Chungue E, Boutin J P, Roux J
Institut Territorial de Recherches Médicales Louis Malardé, Papeete, Tahiti, Polynésie Française.
Res Virol. 1989 May-Jun;140(3):229-40. doi: 10.1016/s0923-2516(89)80100-1.
The usefulness of IgM antibody capture enzyme-linked immunosorbent assay (ELISA-IgM) for the diagnosis of dengue was studied using several groups of sera. An attempt was made to detect IgM against each dengue serotype. Of 76 paired sera from patients with dengue type 4 infection, the diagnosis was confirmed by ELISA-IgM in 74: in 47 out of 49 primary dengue infections and in all 27 secondary dengue infections. It was possible to detect IgM in 15 of the acute sera of primary infections and in 16 of the acute sera of secondary infections. In 20 patients from whom only single serum with high haemagglutination-inhibition titre (greater than or equal to 640) was available, 18 were found positive for dengue IgM. Dengue infection was also confirmed in 10 patients with dengue type 1 and in 10 patients with dengue type 2. IgM was detected in 1 of the acute sera of patients with either dengue type 1 or dengue type 2 infection. In all cases in which IgM was detected, a positive response was obtained for the homologous antigen. ELISA-IgM on sequential serum samples from 7 proven cases of dengue type 4 revealed that antibody titres greater than or equal to 400 are reached early in the second week of the illness and persist for 60 days or more at a low level (titre less than 400). An attempt was made to obtain a type-specific presumptive diagnosis by analysing the relative titre against each of the 4 antigens. It was possible to make a diagnosis of dengue type 4 in 85% and 52% of IgM-positive responses in primary and secondary infections (p less than 0.01), respectively, using paired sera from patients with known dengue type 4 infection. ELISA-IgM was shown to be of interest in the diagnosis and surveillance of dengue in French Polynesia where dengue viruses are, presently, the only known flavivirus.
使用几组血清研究了IgM抗体捕获酶联免疫吸附测定法（ELISA-IgM）在登革热诊断中的效用。尝试检测针对每种登革热血清型的IgM。在76例4型登革热感染患者的配对血清中，ELISA-IgM确诊了74例：49例原发性登革热感染中的47例以及所有27例继发性登革热感染。在原发性感染的15份急性血清和继发性感染的16份急性血清中检测到了IgM。在20例仅提供了一份血凝抑制效价高（大于或等于640）血清的患者中，发现18例登革热IgM呈阳性。在10例1型登革热患者和10例2型登革热患者中也确诊了登革热感染。在1型或2型登革热感染患者的急性血清中检测到了1例IgM。在所有检测到IgM的病例中，针对同源抗原均获得了阳性反应。对7例确诊的4型登革热患者的系列血清样本进行ELISA-IgM检测显示，抗体效价在疾病第二周早期达到大于或等于400，并在低水平（效价小于400）持续60天或更长时间。尝试通过分析针对4种抗原中每种抗原的相对效价来获得型特异性的初步诊断。分别使用已知4型登革热感染患者的配对血清，在原发性和继发性感染中，IgM阳性反应的85%和52%中可以做出4型登革热的诊断（p<0.01）。在法属波利尼西亚，登革热病毒是目前唯一已知的黄病毒，ELISA-IgM在登革热的诊断和监测中显示出价值。
