da Matta V L, Hoshino-Shimizu S, Dietze R, Corbett C E
Department of Pathology, Medical School, University of São Paulo, Brazil.
J Clin Lab Anal. 2000;14(1):5-12. doi: 10.1002/(sici)1098-2825(2000)14:1<5::aid-jcla2>3.0.co;2-f.
Sera from patients with American visceral leishmaniasis (AVL) were studied before and after treatment based on their antibody isotypes and subtypes. The study was comprised of 33 Brazilian patients with well-defined diagnosis of AVL and 39 clinically healthy individuals. Antileishmanial antibody isotypes and subtypes were observed in almost all patients, except IgA that was detected in about 63% of them. The sensitivity and specificity of the immunofluorescence assay in the detection of antibody isotypes (IgG and IgM) and subtypes (IgG1, IgG2, IgG3, and IgG4) were high with no statistical difference, ranging from 0.937 to 1.000 and from 0.954 to 1.000, respectively. All IgG antibodies and its subtypes had their levels reduced after treatment. However, the IgG4 had an early decay and its conversion to negative was significantly high in children. Moreover, the profile of IgG4 before treatment corresponded to a unimodal curve that shifted to a patent bimodal curve after treatment, indicative of therapeutic success. Thus, the IgG4 shows to be a suitable immunological marker for the assessment of chemotherapy in AVL patients or communities. Our findings suggest that IgG4 correlates with IL-4 that also decreases after therapy.
基于抗体同种型和亚型，对患有美洲内脏利什曼病（AVL）的患者治疗前后的血清进行了研究。该研究包括33例诊断明确的巴西AVL患者和39名临床健康个体。几乎在所有患者中都观察到了抗利什曼原虫抗体同种型和亚型，但IgA仅在约63%的患者中检测到。免疫荧光法检测抗体同种型（IgG和IgM）和亚型（IgG1、IgG2、IgG3和IgG4）的敏感性和特异性都很高，无统计学差异，分别为0.937至1.000和0.954至1.000。治疗后，所有IgG抗体及其亚型的水平均降低。然而，IgG4下降较早，且在儿童中其转为阴性的比例显著较高。此外，治疗前IgG4的分布呈单峰曲线，治疗后转变为明显的双峰曲线，表明治疗成功。因此，IgG4是评估AVL患者或社区化疗效果的合适免疫标志物。我们的研究结果表明，IgG4与治疗后也会降低的IL-4相关。
