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New compact-type latex photometric immunoassay system for hemoglobin and three acute inflammation markers: neutrophil count, C-reactive protein, and anti-streptolysin O.

A new compact-type latex photometric immunoassay system, SPOTCHEM IM SI-3510 (ARKRAY, Inc., Kyoto, Japan), which assays three kinds of inflammatory markers-neutrophil count (NPC), C-reactive protein (CRP), and anti-streptolysin O (ASO)-was evaluated. Hemoglobin (Hb), which is a good marker for anemia, can also be measured with it. NPC and CRP are measured using antibodies against neutrophilic elastase and CRP, purified streptolysin O was used for ASO determination, and Hb was measured by an azide-methemoglobin method. Whole blood, serum, and plasma specimens can be used as samples with this system. In this study, whole blood treated with dipotassium ethylenediamine tetraacetic acid was used for evaluation. Linearity and reproducibility were good for all of the items studied. Good correlations were observed between the results obtained by this system and those obtained by routine methods. Since NPC exhibited a high correlation with the routine white blood cell (WBC) counts, it was judged to be useful as a substitute for WBC counting. Since this system is small and easy to operate, and evaluation revealed reliable results, it was judged to be practical for small laboratories, and satellite testing in hospitals and physicians' office laboratories for patients suspected to have acute inflammation.

Antibodies, Bacterial↗

Reverse passive haemagglutination test in the diagnosis of infectious bursal disease.

The reverse passive haemagglutination test (RPHA) was used to detect infectious bursal disease (IBD) virus antigen in various organs of experimentally infected chickens and field cases. The results of RPHA were compared with those of agar gel immunodiffusion (AGID) and latex agglutination (LAT) tests. IBD antigen was detected in 86.4%, 80.4% and 80.5% of different organs by RHPA, LAT and AGID respectively. Although the differences are not statistically significant, the LAT is recommended because of cost and speed of obtaining results.

Animals↗

Study of a myoglobin test in patients hospitalized for suspected myocardial infarction.

An immunoagglutination latex test was studied in comparison with a plasma myoglobin radioimmunoassay in 103 subjects with suspected myocardial infarction. The test provided an early and reliable indication of raised plasma myoglobin (greater than 85 micrograms/l), a biochemical marker for the early phase (12 h) of myocardial infarction. The diagnostic values (sensitivity and specificity) studied over a 36 h period were the same as those for the plasma myoglobin assay. The sensitivity was similar to that of creatine kinase activity and better than that of the creatine kinase MB/creatine kinase ratio; the lower specificity was due to false-positive results in some subjects with angina. The myoglobin test, which provides rapid results, may be substituted in early diagnosis of myocardial infarction for the plasma myoglobin assay which is unsuitable for emergency analysis.

Aged↗

The use of a radioreceptorassay of human chorionic gonadotropin for the diagnosis and management of ectopic pregnancy.

The radioreceptorassay of human chorionic gonadotropin (hCG), with a sensitivity of 50 pg or 3 mIU/ml of plasma, has provided almost 100% reliability in detecting pregnancy after the first missed cycle. This test may be performed within 1 hour and is ideally suited to the clinical detection of ectopic pregnancy, especially in patients who require immediate surgical intervention. Thirteen patients with suspected ectopic pregnancy were evaluated by the radioreceptorassay, one of whom was followed with four separate determinations. The results of the assay were subsequently compared with those of hemagglutination pregnancy tests, clinical symptoms, and pathologic findings. All of the patients were diagnosed accurately by the radioreceptorassay, even when hemagglutination tests yielded a false indication of pregnancy. By this assay, the hCG levels during ectopic pregnancies are generally lower than those found during a normal intrauterine pregnancy; in addition, pregnancy may be detected much earlier (prior to the rupture) than is possible by hemagglutination tests. Furthermore, the diagnosis of ectopic pregnancy may be excluded for patients admitted to the hospital with acute abdominal emergencies.

Acromegaly↗

Screening for cytomegalovirus antibody in a donor insemination program: difficulties in implementing The American Fertility Society guidelines.

With the recommendations of The American Fertility Society that all donors and recipients in a donor insemination programme should be screened for CMV antibody, we have documented the prevalence of CMV antibody in donors, recipients, and their partners in our clinic. Forty percent of our donors were CMV-positive, and in only 35% of the couples were both partners negative. The implications of using exclusively CMV-negative donors are examined. The necessity for further research on the detection and the transmission of various strains of CMV and the effects of cryopreservation on them is emphasized.

Antibodies, Viral↗

[HBs antigen screening with Groupamatic. Inhibition of passive hemagglutination and latex test].

Some agglutination tests for HBs Ag and anti-HBs detection may be easily automated. Reverse hemagglutination, needing a lengthy incubation and several steps to carry out is unfit for Groupamatic, but hemagglutination inhibition and latex agglutination may be used. Hemagglutination inhibition using selected human red cells (ORh+) coated with cesium chloride purified HBs Ag, has been now routinely used at the C.N.T.S. with visual reading for almost 2 years. Negative and positive controls are necessary. The anti-HBs serum utilized has to be checked daily to get sensitive detection. Every new batch of coated red cells (valid 4 to 6 weeks) is checked in microtiter plates in the laboratory, before being used on Groupamatic. Both positive and dubious results are systematically retested in RIA. We found only 0,5% of false positive. The sensibility of the test compared favourably with other third generation test as reverse hemagglutination. It was close to the results obtained with radio-immuno-assay or enzyme-immuno-assay and it was more sensitive than counter-immuno electrophoresis. 65,472 samples were tested in parallel: we were able to detect 97% of HBs Ag detected by RIA. False negative results were less than 1 per 10 000 and may be avoided by using citrated solution for the anti-HBs serum dilution (suppression of auto-agglutination of the red cells). Antigex TG (the most active batch of latex coated with guinea pig, anti-HBs antibody) made by Pfizer, gave good results on Groupamatic and automatic reading was possible. But more results are necessary using various batches, before to recommend such reagent.

Autoanalysis↗

Use of in vivo challenge to assess rubella immunity determined by haemagglutination inhibition and latex agglutination.

In order to estimate the protection afforded by low levels of rubella antibody, pregnant women were tested by haemagglutination inhibition (HAI) and latex agglutination (LA). Fifty-nine women whose sera were HAI-negative (less than 25 IU/ml) or weakly positive (25 IU/ml) received rubella vaccine (RA 27/3) after delivery. Serum samples were collected one week and one month after immunization and tested for rubella total antibody and rubella IgM and IgA antibody. No patients found positive by HAI and LA showed any evidence of primary immunization. Furthermore, rubella IgM antibody was never detected after immunization in women who were HAI-negative and LA-positive during pregnancy. These results show that low antibody titres detected by LA are sufficient to protect individuals against infection with the attenuated virus. It is conceivable that such low titres also ensure protection against natural rubella infection.

Antibodies, Viral↗

Urinary microalbumin as a marker for intermittent claudication.

OBJECTIVE: The urinary microalbumin concentration was analysed in patients with intermittent claudication in order to investigate its usefulness as a marker for intermittent claudication. MATERIALS AND METHODS: Urinary samples were collected prior to and following exercise in 15 patients with claudication. The patients walked on a treadmill as far as possible until they were stopped by pain. Urinary microalbumin concentration was measured by a latex agglutination system, and the result was considered abnormal when the concentration exceeded 10 mg/g creatinine. The ankle brachial pressure index (ABI) at rest and the time taken for the ankle pressure to return to the resting level following exercise (ABI recovery time) also were measured. RESULTS: In seven (47%) of the patients, the urinary microalbumin concentration was elevated to more than 10 mg/g creatinine following exercise, while in eight (53%) it remained normal. The ABI recovery time was significantly longer in the patients in whom the microalbumin concentration was elevated, compared to that in patients without an elevated concentration. The urinary microalbumin concentration following exercise was reduced significantly when the walking distance was decreased 50% or 15%. Following vascular bypass surgery, the elevation in urinary microalbumin concentration was reduced. CONCLUSIONS: The use of urinary microalbumin as a diagnostic marker for intermittent claudication is limited. However, in cases where the concentration is elevated, it can be used to follow the course of the disease.

Albuminuria↗

Comparison of the SpermMar test with currently accepted procedures for detecting human sperm antibodies.

To eliminate the possibility of immunological infertility in spontaneously infertile and re-anastomosed men, a screening test that can be applied directly to semen is desirable. The SpermMar test is one such possibility. In this study, indirect tests for sperm antibodies using the commercial SpermMar test have been applied to a panel of sera whose reactions in the tube slide agglutination test (TSAT), gelatin agglutination test (GAT) and sperm immobilization test (SIT) for sperm antibodies are well characterized. The results from the SpermMar tests are compared directly with those obtained from Immunobead tests carried out at the same time. Results from screening tests performed on 30 sera confirmed complete correspondence between the GAT, SpermMar and Immunobead tests. When sera were titrated, the Immunobead test proved slightly more sensitive than the GAT and the SpermMar test was slightly more sensitive than the Immunobead test. The SpermMar test proved easier to use and to assess than the Immunobead test and it is recommended for consideration as a screening procedure for sperm antibodies despite the fact that at this stage only IgG antibodies can be detected.

Autoantibodies↗

Evaluation of the Directigen and Phadebact agglutination tests.

Comparison testing of the Directigen latex agglutination (LA) kit, the Phadebact coagglutination (COA) kit, and counter-immunoelectrophoresis (CIE) demonstrated that the commercial LA reagents were slightly more sensitive than the COA reagents for the detection of pneumococcal polysaccharide types 2, 4, 8, 9, 12, 19, 23, 25, 51, and 56, and meningococcal polysaccharide from Group C. The COA reagents were slightly more sensitive than the LA reagents for the detection of pneumococcal polysaccharide type 6A. The sensitivity of LA and COA reagents for the detection of Hemophilus influenzae type b capsular polysaccharide, pneumococcal polysaccharide types 1, 3, 14, and meningococcal Group A were equivalent. Purified meningococcal polysaccharides of Groups B, C, and W135 were detected uniformly by CIE but not with the COA reagent. The COA reagent reacted with antigen of Groups B, C, and W135 from broth culture but with less sensitivity than CIE. In general, CIE was the least sensitive method for detecting bacterial antigens. In addition, the commercial CIE antisera for H. influenzae type b, or meningococcal polysaccharides were susceptible to false-negative results due to antigen excess.

Agglutination Tests↗

Challenge with rubella virus after loss of detectable vaccine-induced antibody.

Studies were conducted of experimental challenge with rubella virus in vaccinees whose possession of vaccine-induced antibody after vaccination had been documented and whose antibody level had become undetectable or very low over time. The challenge virus was the Howell strain, which had been shown to produce typical clinical and laboratory features of rubella in susceptible persons. The challenge of the vaccinees resulted in local viral replication in all but one; in viremia, a primary immunologic response, and a secondary antibody response in some; and usually in illness without a rash or in subclinical infection. The results emphasize the importance of continuing careful clinical and laboratory surveillance of vaccinees for determining the persistence of vaccine-induced immunity and of considering methods for identifying and revaccinating the minority of vaccinees who lose such immunity.

Antibodies, Viral↗

Latex-agglutination test for rubella antibody: validity of positive results assessed by response to immunization and comparison with other tests.

A commercial-latex agglutination (LA) assay ( Rubascan , Hynson , Westcott and Dunning, Baltimore, Md) performed on undiluted serum may be more sensitive than is the standard hemagglutination-inhibition assay for the detection of rubella antibody. To investigate whether a positive result of an LA test on undiluted serum was correlated with rubella immunity, we identified 29 persons whose sera produced negative results when initially tested by LA at a 1:10 dilution; 15 of these sera produced positive results and 14 produced negative results when retested undiluted. The immune status of each person for rubella was determined with a test for IgM rubella antibody on serum samples obtained three to five weeks after rubella immunization. None of the 15 persons whose preimmunization sera produced positive results by LA when tested undiluted developed IgM rubella antibody, as compared with 10 of the 14 persons whose preimmunization sera produced negative results (P less than 0.001). Data from this study support the specificity of a positive result of an LA test performed on undiluted serum, but a 1:5 dilution may be optimal for determination of rubella immune status.

Adolescent↗