Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan.
Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
Pediatr Int. 2020 Aug;62(8):920-925. doi: 10.1111/ped.14244. Epub 2020 Jul 19.
Subacute sclerosing panencephalitis (SSPE) is a progressive neurologic disorder caused by the measles virus (MV) and is identified by positive MV-specific antibody titers, detected mainly by hemagglutination inhibition (HI) tests in the cerebrospinal fluid (CSF). However, an alternative method, the enzyme immunoassay (EIA), has increasingly become a preferred method for detecting MV antibodies. To establish the index for SSPE diagnosis using EIA, we investigated the correlation between HI and EIA titers of MV antibodies in SSPE patients.
Data on MV antibody titers and measurement methods at the time of diagnosis in 89 Japanese SSPE cases diagnosed between 1979 and 2006 were obtained by a survey. We also assessed the serum and CSF MV antibody titers in three patients with SSPE and serum MV antibody titers in 38 healthy adults using immunoglobulin G (IgG)-EIA and HI.
In all cases diagnosed as SSPE, IgG-EIA titers in the CSF were ≥0.49 IU/mL. There was a positive correlation between serum antibody values in the controls measured by IgG-EIA and HI. In patients with SSPE, both serum and CSF antibody values, measured by IgG-EIA, and HI, were positively correlated, and a positive correlation was found between the serum and CSF MV antibody titers as measured by IgG-EIA. The serum/CSF MV antibody titer ratios determined by IgG-EIA were <20 in most SSPE patients.
Immunoglobulin G-EIA may be a suitable alternative method for SSPE diagnosis; however, its potential utility and the cut-off point of ≥0.49 IU/mL should be tested with additional patient cohorts.
亚急性硬化性全脑炎（SSPE）是一种由麻疹病毒（MV）引起的进行性神经疾病，其特征是 MV 特异性抗体滴度呈阳性，主要通过脑脊液（CSF）中的血凝抑制（HI）试验检测到。然而，酶免疫测定（EIA）等替代方法已越来越成为检测 MV 抗体的首选方法。为了建立 EIA 用于 SSPE 诊断的指标，我们研究了 SSPE 患者中 MV 抗体的 HI 和 EIA 滴度之间的相关性。
通过调查获得了 1979 年至 2006 年间诊断的 89 例日本 SSPE 病例的 MV 抗体滴度和诊断时的检测方法数据。我们还使用 IgG-EIA 和 HI 评估了 3 例 SSPE 患者的血清和 CSF MV 抗体滴度以及 38 名健康成年人的血清 MV 抗体滴度。
在所有诊断为 SSPE 的病例中，CSF 中的 IgG-EIA 滴度均≥0.49 IU/mL。通过 IgG-EIA 测量的对照组血清抗体值与 HI 呈正相关。在 SSPE 患者中，通过 IgG-EIA 和 HI 测量的血清和 CSF 抗体值均呈正相关，并且通过 IgG-EIA 测量的血清和 CSF MV 抗体滴度之间存在正相关。通过 IgG-EIA 确定的血清/CSF MV 抗体滴度比值在大多数 SSPE 患者中<20。
IgG-EIA 可能是 SSPE 诊断的合适替代方法；但是，应该用更多的患者队列来测试其有效性和≥0.49 IU/mL 的截断值。
