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Comparison of a new rapid plasma reagin card test with the standard rapid plasma reagin 18-mm circle card test and the venereal disease research laboratory slide test for serodiagnosis of syphilis.

The rapid plasma reagin (RPR) card test manufactured by Beckman Instruments, Inc., was compared, qualitatively and quantitatively, with the Venereal Disease Research Laboratory (VDRL) slide test and the standard RPR 18-mm circle card tests for the serodiagnosis of syphilis. Sera from 638 individuals were used in this study. Two pilot lots and two production lots of antigen were submitted by Beckman Instruments, Inc., for evaluation. Qualitative agreement among the three RPR card tests was 98.1%; between the Beckman RPR card and the VDRL slide tests, 95.0%; and between the reference RPR card and the VDRL slide tests, 95.5%. The Beckman RPR card test was 95.3% specific, whereas the specificities of the reference RPR card and the VDRL slide tests were 98.8% and 96.1%, respectively. Sensitivities of the three nontreponemal tests were: Beckman RPR card test production lots, 94.7%; reference RPR card test, 96.8%; and VDRL slide test, 90.6%. Quantitative agreement +/- 1 dilution among the three RPR card tests was 93.0%, whereas quantitative agreement was approximately 40% when both RPR card tests were compared with the VDRL slide test. We found the Beckman RPR card test comparable to the standard RPR card tests. Therefore, the decision of which test to use for the serodiagnosis of syphilis is at the discretion of the user.

Antibodies↗

Evaluation of the serodia Treponema pallidum particle agglutination, the Murex Syphilis ICE and the Enzywell TP tests for serodiagnosis of syphilis.

We evaluated the Treponema pallidum haemagglutination assay (TPHA), a treponemal test, with three other treponemal tests, the Serodia T. pallidum particle agglutination assay, the Murex Syphilis ICE IgG + IgM enzyme immunoassay (EIA) and the Enzywell TP IgG + M EIA (a new rapid EIA) for use in conjunction with the rapid plasma reagin test (RPR), a non-treponemal test, for serodiagnosis of syphilis. In all, 124 serum samples were found reactive with RPR and/or TPHA after testing by the routine laboratory protocol. Twenty-three (18.5%) of them were positive only by RPR test and were evaluated as biologically false-positive, 16 were positive only by the TPHA and 84 by both the RPR and TPHA tests; one sample was non-specific (heterophile reaction) in the TPHA. Agreements of the TPHA with the Serodia TPPA, the Murex Syphilis ICE and the Enzywell TP tests were 96.7%, 100% and 99.1%, respectively. We conclude that each one of the tests, the Serodia TPPA, the Murex Syphilis ICE and the Enzywell TP, is an appropriate substitute for screening for serodiagnosis of syphilis.

Antibodies, Bacterial↗

Development and assessment of ELISA for serodiagnosis of HIV-infection.

A home-made ELISA for serodiagnosis of HIV-infection was developed. It made use of the HIV viral lysate to coat on ELISA microplates. The purpose was to establish an ELISA for serodiagnosis of HIV-infection. The newly-developed ELISA, "H-ELISA", was applied to test 792 samples of HIV-positive serum as confirmed by Western blot. All 792 samples were positive by H-ELISA. It was also applied to test 540 samples of normal sera obtained from different laboratories in Srinagarind Hospital. A number 530 normal sera was negative, 8 samples were positive and confirmed by Western blot and 2 samples were false positive. It was concluded that the H-ELISA possessed 100% sensitivity with a false positive rate of 2/532(0.38%). The H-ELISA, the cost/test was less than 5 bahts, appears to be promising for substitution of imported commercial kits.

AIDS Serodiagnosis↗

Radio immune Western blotting: a possible solution to indeterminate conventional Western blotting results for the serodiagnosis of HIV infections.

Western blot is used worldwide as a confirmatory assay after a positive or doubtful ELISA result in the serodiagnosis of HIV infections. Despite the use of this test some results may be not definitive due to the presence in Western blot of only few or a single band to HIV protein. This result has been defined as indeterminate. To resolve indeterminate results obtained with conventional Western blotting (WB) we used radio immune Western blotting (RIWB), a method capable of detecting antibodies to HIV-1 proteins with greatly increased sensitivity with respect to conventional WB. We used RIWB to perform a retrospective survey on 20 sera belonging to individuals undergoing HIV serodiagnosis (not blood donors) with positive or borderline EIA results, and indeterminate WB results who only later fully seroconverted. Fifteen of the sera tested by RIWB showed a positive result which clarified any doubtful indeterminate WB result; all bands present in conventional WB were enhanced in intensity using RIWB and new bands, absent in the WB assay, were highlighted using RIWB. RIWB may resolve most indeterminate WB results.

AIDS Serodiagnosis↗

Usefulness of BP180 NC16a enzyme-linked immunosorbent assay in the serodiagnosis of pemphigoid gestationis and in differentiating between pemphigoid gestationis and pruritic urticarial papules and plaques of pregnancy.

BACKGROUND: Pemphigoid gestationis (PG) is a rare pregnancy-associated subepidermal immunobullous disease that targets hemidesmosomal proteins, particularly BP180. Clinically, PG can resemble the eruption known as polymorphic urticarial papules and plaques of pregnancy (PUPPP), and accurate differentiation between these 2 pruritic pregnancy dermatoses has important implications for fetal and maternal prognoses. Results of epitope mapping studies show that IgG autoantibodies in up to 90% of PG serum samples target the well-defined membrane-proximal NC16a domain of BP180. OBJECTIVE: To examine the usefulness of a commercially available NC16a domain enzyme-linked immunosorbent assay in the serodiagnosis of PG and in the differentiation of PG from PUPPP. PARTICIPANTS: A total of 412 women consisting of pretreatment patients with PG (n = 82), patients with PUPPP (n = 164), and age- and sex-matched controls (n = 166). METHODS: All serum samples were assayed in duplicate. Receiver operating characteristic analyses were performed to determine a cutoff value for the diagnosis of PG and for differentiation from PUPPP and controls. RESULTS: A cutoff value of 10 enzyme-linked immunosorbent assay units was associated with specificity and sensitivity of 96%. CONCLUSIONS: The NC16a enzyme-linked immunosorbent assay is highly sensitive and highly specific in differentiating PG from PUPPP, and it is potentially a valuable tool in the serodiagnosis of PG.

Adult↗

Comparative study of three different mycobacterial antigens with a novel lipopolysaccharide antigen for the serodiagnosis of tuberculosis.

Demonstration of Mycobacterium tuberculosis in a smear or culture is the most reliable method for diagnosing tuberculosis (TB). In the last 10 years, several enzyme-linked immunosorbent assays (ELISAs) based on mycobacterial antigens (such as antigen 60, 38 kDa antigen, and antigen Kp90) have been used for the rapid diagnosis of TB. In this study, we report the isolation of an immunodominant lipopolysaccharide (LPS) antigen from M. tuberculosis H(37)Rv, which can be used for the serodiagnosis of TB. The LPS antigen was compared with three commercially available mycobacterium-specific antigens for the detection of TB. The antigens were evaluated using serum samples obtained from 59 Indian patients (19 patients with active pulmonary TB, 20 with extrapulmonary TB, and 20 with nontuberculous pulmonary disease) and 20 healthy adults. Antigen 60 IgG (sensitivity 89%, specificity 97%) and LPS (sensitivity 84%, specificity 97%) were more sensitive and specific than 38 kDa antigen IgG (sensitivity 79%, specificity 97%) and Kp90 IgA (sensitivity 82%, specificity 40%). These results indicate that the LPS antigen can be used as a sensitive tool for the serodiagnosis of TB and could be utilized to develop an ELISA for the screening of patients for TB.

Adult↗

Application of the single radial complement fixation test for serodiagnosis of influenza, respiratory syncytial, mumps, adeno type 3, and herpes simplex type 1 virus infections.

A stabilized modification of the single radial complement fixation (SRCF) test in gel was developed for detecting various virus antibodies. The principle of the test is based on the use of a single-stage procedure with an agarose plate containing virus antigens and antibody-coated erythrocytes, and thin plastic film coated with complement. By filling the wells in the agar plate with a 1:4 diluted heat-inactivated sera and covering the agar surface with a complement film, a zone of unlysed cells surrounded by a hemolytic area appears after incubation overnight at 4 degrees C and then for 1-2 h at 37 degrees C, depending on the antibody titers. The SRCF antibody titer is calculated numerically from the square of the diameter of the unlysed cell zone. The stability of reagents could be significantly improved using thin complement film and several stabilizers. When this test was used for serodiagnosis of influenza, respiratory syncytial (RS), mumps, adeno virus type 3 and herpes simplex type 1 virus infections (using a total of 400 sera), excellent correlations were demonstrated for antibody titers between conventional complement fixation (CF) and SRCF titers. Furthermore, the expression of antibody titer as an SRCF unit with consecutive value, produced results sensitive to fluctuations in the antibody titers. The simplicity of the procedure, stability of the reagents, and excellent correlation with the conventional CF test might make this a useful test for routine serodiagnosis and seroepidemiological survey of various virus infections.

Adenovirus Infections, Human↗

Immunoblotting patterns in the serodiagnosis of aspergilloma: antibody response to the 90kDa Aspergillus fumigatus antigen.

At present there are no accepted criteria to assess the usefulness of Western blot assays for the serodiagnosis of aspergilloma. An Aspergillus fumigatus cytosolic fraction complex (CFC) composed of four proteins (p90, p60, p40, and p37) has been identified. The usefulness of Western blotting with CFC antigens for the serodiagnosis of aspergilloma was evaluated in 25 patients with well-established diagnoses and in 94 controls. The most consistently reactive antigen was p90 (92% of patients with aspergilloma), followed by p40 (76%) and the entire CFC taken together (76%). With these data, interpretive criteria for positive and negative immunoblots were established, with p90 indicated as a helpful marker of aspergilloma.

Antigens, Fungal↗

Serodiagnosis of Helicobacter pylori infections with an enzyme immunoassay using the chromatographically purified 120 kilodalton protein.

A membrane-associated 120 kDa protein of Helicobacter pylori with known species-specificity was isolated and used in an enzyme immunoassay (EIA) for the detection of Helicobacter pylori-specific IgG antibodies in patient sera. The EIA was compared with two other methods used for serodiagnosis of Helicobacter pylori infections: an EIA using sonicated whole Helicobacter pylori cell antigen and Western immunoblot. In a prospective study 127 unselected patients (76 patients with antrum gastritis, 51 patients without gastritis) who underwent gastroscopy were studied histologically and serologically. The EIA using the purified 120 kDa protein had the highest specificity (92%) compared with the EIA using a whole cell sonicate of a single Helicobacter pylori strain as antigen (60.7%) and the immunoblot (90.2%). The sensitivity was 96%, 100% and 92%, respectively. Sera of three control patients reacted strongly in all three methods, indicating possible Helicobacter pylori infection with negative histological findings. The EIA using the 120 kDa protein as antigen was shown to be a specific and sensitive technique for the serodiagnosis of Helicobacter pylori infections.

Adult↗

Detection of antibody for the serodiagnosis of hantavirus infection in different rodent species.

Peroxidase-labeled staphylococcal protein A, streptococcal protein G, and antibodies directed against Mus musculus (mouse), Rattus norvegicus (rat), Mesocretus auratus (hamster), and Peromyscus leucopus were examined for their reactivity with immunoglobulin G (IgG) from various rodent species. The purpose of this study was to identify the optimal secondary antibodies or reagents for specific serodiagnosis of hantavirus infection in various rodent species. Using ELISA, a total of 65 sera from 29 rodent species of the family Muridae and one serum sample from family Octodontidae were compared for IgG reactivity with the six different reagents. The results demonstrate that the reactivities of the secondary antibodies and reagents to the sera varied, even among sera from rodents of the same genus. Hantavirus-specific antibody ELISA revealed that hantavirus-infected rodent sera obtained from M. musculus, R. norvegicus, Apodemus agrarius, A. peninsulae, and Bandicota indica bound to the six different conjugates in a similar pattern as that detected in IgG ELISA. These results indicate that the applicability of secondary antibodies and protein A and G should be carefully evaluated before use for serodiagnosis in different rodent species.

Animals↗

Application of the soluble antigen fluorescent antibody (SAFA) test to the serodiagnosis of rabies.

The adaptation and evaluation of the Soluble Antigen Fluorescent Antibody (SAFA) test for the serologic diagnosis of rabies is described. Evaluation of the SAFA test was based on a comparison between serum titers obtained in the SAFA test, the mouse Serum Neutralization (SN) test and in the Indirect Fluorescent Antibody (IFAT) test. Dog, fox, raccoon and skunk sera were used for the comparison with mouse SN titers. Human serum was used for the comparison with the IFAT titer. The purity and concentration of the test antigen is a crucial factor in determining the efficiency of the SAFA test for rabies serodiagnosis. Viral antigen obtained by the AIPO4 gel method for rabies virus purification and concentration was found to be sufficiently purified and concentrated for use in the SAFA test. Conjugate dilution decreased the level of non-specific staining. Although specific activity was also decreased, there was a statistically significant difference (P less than or equal to 0.05; Student's t test) between the rabies positive and the rabies negative serum samples at all conjugate dilutions for all species studied. In three cases (fox, raccoon, skunk) SAFA titers were greater than mouse SN titers. In one case (dog) the SAFA titer was less than the mouse SN titer. The IFAT titer of the human serum sample was greater than the SAFA titer. Comparison of Fluorometer Dial Readings (FDR) of sera obtained in separate protocols demonstrated satisfactory reproducibility of the SAFA test for rabies serodiagnosis.

Animals↗

ELISA using whole Legionella pneumophila cell as antigen. Comparison between monovalent and polyvalent antigens for the serodiagnosis of human legionellosis.

An indirect enzyme-linked immunosorbent assay (ELISA) using the six serogroups of whole L. pneumophila bound to microtitre plate wells is described for the serodiagnosis of legionellosis. Comparative studies using monovalent antigen indicated a high correlation between ELISA and indirect immunofluorescence antibody (IFA) tests (r = 0.90, P less than 0.001). Testing 196 human sera by ELISA using both monovalent and polyvalent antigens have established the efficiency of the polyvalent antigen for screening purposes. The ELISA test system exhibited rapidity, sensitivity and reproducibility and should be considered as an alternative to the IFA test for routine serodiagnosis of legionellosis.

Adult↗

Serodiagnosis of human cysticercosis using a chromatofocused antigenic preparation of Taenia solium cysticerci in an enzyme-linked immunosorbent assay (ELISA).

Crude preparations of Taenia solium cysticerci were partially purified by a chromatofocusing procedure to obtain antigenic fractions that were shown to be active in the enzyme-linked immunosorbent assay (ELISA) with known positive cysticercosis sera. Evaluation of this antigen in the ELISA serodiagnosis of human cysticercus infection showed an 80% detection of clinically typical cysticercosis patients from West New Guinea, and gave no false positive results in healthy control subjects from either Papua New Guinea or the USA. Cross-reactivity to sera from a panel of subjects with a variety of other parasitic infections was limited to convalescent sera from individuals with echinococcosis. Seroepidemiological screening of three selected tropical populations verified the presence of human cysticercus infection on Bali (Indonesia) and its absence on Guam (in the Mariana Islands) and on Mota Lava (in the Banks Islands of Vanuatu). The purified cysticercus antigen was more sensitive and more specific than crude cysticercus or whole worm preparations for the serodiagnosis of human cysticercosis.

Antigens↗

Comparison of adult somatic and excretory-secretory antigens in enzyme-linked immunosorbent assay for serodiagnosis of human infection with Paragonimus heterotremus.

Adult somatic antigen extract of Paragonimus heterotremus was compared with excretory-secretory (ES) antigen in an enzyme-linked immunosorbent assay (ELISA) for serodiagnosis of human paragonimiasis. The absorbence values in ELISA using the adult somatic antigen were not significantly different from the values obtained using ES antigens (P greater than 0.05). The sensitivity of the ELISA using either antigen was 100%, but the specificity was 96% with somatic and 98% with ES antigens due to a cross reaction with fascioliasis sera. It appears that both somatic and ES antigens are effective antigens for use in serodiagnosis of human paragonimiasis heterotremus.

Animals↗

Serodiagnosis of alveolar hydatid disease by western blotting.

The purpose of this study was to identify species-specific protein components of Echinococcus multilocularis by Western blotting and establish a simple and highly sensitive method for differential serodiagnosis of alveolar hydatid disease (AHD) from cystic hydatid disease. Using Western blotting analyses we demonstrated 2 previously undescribed, species-specific, antigenic components of protoscoleces of E. multilocularis easily detectable with sera from active AHD patients exclusively. The 18 kDa component was recognized by sera from all active AHD patients, whereas the 16 kDa antigen was characteristically detected by patients with advanced lesions. The potential utility of these components for differential serodiagnosis of AHD is discussed.

Animals↗

Biochemical characterization of an antigenic saline extract of Actinobacillus pleuropneumoniae serotype 5 and identification of a serotype-specific antigen for ELISA serodiagnosis.

A saline extract of boiled-formalinized whole cells from a local strain (81-750; Quebec, Canada) of Actinobacillus pleuropneumoniae, serotype 5b was used as an antigen in an enzyme-linked immunosorbent assay (ELISA) for serodiagnosis of swine pleuropneumonia. Characterization of this crude extract was done and proteins, neutral sugars, hexosamines, and 2-keto-3-deoxyoctonate (KDO) were evaluated. On phenol extraction of the crude extract a serotype-specific antigen of polysaccharidic nature was recovered from the aqueous phase. This antigen was characterized using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) with Coomassie blue, silver and Schiff stainings. Immunoblots were done using sera of experimentally infected pigs that showed serotype specificity and cross-reactivity. Overall, the results indicate that the O-chain of lipopolysaccharides is a specific antigen that could be used in ELISA for the serodiagnosis of serotype 5 of A. pleuropneumoniae.

Actinobacillus Infections↗

Lipopolysaccharides of Actinobacillus pleuropneumoniae (serotype 1): a readily obtainable antigen for ELISA serodiagnosis of pig pleuropneumonia.

A saline extract of boiled-formalinized whole cells of Actinobacillus pleuropneumoniae serotype 1 reference strain (Shope 4074) has been previously used as the antigen in an enzyme-linked immunosorbent assay (ELISA) for serodiagnosis of swine pleuropneumonia. Phenol extraction of this crude extract permitted the recovery of LPS with long O-chains in the aqueous phase. This antigen was shown to be specific for serotypes 1, 9 and 11 as they all possess structurally similar O-chains. Immunoblotting was used to identify the fraction present in the crude extract of strain 4074 responsible for cross-reactions observed in ELISA with a serum raised against a serotype 3 strain of A. pleuropneumoniae. The specific reactions in ELISA were shown to be associated with long O-chain LPS and the cross-reactions to LPS with short O-chains. LPS seem to be an important antigen for A. pleuropneumoniae serotype 1 as all homologous sera tested reacted with it. This antigen is easily recovered from the crude extract and it can be used in minute amounts (1-6 micrograms) for ELISA serodiagnosis of pig pleuropneumonia.

Actinobacillus Infections↗

Reduced sensitivity of tuberculosis serodiagnosis in patients with AIDS in Uganda.

SETTING: The diagnostic utility of serodiagnosis of tuberculosis in HIV-infected persons was studied in Kampala, Uganda. OBJECTIVE: This study was undertaken to evaluate the utility of a recently described serologic assay for the diagnosis of tuberculosis in HIV-infected patients. DESIGN: The study was undertaken as a cross-sectional survey of 349 subjects, including human immunodeficiency virus-infected and uninfected patients with tuberculosis and control subjects. Serum from each subject was assayed by enzyme-linked immunosorbent assay (ELISA) for IgG antibody to the 30,000 dalton antigen of Mycobacterium tuberculosis. RESULTS: Test sensitivity dropped from 0.62 in non HIV-infected tuberculous patients to 0.28 in HIV-infected patients. CONCLUSIONS: ELISA serodiagnosis of tuberculosis may have a markedly decreased utility in populations where HIV infection is prevalent.

AIDS-Related Opportunistic Infections↗