Ehrnst A, Barkholt L, Brattström C, Czajkowski J, Teodosiu O, Tollemar J, Ljungman P
Department of Virology, Central Microbiological Laboratory of Stockholm County Council, Sweden.
J Med Virol. 1993 Feb;39(2):118-24. doi: 10.1002/jmv.1890390207.
The finding that active cytomegalovirus (CMV) infection is associated with an increased mortality after organ transplantation and the introduction of successful antiviral treatment render more urgent the development of rapid and accurate diagnostic methods. Rapid immunodiagnosis of active CMV infection was investigated by means of immunofluorescence staining of leucocytes by monoclonal antibodies. Monoclonals directed against the matrix protein, pp65, and ClonabR monoclonal antibody, which has been claimed to be directed against immediate early antigens, were used. All monoclonal antibodies directed against the matrix protein reacted equally well in staining of polymorphonuclear cells. Monoclonals described by Gerna et al. [1991] and by Pereira et al. [1982] also reacted more clearly with mononuclear cells. One hundred fifty heparinized blood samples were collected monthly from 82 patients within 3 months after transplantation. In addition, 132 EDTA blood samples were tested in connection with suspected CMV infection. The latter approach gave a better agreement between antigen detection and virus isolation. There was a relationship between active CMV infection and the finding of antigen-positive leucocytes (P = 0.002, Fisher's exact test) found within 1 month of one another. When the number of antigen-positive cells was taken into account, a relationship to severe CMV disease was detected (P < 0.001, Fisher's exact test). The antigen test was positive at an early stage during the development of severe CMV disease. This rapid method is useful for following the disease process of CMV and in determining when to initiate antiviral treatment.
活动性巨细胞病毒（CMV）感染与器官移植后死亡率增加相关，且成功的抗病毒治疗方法的引入使得快速准确的诊断方法的开发更为迫切。通过用单克隆抗体对白细胞进行免疫荧光染色，研究了活动性CMV感染的快速免疫诊断。使用了针对基质蛋白pp65的单克隆抗体以及据称针对即刻早期抗原的ClonabR单克隆抗体。所有针对基质蛋白的单克隆抗体在多形核细胞染色中反应同样良好。Gerna等人[1991年]和Pereira等人[1982年]描述的单克隆抗体与单核细胞的反应也更明显。在移植后3个月内，每月从82名患者中采集150份肝素化血样。此外，对132份EDTA血样进行了与疑似CMV感染相关的检测。后一种方法在抗原检测和病毒分离之间达成了更好的一致性。活动性CMV感染与在彼此1个月内发现的抗原阳性白细胞之间存在关联（P = 0.002，Fisher精确检验）。当考虑抗原阳性细胞数量时，检测到与严重CMV疾病存在关联（P < 0.001，Fisher精确检验）。在严重CMV疾病发展的早期阶段，抗原检测呈阳性。这种快速方法对于跟踪CMV的疾病进程以及确定何时开始抗病毒治疗很有用。
