Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
mSphere. 2018 Nov 7;3(6):e00484-18. doi: 10.1128/mSphere.00484-18.
Sensitive and specific detection of anti- antibodies in standard enzyme-linked immunosorbent assays (ELISAs) is compromised by cross-reactivity and poor sensitivity of classical antigens. Previously, we discovered 48 strongly reactive peptide antigens of -specific B-cell epitopes from 21 immunodominant proteins. By comprehensive individual testing of 11 top-ranked peptide antigens, we found very high sensitivity and specificity for detection of anti- antibodies in chemiluminescent ELISAs. The current study established a labor-saving colorimetric ELISA by using a mixture of 12 strongly reactive peptide antigens (Ctr Mix1) in a single well/serum rather than assaying reactivity to each individual peptide. For performance evaluation, we used a simulated population of 212 anti- antibody-positive and -negative sera from 125 women with NAAT-confirmed active infection and from 87 healthy women at low risk for infection. In comparison to a composite reference standard (CRS) for anti- antibody status, the Ctr Mix1 IgG ELISA achieved 93.9% sensitivity, significantly superior to the 49% to 79% sensitivities of four commercial anti- IgG ELISAs, and 98% specificity of all tested assays. Compared to the labor-intensive individual peptide testing, this mixed peptide ELISA retained high specificity with only marginal, ∼5% sensitivity loss. By ROC-AUC, likelihood ratio, and predictive value analyses, the Ctr Mix1 ELISA performed satisfactorily at 10% to 75% prevalence range of anti- antibodies but significantly better than commercial ELISAs. Thus, the labor-saving mixed peptide colorimetric ELISA format provides simultaneously high specificity and sensitivity for detection of anti- antibodies. For detection of anti- antibodies by serological assays, use of classical chlamydial antigens results in high cross-reactivity and poor sensitivity. Previously, we discovered 48 strongly reactive peptide antigens of -specific B-cell epitopes from 21 immunodominant proteins, and individual testing and combined scoring of 5 to 11 peptide antigens provided highly sensitive and specific detection of anti- antibodies in chemiluminescent ELISAs. To simplify this method, this study established a single-well labor-saving colorimetric ELISA using a mixture of 12 strongly reactive peptide antigens (Ctr Mix1) for detection of anti- antibodies. This Ctr Mix1 ELISA (94% sensitivity and 98% specificity) outperformed 4 commercial ELISAs (49% to 79% sensitivity and 98% specificity). This ELISA can be easily implemented and commercialized, with convenient setup for use in nonspecialized laboratories. Thus, this mixed peptide assay with superior specificity and sensitivity will improve serodiagnosis of infections.
敏感和特异地检测抗抗体在标准酶联免疫吸附测定(ELISA)中受到交叉反应和经典抗原灵敏度差的影响。以前,我们从 21 种免疫显性蛋白中发现了 48 个强烈反应的肽抗原,这些抗原具有特异性 B 细胞表位。通过对 11 种排名最高的肽抗原的综合个体测试,我们发现化学发光 ELISA 检测抗抗体具有非常高的灵敏度和特异性。目前的研究通过在单个孔/血清中使用 12 种强烈反应的肽抗原(Ctr Mix1)混合物建立了一种节省劳力的比色 ELISA,而不是检测每个单独肽的反应性。为了进行性能评估,我们使用了来自 125 名经核酸扩增试验(NAAT)证实患有活动性感染的女性和 87 名感染风险低的健康女性的模拟人群中的 212 份抗抗体阳性和阴性血清。与抗抗体状态的综合参考标准(CRS)相比,Ctr Mix1 IgG ELISA 达到了 93.9%的灵敏度,明显优于四种商业抗 IgG ELISA 的 49%至 79%的灵敏度,并且所有测试的检测都具有 98%的特异性。与劳动强度大的个体肽检测相比,这种混合肽 ELISA 保留了高特异性,仅灵敏度略有下降,约为 5%。通过 ROC-AUC、似然比和预测值分析,Ctr Mix1 ELISA 在抗抗体 10%至 75%流行范围的表现令人满意,但明显优于商业 ELISA。因此,节省劳力的混合肽比色 ELISA 格式同时提供了抗抗体检测的高特异性和灵敏度。对于血清学检测抗抗体,使用经典衣原体抗原会导致高交叉反应性和低灵敏度。以前,我们从 21 种免疫显性蛋白中发现了 48 个强烈反应的肽抗原,这些抗原具有特异性 B 细胞表位,对 5 至 11 个肽抗原进行个体测试和联合评分可在化学发光 ELISA 中高度敏感和特异性地检测抗抗体。为了简化此方法,本研究使用 12 种强烈反应的 肽抗原混合物(Ctr Mix1)建立了一种单孔节省劳力的比色 ELISA,用于检测抗抗体。这种 Ctr Mix1 ELISA(94%的灵敏度和 98%的特异性)优于 4 种商业 ELISA(49%至 79%的灵敏度和 98%的特异性)。该 ELISA 易于实施和商业化,在非专业实验室中设置方便。因此,这种具有优越特异性和灵敏度的混合肽检测将改善衣原体感染的血清学诊断。