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[口咽型白喉无毒形式下抗毒素及抗菌免疫反应的特征]

[Characteristics of antitoxic and antibacterial immune response in nontoxic forms of oropharyngeal diphtheria].

作者信息

Anokhin V A, Zinkevich O D, Fatkullina G R, Safina N A, Platonova O A, Shmeleva E A, Bondarenko V M

机构信息

Medical University, Research Institute of Epidemiology and Microbiology, Kazan, Russia.

出版信息

Zh Mikrobiol Epidemiol Immunobiol. 2002 Nov-Dec(6):47-52.

Abstract

The enzyme immunoassay system (EIA) for differentiation of antibodies in therapeutic heterogeneous antitoxic serum and antibodies to Corynebacterium diphtheriae toxigenic strains in patients and carriers was developed. The use of EIA permitted the dynamic evaluation of the characteristics of humoral antitoxic and antibacterial immune response in 50 patients with the localized and disseminated forms of stomatopharyngeal diphtheria and 14 "healthy" carriers of toxigenic C. diphtheriae. As revealed in this study, the symptoms of the disease in patients with disseminated forms of stomatopharyngeal diphtheria developed in the presence of statistically significant low quantitative values of antitoxic and antibacterial antibodies to C. diphtheriae antigens. In the group of patients with the localized forms of the disease the initially low level of antitoxic antibodies was detected with the concentration of antibacterial antibodies remaining unchanged. During the period of convalescence the levels of antitoxic antibodies in both groups reached those of healthy persons. In case of localized forms of the disease the level of antibacterial antibodies decreased as compared with healthy persons, starting from the second week of the disease. The period of convalescence in the disseminated forms was characterized by the low concentration of antibacterial antibodies. Carrier state was formed in the presence of high levels of antitoxic antibodies and significantly low levels of antibacterial ones.

摘要

开发了一种酶免疫分析系统(EIA),用于鉴别治疗性异种抗毒素血清中的抗体以及患者和携带者体内针对产毒白喉棒状杆菌菌株的抗体。使用EIA能够动态评估50例患有局部性和播散性口咽白喉的患者以及14例产毒白喉棒状杆菌“健康”携带者的体液抗毒素和抗菌免疫反应特征。本研究表明,在口咽白喉播散型患者中,疾病症状是在针对白喉棒状杆菌抗原的抗毒素和抗菌抗体定量值在统计学上显著较低的情况下出现的。在局部性疾病患者组中,最初检测到抗毒素抗体水平较低,而抗菌抗体浓度保持不变。在恢复期,两组患者的抗毒素抗体水平均达到健康人的水平。对于局部性疾病,从疾病第二周开始,抗菌抗体水平与健康人相比有所下降。播散型疾病恢复期的特点是抗菌抗体浓度较低。在抗毒素抗体水平较高而抗菌抗体水平显著较低的情况下形成携带者状态。

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