Mastracchio G, Malcangi A, Mineccia C, Martinetto P
Ospedale Civile di Saluzzo, Università di Torino.
G Batteriol Virol Immunol. 1989 Jan-Dec;82(1-12):192-213.
The importance that Toxoplasma gondii congenital infection may assume is still representing a stimulus for trying to improve Toxoplasmosis serological diagnosis; task, this one, which Laboratory is charged with, and that is often hard, particularly when we have to value the possibility of an infection in progress. With the purpose to complete the results obtained in a preceding work of ours, we have valued two among the most commonly used tests for Toxoplasmosis serodiagnosis, the AD (direct agglutination provided by BioMerieux) and the IHA (indirect haemoagglutination provided by Behring), together and separately, in order to make use of their coupling with major security and effectiveness, on the ground of the results obtained on two different groups of individuals, in the number of 125 for each group; for these groups it was possible to expect a different index of receptivity and a different percentage of recent or in progress infections. It was come out, as regards the IHAm a very good degree of assurance in trying to single out the past immunity, while this test wouldn't generally seem to be able to offer sufficient indications to distinguish the recent or in progress infection from past immunity, as it often declares, in fact, middle-high titres also in cases probably referable to the last mentioned situation. The AD has offered a good tribute in estimating the past immunity and it would also appear to give assurance in singling out recent or in progress infection (thanks to the possibility to determine IgM presence); while the presumed capacity of this test in revealing cases of very early infection has resulted not sufficiently assured. In substance the coupling of the two test, which in the direct comparison have shown a good correlation, but also several discordances, seems to be an useful procedure of reciprocal confirmation as regards the singling out of immunity; while the possibility of showing the recent or in progress infection--anyway, always a difficult task, above all, when, as it happened in this research, we deal with it without being able to follow the titre evolution in the time-should be entrusted with major certainty to the AD.
弓形虫先天性感染可能具有的重要性仍然是推动人们努力改进弓形虫病血清学诊断的一个因素;这项任务由实验室负责,而且往往很困难,尤其是当我们必须评估正在进行感染的可能性时。为了完善我们之前一项工作中获得的结果,我们对弓形虫病血清学诊断中最常用的两项检测进行了评估,即生物梅里埃公司提供的直接凝集试验(AD)和贝林公司提供的间接血凝试验(IHA),将它们一起或分别用于两组不同个体,每组各125人,以便根据所获得的结果,以更高的安全性和有效性利用它们的联合检测;对于这两组个体,可以预期有不同的易感性指标以及不同比例的近期或正在进行的感染。结果表明,就IHA而言,在试图确定既往免疫方面有很高的确定性,而这项检测通常似乎无法提供足够的指征来区分近期或正在进行的感染与既往免疫,因为事实上,在可能属于后一种情况的病例中,它也常常显示出中高滴度。AD在评估既往免疫方面表现良好,而且在确定近期或正在进行的感染方面似乎也能提供确定性(得益于能够检测IgM的存在);而这项检测在揭示极早期感染病例方面的假定能力结果并不足够可靠。实质上,这两项检测在直接比较中显示出良好的相关性,但也存在一些不一致之处,它们的联合似乎是一种有用的相互确认程序,有助于确定免疫情况;而确定近期或正在进行的感染的可能性——无论如何,始终是一项艰巨的任务,尤其是在本研究中这样的情况下,我们在无法跟踪滴度随时间变化的情况下进行处理——应主要依靠AD来获得更高的确定性。