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致病性钩端螺旋体属的成分在人类钩端螺旋体病诊断中的潜在应用。

Components of pathogenic Leptospira spp. with potentials for diagnosis of human leptospirosis.

作者信息

Saengjaruk Patcharin, Sakolvaree Yuwaporn, Maneewatch Santi, Tomanakan Kanchana, Tongtawe Pongsri, Tapchaisri Pramaun, Chaicumpa Wanpen

机构信息

Department of Pathology, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhonnayok 26120, Thailand.

出版信息

Asian Pac J Allergy Immunol. 2007 Dec;25(4):225-32.

Abstract

Existing serological methods for diagnosis of leptospirosis are still unsatisfactorily due mainly to their low accuracy. In this study, serum samples of 18 clinically diagnosed-, IgM dipstick positive-, MAT positive-leptospirosis patients (group 1) were analyzed by IgG Western blotting against SDS-PAGE separated-whole cell homogenates of pathogenic and non-pathogenic Leptospira spp. belonging to 20 serovars of 15 serogroups. The samples of group 1 were collected from the patients at days 3 to 10 after the fever onset (fist samples). Second and third samples could be obtained from 4 patients. Sera of the 22 patients with other febrile illnesses (group 2) and 22 healthy counterparts (group 3) were used as patient- and normal- controls, respectively. Irrespective of the serovar or serogroup of the pathogenic Leptospira spp. used as antigen in the Western blotting, all of the 18 sera of patients with leptospirosis (group 1) gave characteristic diffuse antigen-antibody reactive bands located at approximately 35-38 and 22-26 kDa; and thus 100% diagnostic sensitivity of the Western blot assay. Some serum samples of the leptospirosis patients also reacted to components located at 80-100, approximately 70, 60, 54, and 48 kDa. More bands or the early recognized bands with increased intensity were observed when tested the second and third samples. The characteristic bands were not seen when homogenates of L. biflexa, serogroup Semaranga, serovar Patoc (saprophytic) and L. biflexa, serogroup Andamana, serovar Andamana (non-pathogenic but can infect host) were used in the assay. Sera of groups 2 and 3 did not react to the components at the seven locations implying 100% diagnostic specificity of the IgG Western blot assay. While awaiting validation with more patients' samples, the IgG Western Blot analysis aiming at the detection of the characteristic antigen-antibody reactive bands described in this study has high potential for early, rapid, simple and accurate diagnosis of human leptospirosis.

摘要

现有的用于诊断钩端螺旋体病的血清学方法仍不尽人意,主要原因是其准确性较低。在本研究中,对18例临床诊断为钩端螺旋体病、IgM试纸条检测呈阳性、显微镜凝集试验(MAT)呈阳性的患者(第1组)的血清样本,采用免疫球蛋白G(IgG)免疫印迹法,针对属于15个血清群的20个血清型的致病性和非致病性钩端螺旋体的十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)分离的全细胞匀浆进行分析。第1组的样本是在发热开始后的第3至10天从患者身上采集的(首次样本)。4例患者可获得第二次和第三次样本。22例患有其他发热性疾病的患者(第2组)的血清和22例健康对照者(第3组)的血清分别用作患者对照和正常对照。无论用作免疫印迹法抗原的致病性钩端螺旋体的血清型或血清群如何,18例钩端螺旋体病患者(第1组)的所有血清均呈现出位于约35 - 38 kDa和22 - 26 kDa处的特征性弥漫性抗原 - 抗体反应条带;因此免疫印迹法的诊断敏感性为100%。一些钩端螺旋体病患者的血清样本也与位于80 - 100 kDa、约70 kDa、60 kDa、54 kDa和48 kDa处的成分发生反应。检测第二次和第三次样本时观察到更多条带或早期识别的条带强度增加。当使用双曲钩端螺旋体、塞马朗血清群、帕托克血清型(腐生型)和双曲钩端螺旋体、安达马纳血清群、安达马纳血清型(非致病性但可感染宿主)的匀浆进行检测时,未观察到特征条带。第2组和第3组的血清在这七个位置未与这些成分发生反应,这意味着IgG免疫印迹法的诊断特异性为100%。在等待更多患者样本验证的同时,针对本研究中描述的特征性抗原 - 抗体反应条带的IgG免疫印迹分析在早期、快速、简单且准确地诊断人类钩端螺旋体病方面具有很高的潜力。

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