T cell proliferative responses to Chlamydia trachomatis antigen in vitro in patients with a history of gynaecological chlamydia infection.
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Publications and source records attributed to K Skaug.
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A simple and rapid staphylococcal co-agglutination (SA) test for detection of rotavirus in human faecal specimens is described. A suspension of protein A-containing staphylococci coated with a rabbit hyperimmune serum against the rotavirus strain of calf diarrhoeae virus was used as reagent. Before the SA test, the faecal specimens were absorbed with a suspension of uncoated staphylococci. 34 of 36 rotavirus immune electron microscopy (IEM) positive samples showed a positive SA test, whereas none of 41 IEM negative specimens agglutinated the staphylococcal reagent. The SA test was as sensitive as an enzyme-linked immunosorbent assay (Rotazyme) and in our hands more sensitive than a latex agglutination test (Rotalex).
Chlamydia trachomatis was cultured from the cervix of 70 of 557 (12.6%) patients admitted for therapeutic abortion. Postoperatively, 22 (3.9%) developed acute pelvic inflammatory disease (PID); of these women, 14 (63.6%) had harboured C trachomatis in the cervix before the abortion. Thus of 70 patients with chlamydial infection, 14 (20%) developed PID postoperatively. Of the chlamydia-positive patients, six of the 15 (40%) aged less than 20 years and eight of the 53 (15%) patients aged 20-30 years developed PID. Twelve of the 70 women with chlamydial infections showed a significant increase in serum chlamydial IgG antibody titres over a four week period; four of these women developed PID. Neisseria gonorrhoeae was recovered from only four patients, one of whom developed PID after the abortion. Treatment with a single dose of intravenous doxycycline (200 mg) was given before and during surgery to about half of the patients. In our study, this regimen had no protective effect against the development of PID associated with C trachomatis.
The T cell proliferative response to Chlamydia trachomatis was studied in otherwise healthy persons. A suspension of partially purified C. trachomatis subtype LGV-2 particles was used throughout the study. Studies of cord blood lymphocytes demonstrated that the preparation was not mitogenic. The proliferative capacity of peripheral blood mononuclear cells (PBM) and T + non-T cells from adults was tested; in about 70% a proliferative response was observed. The proliferative responses were dependent upon antigen presenting cells (APC) and were mainly mediated by T cells, even though B cells proliferated to a lesser extent. Using antigen-pulsed non-T cells as APC, a significant and consistent specific proliferative response could be obtained. High responders could be separated from low responders with different T cell concentrations. We also found that the T cell response was restricted by the HLA-D/DR determinants of the T cell donor.
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Colostrum from 10 of 30 randomly chosen women contained IgA antibodies to Chlamydia trachomatis as shown by an enzyme-linked immunosorbent assay and a single-antigen immunofluorescence test. Specific colostral IgA was present only in seropositive women. In addition, Chlamydial-specific IgA was also detected in milk from 5 of 6 women who were shown to harbour C. trachomatis in the lower genital tract during delivery. There was a close correlation between chlamydial-specific IgA and the chlamydial secretory immunoglobulin titres in colostrum and milk samples but not between chlamydial IgA titres and the total secretory IgA content. No agreement was observed between the specific IgA antibodies in milk and corresponding serum samples. It is suggested that chlamydial-specific IgA in milk is induced by genital infections.
An enzyme-linked immunosorbent assay (ELISA) for the detection of serum IgG antibodies to Chlamydia trachomatis has been developed. The C. trachomatis subtype LGV-2 was used as antigen. The ELISA was reproducible and its sensitivity and specificity compared well with that of the single-antigen immunofluorescence test (r = 0.83). 29 (85%) of the 34 patients with acute salpingitis had chlamydial serum IgG antibodies measured by the ELISA technique. The detection level in single blood donor specimens was 30%. Among the 34 patients with acute salpingitis, 16 paired serum specimens showed a fourfold or greater rise/fall in antibody titres, and 12 of these belonged to the 19 who harboured C. trachomatis in the lower genital tract.
Chlamydia trachomatis was isolated from the cervix of 30 of 218 (13.8%) women admitted for legal termination of pregnancy. During the first two weeks after the abortion seven of the 30 (23.3%) patients developed pelvic inflammatory disease. Four of these had serological evidence of recent active chlamydial infection. Thus, routine examination of patients for genital chlamydial infection before termination of pregnancy is recommended.
During the 1974 rubella epidemic in Oslo, paired sera from 7781 pregnant women were examined for rubella-specific IgG antibodies using the single radial haemolysis (SRH) test. 12.4% of the women with seronegative in early pregnancy, with no significant variations between the different age groups. In the seropositive samples, there was a mean decrease in the rubella IgG concentration of about 30% during 22 gestational weeks. 53 seroconversions were found. In addition, 22 primary infections were detected by the demonstration of rubella specific IgM antibodies using an indirect immunofluorescence test. The persistence of the rubella IgM antibodies was examined and a large individual variation was found, from less than 1 month up to 4 months after onset of the disease. The serological techniques, particularly the SRH test, were found to be well suited for mass screening.
The study is based upon primary rubella infections detected in a collection of 7,781 serum pairs from as many pregnant women out of a total number of about 12,500 in the Oslo area of Norway in 1974. In the spring of that year, a rubella outbreak occurred. The results obtained on the serum pairs were compared and supplemented with acute serodiagnostic data obtained from the files of the virus laboratories, informations obtained from the mothers when interviewed in 1976 and from the files of application for legal abortions. From October 1973 through December 1975 a total of 118 serologically confirmed pregnancy infections were detected in the area, 94 of which took place between February and July 1974. The year following the outbreak showed scattered cases, whereas the last half of 1975 was free of cases. The pairs of the collection covered about one third of the pregnancy months occurring between February 1974 through January 1975, and the rubella infections diagnosed by seroconversion during this period indicated an attack rate for the epidemic period of 2.8% pregnancy months, and 0.35% for the post-epidemic period. 50% of the infections went unrecognised when they occurred, whereas only 17% seemed to have been subclinical. It is estimated that at least 9 children may have been born with rubella sequelae following infections during this period, when the legal abortions because of rubella in taken into consideration.
Absorption of sera with protein A rich staphylococci eliminated unwanted secondary IgM staining caused by rheumatoid factors in the indirect immunofluorescence test for rubella virus antibodies. The absorption did not lower the sensitivity for IgM rubella antibodies as compared with the haemagglutination inhibition test on the IgM serum fractions obtained by ultracentrifugation.
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The indirect fluorescent antibody technique for specific IgM and IgG antibodies was applied to paired sera from 33 patients with a current M. pneumoniae infection, along with the complement fixation test. A roughly parallel increase in antibody titres in all the three tests was observed; the ratio of IgM/IgG titres was, however, higher in patients below 20 years of age than in older patients. Rises in antibody titres were regularly observed in spite of the fact that most of the patients were treated with tetracycline or erythromycin during the acute phase of the disease. Serum specimens from 15 other patients lacking clinical data of a recent M. pneumoniae infection, but with stationary complement fixation titres, all showed IgG antibodies with stationary titers and, with the exception of three patients, a negative IgM antibody test. Sera from 20 individuals lacking complement fixing antibodies were also without demonstrable IgG and IgM antibodies. Sampling of serum from 9 of the pneumonia patients was repeated. The last IgM positive sample was collected up to six months after onset of the disease and all were found to be negative in the IgM test 8 to 10 months after onset of the illness in these treated patients. The implications of these findings for the serological diagnosis of M. pneumoniae infections are discussed.
A passive haemolysis test for the determination of antibodies against rubella virus haemagglutinin is presented. According to this method, the principle of radial immunodiffusion techinque is applied. Rubella haemagglutinin-coated chick erythrocytes in the agarose gel were lysed by the diffusing positive sera of complement at 37 degrees C. The passive haemolysis test was compared with the conventional haemagglutination inhibition method, and the diameter of the haemolysis zones was shown to be a direct measure of the quantity of antibody added to the well. A plot of the log (HI titre) against the zone diameter gives a straight line. There is no need to remove nonspecific haemagglutination inhibitors. However, all serum samples must be inactivated at 56 degrees C for 30 minutes before testing. Tests of 200 serum samples from healthy women showed a good correlation between the haemagglutination inhibition titre and the antibody titre determined by the passive haemolysis technique. Twenty-one samples with a haemagglutination inhibition titre less than 10 were also negative in the passive haemolysis test. With the exception of one, all sera with a positive haemagglutination inhibition titre showed a positive haemolysis reaction. The method was found to be as specific and as sensitive as the haemagglutination inhibition test. In addition, the technique is rapid and simple for quantitative studies of antibodies against rubella virus.
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Testing for hepatitis B core antibodies (anti-HBc) was performed in 12,104 consecutive blood donors, 139 (1.15%) of whom were found to be positive. The first 6036 donors were also screened for ALT; 91 (1.51%) had repeatedly elevated values. ALT screening was of no help in detecting anti-HBc-positive donors. Those with anti-HBc or repeatedly raised ALT levels were further tested for hepatitis C virus antibodies (anti-HCV), and 3 (2.16%) and 1 (1.10%) anti-HCV-positive donors were detected, respectively. This prevalence of anti-HCV (0.5%) is not significantly different from that found in 1000 unselected donors at our blood bank. Testing for ALT and anti-HBc as surrogate markers for hepatitis C is therefore not recommended in Norwegian blood donors and should be replaced by anti-HCV screening.