Nishijima Haruna, Ogawa Tomoko, Shirasawa Hiroshi
Department of Molecular Virology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Division of Virology and Medical Zoology, Chiba Prefectural Institute of Public Health, Chiba, Japan.
Microbiol Immunol. 2022 Nov;66(11):519-528. doi: 10.1111/1348-0421.13021. Epub 2022 Sep 7.
Lactate dehydrogenase (LDH) levels in measles virus (MeV) reinfection cases for the diagnosis of measles have not been extensively studied. Thus, we evaluated the significance of serum LDH in the immune response of patients with MeV reinfection in comparison with those of patients with primary infection. Among 70 patients who tested positive for MeV-RNA, 42 with high MeV-specific IgG avidity (HA) were suspected as cases of reinfection and 28 with low MeV-specific IgG (LA) were suspected as cases of primary infection. The viral loads in the HA group were also lower than those in the LA group (P < 0.001). The titers of MeV-specific IgM and IgG in the HA group were significantly lower and higher, respectively, than those in the LA group (P < 0.001). The total LDH and LDH isozyme levels were elevated in the LA group compared with those in the HA group (P < 0.001). Through receiver operating characteristic curve analyses, we determined that the area under the curve of total LDH level was 0.87 (95% CI 0.74-1.00) and that the discriminatory accuracy was high for total LDH and all isozymes. By stepwise binary logistic regression analysis considering MeV-specific IgG avidity, we developed a model using IgG, IgM, and total LDH as explanatory variables, which was optimal for distinguishing the LA and HA groups (adjusted R = 0.773, P < 0.001). Thus, the serum LDH level in addition to IgM and IgG may be useful parameters for differentiating MeV reinfection from primary infection.
尚未对用于麻疹诊断的麻疹病毒（MeV）再感染病例中的乳酸脱氢酶（LDH）水平进行广泛研究。因此，我们评估了血清LDH在MeV再感染患者免疫反应中的意义，并与原发性感染患者进行了比较。在70例MeV-RNA检测呈阳性的患者中，42例具有高MeV特异性IgG亲和力（HA）的患者被怀疑为再感染病例，28例具有低MeV特异性IgG（LA）的患者被怀疑为原发性感染病例。HA组的病毒载量也低于LA组（P < 0.001）。HA组中MeV特异性IgM和IgG的滴度分别显著低于和高于LA组（P < 0.001）。与HA组相比，LA组的总LDH和LDH同工酶水平升高（P < 0.001）。通过受试者工作特征曲线分析，我们确定总LDH水平的曲线下面积为0.87（95%CI 0.74-1.00），总LDH和所有同工酶的鉴别准确性较高。通过考虑MeV特异性IgG亲和力的逐步二元逻辑回归分析，我们建立了一个以IgG、IgM和总LDH作为解释变量的模型，该模型最适合区分LA组和HA组（调整后R = 0.773，P < 0.001）。因此，除了IgM和IgG外，血清LDH水平可能是区分MeV再感染和原发性感染的有用参数。
