglutinin during convalescence. Between May 1959 and June 1963, mumps virus was recovered from cerebrospinal fluids of 50 of 126 cases of mumps meningoencephalitis; virus isolation rates were highest during the peak incidence of mumps meningoencephalitis in winter and early spring.Mumps vaccine (inactivated) was administered to 34 parents with no history of mumps, shortly after their children developed mumps. Mumps occurred in three of 17 parents without prevaccination mumps antihemagglutinins, and in two others, but in none of 15 who had prevaccination antibodies.     

Immunoglobulin M. Specific for Measles and Mumps in Multiple Sclerosis

Sera from 43 patients with multiple sclerosis were tested by immunofluorescence. Sera from patients with active multiple sclerosis included four with measles virus-specific immunoglobulin M (measles IgM) and two with mumps virus-specific IgM (mumps IgM). In one case each mumps IgM and measles IgM seem to have persisted for two and a half years and three years respectively. In a comparable group of 43 patients with other nervous diseases measles IgM was found in only one serum, and among 43 normal patients no measles or mumps IgM was found.Herpes simplex virus-specific IgM (herpes simplex IgM) was distributed among all three groups. Anticellular IgM was also found, predominantly in active multiple sclerosis, and persisted in two sera for two and a half years.     

Hepatitis C Virus Infection-Associated Markers in Sera from Blood Donors in Surabaya,Indonesia

Among 2,233 sera obtained from volunteer blood donors, 259 (11.6%) showed elevated alanine aminotransferase (ALT) levels. A second-generation enzyme-linked immunosorbent assay (ELISA) revealed that 23 (8.9%) of the 259 sera were positive for antibodies against hepatitis C virus (HCV), whereas only 9 (1.4%) of 646 sera randomly collected from blood donors with normal ALT levels were positive (P<0.001). The overall prevalence of anti-HCV antibodies among blood donors was estimated to be 2.3%. HCV RNA was detected in 19 (83%) of the 23 anti-HCV-positive sera with elevated ALT levels, and 8 (89%) of the 9 sera with normal ALT levels. Among the anti-HCV-positive sera, IgM anti-HCV was detected in 5 (22%) of 23 sera with elevated ALT levels and in 2 (22%) of 9 sera with normal ALT levels. All of the IgM anti-HCV-positive sera were positive for HCV RNA, irrespective of ALT levels.     

Diagnostic value of dengue virus-specific IgA and IgM serum antibody detection

The diagnostic value of dengue virus (DV)-specific immunoglobulin A (IgA) serum antibody detection, by an indirect immunofluorescence assay (IFA) was evaluated. For this study, the kinetics of DV-specific IgA serum antibodies was analysed in two experimentally immunised macaques, paired samples from 35 patients suspected of a primary or secondary DV infection, paired sera from patients with high levels of IgA specific antibodies against influenza virus (n = 15), sera from patients with other viral infections (n = 40) and healthy blood donors (n = 10), which served as controls. The presence of DV-specific IgA serum antibodies in humans and in monkeys was compared with that of DV-specific IgM demonstrated in a capture enzyme-linked immunosorbent assay (ELISA). The development of DV-specific IgA and IgM antibodies in macaques proved to be similar to that observed in humans with a DV infection. In sera obtained from suspected primary DV patients during the acute phase and convalescent phase, DV-specific IgA was detected in 1/6 (17%) and 6/6 (100%), whereas IgM was detected in 4/6 (67%) and 5/6 (83%), respectively. In sera from suspected secondary DV patients during the acute phase and convalescent phase, DV-specific IgA was detected in 18/29 (62%) and 28/29 (97%), whereas IgM was detected in 20/29 (69%) and 28/29 (97%), respectively. The control group consisted of five paired serum samples from yellow fever vaccinated individuals and a patient with acute tick-borne encephalitis, 15 paired serum samples from patients with high levels of IgA antibodies specific for influenza virus and 40 serum samples from patients with specific IgM antibodies against other viruses. Ten serum samples from healthy blood donors were included. Among the control serum samples, in one patient, both DV-specific IgA and IgM antibodies were present, and in three sera DV-specific IgM antibodies could be demonstrated. These data suggest that detection of DV-specific IgA serum antibodies by IFA may have additional value for the diagnosis of DV infection.     

石家庄地区肺炎支原体感染的流行病学调查

目的：了解石家庄地区肺炎支原体感染的血清流行病学情况。方法：选择2011年3月-2012年2月我院住院和门诊收治的急性呼吸道感染患者1902例为研究对象,采用间接免疫荧光法（IFA）检测其血清肺炎支原体IgM抗体,并分析其流行病学资料。结果：1902例血清标本中,284例（14．93％）肺炎支原体IgM抗体阳性,男性和女性的阳性率无显著差异。肺炎支原体抗体阳性的患者主要分布于0～15岁年龄段,阳性检出率最高的年龄组为0～6岁,占21．26％（132／621）。各个季节均有肺炎支原体感染阳性患者,感染率无显著差异性,秋（80例）、冬（96例）两季的阳性感染率高于春（56例）、夏（52例）两季。患者100％出现发热症状,95．77％出现咳嗽。结论：石家庄地区肺炎支原体感染的主要人群为未成年人,无季节性和性别差异,以发热和咳嗽为最主要的临床症状。     

A shortened dengue IgM capture ELISA using simultaneous incubation of antigen and peroxidase-labeled monoclonal antibody

A shortened IgM capture ELISA for the detection of dengue IgM antibodies using simultaneous incubation of antigen and peroxidase-labeled monoclonal antibody was described. The shortened two-step assay was compared with the four-step IgM capture ELISA on sera from dengue patients confirmed by the hemagglutination inhibition (HI) test. When paired acute and convalescent sera were tested, the shortened ELISA showed 100% agreement with HI results. It detected dengue IgM antibodies in the acute sera of 66% of patients with a primary dengue infection, 60% of patients with a secondary infection, and 98% of patients with a presumptive secondary infection. When the results of 151 dengue patients were combined, 75% of the acute sera were positive by the shortened IgM capture ELISA.     

Assessment of the specificity of a commercial human parvovirus B19 IgM assay

Background: It is important to investigate a possible cross-reaction of anti-rubella IgM in the IDEIA^™ Parvovirus B19 IgM test because many B19 infections are either asymptomatic or have clinical symptoms similar to those of rubella virus infections. Epstein-Barr virus (EBV) IgM, cytomegalovirus (CMV) IgM, measles IgM and rheumatoid factor (RF) IgM cross-reactions were also studied.Objectives: In the period from February to September 1994 (including a parvovirus B19 epidemic) more than 10 000 serum samples were examined for parvovirus B19 IgM in Denmark. This gave an opportunity to evaluate the commercial IDEIA^™ Parvovirus B19 ELISA kit (DAKO A/S, Glostrup, Denmark), which was used routinely at Statens Serum Institut from the beginning of 1994 and onwards.Study design: A total of 123 parvovirus B19 IgM positive sera were tested for reactivity in rubella IgM EIA. A total of 78 rubella IgM positive sera, 60 EBV VCA-IgM positive sera, 30 CMV IgM positive sera and 24 measles virus IgM positive sera were tested for reaction in IDEIA^™ Parvovirus B19 IgM test. Finally, 25 parvovirus IgM positive sera were tested for specific IgM against measles virus, EBV (VCA), CMV and for RF.Results: One anti-B19 IgM positive serum sample reacted positively in the rubella IgM test. Of rubella IgM positive serum samples 4% cross-reacted in IDEIA^™ Parvovirus B19 IgM test, as did 17 and 20% of EBV VCA-IgM and CMV IgM positive serum samples respectively. None of measles virus IgM positive serum samples cross-reacted in the IDEIA^™ Parvovirus B19 IgM test. Of 25 initially parvovirus B19 IgM positive sera 20% cross-reacted in EBV VCA IgM test and 8% in the CMV IgM test. None reacted positively in measles virus IgM test; 28% showed weak reactivity in RF IgM test.Conclusions: Precautions must be taken when results of IgM assays are interpreted. Epidemiological and clinical observations must be considered.     

Detection of hantaviral antibodies among patients with hepatitis of unknown etiology in Japan

Hantaviral antibodies were detected in the sera from patients with hepatic disease of unknown etiology in Japan by several different serological diagnostic methods. A total of 105 sera from diseased patients which were negative to A-G hepatitis virus infections in the Tokyo area were tested. Among them, 3 out of 73 sera from patients with chronic hepatic disease were positive to hantaviral antibody by enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescent antibody assay (IFA) and Western blot analysis (WB). Neutralizing antibody titers of the 3 sera to Seoul virus (SEO) were 4 to 8 times higher than those to Hantaan virus (HTN). However, all of the 32 sera from patients with acute hepatitis were negative for hantaviral antibody. Among the 60 patients with chronic hepatitis in Hokkaido which were serologically negative to B and C hepatitis virus infection, one was positive for hantaviral antibody by ELISA and WB. In contrast, the sera from healthy adults in Japan, 550 from the Honshu and Kyushu regions, and 1,000 from the Hokkaido region, were negative for hantavirus antibody. These results show that hantaviral antibodies are more frequently detected in patients with hepatic disease than in healthy adults. However, the observation that no positive sera were detected from patients with acute hepatitis implies that hantavirus might not be directly related to hepatitis.     

Isolation and Characterization of Mumps Virus Strains in a Mumps Outbreak with a High Incidence of Aseptic Meningitis

In 1993, mumps with a high incidence of aseptic meningitis became prevalent in Akita prefecture, Japan. Three mumps virus isolates obtained from the nonvaccine-associated cases lacked the BamHI restriction cleavage site of the P gene, like the Urabe strain (Yamada, A. et al, Vaccine 8: 553-557). However, four additional nucleotide substitutions were found in the determined region of 157 bp. Fourteen of 19 cases from which mumps virus showing the Urabe-like RFLP profile was detected were complicated with symptomatic meningitis, whereas there were only four cases of meningitis among 23 individuals infected with the wild type showing no Urabe-like RFLP profile (non-“Urabe-like” wild-type). The incidence of meningitis was over 70% among patients infected with the “Urabe-like” wild-type virus. The “Urabe-like” wild-type disappeared after February 1994 in the epidemic area and was replaced by the non-“Urabe-like” wild-type. Patients infected with the “Urabe-like” wild-type lived in a closed colony, in which there were two instances of transmission between siblings. Thus this outbreak was transient and narrowly localized.