da Silva M V, Nakamura P M, Camargo E D, Batista L, Vaz A J, Romero E C, Brandao A P
Emilio Ribas Infectology Institute, Sao Paulo, Brazil.
Am J Trop Med Hyg. 1997 Jun;56(6):650-5. doi: 10.4269/ajtmh.1997.56.650.
A dot-ELISA was evaluated using antigen obtained from Leptospira interrogans cultures of the serovars brasiliensis, canicola, cynopteri, hebdomadis, and icterohaemorrhagiae for the detection of human IgM, IgG, and IgA. Single serum samples from 63 patients with the icterohemorrhagic form of leptospirosis in the acute phase, collected 3-14 days (mean = 7 days) after the onset of symptoms were tested. Ten patients were examined during convalescence and followed up for a period of 4-12 months. For a control group, serum samples from 10 apparently healthy individuals with no clinical or epidemiologic history of leptospirosis, and from 38 patients with nonleptospiral illnesses were used. In the acute phase, IgM antibodies were detected in 62 (98%) of 63 patients and IgG and IgA were observed in 70% and 76% of them, respectively. For the admission serum samples, the predictive value negative of the dot-ELISA was 98% for IgM, 72% for IgG, and 76% for IgA detection. All 10 patients followed-up during convalescence showed IgM antibodies up to the sixth month, decreasing to 57% by the 10th month, and persisting in only one of six patients during the 11th and 12th months of follow-up. Immunoglobulin G was detected in six patients up to the fourth month and in two of six individuals up to the end of follow-up. Immunoglobulin A was observed in all patients up to the end of the first month, decreasing progressively up to the sixth month, and was no longer detected in any patients from seventh to the 12th months of follow-up. The dot-ELISA can be used as an important laboratory screening test, especially when detecting IgM antibodies. It proved to be effective in the diagnosis of human leptospirosis, and appears to have advantages in terms of yield, time, and case of execution and low cost.
使用从问号钩端螺旋体血清型巴西型、犬型、食蟹猴型、七日热型和出血性黄疸型培养物中获得的抗原，对斑点酶联免疫吸附测定（dot-ELISA）进行评估，以检测人免疫球蛋白M（IgM）、免疫球蛋白G（IgG）和免疫球蛋白A（IgA）。检测了63例急性期出血性黄疸型钩端螺旋体病患者在症状出现后3至14天（平均7天）采集的单份血清样本。对10例恢复期患者进行了检查，并随访4至12个月。对照组使用了10名无钩端螺旋体病临床或流行病学史的明显健康个体以及38例非钩端螺旋体病患者的血清样本。在急性期，63例患者中有62例（98%）检测到IgM抗体，其中70%和76%的患者分别检测到IgG和IgA。对于入院时的血清样本，斑点酶联免疫吸附测定检测IgM的阴性预测值为98%，检测IgG为72%，检测IgA为76%。所有10例恢复期随访患者在第六个月前均显示有IgM抗体，到第十个月降至57%，在随访的第11个月和第12个月，6例患者中仅1例仍有IgM抗体。6例患者在第四个月前检测到免疫球蛋白G，随访结束时6例中有2例仍可检测到。所有患者在第一个月末均检测到免疫球蛋白A，到第六个月逐渐下降，从第七个月到第12个月随访期间，所有患者均未再检测到。斑点酶联免疫吸附测定可作为一项重要的实验室筛查试验，尤其是在检测IgM抗体时。它在人类钩端螺旋体病的诊断中被证明是有效的，并且在产量、时间、操作简便性和低成本方面似乎具有优势。
