Dibbert H J
Zentralbl Bakteriol Orig A. 1976 Mar;234(2):145-58.
Identification and measurement of rubella antibody of 19 S (IgM) and 7 S (IgG) immunoglobulins by sucrose density gradient centrifugation and a modified hemagglutination-inhibition (HAI)-test is described. Human group 0 of red blood cells were employed after trypsination. The method proved to be highly reliable and sensitive for the rapid detection of rubella IgM antibody in routine research to make an accurate diagnosis of recent rubella infection. Sera from 185 pregnant women, 200 children suspect of congenital infection, 15 mothers of intrauterin infected children, and 32 cases of rubella vaccine-induced immunity control were studied. In postnatal rubella infections, specific IgM-antibody could be detected in all sera after the onset of the rash up to eight or ten weeks after infection. From March 1973 until September 1974 laboratory diagnosis confirmed 30 of 185 pregnant women to have been recently infected with rubella. In less than 3% (4 cases) the results could not confirm or exclude a recent history of rubella. Among 200 children with congenital defects or some irregular development, specific IgM antibody was detected in 36 cases. The diagnosis of congenital rubella was confirmed or detected in the first months of life. One of the infected children was well at birth but later developed mental retardation and hearing loss, and some others showed only minor defects. In some children rubell IgM antibody persisted 5-14 months. IgM rubella antibody was not found in the sera of 15 mothers from children with intrauterine infection confirmed by IgM antibody demonstration. Post-vaccination-tests showed serum IgM and IgG immunoglobulin-responses to be similar to the natural rubella-virus-infection. Maximal titers of both immunoglobulin-fractions were but four-fold lower after vaccination (28 of 32 tested cases). The described method is able to verify the time of infection by testing a single serum. The HAI-test of the 12 fractions collected from each serum after density-gradient centrifugation shows a typical titer-profil for every time of immunization status: beginning with traces of IgM-antibody - when the HAI-test of the uncentrifugated serum may be less than 1:10 - until 10 weeks after infection when only IgG-antibody will be detectable. The greatest amount of IgM-antibody is found in the 2. to 4. week after the rash.
本文描述了通过蔗糖密度梯度离心和改良血凝抑制（HAI）试验鉴定和测量19S（IgM）和7S（IgG）免疫球蛋白风疹抗体的方法。胰蛋白酶处理后使用人类0型红细胞。该方法被证明在常规研究中对快速检测风疹IgM抗体以准确诊断近期风疹感染具有高度可靠性和敏感性。研究了185名孕妇、200名疑似先天性感染儿童、15名宫内感染儿童的母亲以及32例风疹疫苗诱导免疫对照的血清。在产后风疹感染中，出疹后直至感染后八至十周的所有血清中均可检测到特异性IgM抗体。从1973年3月至1974年9月，实验室诊断证实185名孕妇中有30名近期感染了风疹。不到3%（4例）的结果无法证实或排除近期风疹病史。在200名有先天性缺陷或发育异常的儿童中，36例检测到特异性IgM抗体。先天性风疹的诊断在出生后的头几个月得到证实或检测到。其中一名受感染儿童出生时健康，但后来出现智力发育迟缓及听力丧失，其他一些儿童仅表现出轻微缺陷。部分儿童风疹IgM抗体持续5至14个月。在15名经IgM抗体证实其孩子有宫内感染的母亲血清中未发现风疹IgM抗体。接种疫苗后的检测显示血清IgM和IgG免疫球蛋白反应与自然风疹病毒感染相似。两种免疫球蛋白组分的最高滴度在接种疫苗后仅低四倍（32例检测病例中的28例）。所描述的方法能够通过检测单一血清来验证感染时间。从每个血清经密度梯度离心后收集的12个组分进行的HAI试验显示，每种免疫状态时间都有典型的滴度曲线：开始时IgM抗体呈痕量——此时未离心血清的HAI试验可能小于1:1——直到感染后10周，此时只能检测到IgG抗体。出疹后第2至4周发现的IgM抗体量最多。
