Takahashi E E, Rossi C L
Departamento de Patologia Clínica, FCM, Universidade Estadual de Campinas, São Paulo, Brasil.
Rev Inst Med Trop Sao Paulo. 1997 Nov-Dec;39(6):327-31. doi: 10.1590/s0036-46651997000600004.
The persistence, in some subjects, of specific IgM antibodies to Toxoplasma gondii for several months after the acute phase of infection has complicated the interpretation of serological test results for toxoplasmosis. Several reports have emphasized the value of the detection of Toxoplasma-specific IgA antibodies for the diagnosis of acute toxoplasmosis. In this article, we report the follow-up profiles of Toxoplasma-specific IgM and IgA antibodies in serum samples obtained from 12 patients at various intervals after the onset of the clinical manifestations of infection. IgM antibodies were detected by the indirect immunofluorescence (IIF) test, antibody capture enzyme-linked immunosorbent assay (cELISA) and enzyme-mediated chemilluminescent technique (CmL). IgA antibodies were quantified by the direct ELISA (dELISA) and cELISA procedures. As defined by the manufacturer of the cELISA test for IgA used, most patients with acute toxoplasmosis have antibody levels > 40 arbritary units per ml (AU/ml). At values > 40 AU/ml, the cELISA for IgA detected significant antibody levels for a shorter time than the other techniques used for IgM and IgA detection. However, IgA levels < or = 40 AU/ml do not exclude the possibility of acute toxoplasmosis since such levels can be reached very soon after infection with T. gondii. The results obtained in the present study show that the serological diagnosis of acute toxoplasmosis may not be such an easy task. Our data suggest that use of the IgA-cELISA concomitantly with IgM antibody screening could permit, in some circumstances, a more efficient diagnosis of acute acquired toxoplasmosis.
在某些个体中,感染弓形虫急性期过后的数月内,针对弓形虫的特异性IgM抗体持续存在,这使得弓形虫病血清学检测结果的解读变得复杂。一些报告强调了检测弓形虫特异性IgA抗体对急性弓形虫病诊断的价值。在本文中,我们报告了从12例感染临床表现出现后的不同时间间隔采集的血清样本中弓形虫特异性IgM和IgA抗体的随访情况。IgM抗体通过间接免疫荧光(IIF)试验、抗体捕获酶联免疫吸附测定(cELISA)和酶介导化学发光技术(CmL)进行检测。IgA抗体通过直接ELISA(dELISA)和cELISA方法进行定量。按照所使用的IgA的cELISA检测试剂盒制造商的定义,大多数急性弓形虫病患者的抗体水平>40任意单位每毫升(AU/ml)。在>40 AU/ml时,IgA的cELISA检测到显著抗体水平的时间比用于IgM和IgA检测的其他技术要短。然而,IgA水平≤40 AU/ml并不能排除急性弓形虫病的可能性,因为在感染刚地弓形虫后很快就能达到这样的水平。本研究获得的结果表明,急性弓形虫病的血清学诊断可能并非易事。我们的数据表明,在某些情况下,将IgA-cELISA与IgM抗体筛查同时使用可能会更有效地诊断急性获得性弓形虫病。