Abd-Alla Mohamed D, Jackson Terry F G H, Rogers Tyson, Reddy Selvan, Ravdin Jonathan I
Department of Medicine, University of Minnesota, 14-110 Phillips Wangensteen Building, 516 Delaware Street S.E., Minneapolis, MN 55455, USA.
Infect Immun. 2006 Jul;74(7):3897-903. doi: 10.1128/IAI.02018-05.
We monitored 93 subjects cured of amebic liver abscess (ALA) and 963 close associate controls in Durban, South Africa, and determined by enzyme-linked immunosorbent assay that the intestinal immunoglobulin A (IgA) antibody response to the Entamoeba histolytica galactose-inhibitable adherence lectin is most accurately represented by a complex pattern of transitory peaks. One or more intestinal anti-lectin IgA antibody peaks occurred in 85.9% of ALA subjects over 36 months compared to 41.6% of controls (P < 0.0001). ALA subjects exhibited a greater number of anti-lectin IgA antibody peaks (P < 0.0001) than controls. In addition, their peak optical density values were higher (peak numbers 1 to 3, P < 0.003), peaks were of longer duration (for peaks 1 and 2, P </= 0.0054), and there was a shorter time interval between peaks (between 1 and 2 or 2 and 3, P </= 0.0106) than observed for control subjects. A prior E. histolytica infection was associated with the occurrence of an anti-lectin IgA antibody peak (79.1%, P < 0.0001) more so than for Entamoeba dispar infection (57.2%, P < 0.001). The annual number of anti-lectin IgA antibody peaks in ALA subjects was 0.71 per year, compared to just 0.22 in controls (P<0.0001), indicating a higher rate of exposure to the parasite than previously appreciated. Anti-lectin IgA antibody peaks were of higher amplitude following a E. histolytica infection compared to E. dispar (P = 0.01) and, for either, were of greater height in ALA subjects than controls (P < 0.01). ALA subjects demonstrated greater clearance of amebic infection after an anti-lectin IgA antibody peak compared to controls, and only 14.3% remained with a positive culture after the peak, compared to 38.9% in controls (P = 0.035). In summary, this prospective controlled longitudinal study elucidated the dynamic nature of the human intestinal IgA antibody response to E. histolytica and E. dispar infection and revealed that ALA subjects exhibit heightened intestinal anti-lectin IgA antibody peaks that are associated with clearance of E. histolytica and E. dispar infection.
我们在南非德班对93名已治愈的阿米巴肝脓肿（ALA）患者和963名密切接触者进行了监测，并通过酶联免疫吸附测定法确定，肠道免疫球蛋白A（IgA）对溶组织内阿米巴半乳糖抑制性黏附凝集素的抗体反应最准确地表现为一种短暂峰值的复杂模式。在36个月内，85.9%的ALA患者出现了一个或多个肠道抗凝集素IgA抗体峰值，而对照组为41.6%（P<0.0001）。ALA患者出现的抗凝集素IgA抗体峰值数量（P<0.0001）多于对照组。此外，他们的峰值光密度值更高（第1至3个峰值，P<0.003），峰值持续时间更长（第1和第2个峰值，P≤0.0054），且峰值之间的时间间隔更短（第1和第2个或第2和第3个峰值之间，P≤0.0106），均低于对照组。既往溶组织内阿米巴感染比溶组织内阿米巴感染更易引发抗凝集素IgA抗体峰值（79.1%，P<0.0001对比57.2%，P<0.001）。ALA患者每年抗凝集素IgA抗体峰值数量为0.71次，而对照组仅为0.22次（P<0.0001），这表明寄生虫暴露率高于此前认知。与溶组织内阿米巴感染相比，溶组织内阿米巴感染后抗凝集素IgA抗体峰值幅度更高（P = 0.01），且对于两者，ALA患者的峰值高度均高于对照组（P<0.01）。与对照组相比，ALA患者在抗凝集素IgA抗体峰值出现后对阿米巴感染的清除能力更强，峰值出现后仅有14.3%的患者培养结果仍为阳性，而对照组为38.9%（P = 0.035）。总之，这项前瞻性对照纵向研究阐明了人类肠道IgA抗体对溶组织内阿米巴和溶组织内阿米巴感染的动态反应性质，并揭示ALA患者肠道抗凝集素IgA抗体峰值增强，且与溶组织内阿米巴和溶组织内阿米巴感染的清除相关。
