Studies on HSV specific IgA antibodies in lacrimal fluid from patients with herpes keratitis by solid phase radioimmunoassay.

A highly sensitive solid phase radioimmunoassay (RIA) was adapted for determination of herpes simplex virus (HSV) specific IgA antibodies in lacrimal fluids. The RIA procedure was applied to examine HSV IgA antibodies in serial samples of lacrimal fluid and in sera from 14 patients with herpes keratitis. HSV-specific IgA antibodies were detected in the lacrimal fluid of the affected eye in 12 of the 14 patients. HSV IgA antibodies were also detected in the lacrimal fluid of the unaffected eye of 7 of these patients in titers lower than those found in the corresponding affected eye. Evidence for local HSV antibody production in lacrimal fluid in herpes keratitis was supported by examination for antibodies to the unrelated measles antigen. Detection of lacrimal fluid HSV IgA antibodies might be a useful adjunct in rapid diagnosis of herpes keratitis. The advantage of characterizing the local immune response as well as viral expression in the affected vs. the unaffected eye in the same individual as a model for understanding the factors leading to subclinical vs. clinical manifestations of recurrent ocular herpes virus infections will be discussed.