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Maternal IgG avidity and IgM detected by blot as diagnostic tools to identify pregnant women at risk of transmitting cytomegalovirus.

In this study, we determined the avidity index (AI) of anticytomegalovirus (CMV) immunoglobulin G (IgG) and the anti-CMV immunoglobulin M (IgM) profile in 124 pregnant women, 87 of whom were considered at risk of transmitting CMV infection to their offspring and 37 of whom were at no risk. IgG avidity and blot for IgM were performed on two serum samples from each woman, at 6-18 weeks' gestation and at 20-23 weeks' gestation. Pregnancy outcomes were monitored. The results obtained showed that the determination of anti-CMV IgG avidity at 6-18 weeks' gestation can identify all women who would have an infected fetus/newborn (100% sensitivity), whereas IgM detected by blot had poorer results (69% sensitivity). Interestingly, at 20-23 weeks' gestation, the sensitivity of IgM detection by blot was higher than that obtained by avidity (75 % and 63%, respectively) and the combination of IgG avidity and IgM by blot yielded the best results (81% sensitivity).

Antibodies, Viral↗

Standard and alternative regimens of Haemophilus influenzae type b conjugate vaccine (polyribosylribitol phosphate-tetanus toxoid conjugate vaccine) elicit comparable antibody avidities in infants.

BACKGROUND: Haemophilus influenzae type b conjugate vaccines are relatively expensive in the developing world. Previous study of the type b conjugate vaccine polyribosylribitol phosphate-tetanus toxoid conjugate vaccine showed that two dose and fractional three dose schedules elicit protective antibody concentrations equivalent to three full doses. METHODS: Antibody avidity was measured in 73 of these vaccinees with a modified enzyme-linked immunosorbent assay using NH(4) SCN as the chaotrope. Avidity index (AI) is the molarity causing a 50% reduction in OD(405). RESULTS: The postprimary series AI was similar for all dosing regimens. Preboost AI was highest in those receiving three half-doses, although there was no statistical difference among groups. Rises in avidity from age 8 to 12 months were also similar among regimens. Our data support the equivalence of anti-polyribosylribitol phosphate IgG avidity in infants primed with these alternative regimens. CONCLUSIONS: Given the known correlation of avidity with assays of bacterial killing and memory priming, these potentially more economical alternative schedules should be studied in the developing world.

Antibodies, Bacterial↗

Role of avidity and breadth of the CD4 T cell response in progression to AIDS.

The great variability in the time between infection with HIV and the onset of AIDS has been the object of intense study. In the current work, we examine a mathematical model that focuses on the role of immune response variability between patients. We study the effect of variation in both the avidity and the breadth of the immune response on within-patient disease dynamics, viral setpoint and time to AIDS. We conclude that immune response variability can explain the observed variability in disease progression to a large extent. It turns out that the avidity, more than the breadth of the immune response, determines disease progression, and that the average avidity of the five best clones is a much better correlate for disease progression than the total number of clones responding. For the design of vaccines, this would suggest that, if given the choice between stimulating a broader, but average avidity response or a narrower high-avidity response, the latter option would yield better control of virus load and consequently slow down disease progression.

Acquired Immunodeficiency Syndrome↗

High avidity cytotoxic T lymphocytes to a foreign antigen are efficiently activated following immunization with a recombinant paramyxovirus, simian virus 5.

Our previous work has shown that high avidity cytotoxic T lymphocytes (CTL) are optimal for virus clearance in vivo and thus it is necessary that an effective vaccine is capable of eliciting high avidity CTL. To determine if vaccination with the paramyxovirus simian virus 5 (SV5) elicits a high avidity response to a model foreign antigen, a recombinant virus was engineered to express chicken ovalbumin (rSV5-Ova). To compare the CTL response elicited with rSV5-Ova and a recombinant vaccinia virus expressing ovalbumin (rVV-Ova), mice were vaccinated intranasally with various doses of each vector and the Ova-specific CTL response was determined by ELISPOT analysis. Here, it has been shown that rSV5 can be equally as effective as rVV in eliciting antigen-specific CTL, in terms of both the total number of CTL and the number of high avidity cells. This has implications for both the design of vaccine vectors and the route utilized for vaccine administration for the elicitation of high avidity CTL responses. The advantages and future potential use of rSV5 vaccine vectors are discussed.

Animals↗

Humoral immunity to commensal oral bacteria: quantitation, specificity and avidity of serum IgG and IgM antibodies reactive with Actinobacillus actinomycetemcomitans in children.

The levels, specificity and avidities of serum IgM and IgG antibodies reactive with Actinobacillus actinomycetemcomitans (Aa) serotypes a, b and c were determined in periodontally healthy (PH) children and compared with subjects with localized juvenile periodontitis (LJP). All PH children exhibited IgM and IgG Aa-reactive antibodies whether or not Aa was detected subgingivally but the antibodies were not specific for Aa. In contrast, LJP sera contained high concentrations of IgM and IgG antibodies reactive with Aa that were largely specific for this bacterium. IgM and IgG antibodies in both PH and LJP subjects were of low avidity. With one exception, the avidities of IgG anti-Aa antibodies were significantly greater than those of IgM antibodies in both PH and LJP subjects. However, although the LJP subjects had as much as 115-fold more Aa-reactive IgG antibody than did the PH subjects the avidities of their IgG antibodies were no greater than those of the PH group. The induction by the host of low-avidity antibodies, that are ineffective in immune elimination, may be a reason why commensal bacteria persist at mucosal surfaces and why persons with LJP fail to eliminate Aa from their periodontal pockets.

Actinobacillus Infections↗

Avidity of Aspergillus umbrosus IgG antibodies in farmer's lung disease.

Farmer's lung disease (FL), the commonest form of allergic alveolitis caused by repeated inhalation of mouldy hay, is associated with exposure to the fungus Aspergillus umbrosus among Finnish farmers. The antigen-binding avidity of A. umbrosus-specific IgG antibodies was measured in 12 FL patients in acute phases of initial and recurrent attacks and during 1 year follow up as well as in 12 healthy farmers and five healthy urban controls. The farmers' groups were further divided into two subgroups: subjects with short exposure (< 7 years) and subjects with long exposure (> 25 years). During the first acute phase FL patients with long exposure exhibited a high avidity of A. umbrosus-specific IgG antibodies that remained high during the 1 year follow up, although the A. umbrosus-specific IgG antibody titre decreased. A re-exposure to mouldy hay leading to a recurrence further enhanced the maturation of the antibody avidity, so that an even higher A. umbrosus-specific IgG avidity with a less significant increase of antibody titre occurred than during the first acute attack. Notably higher IgG antibody avidity was observed in FL patients with long exposure than in healthy farmers or in healthy controls.

Antibody Affinity↗

[Measles antibody followed after measles vaccination: comparison with gelatin beads agglutination (PA) antibody, hemagglutination inhibition (HI) antibody and IgG-avidity].

The immunity status of 37 cases has been tested at 6 weeks and 3.5 years after vaccination by using gelatin beads agglutination (PA), hemagglutination inhibition (HI) and avidity of specific IgG. The geometric mean titer (GMT) of HI antibody was 34.5 at 6 weeks and had fallen to 17.9 over 3.5 years. On the other hand, GMT of PA antibody was 36.5 at 6 weeks and had increased to 286.0 over 3.5 years. Also, the average of measles specific IgG avidity was 4.5% at 6 week and had increased to 45.4% over 3.5 years. The multiple regression analysis was performed in order to investigate the relationship of HI antibody and avidity to PA antibody. The significant involvement of the HI antibody and avidity to PA antibody (standardized partial regression coefficients; 0.612, 0.726) was recognized and the multiple correlation coefficient was 0.880 (p < 0.001). Hence it was strongly suggested that the increase of PA antibody with time could be dependent on that of IgG avidity.

Agglutination↗

Avidity of immunoglobulin G directed against human cytomegalovirus during primary and secondary infections in immunocompetent and immunocompromised subjects.

Diagnosis of primary human cytomegalovirus (HCMV) infection is accomplished exclusively by serologic testing. Among the possible methods, the determination of immunoglobulin G (IgG) avidity is one of the least explored. In this work, we used a commercially available kit to test anti-HCMV IgG avidity in 336 serum samples from pregnant women and transplant recipients undergoing virologically proven HCMV primary or nonprimary infections and from latently infected blood donors. Our results demonstrate that the anti-HCMV IgG avidity test differentiates primary from nonprimary HCMV infections in both pregnant women and solid organ transplant recipients. In fact, 88.6% of primary infections and no secondary infections showed low-avidity IgG to HCMV. In particular, low IgG avidity is a marker of primary infection for 18 to 20 weeks after onset of symptoms in both immunocompromised and immunocompetent subjects.

Antibodies, Viral↗

Immunoglobulin G avidity in differentiation between early and late antibody responses to West Nile virus.

In 1999 West Nile virus (WNV) surfaced in the United States in the city of New York and spread over successive summers to most of the continental United States, Canada, and Mexico. Because WNV immunoglobulin M (IgM) antibodies have been shown to persist for up to 1 year, residents in areas of endemicity can have persistent WNV IgM antibodies that are unrelated to a current illness with which they present. We present data on the use of IgG avidity testing for the resolution of conflicting data arising from the testing of serum or plasma for antibodies to WNV. Thirteen seroconversion panels, each consisting of a minimum of four samples, were used. All samples were tested for the presence of WNV IgM and IgG antibodies, and the avidity index for the WNV IgG-positive samples was calculated. Panels that exhibited a rise in the WNV IgM level followed by a sequential rise in the WNV IgG level were designated "primary." Panels that exhibited a marked rise in the WNV IgG level followed by a sequential weak WNV IgM response and that had serological evidence of a prior flavivirus infection were designated "secondary." All samples from the "primary" panels exhibited low avidity indices (less than 40%) for the first 20 to 30 days after the recovery of the index sample (the sample found to be virus positive). All of the "secondary" samples had elevated WNV IgG levels with avidity indices of > or =55%, regardless of the number of days since the recovery of the index sample. These data demonstrate that it is possible to differentiate between recent and past exposure to WNV or another flavivirus through the measurement of WNV IgG avidity indices.

Antibodies, Viral↗

Initial serum antibody titer to Porphyromonas gingivalis influences development of antibody avidity and success of therapy for chronic periodontitis.

This study assessed the effect of periodontal therapy on specific serum antibody concentration, expressed as titer, and antibody binding strength, expressed as relative avidity. The immune responses to Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans were investigated. Antibody titer was assayed by enzyme-linked immunosorbent assay (ELISA) and relative avidity was measured by thiocyanate elution in 17 adult periodontitis patients before and after therapy. Immunoglobulin G (IgG) avidities (expressed as thiocyanate molarity) to P. gingivalis increased from 1.01 to 1.38 M (P = 0.05) and IgA titers (expressed as ELISA units [EU]) increased from 89 to 237 EU (P = 0.012). There were no significant changes in avidity to A. actinomycetemcomitans, but the titer of all three immunoglobulin classes increased significantly (P < 0.03). More specifically, when patients were divided into subgroups which had originally been either IgG seropositive (i.e., having an IgG titer to this organism > 2 times the control median) or seronegative for P. gingivalis, only patients who were initially seropositive showed a significant increase in antibody avidity (P = 0.026; mean difference, 0.69 M). Patients who were originally seropositive in terms of IgG and IgA titer to P. gingivalis had demonstrably better treatment outcomes in terms of a reduced number of deep pockets and sites which bled on probing (P < 0.05). These findings suggest that periodontal therapy affects the magnitude and quality of the humoral immune response to suspected periodontopathogens, that this effect is dependent on initial serostatus, and that initial serostatus may have a bearing on treatment outcome.

Adult↗

Improved diagnosis of primary Toxoplasma gondii infection in early pregnancy by determination of antitoxoplasma immunoglobulin G avidity.

The ability to discriminate between primary Toxoplasma gondii infection acquired in early pregnancy and infection that occurred prior to pregnancy was assessed by an enzyme immunoassay (EIA) to determine the avidity of toxoplasma-specific immunoglobulin G (IgG). The results were compared to those of the Platelia Toxo-IgM EIA and the dye test. The mean IgG avidity of 73 serum samples collected within 20 weeks after the estimated time of infection was 5.9%. Among 26 serum samples showing latent infection (toxoplasma-specific IgG positive and IgM negative) and 56 IgM-positive serum samples with a low dye test titer (<300 IU/ml), the mean avidities were 51.3 and 57.5%, respectively. A total of 72.8% of 92 IgM-positive serum samples with a high dye test titer (>300 IU/ml), suggesting a recent toxoplasma infection, had an IgG avidity of >20%, indicating that the infection started more than 20 weeks earlier. By introducing high IgG avidity as a criterion in the first half of pregnancy to exclude the possibility that toxoplasma infection was acquired during gestation, many women will avoid unnecessary examinations, treatment, and anxiety.

Animals↗

Low avidity antibodies to dsDNA as a diagnostic tool.

An evaluation of the diagnostic value of low avidity antibodies to double stranded DNA (dsDNA) measured by the polyethylene glycol (PEG) assay was undertaken. By routine screening low avidity anti-dsDNA were detected in the serum samples of 106 hitherto unknown patients. Clinical data of these patients were collected and when only low avidity anti-dsDNA was present (n = 92) a varied disease spectrum was observed. A diagnosis of systemic lupus erythematosus (SLE) was established in 48/92 (52%), lupus-like disease in 21/92 (23%), autoimmune hepatitis in 9/92 (10%), rheumatoid arthritis in 8/92 (9%), and mixed connective tissue disease in 2/92 (2%) of all patients. Patients with definite SLE were all older than 45 years and predominantly female (46/48, 96%). They showed a remarkably low incidence of renal disease (2/69, 3%). When high avidity antibodies to dsDNA as measured by the Farr assay were present as well (n = 14) a diagnosis of SLE could be established in 12/14 (86%) of all patients, indicating the secondary importance of low avidity anti-dsDNA in these patients.

Adult↗

Functional avidity directs T-cell fate in autoreactive CD4+ T cells.

Major histocompatibility complex class II tetramer staining and activation analysis identified 2 distinct types of antigen-specific CD4+ T cells in the peripheral blood of humans with type 1 (autoimmune) diabetes. T cells with low-avidity recognition of peptide-MHC ligands had low sensitivity to activation and inefficient activation-induced apoptosis. In contrast, high-avidity T cells were highly sensitive to antigen-induced cell death through apoptotic mechanisms, and both apoptosis-resistant high- and low-avidity T cells that survived prolonged tetramer treatment were rendered anergic to restimulation by antigen. In addition, however, apoptosis-resistant high-avidity T cells acquired regulatory features, being able to suppress both antigen-specific and nonspecific CD4+ T-cell responses. This suppression was contact-dependent and correlated with the down-regulation of HLA class II and costimulatory molecules on antigen-presenting cells, including B cells and dendritic cells. T cells face a variety of fates following antigen exposure, including the paradoxic maintenance of high-avidity autoreactive T cells in the peripheral circulation, perhaps due to this capability of acquiring anergic and suppressive properties. Regulation via down-modulation of antigen-presenting cell function, a form of cell-to-cell licensing for suppression, also offers possibilities for the application of peptide-MHC therapeutics.

Adolescent↗

AVID: an integrative framework for discovering functional relationships among proteins.

BACKGROUND: Determining the functions of uncharacterized proteins is one of the most pressing problems in the post-genomic era. Large scale protein-protein interaction assays, global mRNA expression analyses and systematic protein localization studies provide experimental information that can be used for this purpose. The data from such experiments contain many false positives and false negatives, but can be processed using computational methods to provide reliable information about protein-protein relationships and protein function. An outstanding and important goal is to predict detailed functional annotation for all uncharacterized proteins that is reliable enough to effectively guide experiments. RESULTS: We present AVID, a computational method that uses a multi-stage learning framework to integrate experimental results with sequence information, generating networks reflecting functional similarities among proteins. We illustrate use of the networks by making predictions of detailed Gene Ontology (GO) annotations in three categories: molecular function, biological process, and cellular component. Applied to the yeast Saccharomyces cerevisiae, AVID provides 37,451 pair-wise functional linkages between 4,191 proteins. These relationships are approximately 65-78% accurate, as assessed by cross-validation testing. Assignments of highly detailed functional descriptors to proteins, based on the networks, are estimated to be approximately 67% accurate for GO categories describing molecular function and cellular component and approximately 52% accurate for terms describing biological process. The predictions cover 1,490 proteins with no previous annotation in GO and also assign more detailed functions to many proteins annotated only with less descriptive terms. Predictions made by AVID are largely distinct from those made by other methods. Out of 37,451 predicted pair-wise relationships, the greatest number shared in common with another method is 3,413. CONCLUSION: AVID provides three networks reflecting functional associations among proteins. We use these networks to generate new, highly detailed functional predictions for roughly half of the yeast proteome that are reliable enough to drive targeted experimental investigations. The predictions suggest many specific, testable hypotheses. All of the data are available as downloadable files as well as through an interactive website at http://web.mit.edu/biology/keating/AVID. Thus, AVID will be a valuable resource for experimental biologists.

Algorithms↗

Porin A-specific antibody avidity in patients who are convalescing from meningococcal B disease.

Porin A (PorA), which determines the serosubtype of Neisseria meningitidis, is the main antigen of a candidate vaccine against serogroup B meningococci, which has been shown to induce high-avidity antibodies in children. We characterized the immune response of children after convalescing from meningococcal infection with a serosubtype P1.7-2,4 strain. Acute- and convalescent-phase sera of 21 children with meningococcal septic shock caused by strains with PorA subtype P1.7-2,4 were collected. The serum bactericidal antibody titers, IgG isotype distribution, and antibody avidity were measured. We determined whether the differences in avidity of anti-outer membrane vesicle antibodies were PorA specific. Serum bactericidal activity against H44/76 P1.7-2,4 was <4 in all convalescent sera. The IgG isotype distribution of the convalescent sera was dominated by IgG(1), followed by IgG(3), whereas no IgG(2) or IgG(4) was found. The geometric mean avidity index (GMAI) of convalescent sera measured against a strain with the identical subtype as the infective isolate was significantly higher than that against a strain with a heterologous PorA subtype or a PorA-negative mutant strain (57 versus 35 and 23%, respectively; p = 0.005 and p < 0.001). Geometric mean avidity titers were highest for P1.7-2,4, corresponding with the highest GMAI. The GMAI after invasive meningococcal disease was lower than after vaccination of healthy toddlers with a monovalent P1.7-2,4 outer membrane vesicle vaccine.

Antibody Affinity↗

IgG recognizing 21-24 kDa and 30-33 kDa tachyzoite antigens show maximum avidity maturation during natural and accidental human toxoplasmosis.

We describe the avidity maturation of IgGs in human toxoplasmosis using sequential serum samples from accidental and natural infections. In accidental cases, avidity increased continuously throughout infection while naturally infected patients showed a different profile. Twenty-five percent of sera from chronic patients having specific IgM positive results could be appropriately classified using exclusively the avidity test data. To take advantage of the potentiality of this technique, antigens recognized by IgG showing steeper avidity maturation were identified using immunoblot with KSCN elution. Two clusters of antigens, in the ranges of 21-24 kDa and 30-33 kDa, were identified as the ones that fulfill the aforementioned avidity characteristics.

Acute Disease↗

Dynamics of serum immunoglobulin G avidity for Porphyromonas gingivalis in adult periodontitis.

The purpose of this study was to examine avidity of immunoglobulin G (IgG) antibody for surface antigens of Porphyromonas gingivalis in sera from patients with adult periodontitis. The antigens used were whole cell antigens, lipopolysaccharides (LPS), and fimbriae of non-invasive P. gingivalis ATCC 33277 and invasive 16-1. Serum IgG titers for the P. gingivalis antigens were measured by enzyme-linked immunosorbent assay (ELISA) before and after periodontal initial preparation. IgG avidity was measured by diethylamine dissociation ELISA. IgG titers for the whole cell antigens of 16-1, LPS, and the fimbria antigens from both P. gingivalis strains were significantly higher in the patient group than those in the control group, whereas values for avidities were significantly lower in patient sera. Although we found a statistically significant decrease in the IgG titers of patients following initial preparation, avidities against the fimbria antigen of invasive 16-1 strain increased. The present study showed that IgG antibodies elicited in patients were different in their ability to respond to invasive P. gingivalis 16-1 and to non-invasive 33277. The patient sera with high IgG titers demonstrated low values for avidity, suggesting that IgG responses in patients play a limited role in colonization inhibition or elimination of P. gingivalis. The data indicate that periodontally healthy individuals may have highly functional antibodies which may protect against P. gingivalis colonization. Our findings suggest that the ability to produce functional antibodies in the patient group is lower than that in the periodontally healthy group, but the functional antibodies can be induced by the initial preparation.

Adult↗

GAD65-specific CD4+ T-cells with high antigen avidity are prevalent in peripheral blood of patients with type 1 diabetes.

Negative selection of self-reactive T-cells during thymic development, along with activation-induced cell death in peripheral lymphocytes, is designed to limit the expansion and persistence of autoreactive T-cells. Autoreactive T-cells are nevertheless present, both in patients with type 1 diabetes and in at-risk subjects. By using MHC class II tetramers to probe the T-cell receptor (TcR) specificity and avidity of GAD65 reactive T-cell clones isolated from patients with type 1 diabetes, we identified high-avidity CD4+ T-cells in peripheral blood, coexisting with low-avidity cells directed to the same GAD65 epitope specificity. A variety of cytokine patterns was observed, even among T-cells with high MHC-peptide avidity, and the clones utilize a biased set of TcR genes that favor two combinations, Valpha12-beta5.1 and Valpha17-Vbeta4. Presence of these high-avidity TcRs indicates a failure to delete autoreactive T-cells that likely arise from oligoclonal expansion in response to autoantigen exposure during the progression of type 1 diabetes.

Antibody Affinity↗