Institut de Parasitologie et de Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Transrationnelle, Université de Strasbourg , Strasbourg, France.
Laboratoire de Parasitologie et Mycologie Médicale, Hôpitaux Universitaires de Strasbourg , Strasbourg, France.
J Clin Microbiol. 2023 Oct 24;61(10):e0035423. doi: 10.1128/jcm.00354-23. Epub 2023 Sep 20.
This study aimed to evaluate different serological strategies for the postnatal diagnosis of congenital toxoplasmosis (CT) and establish a biological algorithm for CT diagnosis. The study analyzed serological data of immunoglobulins M, A, and G (IgM, IgA, IgG) performed by immunoenzymatic and compared immunological profile (CIP) assays in 668 newborns with CT diagnosis across four testing periods: P1 (D0- D10), P2 (D11-D35), P3 (D36-D45), and P4 (>D45). Forty-nine percent of the 668 CT cases were diagnosed during P1 and 34%, 4%, and 12% during P2, P3, and P4, respectively. CIP assays detected neosynthetized IgMs/IgGs in 98% of CT cases diagnosed during P1, while IgMs and IgAs were detected in 90% and 57% of CT cases diagnosed during P2 and in 88% and 67% of diagnoses made during P3, respectively. Detection of neosynthesized IgMs/IgGs, IgMs, and IgAs by immunoassay contributed to CT diagnosis in 81%, 77%, and 60% of cases, respectively. In total, 46% of serum samples were positive for all three parameters, 27% for two, and 27% for one of the three. The study recommends using the CIP assay as standard during P1 for CT diagnosis and IgM and IgA immunoassays after P1. A clinical and biological follow-up in a specialized center with a close collaboration between biologists and clinicians is highly recommended to increase the chances of early diagnosis. Overall, this study provides useful information for the development of a biological algorithm for CT diagnosis, which can aid in early detection and appropriate treatment of this disease.
本研究旨在评估不同的血清学策略用于先天性弓形虫病（CT）的产后诊断，并建立 CT 诊断的生物学算法。该研究分析了 668 例 CT 患儿的血清免疫球蛋白 M、A 和 G（IgM、IgA、IgG）的酶免疫测定和比较免疫谱（CIP）检测结果，这些患儿来自四个检测期：P1（D0-D10）、P2（D11-D35）、P3（D36-D45）和 P4（>D45）。668 例 CT 病例中有 49%在 P1 期诊断，34%、4%和 12%分别在 P2、P3 和 P4 期诊断。CIP 检测在 98%的 P1 期诊断的 CT 病例中检测到新合成的 IgMs/IgGs，而在 P2 期和 P3 期诊断的 CT 病例中分别检测到 90%和 57%和 88%和 67%的 IgMs 和 IgAs。免疫测定检测新合成的 IgMs/IgGs、IgMs 和 IgAs 对 81%、77%和 60%的 CT 病例诊断有帮助。总的来说，46%的血清样本三种参数均为阳性，27%为两种参数阳性，27%为一种参数阳性。该研究建议在 P1 期使用 CIP 检测作为 CT 诊断的标准，并在 P1 后使用 IgM 和 IgA 免疫测定。强烈建议在专门中心进行临床和生物学随访，并密切协作生物学家和临床医生，以提高早期诊断的机会。总的来说，本研究为 CT 诊断的生物学算法的开发提供了有用的信息，这有助于早期发现和适当治疗这种疾病。
