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[深部念珠菌病中特异性IgG、IgM、IgA和IgE同种型的特征分析]

[Characterization of specific IgG, IgM, IgA and IgE isotypes in profound candidiasis].

作者信息

Toubas D, Aubert D, Marnef F, Villena I, Pignon B, Léon A, Foudrinier F

机构信息

Laboratoire de parasitologie-mycologie, Equipe 4 Inserm U. 314, Upres EA 2070, IFR 53, Hôpital Maison-Blanche, Reims, France.

出版信息

Ann Biol Clin (Paris). 1998 May-Jun;56(3):329-36.

PMID:9754265
Abstract

Enzyme-linked immunofiltration assay technique (Elisa) has been applied to the characterization of G, M, A and E anti-Candida antibodies isotypes specific to cell wall mannans in 201 sera from 126 patients. These sera were studied at the same time using Co-immunoelectrodiffusion and indirect immunofluorescence. In 18 of 21 patients with systemic candidiasis, Elisa demonstrated the presence of antimannan IgG antibodies in sera contemporary of Candida positive blood culture. These IgG were associated with antimannan IgM, A and E in 15 patients. In 37 patients colonized with Candida, used as negative controls, antimannan IgG were detected in 3 cases, and in 2 were associated with specific IgMs. The sensitivity and specificity of Elisa IgM and IgA in the diagnosis of systemic Candidiasis were 85.7% and 81%, respectively. The kinetic study shows that the different isotypes appeared most of the time simultaneously. The evolution of the 4 isotypes beyond the acute episode was variable and without correlation with the clinical status. The decrease of IgG was slower than the one of IgM, IgA or IgE. The systematic research, in at risk patients, of antimannan antibodies using Elisa required simple technology. A simple method should allow to aim at other functional antigens which could be used in a quantitative manner to determine the efficacy of the medical treatment.

摘要

酶联免疫过滤分析技术(ELISA)已应用于对126例患者的201份血清中针对细胞壁甘露聚糖的G、M、A和E抗念珠菌抗体同种型进行表征。同时使用协同免疫电泳和间接免疫荧光对这些血清进行研究。在21例系统性念珠菌病患者中的18例中,ELISA显示在念珠菌血培养阳性的同时血清中存在抗甘露聚糖IgG抗体。在15例患者中,这些IgG与抗甘露聚糖IgM、A和E相关。在37例念珠菌定植患者(用作阴性对照)中,3例检测到抗甘露聚糖IgG,2例与特异性IgM相关。ELISA IgM和IgA在系统性念珠菌病诊断中的敏感性和特异性分别为85.7%和81%。动力学研究表明,不同同种型大多同时出现。4种同种型在急性期后的演变各不相同,且与临床状态无关。IgG的下降比IgM、IgA或IgE的下降慢。使用ELISA对高危患者进行抗甘露聚糖抗体的系统研究需要简单的技术。一种简单的方法应能够针对其他功能性抗原,这些抗原可用于定量确定药物治疗的疗效。

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