Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Pediatr Infect Dis J. 2013 Jan;32(1):13-6. doi: 10.1097/INF.0b013e3182703460.
The aim of this study was to evaluate the association between clinical signs of congenital toxoplasmosis and IgG subclasses found in newborns participating in the Minas Gerais State Neonatal Screening Program.
Neonates with confirmed congenital toxoplasmosis underwent standardized ophthalmologic evaluation, neuroimaging studies and hearing assessment, as well as enzyme-linked immunosorbent assay testing for total IgG and its subclasses (IgG1, IgG2, IgG3 and IgG4) against soluble (STAg) and recombinant (rSAG1 and rMIC3) antigens of Toxoplasma gondii.
Newborns with congenital toxoplasmosis but without ocular lesions were more likely to present anti-rMIC3 total IgG when compared with those newborns with active or cicatricial retinochoroidal lesions. Detection of anti-rMIC3 IgG2 and IgG4 was associated with presence of retinochoroidal lesions and intracranial calcifications, with higher mean reactivity index values than unaffected newborns with congenital toxoplasmosis. Anti-STAg IgG3 was associated with newborns without neurologic damage.
Specific subclasses of IgG antibodies reacting with recombinant antigens of T. gondii may serve as biomarkers of neurologic and ocular changes in newborns with congenital toxoplasmosis.
本研究旨在评估先天性弓形虫病的临床体征与参与米纳斯吉拉斯州新生儿筛查计划的新生儿 IgG 亚类之间的关联。
确诊为先天性弓形虫病的新生儿接受了标准化的眼科评估、神经影像学研究和听力评估，以及酶联免疫吸附试验检测针对弓形虫可溶性（STAg）和重组（rSAG1 和 rMIC3）抗原的总 IgG 及其亚类（IgG1、IgG2、IgG3 和 IgG4）。
与有活动性或瘢痕性视网膜脉络膜病变的新生儿相比，无眼部病变的先天性弓形虫病新生儿更有可能出现抗 rMIC3 总 IgG。检测抗 rMIC3 IgG2 和 IgG4 与视网膜脉络膜病变和颅内钙化有关，其平均反应指数值高于无先天性弓形虫病的新生儿。抗 STAg IgG3 与无神经损伤的新生儿有关。
与弓形虫重组抗原反应的特异性 IgG 亚类可作为先天性弓形虫病新生儿神经和眼部变化的生物标志物。
