Koopmans M, Sánchez-Martinéz D, Patton J, Stewart J
Viral Exanthems and Herpesvirus Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Med Virol. 1995 Aug;46(4):321-8. doi: 10.1002/jmv.1890460406.
Fetal infection with human cytomegalovirus (HCMV) is the leading viral cause of brain damage among newborns at birth or later in life. Efforts to screen newborns routinely for shedding of the virus by immunoassay have been hampered by inhibitors in urine, reportedly the host protein beta2-microglobulin (beta 2m). An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of HCMV antigen in which the reactivity was not affected by the presence of beta 2m, but nevertheless inhibition was observed when urine samples with high levels of virus were tested. The presence of antibodies to HCMV was demonstrated in these urine samples by antibody ELISA and immunoblot using the major antigenic protein of HCMV (pp150) expressed in Escherichia coli; this offers an alternative explanation for the inhibition in ELISA. The presence of HCMV antibodies correlated significantly with congenital HCMV infection (as detected by tissue culture isolation of virus from urine samples of newborns), especially with asymptomatic cases (sensitivity 70%; specificity 94%). The data indicate a local (renal) immune response to HCMV in congenitally infected children, which may have future diagnostic applications.
胎儿感染人巨细胞病毒（HCMV）是新生儿出生时或日后生活中脑损伤的主要病毒病因。通过免疫测定对新生儿进行病毒排出常规筛查的努力受到尿液中抑制剂的阻碍，据报道这种抑制剂是宿主蛋白β2-微球蛋白（β2m）。开发了一种酶联免疫吸附测定（ELISA）用于检测HCMV抗原，其反应性不受β2m存在的影响，但在检测高病毒水平的尿液样本时仍观察到抑制作用。通过抗体ELISA和使用在大肠杆菌中表达的HCMV主要抗原蛋白（pp150）的免疫印迹法，在这些尿液样本中证实了抗HCMV抗体的存在；这为ELISA中的抑制作用提供了另一种解释。HCMV抗体的存在与先天性HCMV感染（通过从新生儿尿液样本中进行病毒组织培养分离检测）显著相关，尤其是与无症状病例相关（敏感性70%；特异性94%）。数据表明先天性感染儿童对HCMV存在局部（肾脏）免疫反应，这可能具有未来的诊断应用价值。
