Alikhan A, Parkhe K A, Reddy M V R, Harinath B C
Department of Biochemistry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra 442102, India.
Natl Med J India. 1990 Nov-Dec;3(6):265-268.
Filarial antigen, antibody and circulating immune complexed antigen (CIC-Ag) profiles were studied by stick ELISA in the sera of patients who were in different stages of Bancroftian filarial infection. The geometric mean titres (GMT), of filarial IgG antibody in patients with microfilaraemia (424) and all three grades of clinical filariasis (1485, 3845 and 40216 for grades I, II and III respectively), were significantly higher than in normal controls from endemic areas (47). If a filarial antibody titre of greater than 300 is considered positive, the sera of 94% of patients with microfilaraemia and all those with clinical filariasis were positive. The sera of only 11% of normal subjects from endemic areas and none from non-endemic areas were positive for filarial antibody. The antibody titres were significantly higher in patients with grades II and III clinical filariasis than in those with grade I clinical filariasis or microfilaraemia. Analysis of sera for filarial antigen by inhibition ELISA showed higher GMTs in patients with microfilaraemia (5778) and grades I (3917) and II (676) clinical filariasis compared to grade III (66) clinical filariasis or normal subjects from endemic areas (57). Thus 81% of patients with microfilaraemia, 85% with grade I, 88% with grade II and 20% with grade III clinical filariasis and none of the normal subjects from either endemic or non-endemic areas had a filarial antigen titre of greater than 300. CIC-Ag was found to be present in 8% of patients with grade I, 21% with grade II and 79% with grade III clinical filariasis and in none of those with microfilaraemia or normal controls. While the detection of filarial antibody is useful for diagnosing. microfilaraemia and clinical filariasis, the detection of filarial antigen may be superior for diagnosis of microfilaraemia and grade I clinical filarial infection. Assay of CIC-Ag is useful for diagnosing a grade III clinical infection in the absence of microfilariae in the blood.
采用试纸条酶联免疫吸附测定法（stick ELISA），对处于班氏丝虫感染不同阶段患者血清中的丝虫抗原、抗体及循环免疫复合物抗原（CIC-Ag）进行了研究。微丝蚴血症患者丝虫IgG抗体的几何平均滴度（GMT）为424，临床丝虫病三个等级（I级、II级和III级的GMT分别为1485、3845和40216）患者的丝虫IgG抗体几何平均滴度，均显著高于来自流行地区的正常对照（47）。若将丝虫抗体滴度大于300视为阳性，则94%的微丝蚴血症患者血清以及所有临床丝虫病患者血清呈阳性。来自流行地区的正常受试者中只有11%的血清丝虫抗体呈阳性，非流行地区的正常受试者血清丝虫抗体均为阴性。II级和III级临床丝虫病患者的抗体滴度显著高于I级临床丝虫病患者或微丝蚴血症患者。通过抑制酶联免疫吸附测定法分析血清丝虫抗原发现，与III级临床丝虫病患者（66）或来自流行地区的正常对照（57）相比，微丝蚴血症患者（5778）以及I级（3917）和II级（676）临床丝虫病患者的GMT更高。因此，81%的微丝蚴血症患者、85%的I级患者、88%的II级患者和20%的III级临床丝虫病患者，以及来自流行地区或非流行地区的正常受试者中均无人的丝虫抗原滴度大于300。发现I级临床丝虫病患者中有8%、II级临床丝虫病患者中有21%、III级临床丝虫病患者中有79%存在CIC-Ag，微丝蚴血症患者或正常对照中均未检测到CIC-Ag。虽然检测丝虫抗体有助于诊断微丝蚴血症和临床丝虫病，但检测丝虫抗原对于诊断微丝蚴血症和I级临床丝虫感染可能更具优势。在血液中无微丝蚴的情况下，检测CIC-Ag有助于诊断III级临床感染。
