Contreras M C, Sandoval L, Salinas P, Muñoz P, Vargas S
Programa de Parasitología, ICBM, Facultad de Medicina, Universidad de Chile, Casilla 9183, Santiago, Chile.
Bol Chil Parasitol. 2000 Jan-Jun;55(1-2):17-24.
Toxoplasmosis, a world-wide zoonotic infection, is generally asymptomatic and benign in immunocompetent individuals, but it can be serious in immunodeficiencies particularly in patients with acquired immunodeficiency syndrome and in children infected in utero. So, it is important to dispose methods which permit discriminate between recent and chronic infections. In order to contribute to improve the diagnosis of toxoplasmosis ELISA IgG, IgM, IgA and ELISA IgG avidity were performed in 15 and 24 sera from patients suspected of having acute and chronic infection respectively, according dye test (DT) titres. ELISA IgG was positive in both groups, ELISA IgM was positive in 78.6 and 58.3% respectively, while ELISA IgA was positive in 85.7 and 33.3% of recent and chronic group respectively. In those sera with low IgG avidity (18.8%) we found specific IgM in 71.5 and 4.2% and IgA in 78.6 and 0.0% of recent and chronic groups respectively. Parallelling, 208 sera samples were classified according to the results of DT, indirect hemagglutination and complement fixation tests in the following groups: acute (97), intermediate (36), chronic (35) and negative (40). The results were: acute (96.9-64.9-55.6 and 65.9%); intermediate (97.2-63.8-44.4 and 47.2%); chronic (45.7-42.8-5.7 and 34.3%) for IgG, IgM, IgA and low IgG avidity respectively. The use of both acute markers, IgA and low IgG avidity in the diagnosis of toxoplasmosis is discussed.
弓形虫病是一种全球性的人畜共患感染病,在免疫功能正常的个体中通常无症状且为良性,但在免疫缺陷患者中,尤其是获得性免疫缺陷综合征患者和子宫内感染的儿童中,可能会很严重。因此,找到能够区分近期感染和慢性感染的方法很重要。为了有助于改善弓形虫病的诊断,根据染料试验(DT)滴度,分别对15份疑似急性感染患者的血清和24份疑似慢性感染患者的血清进行了ELISA IgG、IgM、IgA检测以及ELISA IgG亲和力检测。两组中ELISA IgG均呈阳性,ELISA IgM在急性组和慢性组中的阳性率分别为78.6%和58.3%,而ELISA IgA在近期感染组和慢性感染组中的阳性率分别为85.7%和33.3%。在那些IgG亲和力较低的血清中(18.8%),我们发现近期感染组和慢性感染组中分别有71.5%和4.2%的血清特异性IgM呈阳性,78.6%和0.0%的血清IgA呈阳性。同时,根据DT、间接血凝试验和补体结合试验的结果,将208份血清样本分为以下几组:急性(97份)、中间型(36份)、慢性(35份)和阴性(40份)。结果显示,IgG、IgM、IgA和低IgG亲和力在急性组中的阳性率分别为96.9%、64.9%、55.6%和65.9%;在中间型组中分别为97.2%、63.8%、44.4%和47.2%;在慢性组中分别为45.7%、42.8%、5.7%和34.3%。本文讨论了IgA和低IgG亲和力这两种急性标志物在弓形虫病诊断中的应用。