Grimwood K, Lund J C, Coulson B S, Hudson I L, Bishop R F, Barnes G L
Department of Gastroenterology, Royal Children's Hospital, Melbourne, Victoria, Australia.
J Clin Microbiol. 1988 Apr;26(4):732-8. doi: 10.1128/jcm.26.4.732-738.1988.
The development of mucosal immunity is presumed to be the most important marker of rotavirus infection. The practical difficulties of obtaining small-bowel secretions stimulated this study of the antibody response to acute rotavirus infection at other sites. Forty-four infants admitted to the hospital with rotavirus gastroenteritis had serum, saliva, and feces collected at the acute phase (median, 5.5 days), during convalescence (median, 33.5 days), and 4 months later (median, 12.2 weeks). A subgroup of 19 children also had duodenal juice collected in parallel. Rotavirus-specific immunoglobulin G (IgG), IgA, secretory immunoglobulin, and IgM were measured and compared in all samples. The results showed that the estimation of antirotavirus serum IgM, serum IgG, duodenal juice IgA, and duodenal juice IgM by an enzyme immunoassay indicated an immune response to severe primary rotavirus infection in all children. Four months later, the levels of serum IgG and IgA served as the most sensitive markers of the preceding rotavirus infection. The predictive accuracies of immune responses at different sites in relation to a positive IgA immune response in the duodenum were calculated. Fecal IgA predicted duodenal IgA rotavirus antibodies with accuracies of 86% at 1 month and 92% at 4 months. The high sensitivity of serum IgM and IgG in detecting rotavirus infection and the high predictive accuracy of fecal IgA as an indicator of duodenal IgA abrogates the need for duodenal intubation to detect (or monitor) an immune response to rotavirus infection. This finding has important practical implications for epidemiological studies of acute diarrhea in children and in rotavirus vaccine trials.
黏膜免疫的发展被认为是轮状病毒感染最重要的标志。获取小肠分泌物存在实际困难，因此开展了这项针对其他部位对急性轮状病毒感染抗体反应的研究。44名因轮状病毒胃肠炎入院的婴儿在急性期（中位数为5.5天）、恢复期（中位数为33.5天）以及4个月后（中位数为12.2周）采集了血清、唾液和粪便。19名儿童组成的亚组同时还采集了十二指肠液。对所有样本检测并比较了轮状病毒特异性免疫球蛋白G（IgG）、IgA、分泌型免疫球蛋白和IgM。结果显示，通过酶免疫测定法估算抗轮状病毒血清IgM、血清IgG、十二指肠液IgA和十二指肠液IgM表明，所有儿童对严重的初次轮状病毒感染均有免疫反应。4个月后，血清IgG和IgA水平是之前轮状病毒感染最敏感的标志物。计算了不同部位免疫反应相对于十二指肠中IgA免疫反应阳性的预测准确性。粪便IgA预测十二指肠IgA轮状病毒抗体的准确率在1个月时为86%，在4个月时为92%。血清IgM和IgG在检测轮状病毒感染方面的高敏感性以及粪便IgA作为十二指肠IgA指标的高预测准确性，使得无需进行十二指肠插管来检测（或监测）对轮状病毒感染的免疫反应。这一发现对儿童急性腹泻的流行病学研究和轮状病毒疫苗试验具有重要的实际意义。
