Desai A, Chandramuki A, Gourie-Devi M, Ravi V
Department of Neurovirology, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, India.
Clin Diagn Virol. 1994 Jun;2(3):191-9. doi: 10.1016/0928-0197(94)90022-1.
Antigen detection in the CSF is an invaluable tool in the diagnosis of viral infections of the nervous system, especially in the early phase of the illness. Very little information is available on the use of antigen detection in the diagnosis of Japanese encephalitis (JE).
Evaluation of two monoclonal antibody-based antigen detection methods in the diagnosis of JE in comparison with the detection of virus-specific IgM antibodies in the CSF.
In this study 115 patients with a clinical diagnosis of JE were investigated. A reverse passive haemagglutination test for the detection of soluble JEV antigens, an immunofluorescent assay for the detection of cell-associated antigen and an IgM capture ELISA for the detection of virus specific IgM antibodies in the CSF were used.
Laboratory confirmation of JE was possible in 92/115 patients. Virus-specific IgM was detected in 75/92 and JEV antigen was detected in 52/92 patients. Soluble antigen was detected in 37/52, cell-associated antigen in 30/52. There was no significant difference in the sensitivity of the two antigen detection systems used.
Diagnosis by antigen detection could be done less frequently than by demonstration of virus-specific IgM antibodies in the spinal fluid. However, antigen detection proved useful during the first week of illness when IgM antibodies were not detected in the CSF.
脑脊液中的抗原检测是诊断神经系统病毒感染的一项重要工具，尤其是在疾病的早期阶段。关于抗原检测在日本脑炎（乙脑）诊断中的应用，目前可用信息极少。
与脑脊液中病毒特异性IgM抗体检测相比，评估两种基于单克隆抗体的抗原检测方法在乙脑诊断中的应用。
本研究对115例临床诊断为乙脑的患者进行了调查。采用反向被动血凝试验检测可溶性乙脑病毒抗原、免疫荧光试验检测细胞相关抗原以及IgM捕获ELISA检测脑脊液中的病毒特异性IgM抗体。
115例患者中有92例得到实验室确诊。92例确诊患者中，75例检测到病毒特异性IgM，52例检测到乙脑病毒抗原。52例检测到抗原的患者中，37例检测到可溶性抗原，30例检测到细胞相关抗原。所使用的两种抗原检测系统在敏感性上无显著差异。
通过抗原检测进行诊断的频率可能低于通过检测脑脊液中病毒特异性IgM抗体进行诊断的频率。然而，在疾病的第一周，当脑脊液中未检测到IgM抗体时，抗原检测证明是有用的。
