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Specific syphilis serological tests may become negative in HIV infection.

The diagnosis of syphilis is frequently dependent upon the results of serological tests, but the reliability of syphilis serology in patients with HIV-1 infection has been questioned. We examined specific antibody to Treponema pallidum (TP) using the TP haemagglutination (TPHA) and fluorescent treponemal antibody-absorption (FTA-ABS) tests in AIDS patients and HIV-antibody-negative controls with a history of syphilis. Tests were carried out on two sera separated by an interval of at least 3 years from each patient. Twelve out of 29 AIDS patients compared with four out of 29 controls showed significant falls in titres of specific antibody as measured by the TPHA, FTA-ABS, or by both the TPHA and FTA-ABS (P = 0.02). Furthermore, in three out of 29 (10%) of the AIDS patients with past syphilis infections both the TPHA and FTA-ABS became non-reactive. We conclude that negative specific serology does not exclude a past syphilis infection in patients with AIDS.

Acquired Immunodeficiency Syndrome↗

Evaluation of monoclonal antibodies to HIV-1 by neutralization and serological assays: an international collaboration. Collaborating Investigators.

In a National Institutes of Health (NIH)/World Health Organization (WHO)-sponsored collaboration, 26 laboratories characterized a coded panel of monoclonal antibodies (MAb) to HIV-1 envelope protein. The MAb were evaluated by serological [radioimmunoprecipitation, immunoblot, enzyme-linked immunosorbent assay (ELISA) and peptide mapping] and neutralization assays. Although laboratories used diverse neutralization assays that vary considerably in sensitivity, qualitatively similar data were obtained. The MAb were classified into three neutralization specificities: type-specific for MN and SF2, type-specific for IIIB, and group-specific for MN, SF2, and IIIB. The group-specific MAb displayed much lower neutralizing titers than the type-specific MAb. The specificity of MAb for neutralization was greater than for serological recognition of gp120 protein or peptide epitopes. Some MAb that bound to the same or closely overlapping linear epitopes had very different neutralization properties. The distinction between serological recognition and neutralization may result from differences in affinity of the MAb or may indicate that MAb can neutralize by interactions at a site distinct from the antibody binding site.

Amino Acid Sequence↗

Positive polymerase chain reaction and histology with borderline serology in Parinaud's oculoglandular syndrome.

PURPOSE: To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite a borderline serology, polymerase chain reaction (PCR) testing for a conjunctival biopsy was positive for Bartonella henselae, a source of cat-scratch disease. A Steiner silver stain demonstrated the organism. METHODS: Case Report. RESULTS: A 65-year-old man was seen for a foreign body in his left eye (OS) associated with chemosis and a preauricular node. CONCLUSION: B. henselae is a known cause of POS. This gram-negative pleomorphic rod has been more frequently discovered in connection with this syndrome due to improved diagnostic testing such as indirect immunofluorescence antibody and PCR testing. Frequently, serology is positive if the organism is present. This report describes a patient with clinical findings of POS who, despite borderline serology, had pleomorphic rods on Steiner silver stain and positive PCR testing compatible with Bartonella henselae.

Aged↗

Long-term follow-up and serologic assessment after triple therapy with omeprazole or lansoprazole of Helicobacter-associated duodenal ulcer.

We assessed both the effectiveness of two Helicobacter pylori (Hp) eradication triple therapies and the usefulness of serology in the follow-up. Fifty patients with active or scarred duodenal ulcer were randomized to lansoprazole or omeprazole for 1 to 4 weeks, with clarithromycin 250 mg twice a day and tinidazole 500 mg twice a day for the first week. Endoscopies were scheduled before treatment, after 8 weeks, and after I year. H. pylori status was determined before therapy by rapid urease test and histology and during the follow-up by histology and culture. Serology was determined at baseline and at 6 and 12 months. The regimens were equally effective in inducing ulcer healing (95.8% vs. 87.5%) and eradicating Hp with no recurrences at 12 months. Among 44 patients eradicated, a significant reduction of immunoglobulin G (IgG) titer occurred at 6 (p < 0.0001) and 12 months (p < 0.0001). If a titer reduction of more than 30% was taken as an indicator for Hp eradication, the specificity of enzyme-linked immunosorbent assay was 75% at 6 and 95.4% at 12 months with a 100% sensitivity. Either lansoprazole or omeprazole combined with antibiotics are effective in eradicating Hp. Serology is useful for monitoring Hp eradication provided that an appropriate percent reduction in IgG titer is used after more then 6 months after therapy.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Serology of abnormal fracture healing: the role of PIIINP, PICP, and BsALP.

OBJECTIVE: To determine whether poorly healing tibial shaft fractures exhibit a serological response of bone-specific alkaline phosphatase (BsALP), collagen I carboxy-terminal propeptide (PICP), collagen III amino-terminal propeptide (PIIINP), and collagen I carboxy-terminal telopeptide (ICTP) different from that of normally healing fractures. DESIGN: Prospective. PARTICIPANTS: Twenty consecutive patients with isolated tibial shaft fractures with or without fracture of the fibula. MAIN OUTCOME MEASUREMENTS: Assays of BsALP, PICP, PIIINP, and ICTP were performed with serum samples taken at standard intervals from twenty-four hours to twenty weeks after fracture. Fracture healing was assessed at five, ten, fourteen, and twenty weeks for clinical and radiological evidence of union. RESULTS: Seventeen fractures united within the twenty-week study period. The three fractures exhibiting delayed union demonstrated significantly lower PICP levels and marginally lower BsALP levels at twenty weeks. PIIINP levels were significantly higher in these three fractures at ten weeks. There was no difference in ICTP between the seventeen united and the three ununited fractures. CONCLUSIONS: This study identified three serological features of a poor healing response in tibial shaft fractures. First, matrix collagen I and III production in the first ten weeks of healing was adequate, with evidence of significantly increased production of type III collagen. Second, there was no serological evidence of a deficient osteoblast response, as indicated by normal levels of BsALP and PICP, during this early period. Third, evidence of a deficient osteoblast response appeared only at twenty weeks after injury.

Adolescent↗

The prevalence of Helicobacter pylori-positive serology in asymptomatic children.

Epidemiologic data are presented about the prevalence of Helicobacter pylori positivity as determined by serology in a large series of asymptomatic children (n = 466). Serology is now generally accepted as a valid noninvasive screening method for the detection of Helicobacter pylori infection. Blood samples were taken from 466 apparently healthy children (ages 2-14 years) who were admitted to our pediatric 1-day clinic for elective surgery. The children originated from different ethnic backgrounds. All were born in Belgium and have been living there ever since. Thirty-four (7.3%) had positive titers for Helicobacter pylori. There was a significant increase in the number of positive patients with advancing age (5.4% in the age group 2-8 years and 13.4% in the age group 8-14 years; p < 0.001). We also found a significant difference in the prevalence of Helicobacter pylori positivity between Caucasian Belgian children and non-Caucasian children of different ethnic backgrounds. This relatively high prevalence of positive serology in asymptomatic older children (13.4%) should be considered in studies on the incidence or causative role of Helicobacter pylori in children with chronic abdominal complaints.

Adolescent↗

Serological findings in patients with "ANA-negative" systemic lupus erythematosus.

Serological studies were performed on sera from 66 patients with the clinical picture of systemic lupus erythematosus (SLE). These sera failed to give a positive antinuclear antibody test when tested on cryostat sections of mouse liver and thus these patients' sera appear to be ANA negative. Precipitating antibodies to the cytoplasmic antigen Ro were found in 41 cases and of the remaining 25 sera, 18 were found to have antibodies to single stranded DNA detectable by radioimmunoassay. Thus, 50 of the 66 patients exhibited serological findings which are commonly found in ANA positive SLE patients. Studies with KB cells as immunofluorescent substrate revealed that 66% of these sera were positive for nuclear staining demonstrating that at least part of the failure of these sera to stain mouse liver is due to antigenic deficiency of this substrate. The clinical picture of these patients was dominated by a severe photosensitive dermatitis but more than half of the patients had widespread multisystem disease. As a group these patients had a low frequency of nephritis and neuropsychiatric disease. Detection of these antibodies relates these patients serologically to other SLE patients and suggests that they are best perceived as part of the clinical spectrum of SLE.

Adolescent↗

Serologic response to standard inactivated influenza vaccine in human immunodeficiency virus-infected children.

We compared the serologic response of 46 human immunodeficiency virus (HIV)-infected children and adolescents and 61 age-matched controls to standard trivalent inactivated influenza vaccine (A/Taiwan (H1N1), A/Shanghai (H3N2), B/Yamagata). Children were immunized according to the package insert recommendations before the 1990 to 1991 influenza season. Serum antibody titers to influenza A were determined before and 1 month after each vaccination and compared for study and control subjects. Serologic responses of HIV-infected participants were correlated with absolute CD4 counts and stage of HIV disease. Regardless of age or HIV status, all groups responded with significant increases in antibody to the influenza A strains (range, 2.1-fold to 11.8-fold), with the exception that antibody to H3N2 rose only 1.5-fold (P = 0.058) among HIV-positive subjects > or = 9 years old. Pre- and postimmunization antibody titers were significantly higher for controls than for HIV-positive subjects. There was no correlation between serologic responses and CD4 counts among HIV-infected subjects, but those with Centers for Disease Control and Prevention-defined acquired immunodeficiency syndrome responded significantly less well to vaccine. We conclude that HIV-infected children and adolescents produce significant antibody rises after inactivated influenza A vaccination but that their absolute antibody concentrations are lower than those seen in age-matched controls.

Acquired Immunodeficiency Syndrome↗

Serologic classification and contact-tracing in the control of microepidemics of beta-lactamase-producing Neisseria gonorrhoeae.

Serologic classification of isolated gonococcal strains and thorough contact-tracing were proved to be valuable in controlling an indigenous outbreak of infections caused by beta-lactamase-producing Neisseria gonorrhoeae (PPNG). Only 1-2% of gonococcal strains isolated in Sweden are PPNG, and before 1983 most of them were imported. During January-August 1983, 43 PPNG strains were isolated from 42 patients in Gothenburg. The PPNG strains were auxotyped and classified serologically. PPNG strains of serogroup WI, serovar (subgroup) Ae and of the prototrophic auxotype were isolated from 27 patients, including six prostitutes. Information obtained at interviews with these patients indicated that there had been a chain of infections. Quick and thorough contact-tracing stopped this microepidemic within three months. The serologic classification of the PPNG strains helped us to concentrate the epidemiologic efforts on those persons known to be infected with the epidemic strain, to trace this infection to other parts of Sweden, and to determine when the outbreak was finished.

Disease Outbreaks↗

The influence of sexual and social factors on the risk of Chlamydia trachomatis infections: a population-based serologic study.

BACKGROUND: Genital chlamydia infections often are asymptomatic, which promotes their spread in the population. In women, the possible consequences of infection are pelvic inflammatory disease and infertility. Most studies on the prevalence of Chlamydia trachomatis have been based on clinical series, and prevalences tend to vary with the clinical setting. Few seroepidemiologic studies have emerged from industrialized countries. GOAL OF THIS STUDY: To assess the prevalence of Chlamydia trachomatis using culture and serology, and its relationship with possible risk factors. STUDY DESIGN: This was a population-based study involving completion of a self-administered questionnaire, analysis of cervical samples for Chlamydia trachomatis, and serologic tests for Chlamydia trachomatis antibodies. RESULTS: The prevalence of Chlamydia trachomatis infection was 2.7%, and the seroprevalence was 24.7% among the sexually active women. Seropositivity was correlated with sexual behavior variables, and the incidence of serologic cross-reactivity with respiratory infections (strain TWAR) was low. Multivariate logistic regression analysis showed the number of sexual partners, age at first coitus, history of therapeutic abortion, and previous pelvic inflammatory disease to be independently correlated with seropositivity. CONCLUSION: Early sexual experience and multiple lifetime sexual partners are independent risk factors for Chlamydia trachomatis infection.

Adult↗

Xenoantibody directed against molecular components of the HLA system. Quantitation of antibody to serologically defined HLA complexes on the cell surface.

A quantitative absorption-blocking assay was used to measure the levels of antibody in immune rabbit sera that react with the serologically defined HLA molecular complex on the cell surface. Quantitation was determined by comparing the number of xenoantibody-treated cells with the number of untreated control cells needed to absorb a defined amount of cytolytic alloantibody. Complement-dependent cytolytic titers were used to standardize the total antibody content reactive with cell surface antigens of xenoantisera used to treat absorbing cells. The ability of xenoantibody to "block" or inhibit the reaction of alloantibody with the absorbing cell was observed to be the result of concomitant removal of both xeno- and alloantigenic determinants from the cell surface. Immunofluorescence data with xenoantibody suggested that removal was accomplished by temperature-dependent selective redistribution and endocytosis of the serologically defined HLA molecule complex. By using these procedures, xenoantisera have been characterized that contain different amounts of antibody to the two-component HLA complex relative to their total cytolytic antibody content. Variation ranges from a xenoantiserum with little or no blocking capacity to several highly effective serologically defined HLA blocking xenoantisera.

Animals↗

Serological and molecular studies of Epstein-Barr virus infection in allogeneic marrow graft recipients.

We have shown in two allogeneic bone marrow transplant recipients that Epstein-Barr virus can be eradicated by the BMT procedure or its complications, and that these patients are susceptible to infection with a new EBV strain. This conclusion was based on a combination of EBV serology and virus strain identification ("Ebnotyping," using the size variations of 5 EBV nuclear antigens). In the present study, we conducted a serological survey of EBV infection in 153 marrow graft recipients and their donors. Ten patients who were positive for IgG antibodies against EBV viral capsid antigens prior to BMT became completely seronegative at a median of 197 days post-BMT (range 106-320 days). Four of these patients, who had received seronegative marrow, remained seronegative during prolonged periods (222 to 2105 days). Six patients had received seropositive marrow. Two of them remained seronegative during their subsequent periods of follow-up (895 and 1437 days). An additional 10 patients showed a 100-fold or greater decrease in VCA IgG antibody titers. Their titers reached a nadir of 10 (the lower limit of positive) at a median of 134 days post BMT (range 83-386 days). The serological patterns of the above 20 patients were particularly frequent among patients with chronic graft-versus-host disease; 12 of 20 patients with decreasing VCA titers (60%) developed chronic GVHD versus only 22 of 73 patients with stable or increasing VCA titers (30%). These results suggest that GVHD may contribute to the elimination of residual EBV-carrying recipient cells. Establishment of EBV-carrying lymphoblastoid cell lines (LCL) was attempted in 60 donor-recipient pairs whose cryopreserved peripheral blood mononuclear cells were available. LCL were established from 18 of 51 EBV-seropositive marrow donors and 10 of 57 seropositive recipients prior to BMT. The same EBV strain was detected in 4 of the 6 cases in which LCL could be established from both the donor and the recipient prior to BMT. The persistence of the original EBV strain was demonstrated in a recipient of a T cell-depleted graft who showed only transient hematological recovery and no GVHD, and was associated with the persistence of B cells of recipient origin.

Adolescent↗

In through the out door: serology for atrophic gastritis.

Gastric cancer remains the second biggest cause of cancer death worldwide. The most common type of gastric cancer, the intestinal type, is usually preceded by chronic atrophic gastritis. Gastritis serology is therefore of crucial importance for population-based screening and prevention studies. Helicobacter pylori serum antibodies can adequately diagnose inflammation of the gastric mucosa, but the serological diagnosis of atrophic gastritis is more hazardous. Many tests have been used for this purpose, either alone or in various combinations. Depending on the population, pepsinogens and gastrin often have a high specificity but low sensitivity for the diagnosis of atrophic gastritis, whereas antibodies against H. pylori or CagA have a high sensitivity but low specificity. A combination of two tests, e.g. H. pylori antibodies and pepsinogen I, may balance this issue and provide adequate screening tools, although there is a clear need for further improvement and simplification of serological testing for atrophic gastritis.

Antibodies, Bacterial↗

Chronic Helicobacter pylori infection in a population in southern Sweden analysed by histopathology, immunoblot and ELISA serology.

BACKGROUND: Many individuals are infected with the bacterium Helicobacter pylori. Some develop ulcers or mucosal atrophy. AIMS: To correlate the histological characteristics of the H. pylori -induced gastritis to the immunoblot pattern of the H. pylori infection and to compare the presence of H. pylori bacteria in tissue specimens with ELISA serology and immunoblot analysis. METHODS: One hundred and sixty-six consecutive patients were referred to gastroscopy. Forty patients were excluded for various reasons and 126 were included in the study. RESULTS: Twenty-three patients had ulcerations and 25 erosions. Ninety-two (73%) had a chronic gastritis and in 90 (71%) it involved both the antrum and corpus. Ninety-one (72%), of whom 96% had a chronic gastritis, had visible bacteria in the tissue specimens, used as the 'gold standard' for the detection of infection. In patients with chronic gastritis 65 (70%) had positive H. pylori ELISA serology, 27 (30%) had negative H. pylori ELISA, while 76 (83%) had a positive immunoblot pattern. The ELISA positive patients had more advanced chronic gastritis but a lower frequency of metaplasia and atrophy. Acute inflammatory activity in the chronic gastritis had a high immunoreactivity to 120 kDa (CagA) protein and was significantly correlated to antibody reactivity to proteins in the 53-65 kDa range (heat shock proteins) and to a 43 kDa subunit. Metaplasia and atrophy in antrum was associated with a 62 kDa protein band. CONCLUSION: Almost all H. pylori-infected patients had a pangastritis, visible in both antrum and corpus. Acute inflammatory activity in the chronic gastritis and the presence of metaplasia and atrophy in antrum were associated with a specific immunoblot pattern, indicating infection with more virulent strains. Immunoblot analysis had a better sensitivity than ELISA H. pylori serology.

Adult↗

Do serological markers and cytokines determine the indeterminate?

There is a general sense that indeterminate colitis (IC) runs an aggressive clinical course, is medically refractory, and is associated with higher pouch failure rates following restorative proctocolectomy. The question has been raised whether IC can be assigned to a diagnosis of Crohn's disease or ulcerative colitis through the characterization of immunogenetic similarities, or whether IC may represent a distinct subgroup within these heterogeneous disorders. In this article, the use of serologic markers, genetics, and immune responses to understand the pathogenesis of inflammatory bowel disease (IBD) and define clinically important subgroups of patients will be discussed. Then, how these scientific advances have been applied to the entity of IC will be reviewed. Importantly, a recent prospective study suggests that the absence of IBD-associated serologic markers defines the majority of IC as a separate entity within the spectrum of IBD. The development of serologic, genetic, and immune response markers will allow for rational description of clinically important subgroups, redefine natural history, and predict responses to therapy in IBD.

Antibodies, Antineutrophil Cytoplasmic↗

A comparative chemical and serological study of the full and empty particles of foot-and mouth disease virus.

The chemical and serological properties of the full, naturally occurring empty and artificially produced empty particles of foot-and-mouth disease virus, serotype A(subtype 10, strain 16) have been studies. The full 146S particles comprised the virus RNA, three polypeptides (VP1 to VP3) mol. wt. about 30 X 10-3, one polypeptide (VP4) mol. wt. about 13-5 X 10-3, and a small amount of a polypeptide (VPo) mol. wt. about 43 X 10-3. The naturally occurring 75S empty particles contained no RNA and much less VP1 and VP4 than were found in the fall particles. However they contained a much greater proportion of VPo than the full particles. Dialysis of purified full particles against tris-EDTA, pH 7-6, produced artificial 75S empty particles which contained only a small amount of RNA and no VP4; otherwise the polypeptide composition was similar to that of the full particles. Immunological and serological tests showed that the full particles were antigenically similar to the naturally occurring empty particles but distinct from the artificial empty particles. The latter particles, however, had serological properties similar to those of the 12S protein subunit of the virus. Both the full and naturally occurring empty particles attached efficiently to susceptible cells, whereas the artificial empty particles attached only to a limited extent. The results are related to the function of the individual polypeptides of the virus particle and compared with published work on other picornaviruses.

Animals↗

Comparative biochemical and serological analysis of five isolates of a single serotype of foot-and-mouth disease virus.

A comparison has been made of some of the biochemical and serological characteristics of five isolates of foot-and-mouth disease virus (FMDV), serotype A. Three of the viruses have been assigned to the same subtype, A22; the other two belong to different subtypes, A5 and A24. RNA competition hybridization and two-dimensional electrophoresis of the oligonucleotides produced by ribonuclease T1 showed that the three A22 viruses formed a group which could be distinguished from the A5 and A24 viruses. However, the three A22 viruses showed some differences by both tests. Analysis of the virus polypeptides by polyacrylamide gel electrophoresis methods also distinguished the A22 viruses as a group distinct from the A5 and A24 viruses, but small differences within the A22 group were observed using electrofocusing techniques. Serological differences were observed between the viruses using complement fixation tests and by competition radioimmunoassay with antisera obtained from guinea pigs infected with these viruses. The greatest similarity occurred between the viruses previously subtyped as A22, with A5 and A24 being distinct from the A22 group and from each other. The relationship of the biochemical and serological data is discussed.

Animals↗

Identification of the principal serological immunodeterminants of African swine fever virus by screening a virus cDNA library with antibody.

Protective immunity to African swine fever virus (ASFV) may involve a combination of both serological and cellular mechanisms. This work is focused on the identification of the possible relevant serological immunodeterminants of immunity. Thus, 14 serological immunodeterminants of ASFV have been characterized by exhaustive screening of a representative lambda phage cDNA expression library of the tissue culture-adapted Ba71V strain of ASFV. The library was constructed using RNA extracted from Vero cells infected for 3, 6, 9 and 12 h. A total of 150 clones was selected arbitrarily by antibody screening of the library with a polyclonal antiserum from a domestic pig surviving infection with the virulent Malta isolate of ASFV. Sequencing of these clones permitted identification of 14 independent viral proteins that stimulated an antibody response. These included six proteins encoded by previously unassigned open reading frames (ORFs) (B602L, C44L, CP312R, E184L, K145R and K205R) as well as some of the more well-studied structural (A104R, p10, p32, p54 and p73) and non-structural proteins (RNA reductase, DNA ligase and thymidine kinase). Immunogenicity of these proteins was confirmed by demonstrating the corresponding antibodies in sera from pigs infected either with the Malta isolate or with the OURT88/3-OURT88/1 isolate combination. Furthermore, the majority of these ORFs were also recognized by immune antiserum from the natural host, the bush pig, following secondary challenge with the virulent Malawi (SINT90/1) isolate of ASFV. Thus, it is possible that some of these determinants may be important in protection against virus infection.

African Swine Fever↗