伊朗弓形虫病血清学诊断中确证试验的必要性。
The necessity of confirmatory testing in serodiagnosis of toxoplasmosis in iran.
作者信息
Saraei Mehrzad, Fattahi Seyedeh Zeinab, Shahnazi Mojtaba, Afshari Afshin, Alizadeh Safar Ali, Jahanihashemi Hassan
机构信息
Dept. of Medical Parasitology and Mycology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran ; Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran ; Reference Laboratory, Qazvin University of Medical Sciences, Qazvin, Iran.
Reference Laboratory, Qazvin University of Medical Sciences, Qazvin, Iran.
出版信息
Iran J Parasitol. 2013 Oct;8(4):608-16.
BACKGROUND
Toxoplasma specific IgM antibodies; the common serologic marker in diagnosis of acute toxoplasmosis has its own limitations. Confirmatory testing with other markers, introduced as a complementary tool in distinguish acute and chronic infections is unusual in Iran. In the present study, we investigated the correlation between the results of IgM ELISA, IgA ELISA, and IgG avidity tests in the diagnosis of toxoplasmosis to demonstrate the necessity of confirmatory testing in serodiagnosis of infection in the country.
METHODS
A total of 107 positive Toxoplasma IgG and IgM sera were obtained from patients referred to private laboratories and stored at -20 °C for futures use. Serologic tests were set up in duplicate to analyze the serum levels of IgG, IgM, IgA, and IgG avidity antibodies using commercial ELISA kits. The results were presented as semi quantitative for IgG, IgM and IgA ELISA, and Relative Avidity Index in percentage for IgG avidity test. Pearson's correlation coefficient (rp) was applied to analyze the data.
RESULTS
Of 107 serum samples, T. gondii specific IgM and IgA antibodies were positive in 67.3% and 53.3%, respectively. Besides, 29.9% of the sera displayed low avidity for IgG antibodies. The rp was - 0.572 (P<0.01) between the IgG avidity and IgM ELISA, - 0.364 between the IgG avidity and IgA ELISA (P<0.01), and 0.564 between the IgM and IgA ELISA (P<0.01).
CONCLUSION
The study strongly highlights the necessity of confirmatory testing in differential diagnosis of acute and chronic toxoplasmosis in Iran.
背景
弓形虫特异性IgM抗体是诊断急性弓形虫病的常见血清学标志物，但有其自身局限性。在伊朗，引入其他标志物进行确证检测作为区分急性和慢性感染的辅助工具并不常见。在本研究中，我们调查了IgM酶联免疫吸附测定（ELISA）、IgA ELISA和IgG亲和力检测结果在弓形虫病诊断中的相关性，以证明在该国感染血清学诊断中进行确证检测的必要性。
方法
从转诊至私立实验室的患者中获取总共107份弓形虫IgG和IgM阳性血清，并储存在-20°C以备后用。使用商业ELISA试剂盒一式两份进行血清学检测，以分析IgG、IgM、IgA和IgG亲和力抗体的血清水平。IgG、IgM和IgA ELISA结果以半定量形式呈现，IgG亲和力检测结果以相对亲和力指数百分比形式呈现。应用Pearson相关系数（rp）分析数据。
结果
在107份血清样本中，弓形虫特异性IgM和IgA抗体阳性率分别为67.3%和53.3%。此外，29.9%的血清对IgG抗体显示低亲和力。IgG亲和力与IgM ELISA之间的rp为-0.572（P<0.01），IgG亲和力与IgA ELISA之间的rp为-0.364（P<0.01），IgM与IgA ELISA之间的rp为0.564（P<0.01）。
结论
该研究强烈强调了在伊朗急性和慢性弓形虫病鉴别诊断中进行确证检测的必要性。
Zotero 插件